Electronic Aids Enhance Informed Consent?

Rosemary Flanigan

April 30, 2010

A few years ago a Health Affairs article authored by Annette M. O’Connor, et al. (“Toward the ‘Tipping Point’: Decisions Aids and Informed Patient Choice.” 2007.Health Affairs 26(3)716-725) noted that "preference-sensitive treatment decisions involve making value trade-offs between benefits and harms that should depend on informed patient choice. There is strong evidence that patient decision aids not only improve decision quality but also prevent the overuse of options that informed patients do not value. . . .”

I have long been interested in real informed consent determination, and if “decision aids when used as adjuncts to counseling improve decision quality and reduce the overuse of surgical treatments by 25%,” then I guess they can’t be all bad.

These “decision aids” are growing like rabbits, and the article states that “An important element of these practice models is the key supportive role played by specially designed IT systems. For example, [one breast care program] is attempting to improve clinical care quality by incorporating IT to screen patients, inform physicians, cue the decision aid, assess naïve and informed preference, flat emotional distress and monitor decision quality”

WOW!! And all of this to help the patient decide risks/harms.

But wait, we’re not finished: The article goes on to say that the practice models for these “decision aids” can be used as examples for developing national standards (for health professionals and for health care organizations) AND certification is not far behind.

TELL ME, TELL ME, are we so bad with our present system of gaining informed consent that we might be attracted to these (computer-generated) aids??? (Or is my anti-electronic bias showing??? Might it not be just as well to suggest some people I could talk to if I can’t decide on a treatment modality?) HELP!