The Good News About Patient Portals …

I recently wrote that it’s not clear whether patient portals do much to improve health care.

Now a new study suggests they help in at least one area: medication adherence.

The research involved diabetic patients who were using cholesterol-lowering statin drugs and had registered for online portal access. Among those who started using the system’s online refill function as their only method of getting the medication, “nonadherence” dropped 6 percent.

LDL or “bad” cholesterol also decreased.

The researchers concluded that “wider adoption of online refills may improve adherence.” No decline in nonadherence was seen in patients who didn’t use the online refill function.

The Kaiser Permanente study was published in the journal Medical Care.

The study included plenty of subjects — 8,705 people who used online refills and 9,055 who didn’t. But if there’s a cause-effect relationship at work in this study, you have to wonder in which direction it might run. Might the people who tend to take their medicine as prescribed be more likely to sign up for online refills in the first place?

Still, the study is an intriguing hint that patient portals might be worth at least some of the attention they’re getting. Nonadherence to medication regimens is a huge issue for health care because of both the human toll it takes and the inefficiency it fosters in the system.

Typical nonadherence rates are in the 30-60 percent range, depending on the condition, the medication and other factors, according to Medscape. It’s especially easy to slack off when symptoms disappear.

The study builds on another piece of good news for health IT. Researchers recently found that EMRs can make diabetes care better by rendering care coordination more efficient, as Katherine Rourke wrote here at EMR and HIPAA.

Portals are, of course, experiencing tremendous popularity because they help health care providers to meet Meaningful Use Stage 2 patient-engagement requirements. But, as I wrote earlier, in a review of 46 studies related to portals, researchers didn’t find evidence for much in the way of patient benefits.

Physicians have a major job ahead of them if they’re to make full use of patient portals and receive the available federal incentives. Perhaps this study, modest as its results are, suggests that their efforts will have some benefit for the patients they serve.


About the author

James Ritchie

James Ritchie

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.


  • I have no doubt that a patient portal CAN improve the patient experience. If for no other reason than I don’t have to fill out the same $@#!@$%! form with the same #$%^^#! information each time I visit.

    Though, when I see a 6% drop, I’m not impressed. Maybe I’m jaded, but if we can only get 6% of diabetics to improve their care, then how can we expect any improvement from those without chronic conditions?

  • I would like to see a study of much simpler patient reminder systems in practices that do not yet offer Patient Portals to see if they don’t produce the same or better results.

    I believe every office that reminds patients of their appointment either with staff calls, post cards (like dental practices) or automated electronic reminders by voice, text and/or email will absolutely attest to the benefit of reminders. Dentists absolutely rely upon it. I would be willing to bet it would apply even more effectively to adherence.

    As a matter of fact, I wonder if the Kaiser study of Patient Portals referenced also examines whether reminders are also used in the practice. If so, I wonder from which is really derived the benefit.

    As reminders is also a MU requirement, I don’t think this study is much in the way of justifying Patient Portals. But since implementing Patient Portals is not an option for those doctors who have demonstrated MU Stage 1 for 2 or 3 years and wish to demonstrate MU Stage 2 for 90 days or a quarter in ’14 or ’15 and receive another incentive payment, perhaps the reminder system can be utilized effectively to drive the patient to their Patient Portal. Reminders could make the Portal meaningful for the practice and the patient, and also help the office to get the number patients to use the portal that they need to fulfill the measure.

    Mark Hollis
    MacPractice, CEO

  • I visited an ENT practice today for the first time. I was referred by my primary care physician. Guess what? NO PATIENT PORTAL! And this is a large multi-location group. Here’s the really strange part…they bought an EHR 10 years ago and are still using paper charts!!! Flabbergasted!

    A couple of days ago, I went to their website, downloaded and filled out the forms. (Yes, I typed them). I then called the practice to ask if they wanted me to fax them so they could get my info entered into their system, the girl replied “no, that’s ok, we don’t create your chart until you get here”. That’s how I found out they are still using paper charts. Unreal!

    When I arrived for my appointment today, (NOT 30 minutes early) I could tell the girl at the window was ready to jump on me for being “late”, until I handed her my completely filled out forms. She looked at me in utter amazement. She took my drivers license and insurance card (no, they did not have a scanner for either) so I didnt get them back until I was called back and the nurse gave them back to me. So I had to ask the doctor, “why are you not using your EHR”, he replied, “yeah, we need to start using it” He even commented that he couldnt remember any of his patients that actually typed and then printed the PDF forms. Am I the weirdo here?

    Earlier, while in the waiting room, I sat and watched patient after patient go up to the window and get the “high tech” clipboard. They then sat down to fill out their forms…all the while stopping from time to time to text or perhaps reply to an email on their smartphones. The irony. I watched sadly as an older woman was trying to get the forms filled out with what appeared to be great difficulty because it was obvious she didn’t have all of the information with her that she needed. But she had a smartphone. More irony.

    John B., I’m with you. Just think if my primary care provider and this ENT group were both using EHR and PP. Perhaps I would of had to fill out NOTHING!! All of my info would of been readily available to the ENT doc. I could view the notes from both of the docs..see my reports and tests results and even forward it to another provider of care if necessary. The study is encouraging, but there are going to be so many benefits once PP’s become mainstream.

  • Bill,
    Such a sad story and far too repeated in healthcare today.

    I’ve often said if someone could figure out a way for patients to not have to fill out those dang intake forms, they’d have a golden business. Turns out, it’s a really complex problem to solve because of how many parties are involved and the non-standard way they do it.

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