Patient Readiness Form: A Pilot Study to Increase Patient-Centered Communication during Medical Appointments with Older Patients

Rapid Communication

Gerontol Geriatr Res. 2016; 2(3): 1014.

“Patient Readiness” Form: A Pilot Study to Increase Patient-Centered Communication during Medical Appointments with Older Patients

Stults CD¹*, Cheng PH², Hagstrom A¹ and Tai- Seale M¹

¹Palo Alto Medical Foundation Research Institute, USA

²The Guzik Center for the Advancement of Geriatrics and Palliative Care, Palo Alto Medical Foundation, USA

*Corresponding author: Stults CD, Palo Alto Medical Foundation Research Institute, 2350 W. El Camino Real, 4th floor, Mountain View, CA 94040, USA

Received: April 22, 2016; Accepted: May 21, 2016; Published: May 24, 2016


Agenda setting is an important component of patient-centered communication, yet it often does not happen in ambulatory encounters, particularly with older patients. The “Patient Readiness Form” was developed to have an older patient list their concerns in order of importance and their current medications/supplements and dosage. A small pilot study was conducted in a multi-specialty group practice and found that older patients and physicians were willing to use the Patient Readiness form to help with agenda setting before and during office visits, citing that it helped them focus on the visit. This form has potential to improve patient-centered communication, but more research is necessary.

Keywords: Agenda setting; Pilot projects; Older adults; Communication; Office visits


HER: Electronic Health Record


Patient-centered communication is a centerpiece of effective primary care. Evidence shows that when patients are engaged in revealing their agenda during an ambulatory encounter, the patient is usually more satisfied and more capable of managing their own health [1-3]. The reality of a typical ambulatory encounter, however, is that their agendas are not commonly known [4,5]. Barriers, such as time constraints, disrupt the best of intentions [6]. Multiple patient issues compete for physician’s attention and time, along with physician’s own agendas that need to be covered, often without explicit recognition that there are these competing agendas. In fact, use of Electronic Health Records (EHRs) has been documented to increase the competition, given the proliferation of reminders and care gap alerts [7]. As a consequence, communication continues to be unstructured: “For most patients, there is no systematic or effective method for communicating what happens outside the clinical encounter, such as perceived needs, symptoms, response to treatment, undesirable side effects, effect on function, and what matters to patients and their families” [8].

Effective clinical communication requires patients to actively participate in agenda setting, share information about symptoms and concerns, discuss expectations and options, and ask questions. But patient engagement is even more challenging in older patients as they participate less in medical interviews than do their younger counterparts [9]. Some online tools have been created to help elicit information about patient’s function, symptoms, health habits, preventative needs, and experience of care such as HowsYourHealth. org [8], but these do not specifically ask about what items are of greatest importance to the patient to be discussed with their physician. Given these concerns, we developed a “Patient Readiness” form (Figures 1&2) to help better prepare senior patients for their visit and to aid their physicians with agenda setting. Our objective with this pilot study was to determine if the “Patient Readiness” form affected the visit for both patients and physicians and what was the experience of using the form like for patients.