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147 The effectiveness of shared decision-making combined with the electronic medical record system
  1. Hsing-Jung Li,
  2. Ming-Yuan Hsieh,
  3. Chih-Cheng Wu
  1. Center of Quality Management, National Taiwan University Hospital Hsin-Chu Branch, Hsin-Chu, Taiwan


Introduction Our hospital began to implement Shared Decision Making in 2018, using Patient decision aids (PDA) to collect cases on paper. However, because subsequent filing of paper documents requires more manpower and time, With limited manpower, personnel’s willingness to implement has gradually decreased, and due to the covid-19 factor in 2019, the effectiveness of SDM implementation has even encountered difficulties.

In addition, the data is kept by each medical execution team, and there is a lack of unified integration of data units across the hospital. The hospital management and department heads cannot grasp the current execution status in real time.

Methods In 2022, the hospital will introduce the electronic medical record online system into the informatization function of shared decision-making between doctors and patients, including medical personnel and case interview process records, PDA and effectiveness evaluation forms.

Through the online informatization method, the case is not restricted by time and place, and there is enough time to fill in the PDA, and the medical staff can directly check the response results of the case online.

The following are interventions:

  1. As the coordinating unit of Center for Quality Management, our hospital is responsible for formulating the SDM operation process and management of the whole hospital.

  2. Track the implementation of each unit every month, and feedback the report of the meeting between the director of the medical department and the hospital.

  3. Conduct SDM education and training courses to enhance colleagues’ understanding of SDM.

  4. Incorporate SDM promotion into hospital-wire balanced scoring performance indicators.

  5. The hospital’s official website has set up a ’medical-patient sharing decision-making area’ to provide patients and family members with multiple channels to inquire about relevant information.

Results In 2021, the hospital accepted 493 SDM cases, and began to accept cases electronically in 2023. As of November, the number of cases accepted has reached 1314, with an average of 146 cases per month.


  1. Through the subsidy of the electronic system, the administrative affairs of medical personnel are reduced, and the willingness of personnel to implement SDM is improved.

  2. In the past, SDM topics were limited to the use of the development team, and the topics applicable to each medical department will be listed on the system; during data analysis, if patients in other medical departments are found to need it, they will also assist in referral or use of this tool.

  3. The PDA is converted to online filling, so patients have more time to read the content of the PDA repeatedly or discuss suitable treatment methods with relatives and friends at home, which improves the patient participation rate.

Conclusion(s)Use the following notation for references.1


  1. Last Name, Initials; Last Name, Initials; …; Last Name, Initials, Journal Abbrev. Year, volume (issue number), first page-last page. (Arial, size 9, flush left)

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