We appreciate the thoughtful comments made by Dr. Schattner with regard to our article, Impact of Pre-visit Contextual Data Collection on Patient-Physician Communication and Patient Activation: A Randomized Trial.

While electronic health records (EHRs) have the potential to improve patient-centered care, they have not been designed to capture patient contextual data (PCD) in a structured way and make them available for pre-rounding and point-of-care use. The PCD Tool we evaluated was designed to overcome barriers within the current EHRs by directly inviting patients to share their agenda, priorities, and goals with care team members — ahead of the visit. Effectively, this tool helped humanize the EHR and provided a basis for effective health communication and empowering patient users to engage in their health and health care.1,2,3

Analogous to clinicians’ pre-charting/pre-rounding, the PCD Tool allows patients to share essential elements of their life ahead of the visit. The structured collection and storage in their EHR can facilitate using these patient-centered data points across care teams and lead health care decisions.4,5,6,7,8 Indeed, the results of our clinical trial support the comments by Dr. Schattner, who expressed the need for physicians to review patient data ahead of visits. We extend Dr. Schattner’s recommended review of critical patient data ahead of visits to patients’ health values, goals, challenges, and personal and social determinants of health.

The intervention tested in this trial encourages patients to reflect on and identify their priorities, which increases efficiency during the visit.2,3 Building on this, our trial showed that sharing these priorities enhanced aspects of patient-doctor communication during the visit. Providers often cite the burden of the EHR documentation system as impeding patient-provider communication.9 Now, we are embarking on a time when innovators must design technology that assists rather than inhibits care. Consumer informatics tools that prioritize patients’ perspectives on health/illness and management are one such innovation.


Jeana M. Holt, Ph.D., DNP, MSN, RN, FNP-BC

Bradley H. Crotty, MD, MPH, FACP