Advantages, Disadvantages and Consequences of OpenNotes in Cancer Settings

Principal Investigator: Richard Brown, Ph.D.

Co-Principal Investigator: Jordan Alpert, Ph.D.

Funding Source: National Cancer Institute R25 CA093423

Cancer patients in the VCU health system (VCUHS) are now able to access their electronic medical record through a patient portal. This initiative is called OpenNotes and enables patients to access information, such as scans, x-rays and radiology reports, often before seeing their oncologist. OpenNotes has been positively received in primary care settings, but its impact has not yet been explored in cancer settings. In this study we are exploring how this unfettered access to complex information may be positively and negatively impacting physician – patient communication. This formative research will explore patient, clinician and OpenNotes advocate views about, and experiences of patient access to medical data before oncologist consultations. Semi-structured Interviews will be conducted along with analysis of oncologists’ notes, comparing written messages before and after OpenNotes was adopted in the VCUHS.

Communication Strategies during Fertility Preservation Discussions

Principal Investigator: Richard Brown, Ph.D.

Co-Principal Investigator: Jordan Alpert, Ph.D.

Funding Source: National Cancer Institute R25 CA093423

Although the American Society of Clinical Oncology recommends discussions of fertility preservation between patients and providers prior to treatment, evidence suggests that fertility risks are not effectively communicated. This study will explore how conversations between patients and oncologists transpire, discover the type of information sought and identify communicative behaviors that occur during consultations. To achieve this, discussions among oncologists and patients will be audio recorded and subsequently analyzed. 

African American Cancer Clinical Trial Decisions: Testing Tailored Messages

Principal Investigator: Richard Brown, Ph.D.

Funding Source: American Cancer Society Research Scholar Grant

The purpose of this study is to demonstrate the efficacy of an established method, tailored health messaging, to aid African American (AA) cancer patients’ decision-making about joining a therapeutic clinical trial. This study moves the field forward as it is the first to utilize tailored heath messages to directly intervene in the physician – AA patient clinical trial consultation communication process to increase patient activation in the consultation and thus, potentially improve a range of relevant patient outcomes associated with AA barriers to accrual. We propose to conduct a randomized controlled trial to assess the differential impact on consultation communication of two different levels of tailored messages, (deep vs shallow tailoring) and the additional impact of either providing or not providing the patient’s oncologist with a summary of the tailored messages prior to the trial consultation.