Regional Representative Report – June 2019 – HNHB LHIN – Diane Gwartz

June 2019
Report by Diane Gwartz, NPAO LHIN 4 Representative
I am representing NPAO on the Cancer Care Ontario OBSP Expert Panel on Informed
Choice and Shared Decision-Making. There has been one meeting so far, which I have
attended.
In December 2018, the Canadian Task Force on Preventive Health Care released
updated breast cancer screening guidelines. This Expert Panel has been formed to
look at the changes in recommendations regarding informed choice and shared
decision-making which are essential to the new guidelines as such:
“In light of low-certainty evidence for benefits and harms from breast cancer screening,
as well as variability in patient preferences, women should be
o supported to make an informed choice on screening that is congruent with their own
values and preferences
o engaged in shared decision-making with their health care providers”
Initial discussions focussed on the concepts of informed choice and shared decision-
making and how that impacts self-referral, as per the current process for OBSP. During
the discussion, it was my opinion that it is essential that patients be able to continue to
self-refer and suggested that opportunities for informed choice and share decision-
making could be made available through a variety of patient education platforms and
with health care providers that would include the family physician, but not be exclusive
to FPs. In addition, I recommended processes to ensure informed choice and shared
decision-making when a patient requires further evaluation based on the initial
mammogram screening (which I feel is lacking in the current process).
Further meetings are planned, but not yet scheduled.