Engaging Consumers
in health care in
Washington State
2010 National Health Policy Conference
Richard K. Onizuka, Ph.D.
Washington State Health Care Authority
Agenda
 Health Care Reform Efforts
 Health Care Legislation - Shared Decision
Making/Patient Decision Aids
 Demonstration Projects
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The Health Care Challenge
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WA Health Care Reform Efforts
 2005 - Governor’s 5-point Health Care Plan
Use evidence-based medicine to ensure that
patients receive health care that works;
 Expand chronic care management to better
serve those who use it the most;
 Emphasize health promotion and prevention;
 Promote use of health information technology;
 Increase data transparency to give consumers
better information about health-care costs and
quality.

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WA Health Care Reform Efforts
 2006 - Blue Ribbon Commission (BRC)
Goals/recommendations (16) include:
Use state purchasing to improve health-care
quality
 Deliver on the promise of health information
technology
 Reduce unnecessary emergency room visits
 Strengthen the public health system
 Reduce health care administrative costs

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2007 Legislation
 E2SSB 5930 – Providing high quality,
affordable health care to Washingtonians
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Omnibus health reform legislation to
implement BRC goals and recommendations
Section 2: First state to endorse Shared
Decision Making (SDM) with Patient
Decision Aids (PDA)
Legislation required demonstration projects
Provides “safe harbor” for informed consent
No state funding
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SDM Collaborative
■ Legislation required:
■ State to implement
demonstration
projects
■ Evaluation
■ HCA convened a
community
collaborative with
involved
practitioners and
practice teams for
ongoing training
and support
Shared Decision
Making
Collaborative
Stakeholder Group
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2010 National Health Policy Conference
Group Health Cooperative Pilot
■
Funded by Foundation for Informed Medical
Decision Making (FIMDM), Group Health
Foundation, and Commonwealth Fund
■ Acquisition of patient decision aids (PDA)
■ Evaluation
■
Demonstration Program
■ PDAs (12) went live January, 2009
■ Retrospective control group
■ One year outcomes (two year evaluation period)
■ Evaluation
■
■
■
■
Impact of PDAs on surgery rates
Total health care use and costs (e.g., decrease utilization)
ROI (total health care costs/intervention costs)
Process barriers, implementation challenges
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University of Washington Pilot
■
Funded by Foundation for Informed Medical
Decision Making (FIMDM)
■ $400k for two years, beginning July, 2009
■ Funds PDA acquisition, implementation
■
Demonstration program
■ Four pilot sites: Virginia Mason Medical Center, Everett
Clinic, MultiCare, Carol Milgard Breast Center
■ Pilots use FIMDM decision aids
■ Going live January, 2010
■ final survey (mail or handout) (GHC 6 months f/u)
■
Feedback
■ Providers are excited, no concerns with patient flow
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Resource and Contact Info
 WA SDM/PDA Legislation and information
www.informedmedicaldecisions.org
 Washington State Health Care Authority
Leah Hole-Curry, JD, Program Director
leah.hole-curry@hca.wa.gov
 Group Health Cooperative
Karen Merrikin, JD, Executive Director, Public Policy
merrikin.k@ghc.org
 University of Washington
Cindy Watts, PhD, Principal Investigator
watts@u.washington.edu
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