The following is a guest blog post by Dave Dyell, President & CEO at Jellyfish Health.
Over a decade ago, patient portals were created to give patients 24/7 access to their own medical records. According to the 2017 Health Information Trends Survey by the National Cancer Institute, 52 percent of patients nationwide reported their provider or insurer had offered online access to their medical records. Yet, a Data Brief from The Office of the National Coordinator for Health Information Technology about the 2017 HINTS states that of the 52 percent who were offered access, only 53 percent actually viewed their record at least once.
This represents 28 percent of patients nationwide who accessed their medical records via a portal. While patient portal availability grew by 10 percent from 2014 to 2017, and 90 percent of providers say they now offer a portal, the healthcare industry has plenty of room to improve. To support the new objectives of Promoting Interoperability (formerly referred to as meaningful use), technology vendors have unlimited opportunities to make it easier for patients to engage in their own care.
For providers, investments in electronic health records and corresponding patient portals have a financial impact that cannot be ignored when tied to Medicare reimbursement. In addition, patient portals have the capacity to deliver other benefits such as:
- Reduction in medical errors due to missing or inaccurate information
- Reduction in costs due to duplicative orders among providers
- Direct and more personal communication with patients to ensure they are compliant in their own daily care
- Enabling value-based care among a population
For patients, portals have the potential to fix time – the time spent filling out forms, waiting in an office or waiting for test results. There’s a reason why consumers have embraced apps such as Starbucks, Panera and Amazon. The ability to order online from a mobile device, and then pick up the order, or have it delivered, is invaluable.
Time is our most cherished commodity, and improved functionality with augmented patient portals can deliver that consumer-based experience in healthcare. The clinical benefit of patient engagement is unquestionable. Portals offer a source of information that enables patients to become actively involved in their own care.
Even with recent advancements, portals have limitations
The ONC Data Brief states patients typically use portals to perform tasks such as viewing test results, requesting prescription refills, completing paperwork, making appointments, messaging with providers and updating medical records.
Even with continued improvements from portal vendors, patients are limited today in what they can do within portals. Some of these limitations include:
Patients are limited in their ability to share medical records with multiple providers or other caregivers. Patients who want to use a portal to manage their own care need a way to share information at their discretion. Though the Centers for Medicare & Medicaid Services created the Blue Button initiative to aid in the portability of medical records, some technologists believe that its usability from a patient perspective is lacking.
- Actionable data
We know patients are viewing lab and other test results, but what can they actually do with that data? How can patients take the next steps based on what the data says? In addition to serving as a data repository, portals need intelligence to engage patients in their own care. Currently, patients can review the data, but they typically have to research unfamiliar terminology via another source in order to take required action.
Some vendors now offer functionality that allows patient-generated health data, but many portals traditionally capture data for a single episode of care at a time. The ability for patients to self-attest provides a richer picture of their overall healthcare. For example, if patients are performing daily blood tests, or if they have their own lab results, why should they have to keep that information in a separate place? If patients could include that information in the portal, the visibility of overall health would be clearer to any provider treating that patient.
Patient portals suffer from the same interoperability challenges as the rest of healthcare. Are portal systems connected with multiple EHR systems? Because many third-party portal systems do not interact with EMRs today, providers must manually transfer data from one system to the other.
What about health monitoring devices? Nearly half of the HINTS respondents said they monitor their health with a healthcare application or device such as a Fitbit, blood glucose meter or blood pressure monitor. Over one-third of the respondents reported they use their tablet or smartphone to share healthcare data with providers during office visits. What if the information from these health monitoring devices and applications could automatically sync with the patient portal? Again, with interoperability among various technologies, providers have an opportunity to access a more complete, actionable picture of a patient’s overall health.
Functionality and user experience are vital to interaction—four hurdles to overcome
Despite the general availability of portals, patient adoption lags. How can technology vendors and providers garner more patient access and interaction?
- Make portals easily accessible.
If we want a consumer-facing technology, we have to make it easy for patients to access. Though many doctors offer a patient portal, there’s often no connection from their website. Rather, these providers use email to drive traffic to the portal. If patients don’t bookmark or somehow save that link, and there’s no accessibility from the provider website, there is no easy way to get back to it. Retail and social media show us an easy way to do this by offering multiple channels of access. For example, logging in with a Facebook account or a Google account is common. Healthcare can learn from this functionality.
- Solve the multiple portal challenge.
Consider the reality of most patients’ healthcare. Patients typically have more than one doctor, may have a few different specialists or have a procedure at an outpatient surgery center. As a result, the patient ends up with more than one portal to manage. Many patients will default to the portal of their primary care physician, but this is not a long-term solution. Patients want a single portal. The problem will likely be solved in the future by a non-healthcare vendor such as Apple, Microsoft or Google.
- Design the portal experience around the patient.
Portal vendors are used to building software for a clinical user. Consumers have different needs that should be aligned with their user experience. However, patient portals are generally not intuitive or easy to use. Portal vendors design a consumer-based interface that reflects the patient experience with online retail today.
- Expand functionality available in the portal.
Does the patient get value by using the portal? What features or information can be added to keep patients coming back? Facebook is a great example. Users know that their feed will be updated every time they open the app, which keeps them engaged day after day. As portal technology matures, vendors need to consider the value they can provide to keep patients involved in their own care on a daily basis.
Patient engagement technology aligns with portals for true digital patient experience
As with data repositories, EHRs and corresponding portals were not purpose-built to communicate with patients. Providers need another layer of technology to fill the gap and complete the cycle for the patient.
This is where digital patient experience and engagement technology become part of the portal ecosystem for providers. Patient experience technology can help communicate the availability of the portal and continually drive patients to use it.
With patient engagement technology, the portal usage paradigm shifts from an on-demand approach, where patients are expected to interact independently, to a push strategy, where providers can continually communicate with patients directly, driving them back to the portal for future engagement. Patient engagement platforms offer intelligent push notifications that prompt patients to take action and follow through with their care.
Patient engagement technology also helps solve the problem of time and convenience by enabling patients to enter information into a portal online, on their own time, in their own space and from a mobile device.
As healthcare technology becomes more advanced, and as patients become more comfortable with online and mobile engagement, the promise of patient portals can be fulfilled. Patient portals and digital patient engagement technology are uniquely positioned to align in a way that encourages patients to interact in a consumer-driven environment.
About Dave Dyell
Dave Dyell is President & CEO at Jellyfish Health. For the past 2+ decades, Dave has been busy building award-winning healthcare IT companies. Most recently, in 2008, he founded and led iSirona, a company that, by 2013, grew by more than 3,000 percent. To no one’s surprise, he was named a state finalist for the 2014 Ernst & Young Entrepreneur of the Year Award. When he’s not launching successful startups, Dave is out enjoying the white sands and emerald waters of Panama City, Florida.