Functional Assessment Screening Patient Reported Information: FAST-PRI

Health care providers play an important role in encouraging healthy behaviors and identifying factors that impact patients’ mental and physical health-related quality of life (HRQoL). Tobacco, physical activity, and poor emotional HRQoL are major causes of morbidity and mortality that are not adequately addressed in current systems of care. While physician involvement can help patients make positive changes in their health behaviors and improve their HRQoL, provider time constraints and limited physician self-efficacy may limit patients’ behavior change.

This project evaluated the Functional Assessment Screening Tablets (FAST) tool, which provides patients with self-management support. FAST is a wirelessly-networked tablet computer that collects patient-reported information (PRI) while patients wait to see their primary care provider. These data are then available to providers at the time of the patient’s visit. The FAST-PRI intervention provides patients with immediate, personalized, guideline-based feedback about tobacco use, physical activity, and mental HRQoL and encourages them to take a more active role in their health.

The specific aims of the project were as follows:

• Use IT patient feedback regarding study-designated PRI (i.e., tobacco use, physical inactivity, and mental HRQoL) to activate patients. 
• Assess the impact of FAST patient feedback on study-designated PRI. 
• Evaluate potential mediators of the effectiveness of FAST patient feedback on study-designated PRI. 

FAST-PRI was evaluated with a randomized controlled trial clustered at the physician level. Patient and physician participants completed questionnaires at baseline, 6 months, and 12 months regarding smoking cessation attempts, physical activity, mental HRQoL, referral to other sources of care, and self-efficacy. FAST-PRI activated patients and prompted more discussions of difficult behavioral health topics between patients and providers; however, the rates of smoking, physical activity, or mental HRQoL did not change. Researchers concluded that future studies may consider allowing patients to directly ask for behaviorist assistance in managing these challenging health care needs.