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In 2008 Don Berwick and colleagues identified the need for simultaneous pursuit of three aims to improve the U.S. health care system:

  • Improving the experience of care;
  • Improving the health of populations; and
  • Reducing per capita costs of health care.

Shared Decision Making (SDM), a process of engaging patients in making informed, values based decisions for preference sensitive conditions, has the potential to address each element in Berwick’s triple aim.

Patients often learn about new diagnoses and pending medical decisions at primary care practices. Facilitating informed patient choice requires getting the right information to the right patient at the right time. Making changes for the effective delivery of Shared Decision Making and Decision Aids (DAs) takes substantial effort by administrative leadership, practicing clinicians, and clinic staff.

This toolkit builds on three years of experience implementing decision aids to facilitate SDM into six rural primary care practices in Oregon. In 2009, ORPRN was one of 11 sites selected by the Informed Medical Decisions Foundation (IMDF) to participate in their national primary care demonstration project.

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