At Dartmouth, Shared Decision Making (SDM) is more than just a concept - it is a culture that is transforming the relationship between patients and providers.

Established in 1999, the Dartmouth-Hitchcock Center for Shared Decision Making (CSDM) is the first patient-focused facility of its kind in the United States. Working in collaboration with The Dartmouth Institute's Center for Informed Choice, these centers provide support for patients and providers making difficult healthcare decisions, as well as develop innovative shared decision making implementation, research and training programs.

A review of published randomized controlled trials shows that patient decision aids can have a positive effect on: patient involvement, knowledge and realistic perception of outcomes, patient-practitioner communication, rates of elective surgery, and improving decision quality. The clinical Shared Decision Making care pathways at DHMC have provided opportunities to answer research questions about patients using decision support programs in routine care.

New electronic medical records (EMR) and meaningful use criteria offer opportunities for integrating Shared Decision Making into clinical care. At DHMC, we have implemented decision aids ordering through the EMR (including quick clinician access to Shared Decision Making resources) and are working to improve the documentation of the use of decision aids and decision support interventions in the medical record to make Shared Decision Making a sustainable and routine component of clinical care.

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