BACKGROUND Healthcare providers play an important role in encouraging healthy behaviors and improving health-related quality of life (HRQoL). They are most effective when they partner with informed, engaged patients. OBJECTIVE To examine the impact of a new health-information technology intervention (FAST-Feedback) that provides patients with immediate, personalized, guideline-based feedback regarding tobacco use, physical activity, and HRQoL, and encourages patients to initiate discussions regarding these topics with their primary care physician. DESIGN A pilot, randomized controlled trial clustered by resident physician, with patients as the unit of analysis. PARTICIPANTS Resident physicians and their out-patients in a single academic health center between May and October 2011. INTERVENTION Patients received (intervention) or did not receive (control) FAST-Feedback prior to the clinical encounter. MAIN OUTCOME MEASURES Primary outcomes were patient reports of initiating any discussions regarding tobacco use, physical activity, and HRQoL. Subgroup analyses examined patient reports of discussions regarding tobacco use, physical activity, and HRQoL, respectively. KEY RESULTS Thirty of the 36 eligible resident physicians (83 %) agreed to participate; 173 of their 415 eligible patients (42 %) expressed interest in the study and 99 (24 %) consented to participate. Compared to controls, a higher percentage of intervention patients reported initiating any discussion with their resident physician, although this difference was not statistically significant (40 % vs. 27 %; p = 0.12). For subgroup analyses regarding specific topics of discussion, patients in the intervention group reported initiating more discussions regarding mental HRQoL than controls (23 % vs. 0 %; p = 0.02). There was no difference in patient reports of initiating discussions regarding smoking, physical activity or physical HRQoL. CONCLUSIONS Providing patients with immediate, personalized, guideline-based feedback prior to the clinical encounter can increase patient-initiated discussions regarding mental HRQoL. Future work should test FAST-Feedback in a larger population and evaluate the impact on tobacco cessation, increased physical activity, and improvements in HRQoL. © 2014 Society of General Internal Medicine.