An approach to shared decision making using HIPAA compliant email

Shared decision making is a method of fostering a cooperative relationship between patients and their healthcare providers. By using HIPAA compliant email as a medium, organizations can use the SHARE principles to improve patient outcomes through improved communication.

What is shared decision making? 

A BMJ Open Access study provided the following shared decision making, “Shared decision making (SDM) has been traditionally defined as a collaborative approach by which, in partnership with their clinician, patients are encouraged to think about the available care options and the likely benefits and harms of each, to communicate their preferences, and help select the best course of action that fits these.”

Shared decision making allows patients and their healthcare providers work together to make healthcare decisions. The clinician provides detailed information about the available treatment options, including their potential benefits and risks. Patients are encouraged to reflect on these options, consider how they align with their personal values and preferences, and express their views and concerns.

This shifts the traditional, often hierarchical relationship into a more balanced dialogue where patients feel empowered and engaged. This involves patients more deeply in their care and improves their understanding and satisfaction with the treatment process. Effective shared decision making leads to better outcomes by ensuring that the chosen medical interventions are tailored to the specific needs and wishes of the patients.

The SHARE approach

Developed by the Agency for Healthcare Research and Quality, it breaks down the shared decision making process into five actionable steps, each represented by a letter in the word "SHARE": 

• Seek your patient’s participation.
• Help your patient explore and compare treatment options.
• Assess your patient’s values and preferences.
• Reach a decision with your patient.
• Evaluate your patient’s decision.
  
  

The benefits of using shared decision making in healthcare 

• Shared decision making allows for more personalized treatment plans that consider the patient's unique medical history and lifestyle.
• It encourages patients to express concerns about their health.
• This approach helps mitigate the risk of overtreatment and undertreatment by aligning medical interventions more closely with patient needs.
• Shared decision making can enhance patient education about their conditions.
• It supports the psychological well being of patients by reducing anxiety associated with feeling uninformed or excluded from decision processes.
• This method can improve clinical outcomes by fostering cooperation and mutual understanding.
• It assists in the management of chronic diseases by involving patients in ongoing decisions about long term treatment strategies and lifestyle adjustments.
• Shared decision making can lead to more cost effective care by avoiding unnecessary tests and procedures that do not align with patient preferences.

See also: Can you personalize a healthcare email?

An approach to using shared decision making in HIPAA compliant email

An HHS Public Access Author Manuscript study puts forward the approach based on the findings of Purposeful shared decision making. This method involves adapting the generalized shared decision making model, specifically the SHARE Approach, to cater to the unique, problem specific needs of patients, thereby enhancing communication and patient involvement across diverse clinical scenarios.

The implementation

• Patient identification and initial contact: Use electronic health records to identify patients facing decisions in one of the four modes described in Purposeful shared decision making (Alternatives, Conflict and Ambiguity, Problematic Situation, Humanity). Send an introductory HIPAA compliant email to introduce the shared decision making process and its benefits.
• Educational content and decision aids: Develop and send a series of HIPAA compliant emails containing easy to understand information, infographics, and links to decision aids. These emails should be customized to address the specific mode of shared decision making applicable to the patient's situation.
• Interactive decision tools: Include interactive tools such as digital forms or surveys within the emails that help patients articulate their preferences and values. These tools should help clarify the patient’s stance on various treatment options or management strategies.
• Ongoing dialogue and adjustment: Encourage patients to respond to emails with questions or concerns. Utilize their feedback to refine further communications and decision aids. Also, make sure to schedule virtual consultations if complex issues arise that are better handled in a synchronous format.
• Final decision and follow up: Once a preliminary decision is reached via email interactions, send a detailed plan of the agreed upon treatment or management strategy. Follow up with additional emails to assess the patient’s experience and satisfaction with the decision.

See also: Top HIPAA compliant email services

FAQs

Can any healthcare provider use email to communicate with patients?

Yes, any healthcare provider can use email to communicate with patients, but they must ensure that the email system is HIPAA compliant.

What should a patient do if they receive a healthcare email in error?

If a patient receives an email in error, they should notify their healthcare provider immediately. They should not forward or share the email with anyone else to protect the privacy of the information.

How can healthcare providers ensure the security of email communications?

Providers should use email services that offer a business associate agreement, strong authentication measures to access the email system, and train staff on the need to maintain the confidentiality and security of patient information.