Background: All healthcare decisions aim to optimize value; however, value is an elusive construct. First, “value” is both a noun and a verb, and it can relate to deeply held beliefs or a mathematical ratio of benefits and costs. Patients, providers, healthcare systems, and payers bring different perspectives and priorities to the assessment of healthcare value. Achieving true high value care requires a transformational approach acknowledging these different perspectives. The 2019 conference for the Society for Medical Decision Making (SMDM) aims to integrate the views of the many stakeholders to advance the fundamental construct of value in health care.
Proposed Solution: The Society for Medical Decision Making (SMDM) proposes to address this complex task at its 41st Annual Meeting, October 20-23, 2019, themed: “Many Views on Value.” The organization’s strong history of methodological expertise and scientific rigor puts it in a unique position to find commonalities across perspectives on value and use cutting-edge methods to bring scientific rigor to questions of how to make the best possible health decisions that optimize value for multiple stakeholders.
- To continue to advance the transdisciplinary field of medical decision making
- Explore many views on value by including symposia that incorporate many perspectives (patients, clinicians, systems, and payers) on the value of health care.
- Disseminate the content of the meeting symposia via real-time streaming and papers in MDM Policy and Practice
Activities: SMDM has a number of mechanisms to foster this agenda through its annual meeting. These include preconference short courses (one specifically devoted to the theme and slated for PCORI support), symposia during the meeting (two slated for PCORI support: one a multi-stakeholder panel describing approaches to express value in response to a case study and one stakeholder assessing the value of 8–10 shared decision making tools), and dissemination plans.
Outcomes: SMDM has an existing robust infrastructure for meeting evaluations. Specific 2019 outcomes include:
- Reach of the live streaming. To assess the effectiveness of the live streaming, the project team will determine the number of people who live-streamed each symposium and the length of time for each sign-on. The team will assess each person’s stakeholder group: patient, researcher, trainee, payer, or healthcare administrator.
- The team will evaluate its social media reach by assessing the number of meeting tweets for 2019.
- The team will publish two papers from the 2019 meeting in MDM Policy and Practice
Patient and Stakeholder Engagement Plan: The strength of the team’s proposal is that it will engage not only patients, but also other PCORI priority stakeholders. To diversify patient views, the team proposes four groups of patient representatives: a patient advocate; a patient from the Colorado multimorbidity panel; a patient from the Colorado transcatheter aortic valve replacement (TAVR) stakeholder group; and local participants (n=10) from Portland, Oregon. New this year, the team will invite representatives from the clinician, payer, and healthcare system perspective.
Project Collaborators: The Colorado Multimorbidity panel run by Dan Matlock, MD, and Carmen Lewis, MD; TAVR patient panel at the University of Colorado: