The Pennsylvania Medical Society (PAMED) is providing an informed decision-making form to aid in the care of patients for whom physician practices have recommended screening tests or vaccines. In addition to promoting patient awareness and compliance, the form is a useful charting tool for physician practices.
This form was developed by the PAMED Medical Directors Forum, a coalition of PAMED physician leadership and medical directors from a majority of the health plans operating in Pennsylvania.
The form does not meet HEDIS reporting data requirements and its use will not affect HEDIS scores or any quality scores following HEDIS specifications. Credit for use of the form for quality-based enhancement programs is at the discretion of each health care plan. However, several health plans report similar tools increase acceptance of the recommended services, as patients take a closer look when asked to “sign on the dotted line.” When this occurs, HEDIS results improve, because patients, who might otherwise have refused, consent to the services.
The list of screening tests and vaccines on the form is not intended to replace more expansive national or society guidelines and is not intended to substitute for professional judgment in individual cases. The form also is not intended for use in the care of minor patients, including recommended childhood vaccines. The American Academy of Pediatrics (APA) has created a similar template for parental refusal to have their children vaccinated. The APA form and related resources can be found on its website.
Depending upon the circumstances, it may be prudent to document in more detail a discussion with a patient regarding matters such as the benefits of the recommended care, the risks of not receiving the care, and the patient’s reasons for refusal. The form is not a substitute for legal advice from a qualified attorney on any issue including appropriate documentation for professional liability purposes. It is made available with the understanding that neither PAMED nor the Medical Directors Forum are engaged in rendering legal services.
The form may be duplicated or modified as appropriate to meet the needs of a physician practice and its patients.