This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
Patients who can speak openly with their doctors are more likely to get care that addresses what matters most to them. But research shows that patients often hesitate to talk openly with their doctors because they fear being labeled as difficult. Doctors also may not be prepared to answer all the questions a patient may have.
Many approaches can help doctors improve communication with patients, but studies have not compared these approaches. This study compares three approaches, one of which improved communication between patients and doctors in earlier studies.
Who can this research help?
Doctors and leaders at healthcare organizations can use findings from the study to improve communication with patients. Findings from the study can help patients get more out of visits with doctors.
What is the research team doing?
This research is building on a previous study of an approach called Open Communication. The previous study showed that patients and doctors who used Open Communication had better communication than did patients who had usual care. In the current study, the research team is comparing three approaches to improve how patients and their doctors interact. Two approaches—Open High Touch and Open High Tech—are new and build on the initial Open Communication approach.
The research team is also comparing a third approach called Ask, Share, Know, or ASK. The team wants to learn whether one of the three approaches works better than the others. The team also wants to know if one approach is easier than the others for healthcare organizations to put into practice.
The research team includes researchers at three large healthcare organizations in two states. Twenty-one clinics and 105 primary care doctors are taking part in the study. The team is testing each of the three approaches with 5,250 patients.
The team is assigning clinics, by chance, to use one of three communication approaches:
- Open High Touch—Patients use an electronic system, called a patient portal, to prepare for office visits and communicate with their doctors. Before an office visit, patients are using the portal to answer questions about what they want to discuss with the doctor. Patients also watch a video about how to prepare for the upcoming appointment and get the most from the visit. Doctors are receiving in-person training on how to discuss what matters most to patients.
- Open High Tech—Patients use the patient portal in the same manner as the patients in the Open High Tech group. Doctors receive training via a mobile app instead of in person.
- ASK—Clinics that use this approach place posters in exam rooms that encourage patients to ask their doctors the following questions: What are my options? What are the possible risks and benefits of each option? How likely are the benefits of each option to occur to me?
Patients, a patient advocacy group, doctors, clinic staff, and leaders in two large healthcare organizations meet regularly with the research team to guide the study’s progress.
Research methods at a glance
- Ellen Uhrbrock, MBA, Palo Alto Medical Foundation
- Andrea Maldonado, Palo Alto Medical Foundation
- Beth Gribbin, Palo Alto Medical Foundation
- Patricia Alexander, Palo Alto Medical Foundation
- Libby Hoy, Patient, Family Centered Care Partners
- Chet Frankenfield, Palo Alto Medical Foundation
- Paul Mahon, Reliant Medical Group
- Bonnie Cassidy, Reliant Medical Group
- Patrick George, Reliant Medical Group
Other Stakeholder Partners
- Dominick Frosch, PhD, Palo Alto Medical Foundation
- Albert Chan, MD, Sutter Health
- Edward Yu, MD, Palo Alto Medical Foundation
- Ellis Dillon, PhD, Palo Alto Medical Foundation Research Institute
- Cheryl Stults, PhD, Palo Alto Medical Foundation Research Institute
- Kathleen Mazor, EdD, University of Massachusetts Medical School
- Sarah Cutrona, MD, MPH, University of Massachusetts Medical School
- Larry Garber, MD, Reliant Medical Group
- Robert Yood, MD, Reliant Medical Group
- Alice Pressman, PhD, Sutter Health Research Development & Dissemination
- Sylvia Sudat, PhD, Sutter Health Research Development & Dissemination
- Pragati Kenkare, MS, Palo Alto Medical Foundation
- Alan Aman, Palo Alto Medical Foundation
- David Sofen, MD, Palo Alto Medical Foundation
- Kelly Reilly, RN, MS, CDE, Palo Alto Medical Foundation
- Andrea Aguirre, Palo Alto Medical Foundation
- Peter Cheng, MD, Palo Alto Medical Foundation
- Roberta Mori, RN, MSN, Sutter Health, Office of Patient Experience
- Dominique Quincy, MD, Palo Alto Medical Foundation
- Laarni Slusher, BSN, Palo Alto Medical Foundation
- Thad Schilling, MD, Reliant Medical Group
- Melissa Dacosta, Reliant Medical Group
- Ned Faltas, Reliant Medical Group
- Nicholas Kelliher, Reliant Medical Group
- Robert Jandle, MD, Reliant Medical Group
- Alison Venuti, University of Rochester
- Glyn Elwyn, MD, PhD, The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine, Dartmouth College
^Palo Alto Medical Foundation Research Institute was the original organization associated with this project