To be sure, I’m grateful for the patient portal provided to me by Kaiser Permanente, my insurer and healthcare provider. Using MyChart, the standard Epic portal, I can at least get the basics of what I want to do done.
I’m definitely interested in getting more out of my digital interactions with my providers, though, so I paid close attention when I stumbled upon a blog item proposing some changes to the portal model. While the model that blogger Colton Ortolf outlines may not be completely unique, I like the way blogger Colton Ortolf lays things out. He had me smirking when he summed up current portals thusly:
Hey look! You can manage your appointment online on this web page that looks like it was developed by high school students in 2002. Just so you know – you can only view it on your desktop running Internet Explorer! Also, it works [just] 20% of the time so just reload the page if it crashes.
Instead, he proposes that we create a “patient health hub” which includes all of the consumer’s health data rather than being tied to any single health system or medical practice.
Ortolf is far from the first person to argue that patients actually need access to an untethered portal, but I think it’s good to keep kicking the ball around, and I dig his suggestions. My favorite features of his proposed patient health hub include:
* A “Care Communicator” function, which would support the use of video, voice and SMS. I’d be thrilled if my portal offered more than flat-file email options for connecting with my providers. I know providers aren’t thrilled by the idea of being reachable via multiple channels, but IT leaders could set stringent controls on such things.
* A “My Care Plan” section, which would help patients manage and track their health goals using their desired metrics. Honestly, I’m amazed nobody seems to be making a move to help patients compare their health stats to their perceived outcomes. It’s an obvious next step in engaging them with improving their health.
* A “Device Integrations” feature permitting consumers to have data from their devices (e.g. fitness trackers, smartwatches and connected glucose monitors and the like) automatically pushed to their medical records. This a is brain-dead obvious next step for portals. I can’t imagine a way for providers to collect high volumes of such information and use it for predictive analytics unless they convince consumers to engage on this level.
Of course, Ortolf’s proposal hits the same wall that other similar ones do, which is that it’s impractical at present. I mean, like, really impractical.
As he readily admits, if patients have all of their data in one place they’re not tied to a single provider, which makes a central record a potent competitive threat. Another major obstacle is that while FHIR is helpful, true interoperability between all health records is still almost a daydream. Then there’s the reality that EMR vendors are only going to support interoperability at gunpoint due to their desire to lock in customers with proprietary software. And so on. I could go on, but we all know where this goes…nowhere.
Still, I think we should keep looking at how things should work even if they’re not likely to emerge anytime soon, and I think Ortolf has shared some good ideas here. What would you add?