Provider Skill Building for Engagement and Communication in Healthcare - Hypertension Management

Primary outcome for audio-recorded clinical encounters, the primary outcome is change in patient-centeredness, which includes behaviors like exploring the patient's perspective, showing empathy, and involving the patient in decision-making. This measure will be assessed using the Roter interaction analysis system (RIAS), a method for coding medical dialogue. The system codes each utterance (the smallest meaningful unit of speech) into one of approximately 40 categories related to task-focused or socioemotional communication. The scores derived are typically percentages or frequencies of specific communication behaviors within a given interaction (e.g., percentage of doctor talk, patient questions, or empathetic statements). A higher score is generally associated with more patient-centered communication.

A lower (mean) systolic blood pressure may suggest the intervention was effective.

A lower (mean) diastolic blood pressure may suggest the intervention was effective.

Secondary Outcomes for EHR data is hypertension control defined by Healthcare Effectiveness Data and Information Set (HEDIS) criteria. HEDIS criteria are grouped into six domains: Effectiveness of Care, Access/Availability of Care, Experience of Care, Utilization and Risk Adjusted Utilization, Health Plan Descriptive Information, and Measures Reported Using Electronic Clinical Data Systems. HEDIS measures are used to evaluate performance on important dimensions of care and service, and are crucial for quality improvement and value-based care initiatives. A high score may suggest the intervention was effective.

Secondary Outcome for EHR data is treatment intensification (a measure of therapeutic inertia). These scores are calculated by comparing observed medication changes with expected changes, often based on clinical guidelines or individual patient needs. These scores range from -1 to +1. A score of 0 indicates perfect responsiveness to treatment goals, while -1 represents complete neglect, and +1 suggests excessive aggression in treatment adjustments.

Secondary outcome for audio-recorded encounters is verbal dominance. This measure will be assessed using the Roter interaction analysis system (RIAS), a method for coding medical dialogue. The scores derived are typically percentages or frequencies of specific communication behaviors within a given interaction. The RIAS defines verbal dominance as a reflection of the patient's overall participation in the consultation, measured by their total speech time in relation to the physician's speech time. Greater change scores may suggest the intervention was effective.

Secondary outcome for audio-recorded encounters is story questions (lifestyle and psychosocial topics queried by the clinician). This measure will be assessed using the Roter interaction analysis system (RIAS), a method for coding medical dialogue. The scores derived are typically percentages or frequencies of specific communication behaviors within a given interaction. Greater change scores may suggest the intervention was effective.

Secondary outcome for audio-recorded encounters is partnering behaviors such as fostering active participation and collaboration with patients. This measure will be assessed using the Roter interaction analysis system (RIAS), a method for coding medical dialogue. The scores derived are typically percentages or frequencies of specific communication behaviors within a given interaction. Greater change scores may suggest the intervention was effective.

Secondary outcome for audio-recorded encounters is emotional statements. These measure will be assessed using the Roter interaction analysis system (RIAS), a method for coding medical dialogue. The scores derived are typically percentages or frequencies of specific communication behaviors within a given interaction. Greater change scores may suggest the intervention was effective.

Secondary outcome for audio-recorded encounters is encounter duration. This measure will be assessed by the length of the recorded dialogue of the Roter interaction analysis system (RIAS), a method for coding medical dialogue. Longer recorded encounters may suggest the interventon was effective.