Victor M. Montori, M.D.

The purpose of this study is to observe the occurrence of shared decision making (SDM) and identify characteristics of unhurried conversations in clinical encounters of clinicians and patients. The findings from these observations will contribute to the development of measures to evaluate shared decision making (SDM) and unhurried conversations.

1. The primary purpose of this study is to assess the comparative effectiveness of the following 4 approaches to promote high-quality SDM for at-risk patients with AF:  a PDA alone, (2) an EDA alone, (3) a combination of a PDA and an EDA, and (4) control with neither a PDA nor an EDA.

The purpose of this study is to evaluate the burdensome aspects of digital healthcare for a diverse range of chronic patients with varying levels of digital comfort.

The study will have three phases:

• interviewing up to 40 patients to elicit content related to the burden of digital interventions for healthcare self-management (DRx) and understand how well the current TBQ capture it (Aim 1a);
• patient-centered, iterative development (i.e., item generation), cognitive testing, and refinement of an adapted TBQ that addresses DRx (Aim 1b); and
• field testing of DRx TBQ to test its validity (Aim 2).

The purpose of this study is to develop an evidence-based decision aid for patients with nonvalvular chronic atrial fibrillation.

The purpose of this study is to determine the impact of patient decision aids compared to usual care on measures of patient involvement in decision-making, diabetes care processes, medication adherence, glycemic and cardiovascular risk factor control, and use of resources in nonurban practices in the Midwestern United States.

The purpose of this study is to better understand what patients with chronic conditions feel should be discussed in appointments with doctors by watching and listening to patients discuss it during a support group. 

The purpose of this registry is to develop a database of patient experience that can be used for internal research, education, and training that improves the care of patients.

The purpose of this study is to collect data and then design a decision aid for patients who are having a lung screening.

The objective of this project is to develop and evaluate an anticoagulation therapy decision aid for patients with non valvular atrial fibrillation.

The objective of this project is to provide space for participants to collectively reflect on previous conversations with their clinicians as well as outline and practice a conversation they would like to bring to their clinician in the future.

The objective of this project is to capture stories as well as develop and evaluate communication tools for the clinical encounter that encourage patients to introduce information from their lives that they believe to be relevant to their lives and ability to enact self-care.

The active strategy for dissemination and implementation of Share Evidence Based Medicine (EBM) will yield greater reach of clinicians, be adopted by the practices more readily, and a greater uptake of use amongst encounters will be seen.

The Institute for Clinical Systems Improvement (ICSI) is a nonprofit organization with expertise in large-scale practice improvement at the state and national level. Largely funded by health organizations in Minnesota, ICSI has a sustainable model to translate evidence into practice, through clinical practice guidelines, shared decision making, and practice redesign. A partnership between these two organizations (ICSI and Mayo Clinic) may lead to a sustainable and innovative approach to the dissemination of evidence-based health information at the point of care.

The objective of the current study is therefore to leverage the expertise of these two organizations to compare the impact of an active to a passive dissemination and implementation strategy of the ShareEBM toolkit. The aim of the study is to disseminate evidence-based information through the use of decision aids during encounters. The overall purpose of the qualitative evaluation is to understand why decision aids were used more or less in certain practices and what factors contributed to or hindered this uptake.

The purpose of this study is to evaluate the patients’ knowledge regarding the risks and benefits of parathyroidectomy in the setting of mild primary hyperparathyroidism.

Can QBSAfe be implemented in a clinical practice setting and improve quality of life, reduce treatment burden and hypoglycemia among older, complex patients with type 2 diabetes?

The purpose of this study is to determine whether a diagnostic reconciliation conversation aid can assist a shared decision making conversation between patients and clinicians to reach a consensual diagnostic plan of care and confirm that patients and clinicians have the same understanding of its goals, nature (including patient experience), and downstream consequences (including implications for further testing and treatment).

The investigators' decision aid for patients with GD, GD Choice, will be the result of a user-centered participatory action research involving) synthesis of the best available evidence from the literature and real-world registry experience, ii) input and involvement of patients, clinicians and other stakeholders, iii) direct observation of encounters and iv) extensive field-testing. The goal is to create a decision aid that will be rigorously evidence-based, clear and complete, able to be used by clinicians with minimal training time, while satisfying extant standards for rigorous high-quality shared decision making tools.

The purpose of this study is to develop and evaluate a treatment decision aid for patients with asymptomatic primary hyperparathyroidism.

This research study is being done to develop educational materials that will help patients and clinicians talk about diabetes treatment and management options.

This study is designed to answer a key question in the field of implementation science. Specifically, it seeks to determine if a proposed model for the implementation and scale-up of healthcare innovations (the AIDED model) is effective and useful. To fully evaluate the potential of this model, the investigators will conduct a multi-year study comprising 3 phases. This proposal represents the first of these phases.

This mixed methods study aims to answer the question: "What is the work of being a patient with type 2 diabetes mellitus?" .

The purpose of this study is to track the treatment burden experienced by patients living with Type 2 Diabetes Mellitus (T2DM) experience as they work to manage their illness in the context of social distancing measures. 

To promote social distancing during the COVID-19 pandemic, health care institutions around the world have rapidly expanded their use of telemedicine to replace in-office appointments where possible.1 For patients with diabetes, who spend considerable time and energy engaging with various components of the health care system,2,3 this unexpected and abrupt transition to virtual health care may signal significant changes to the treatment burden associated with diabetes management.4 Previous research has characterized the effect of telemedicine approaches on outcomes such as glycemic control, patient satisfaction, cost savings, and appointment adherence rates,5-8 but its influence on treatment burden has not been explored. Importantly, work in this area has largely drawn from the experiences of patients who voluntarily selected to use virtual health services. The current situation, in which patients with chronic health conditions have been obligated to use telemedicine in order to receive care, therefore presents a unique opportunity to explore the ways in which virtual diabetes management impacts the workload associated with managing chronic illness.

Aim: Explore patient experiences managing diabetes mellitus in the context of recent widespread changes in healthcare and social distancing due to the novel coronavirus pandemic, including barriers and facilitators to obtaining needed health care services and changes in social networks. To accomplish this aim, we will conduct qualitative interviews with up to 30 participants.