Why have patient portals become such a major topic of interest? It isn’t just because meaningful use Stage 2 requires that eligible professionals ensure at least 5% of patients view, download, or transmit their electronic health records. It also has to do with quality of care, time, and money.
Access to physicians isn’t a problem just for pharmaceutical reps. It’s also a challenge for patients. Getting an appointment often takes days—and that’s if you have something that needs quick attention. If it’s just an annual checkup, we may be talking weeks. Then there’s the famous 15-minutes-or-less that the physician is able to spend with the patient. Add to that the near impossibility of actually getting your physician on the phone, and you have a situation in need of serious therapy.
Researchers at Kaiser Permanente report that use of their patient portals is increasing at a rapid rate. At first, prescription refills, a facility directory, and educational materials were the most popular features on the site, which also allowed appointment scheduling. But when online test results and the ability to email a doctor’s office became available, the number of website registrations tripled. The most widely used features were lab results, prescription refills, and electronic consultations with physicians.
The researchers concluded that the portal features that Kaiser members regard as the most important are:
- Connectivity with their care teams
- The ability to view key components of their medical records and conduct clinical transactions online
- The ability to obtain information that helps them makes better health decisions
Other factors will also contribute to the spread of such portals. For one thing, the primary care workforce is aging. As more older doctors retire and younger doctors take their place, we will have more technically adept professionals eager to use technology to facilitate their practices.
How Patients Benefit
Patients appreciate the fact that, for instance, 24 to 48 hours after blood work is done, their results can be available on a portal. It helps them prepare to ask questions during their next appointment. Or, they can ask questions about a prescription renewal and get an answer within an hour. Answering an email is much more efficient than dealing with a phone call. Mobile health and home monitoring data could eventually be uploaded to these portals.
The other benefit is that the face-to-face appointments are more efficient. Patients already have had some questions answered, and know what they want to ask. Having information archived electronically also allows both patients and doctors to review old information that could be clinically relevant. They can make comparisons to a patient’s condition a year or two ago.
According to the American Academy of Family Physicians, 41% of family practice physicians use portals for secure messaging, another 35% use them for patient education, and about one-third use them for prescribing medications and scheduling appointments. Doctors report that patients may be a little resistant at first, but once they get used to a portal, they realize the benefits and become regular users. It’s also a better way to schedule appointments. You don’t have to hold the phone while the staff takes care of other patients or checks the calendar.
Communicating through portals can save nurses and receptionists time, too, since the messages pop up in real time on their computer screens. Direct patient-to-doctor communication also cuts out other staff members’ interpretation of medical issues and patient needs that can occur during phone calls. Portals will likely help facilitate telemedicine as well.
How We Can Help
We can foster broader portal use by encouraging hospitals and clinical practices to promote this use—for their good, for ours, and for the patients. Some have reported significant success simply due to the staff wearing buttons that say, “Ask me how you can access your medical records online.”
Physicians also may need help in setting up a portal, which can be a big budget item for a small practice, and would also have to consider the time involved in answering all the queries. And, of course, there’s the issue of teaching staff, as well as patients, to use it. Workflow will be an issue. Physicians may see value in delivering patient lab results online, for instance, but only if this is an easy process. If not all of the labs they use are online with their EHR, and results must be entered manually to transfer them to the portal, it may prove to be too much work.
Although it may require additional hours at first, using the portal eventually becomes an accepted way to communicate for both staff and patients. In the long run, a portal can save money by automating routine processes such as answering phone calls, providing referrals, and scheduling. If you’re going to help HCPs with their portal efforts, some suggested steps include:
- Help patients to create a portal account during their visits and print out that information for them, along with instructions on how to use the portal.
- Send patients their visit summary right away so they will have that message in their account before they leave the office and can message the office back from it.
- It’s also helpful for staff to create their own portals so they know what patients are experiencing.
- Finally, staff should follow up with patients who have not logged onto their accounts within one week of a message being sent to them.
The widespread adoption of patient portals will serve many of our goals, promoting greater patient compliance, stronger patient connection to a healthcare system, and greater responsibility for taking care of themselves. Portals move us closer to these objectives.