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Better decisions, better care

DHMC model to be used in New Hampshire hospitals

Mark McClellan, Administrator of the national Centers for Medicare and Medicaid Services (CMS) announced in late October a one-year demonstration project aimed at assessing whether empowering patients with information and control over health choices may lead to greater patient awareness and satisfaction and lower costs.

Using the Center for Shared Decision-Making at Dartmouth-Hitchcock Medical Center (DHMC) as a model, the project provides funding to extend that program to Concord Hospital and to Lakes Region General Hospital (LRGH).

"I have seen the future of health care here at the Spine Center of the Dartmouth-Hitchcock Medical Center."

- Steven Pearlstein

U.S. Sen. Judd Gregg (R-NH) Chairman of the Senate Health, Education, Labor and Pensions Committee, was instrumental in crafting the initiative and working with Health and Human Services Secretary Tommy Thompson. Said DHMC hospital President James W. Varnum, "Senator Gregg has been a keen and dedicated ally in our efforts to continually improve the quality of care for our patients, while searching for solutions to the financial crisis around health care. We're grateful for his insight and his innovation and look forward to working with our colleagues at Concord and Lakes Region."

The Center for Shared Decision-Making is an outgrowth of the work of the Center for the Evaluative Clinical Sciences at Dartmouth Medical School. There, Director Jack Wennberg, Professor of Community and Family Medicine and of Medicine; Jim Weinstein, Professor of Orthopaedics and of Community and Family Medicine, and others have spent years looking at factors that can improve doctor-patient relationships and the quality of clinical care. By involving patients far more actively in their health-care decisions and fully engaging them in a value-based discussion of options, they argue that patients will make better, wiser and often less costly choices about their treatment plan.

In a recent column in the Washington Post, financial columnist Steven Pearlstein wrote about the process with patients at DHMC's Spine Center.

"I have seen the future of health care here at the Spine Center of the Dartmouth-Hitchcock Medical Center," he wrote. "It is not that Jim Weinstein and his colleagues have any breakthrough cures for back pain. What they do have is a revolutionary model for how doctors and patients interact that improves medical care while saving money."

CMS Administrator McClellan hailed the Shared Decision-Making model, saying, "The evidence shows that the quality of medical care improves when patients are given thorough, unbiased information about options they have. In many cases, the shared decision-making process leads to lower costs and higher patient satisfaction."

Under the plan, about $5 million will be awarded to the three New Hampshire hospitals: DHMC will receive approximately $3.2 million; Concord $1.2 million; and LRGH $500,000 to cover implementation, operations and other costs.

"Concord Hospital is pleased and excited to be able to further develop our collaborative relationship with DHMC on this project, which will promote quality and cost effectiveness. We are most appreciative of the continuing efforts of Senator Judd Gregg to both bring health-care resources to New Hampshire and to tap into the tremendous intellectual energy within our health-care community in a way that will improve patient care," said Michael B. Green, President and CEO of Concord Hospital/Capital Region Health Care.

Tom Clairmont, President of LRGH, said, "This demonstration project is another example of Senator Gregg's leadership in health care. We thank the senator for his ongoing commitment to New Hampshire patients. Working collaboratively with Concord Hospital and Dartmouth-Hitchcock, this project will enable our region's providers to expand upon their efforts to empower patients to be active participants in their care."


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Last Updated: 12/17/08