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Open and Ask

Improving Patient-Centered Communication in Primary Care: A Cluster Randomized Controlled Trial of the Comparative Effectiveness of Three Interventions

April 2017 - December 2022
Sponsor: Patient-Centered Outcomes Research Institute (PCORI)

Open and Ask is a cluster randomized controlled trial evaluating three strategies for enhancing patient-centered communication. The goal of the study is to engage patients and physicians to incorporate patient-centered communication in their encounters. This research is building on a previous study of an approach called Open Communication.

A brief description of the strategies being evaluated are included below. Additional information on the Open and Ask study can be found here.

Ask Study Arm

Posters will be placed in physician exam rooms. The posters suggest three questions intended to encourage patients and physicians facing decisions to discuss options, risks, and benefits.

Open Communication Study Arms 


researcher reviews documents with study participantPhysicians will receive two in-person coaching sessions with a trained Standardized Patient Instructor (SPI) to provide communication coaching for physicians on how to incorporate what matters most to patients in the visit, with empathy and clarity. Physicians record one visit with a real patient after the first in-person coaching session, and the SPI provides feedback on how well the physician applied communication skills during the visit. The physician also receives an assessment of performance after the second coaching session.


Physicians will use a mobile app that contains similar contents covered in the High-Touch in-person coaching sessions. They are asked to record their practices in the app and perform self-assessment of their practice. At the conclusion of their use of the app, they will receive a report on their performance via email.   

The Patient Experience

Patients in the two Open Communication study arms 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.