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The Article in Brief
Visit Planning Using a Waiting Room Health IT Tool: The Aligning Patients and Providers Randomized Controlled Trial
Richard W. Grant , and colleagues
Background There is limited time during primary care visits. This study tests the hypothesis that an information technology tool in the waiting room could help patients identify and express their top visit priorities, which would lead to better visit interactions and improved quality of care.
What This Study Found An information technology tool in waiting rooms of primary care practices helped patients prepare questions and express their concerns to their doctors, but did not reduce gaps in clinical care. The "Visit Planner" tool, which was placed in eight primary care practices, was designed to help adult patients identify priorities for their visit and effectively express them to their clinician. Eligible patients had at least one clinical care gap (eg, not meeting diabetes goals). Of 359 patients in the intervention group, 59 percent (n=198) reported that they "definitely" prepared questions for their doctor, compared to 45 percent (n=160) of control patients. A high percentage of intervention group patients also reported "definitely" expressing their top concerns at the beginning of the doctor visit (91 percent vs 83 percent of control group patients). Patients in both arms of the study reported high levels of satisfaction with their care. Overall, half of study patients (394/747, 53 percent) had all baseline care gaps closed by the end of the 6-month follow-up period. The prevalence of clinical care gaps was reduced by a similar amount in both groups.
Implications
- The Visit Planner successfully guided patients to begin primary care visits by communicating their top care priorities, an important gap in visit interactions. Improving this crucial first step of prioritization, the authors state, can be a building block for the next generation of tools that address communication barriers related to care planning with the ultimate goal of improving clinical care outcomes.