Collaboration, MIP | 2015
In spring of 2015, the Department of Medicine Innovation Program (MIP) and the Healthcare Transformation Lab partnered to award funding to the digital health project, PrOE PCI. PrOE, which stands for Procedure Order Entry, is a tool used across MGH to measure the appropriateness of clinical procedures. Percutaneous coronary intervention (PCI) is a non-surgical procedure used to treat the narrowed arteries of the heart. The grant was used to add risk models for PCI into the PrOE platform, building upon work started by Dr. Robert Yeh. The final products generated from the risk models are an individualized consent form, which shows patients their individual risk scores, and a worksheet that shows physicians a patient’s risks and proposes patient-specific treatment options.
Dr. Jason Wasfy, a practicing Cardiologist and Director of Quality and Analytics for the MGH Heart Center took over the grant from Dr. Yeh. Dr. Wasfy explains the importance of decision support tools, such as PrOE PCI, saying, “If you think about the way that medicine has evolved, the traditional model is of physicians making decisions based on their experience and their gut that in many ways has a lot of value…We are not smart enough to integrate a model of seven variables; it’s too complicated for the human brain. So what happens is, just like all humans, we revert to our gut. The problem with your gut is that it’s biased by all kinds of history.”
The goals of the individualized consent forms and worksheets are to address cognitive bias in decision making and ensure patients feel fully informed before consenting. As Dr. Wasfy explains, “The nice thing about these kinds of tools is that it will not only better align our clinical decisions with meaningful risks and benefits for individual patients, but it will also be a more fundamentally right way of sharing information with patients.”