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204 Top 10 legal developments in SDM: law and policy update on implementing SDM into clinical practice
  1. Thaddeus Mason Pope
  1. Mitchell Hamline School of Law, Saint Paul, Minnesota USA


Introduction Real-world use of SDM and PDAs remains persistently and distressingly sparse. While most ISDM sessions and posters rightly explore the latest tools and strategies for improving patient oriented SDM, we must also explore ways to increase clinician uptake outside the research laboratory.

Methods This is a comprehensive and up-to-date status report on legal and policy incentives for SDM implementation. Because more work has been done on SDM in the USA, the authors reviewed statutes and regulations at both the state and federal level in the United States.

Results Three different types of new legal and policy incentives are pushing SDM implementation.

Payment incentives link PDA use to insurance/payor reimbursement.

Liability incentives link PDA use to legal protection from liability.

Mandate incentives require PDA use categorically.

In this highly graphic session, an attorney/bioethicist describes recent examples of each of these three types of legal incentives. He explains how these incentives push clinicians to use PDAs and engage in SDM. And he assesses how effectively these incentives are working.

Discussion Law cannot solve the implementation challenge by itself. Guidance documents identify multiple, overlapping strategies for implementing SDM and increasing clinician uptake. Still, law remains one important piece of the implementation puzzle. This session offers a succinct, yet comprehensive, review of recent law and policy related to SDM and PDAs.

Conclusion It is not enough to design communication materials and best practices. To ensure patient safety and protect patient rights, we must also ensure that they get adopted and assimilated into clinician-patient encounters.

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