Authors

C. Jessica Dine, MD MSHP
Associate Professor of Medicine, Division of Pulmonary and Critical Care
Perelman School of Medicine at the University of Pennsylvania

Lilian Dindo, PhD
Department of Internal Medicine
Section of Health Services Research
Baylor College of Medicine

Jessica Esterson, MPH
Project Director
Section of Geriatrics
Yale School of Medicine

Terri Fried, MD
Professor of Medicine
Yale School of Medicine

Mary Geda, RN, BSN, MSN
Project Manager, Pilot Study
Section of Geriatrics
Yale School of Medicine

Ariel R. Green, MD, MPH
Assistant Professor of Medicine
Division of Geriatric Medicine and Gerontology
Johns Hopkins University School of Medicine

Kizzy Hernandez-Bigos, BA
Practice Facilitator 
Connecticut Center for Primary Care
ProHealth Physicians, Part of OptumCare

Libby Hoy
Founder/CEO 
PFCCpartners

Natalie Hundt, PhD
Psychologist
Michael E DeBakey VA Medical Center  

Amy S. Kelley, MD MSHS
Associate Professor and Vice Chair of Health Policy and Faculty Development 
Hermann Merkin Professor in Palliative Care
Brookdale Department of Geriatrics and Palliative Medicine
Icahn School of Medicine at Mount Sinai

Dan D. Matlock, MD, MPH  
Associate Professor of Medicine
Department of Medicine, Division of Geriatrics

Aanand D. Naik, MD
Houston Center for Quality, Effectiveness, and Safety at the
Michael E. DeBakey VA Medical Center;
Associate Professor and Vice Chair of Medicine
Baylor College of Medicine

Jennifer A. Ouellet, MD
Assistant Professor
Section of Geriatrics
Yale School of Medicine

Cynthia (Daisy) Smith, MD, FACP
Vice President, Clinical Programs
American College of Physicians

Mary Tinetti, MD
Gladys Philips Crofoot Professor
Medicine and Public Health
Chief, Section of Geriatrics
Yale School of Medicine

Editor

Deanna Laing, ELS
Independent Editor

Reviewers

Michael J Barry, MD, MACP
Director, Informed Medical Decisions Program
Massachusetts General Hospital
Professor of Medicine,
Harvard Medical School

Jan K. Carney, MD, MPH, FACP
Associate Dean for Public Health
Professor of Medicine
Larner College of Medicine at the University of Vermont

Disclosures

Individuals not named below have nothing to disclose.

Cynthia (Daisy) Smith, MD, FACP
Vice President Clinical Programs, ACP
Dr. Smith has disclosed that her spouse is employed at Merck and Co. and that both she and her spouse hold Merck and Co. stock and stock options.

Continuing Medical Education

The American College of Physicians (ACP) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education (CME) for physicians. 

The ACP designates each Enduring Material for a maximum of 1 AMA PRA Category 1 Credit(s)™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of each CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1 Medical Knowledge MOC points and patient safety MOC credit in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credit claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

The "Helping Your Patients Identify their Health Priorities" module is also authorized for CE credits through the Yale University School of Nursing, an Approved Provider Unit of Continuing Nursing Education by the Connecticut Nurses Association, and an Accredited Approver by the American Nurses Credentialing Center's Commission on Accreditation.

Release Date:  May 15, 2019
Termination Date:  May 14, 2022

MOC Approval Statements

Through the American Board of Medical Specialties’ (“ABMS”) ongoing commitment to increase access to practice-relevant Continuing Certification Activities through the ABMS Continuing Certification Directory, Patient Priorities Care – Helping Your Patients Identify Their Health Priorities has met the requirements as a MOC Part II CME Activity (apply toward general CME requirement) for the following ABMS Member Boards:

MOC Part II CME Activity
Allergy and Immunology
Anesthesiology
Family Medicine
Physical Medicine and Rehabilitation
Plastic Surgery
Preventive Medicine
Psychiatry and Neurology
Urology

https://www.continuingcertification.org/activity/patient-priorities-care-helping-your-patients-identify-their-health-priorities/

Through the American Board of Medical Specialties’ (“ABMS”) ongoing commitment to increase access to practice-relevant Continuing Certification Activities through the ABMS Continuing Certification Directory, Patient Priorities Care – Introduction to Patient Priorities-Aligned Decision-Making has met the requirements as a MOC Part II CME Activity (apply toward general CME requirement) for the following ABMS Member Boards:

MOC Part II CME Activity
Allergy and Immunology
Anesthesiology
Family Medicine
Physical Medicine and Rehabilitation
Plastic Surgery
Preventive Medicine
Psychiatry and Neurology
Urology

https://www.continuingcertification.org/activity/patient-priorities-care-introduction-to-patient-priorities-aligned-decision-making/

Through the American Board of Medical Specialties’ (“ABMS”) ongoing commitment to increase access to practice-relevant Continuing Certification Activities through the ABMS Continuing Certification Directory, Patient Priorities Care – Common Challenges in Patient Priorities-Aligned Decision-Making has met the requirements as a MOC Part II CME Activity (apply toward general CME requirement) for the following ABMS Member Boards:

MOC Part II CME Activity
Allergy and Immunology
Anesthesiology
Family Medicine
Physical Medicine and Rehabilitation
Plastic Surgery
Preventive Medicine
Psychiatry and Neurology
Urology

https://www.continuingcertification.org/activity/patient-priorities-care-common-challenges-in-patient-priorities-aligned-decision-making/
 

Overall Learning Objectives

Helping Your Patients Identify Their Health Priorities

  1. Identify communication strategies to partner with patients and their families to provide patient-priorities-aligned care.
  2. Describe the steps to identify patient priorities (health outcome goals and healthcare preferences) and align their health care.
  3. Discuss the patient’s "specific ask"—the one most important thing they want to focus on.
  4. Describe how the health care team uses the specific ask to guide current and future health care.

Introduction to Patient Priorities-Aligned Decision Making

  1. Incorporate patient priorities (health outcome goals and healthcare preferences) into clinical decision-making about continuing current treatments or starting new treatments.  
  2. Incorporate overall health trajectory and prognosis into discussions with patients and use this to inform potential care options. 
  3. Describe the key tradeoff of short-term burden versus long-term potential benefit and incorporate this tradeoff into clinical decision-making.  
  4. Discuss and implement strategies to reduce complexity of care and minimize treatment burden without compromising patient priorities and outcomes.

Common Challenges in Patient Priorities-Aligned Decision Making

  1. Explore differences and challenges in applying patient priorities (health outcome goals and healthcare preferences) to decisions about invasive, one-time interventions versus chronic, daily interventions. 
  2. Acknowledge and discuss concerns clinicians may have in applying Patient Priorities Care, specifically discomfort with decisions that do not align with national guidelines or “best” evidence.
  3. Identify strategies to apply Patient Priorities Care when clinicians disagree on the best treatment decisions.

Instructions

To complete this activity the participant must read the Introduction page, complete the relevant modules, and complete the questions at the end of each module.