Ottawa Hospital Foundation offers online decision aid

With the barrage of seemingly conflicting news stories about major health-care issues such as hormone replacement therapy or cancer treatment options, it can be tough for patients to decide on the best options for them.

To make that choice a little easier, the Ottawa Hospital Foundation in partnership

with Bell Canada have announced the opening of the Bell Patient Decision Support Laboratory, a facility at the Ottawa Hospital, as well as an online Web portal available with a “”decision aid”” tool.

The decision aid, which is presented as a worksheet, describes in detail options, outcomes, probabilities of benefits and harms of various treatment. It helps users clarify personal values and understand the scientific uncertainty associated with some options.

The lab and portal are a Canadian first, and possibly as world first as well, said Dr. Annette, O’Connor, director of the new lab, which is part of the Ottawa Health Research Institute.

“”There are some other places that have a lab that looks at decision making, but not to extent we have,”” she said. “”We’re the first to look at ways to implement this in the real world.””

Bell Canada donated $500,000 to the project, which has qualified the hospital for matching funds from the provincial and federal governments. About half that donation has been spent on building the portal, according to O’Connor.

O’Connor said the decision support tool is the outcome of years of research into ways to help patients make better-educated decisions about health care. Research scientists have had access to a number of decision aids for years, but now that information is available to the public.

There are about 200 publicly available decision aids, all focused on major medical issues, as opposed to whether or not to take an antibiotic. Another 300 are in development, O’Connor said.

“”We also register all the ongoing studies, so we have ones that are ongoing and under evaluation but they’re not ready or they were done 10 years ago, so useful to have registered but they’re out of date,”” she said.

At last count, she said, the site has had about 600,000 hits over the past seven weeks or so. So far, the most used decision aid is the all-purpose personal one, she says, as well as the cancer decision aid.

“”It allows the person to build their set of options, see the pros and cons of those options — and this is the ‘aha’ part of it — to assign a value to each of positives and negatives,”” O’Connor said. “”At a glance they can see which features of different options they value most and where they are overall leaning. They also can assess their own needs. Based on their responses we have suggested strategies.””

O’Connor said the worksheet design of the decision aids is still a work in progress.

“”Once we get something really workable we can start to develop case studies of how people used it in particular situations so others can see how people used it,”” she said.

The decision aids are also being used to train nurses and doctors to better help their patients through the decision-making process.

“”Every one of them knows how to provide information, so that’s a no-brainer… but when it comes to clarifying values they all say, ‘I don’t know what that means.’””

Although users can register on the site if they want to privacy of user information is not an issue at the moment because the hospital doesn’t use the data other than for quality monitoring purposes, such as to see if users stop in the middle or are unable to progress through certain sections.

“”The only reason you have to register is if you want to track your progress,”” she said. “”The Web site is secure for registration, and we’re going to try to get it secure for everything. It’s behind the Ottawa Hospital’s firewall.

“”If we decide to have research project where we would summarize data we then would change the privacy policy and ask people if they’d like to participate in a research project.””

According to Gary Cameron, vice-president of enterprise accounts at Bell Canada, Bell got involved in the project because it meets the company’s criteria for community, health care and innovative use of technology.

“”A fourth criteria is the impact of what’s deployed,”” he said. “”In this case it has national and international implications. We found the fact that it’s Ottawa based but would provide service that could be used by people across Canada very appealing.””

Cameron says the investment is just one of many Bell has in health care across Canada.

“”There are benefits for both of us that will go outside this specific initiative,”” he said. “”We’re looking at doing things in health care across the country and we can inject what we learn from this back into other projects.””

Bell’s investment is important to the hospital because it proves it’s a worthwhile endeavor, he added.

“”The reality is private sector engagement is a form of validation to show the public sector it’s got legitimacy because there are so many choices.””

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