Improve Patient Engagement, Experience and Outcomes: Patient Portals
Like it or not, patient portals are here to stay. As part of the Meaningful Use (MU-2) certification requirements, CMS has mandated that patient portals are an integral and necessary part of Electronic Health Records (EHRs). Furthermore, as a quality reporting measure to the federal government, practices must demonstrate at least a 5% portal usage by patients.
The idea stems from the growing body of evidence which shows that patients who are actively engaged in their own care have better health outcomes and lower overall costs than those patients who are not engaged in their own care. Patient portals should provide an opportunity to promote practice operational efficiency by successfully engaging patients.
My first experience with a patient portal was quite positive. I’d been referred to an orthopedic surgeon for shoulder pain. When scheduling my appointment, the receptionist asked for my email address to send me “an appointment reminder and instructions to sign up for the patient portal”.
On arriving at the office, I was greeted by a sign on the front desk asking: “Have you signed up for our patient portal?” And, once again, inside the exam room there was another sign asking the same thing.
The sign-up was simple. I was emailed a link which, when clicked, sent a passcode to my phone (via text message), and also opened a page on the website to enter the passcode. I entered the code and voilà, my medical record appeared!
The medical record contained my history, physical, diagnosis, and treatment, and had a “Contact My Physician” button on each page. I was so impressed that I now intend to use the patient portals of my other physicians, as well. This practice did everything right to steer me in the direction of their portal, from the first phone call to the office reminders.
My orthopedic surgeon’s patient portal had some important aspects. First off, they valued secure messaging. As mentioned, there was a button on every screen to “Contact My Physician”. This secure messaging aspect showed that questions about my health were encouraged—even vital to my relationship with the physician and the practice.
The portal allows viewing of my x-rays and other test results, as well as my medical history, which prompted me to read and check it for accuracy. It allows for appointment requests, bill payments, and refill requests. It provided educational material specific to my diagnosis, gave advice on over-the-counter medications, and offered physical therapy techniques.
It was evident that this portal was an integrated extension of their Electronic Health Record (EHR) and Practice Management (PM) systems. Information from the EHR and PM populate various fields in the portal, which eliminates data input redundancy. Overall, it was a well-designed patient portal that encouraged patient engagement.
There is, however, little evidence that patient portals have any impact on overall clinical outcomes. Several studies looking at whether patients using portals have, for instance, lower hemoglobin A1c levels or improvement in hypertension, concluded no differences in portal user versus non-portal users. Yet this does not mean there are no clinical benefits to patient portals. Suspected benefits perhaps have not yet been realized, but will be discovered soon given appropriate study parameters and increased usage of patient portals.
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