PROJECT SUMMARY/ABSTRACT Seizure freedom is an elusive goal for the vast majority of the 1,000,000 Americans with drug-resistant epilepsy. While the primary goal of epilepsy treatment is seizure control, this is not achievable for most patients with drug-resistant epilepsy. Yet pursuit of seizure freedom dominates epilepsy care, often with patients unaware of the small likelihood of seizure freedom. Moreover, providers may assume that every patient’s top goal is seizure freedom rather than other important determinants of quality of life, such as mental health or cognitive function. This lack of clear patient-provider communication around individual patient priorities leads to missed opportunities to improve patient-centered outcomes for patients with drug-resistant epilepsy. Priority communication tools, which elicit patient priorities and support patient-provider goal setting around those priorities, have improved patient-centered outcomes in other clinical contexts; but no such tools exist for patients with drug-resistant epilepsy. The objective of this application is to develop a mobile health priority communication tool for patients with drug-resistant epilepsy. The central hypothesis is that the priority communication tool can enhance patient-provider communication to align care priorities and ultimately improve clinical outcomes for patients with drug-resistant epilepsy. Dr. Hill’s research and training goals will be accomplished through the following specific aims: (1) To adapt a priority communication tool to enhance patient-provider communication during clinic visits for patients with drug-resistant epilepsy, and (2) To conduct a clinical trial to assess whether patients who receive the tablet-based waiting room priority communication tool have improved outcomes compared to patients who do not receive the tool. Findings from this study will define parameters for a full-scale prospective randomized controlled trial (R01) testing the intervention’s effectiveness to improve quality of life and clinical outcomes for patients with drug-resistant epilepsy. Dr. Hill has a strong foundation in clinical epilepsy and health services research. She will develop further expertise in qualitative data collection and analysis, stated preference methods, user-centered design of mobile health tools, and clinical trial design. Her long-term goal is to become an independent clinician-investigator in the development and testing of mobile health communication tools to facilitate patient-centered care and thereby improve outcomes for neurology patients. This proposal capitalizes on the unique strengths of the University of Michigan, the Neurology Health Services Research Program and the Institute for Healthcare Policy and Innovation, and an exceptional multidisciplinary mentorship team.