Different deliberative techniques or tools can be used to explore how groups make decisions when faced with various options. Approaches vary depending on the topic of the deliberation, the types and number of individuals that will participate, and the time and resources available. CHCD uses a variety of approaches:
CHAT: a computer-based process
CHAT® (Choosing All Together) is a computerized process for individual and group decisions. Licensed through the University of Michigan, CHAT is an effective tool for considering coverage priorities and other types of priority-setting when multiple options are available. Since 2002, CHCD has designed more than a dozen versions for use in California and other states, facilitating more than 300 sessions with various demographic populations. Learn more »
Articles about CHAT have been published in professional journals:
- (De)constructing Basic Benefits: Citizens Define The Limits of Coverage (Ginsburg M, Goold S, Danis M), Health Affairs, November/December 2006
- Experience in the United States With Public Deliberation About Health Insurance Benefits Using the Small Group Exercise, CHAT (Danis M, Ginsburg M, Goold S), Journal of Ambulatory Care Management, July/Sept 2010
- The Coverage Priorities of Disabled Adult Medi-Cal Beneficiaries (Danis M, Ginsburg M), J Health Care for the Poor and Underserved, August 2006
Many of the challenging issues in healthcare policy or practice relate to health care quality, cost containment, physician or patient authority, and the results and use of medical research. Both the lay public and healthcare professionals can best respond to complex trade-offs when they are described using scenarios that illustrate the issue through a common medical situation. Case scenarios are used as examples of the issue at stake; from these examples – and by introducing variations of the scenarios – facilitators draw out the underlying principles that are foundational for individual/group choices.
As noted in What is Public Deliberation?, phone or internet surveys are not considered deliberative. Yet CHCD has occasionally used surveys to lay a foundation for a deliberative process. For example, identifying how the public responds to an uncomplicated healthcare policy issue could form the basis for a more detailed exploration that involves trade-offs. In other instances, a survey can be used to validate qualitative conclusions.
Educating Others on Social Decision-Making
While our work is primarily to inform healthcare policy and practice, deliberative discussions are also educational for participants. Regardless of the healthcare topic, the process itself exposes individuals to insights about themselves and others and fosters understanding of “social decision-making” – when the needs of many people are taken into account. This is especially important in health care whose structure, financing and delivery are based on models that must serve diverse populations. See Healthcare Matters.