This research concluded that substantial investments in provider training, information systems and process re-engineering may be necessary to implement shared decision making successfully.

To better understand how delivery systems can implement shared decision making, the authors interviewed representatives of eight primary care sites participating in a demonstration, funded and coordinated by the Informed Medical Decisions Foundation.

Barriers to shared decision making included overworked physicians, insufficient provider training and clinical information systems incapable of prompting or tracking patients through the decision-making process.

Methods to improve shared decision making included using automatic triggers for the distribution of decision aids and engaging team members other than physicians in the process.