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The New Health Dialogue

A Blog from New America's Health Policy Program

HEALTH IT: Branching Out on the Decision Tree

Published:  September 22, 2010
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Second of the health tech-y posts for today. (We just did one on doctors rounding with iPads.)

Thomas Goetz, editor of Wired, published a book earlier this year called The Decision Tree: Taking Control of Your Health in the New Era of Personalized Medicine.  It came out several months ago, but we were pretty focused on health reform legislation at the time. Goetz, who has an MPH in addition to his tech/journalism career, is interested in consumer health, and the intersection between consumer health and technology, everything from simple self-monitoring iPhone apps to "proteomics" (a molecular medical technology which can potentially improve diagnostics of diseases like Parkinsons). Maria Gifford has an interview with Goetz up at getbetterhealth. We thought these two snippets drove home key points about what patients face in an overwhelmingly complex health system where the financial incentives permeating the system aren't necessarily pointing patients toward the best or most cost-effective (not a synonym for cheapest) solutions. Goetz wants to link information and action -- but keep in mind that the "right" action for one patient isn't necessarily the right one for all, and that "taking action" doesn't necessarily mean taking the most aggressive, expensive, newest action.

Maria: From your standpoint, what are the main barriers to making good health decisions in the U.S.?

Thomas: I think there are two obstacles to good decision making among individuals. One is delivering information to people in a clear, compelling way that helps them understand their particular position and options rather than a generic blast of broad information that can be laced with jargon, statistics, and irrelevance. Second, I think we give information and stop there. We need to make sure that people recognize that they CAN act and that they know WHEN to act. We need to empower people so they feel secure in making a choice that can often times change their lives, and we need to help them see the potential for making real changes.

Maria: How can the everyday person use a health “decision tree?”

Thomas: A decision tree is a framework for fleshing out our choices and understanding our options and the risks and rewards that every option carries. It can be as simple as a list of pros and cons or as elaborate as a computerized decision-making tool that plays out statistical odds. But in all of its forms, a decision tree can help people see where they stand, what choices lie in front of them, and what the eventual outcomes and results might be. Too often these things are either obscure or taken for granted in medicine today

(Both of these posts I found -- this is sort of the hat tip equivalent of a second cousin twice removed -- via Pallimed which in turn linked to Grand Rounds...)

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