​Giving patients the opportunity to type their own primary care visit agendas into the electronic health record improves patient-clinician communication, according to a study published in the March/April 2017 Annals of Family Medicine. Setting an agenda before a patient arrives, the authors said, can decrease the potential for "Oh, by the way" items brought up at the end of a visit. The authors had 101 patients type in pre-visit agendas before meeting with one of 28 clinicians at a primary care clinic serving a safety-net community hospital in Seattle. The agendas were brief, with 83% of patients typing for less than 10 minutes and 80% typing fewer than 60 words. For example, one patient wrote "lumps on my lung." In this example, the clinician later responded that this was an incidental finding, a pulmonary nodule identified by a CT scan, and it might have been missed were it not on the agenda. Follow-up surveys indicated that 79% of patients and 74% of clinicians thought the agendas improved communication and 73% of patients and 82% of clinicians wanted to continue to use the agendas in the future. One patient wrote in a follow-up survey that setting the agenda showed "the doctor and I [are] on the same page." One clinician commented that a benefit of the pre-written agenda was the opportunity for "time to think about issues ahead of time."

HRC Recommends: An interactive exchange of information is vital to the physician-patient relationship and establishes a basis for positive encounters. Providing patients a way to communicate concerns before the visit can help them remember what they wanted to speak with the doctor about, help the doctor prepare for the visit, and keep the visit on track. Improving interpersonal communication should be a priority, as should implementing systems and tools that support effective communication, such as the agenda in the study above.