This blog explores health informatics—a collaborative activity connecting people, process, and technologies to produce trusted data for better decision-making.
By Amanda Wickard, MBA, RHIA, CPHI
Patient portal registration doesn’t always translate to patient usage or engagement with one’s healthcare. Patient portals were designed to allow patients to have access to their health information and be able to communicate with their physicians without a visit. Sounds like a great idea, but why has adoption been so low in some patient populations? Typically, the patient portal allows patients to view their lab results, while others are starting to allow patients to update medication lists, show visit summaries, and display problem lists. For the average generally health patient, what else do they need? The ability to schedule their next appointment online, perhaps, or to pay their bill? For those that suffer from chronic disease, management advice would be useful.
As I sit here and think to myself (for the second week in a row) that I need to reschedule my son’s orthodontist appointment because we will be out of town, an online option sounds pretty good. How would this really work from a workflow perspective? There would still need to be the human element involved, especially to ensure that non-urgent appointments are not getting scheduled into urgent time slots and making sure that the patient that feels they need extra time isn’t taking up multiple appointment times. Not everyone is going to jump on board with an online scheduling system, so someone is still going to need to man the phone and the scheduling software so the physician isn’t double booked. A quick interface will need to be in place so that a self-scheduling system is more consumer-friendly, faster and easier as delays could stop patients from using the system.
From a healthcare organization and patient perspective, the ability to pay bills online isn’t exactly new. Personally, I’m actually more likely to pay the bill if I have an electronic means to do so, because I rarely have a check handy to pop in the mail and often get distracted by other things and forget to call the office. But rather than getting a hard copy bill (and another and another) perhaps the ability to receive a text message that has a link to the bill portal would be just as effective. I rely on the patient appointment reminders I get via text message; why not a bill reminder as well? As long as the bill with the description of service is provided along with my receipt, so I can still submit to flex spending, I’d still be ok; and I wouldn’t have to file a hardcopy! Now, this is probably a huge step for some, similar to letting go of the paper medical record. There are good reasons why people keep their paper bills and healthcare organizations may want to still allow those patients that prefer cash or check payments to continue paying in those methods, but there is no question that healthcare is evolving and will continue to trend toward reaching patients with the quickest and easiest methods possible.
We can’t talk about patient portals and not mention the “meaningful use” EHR Incentive Program, now known as Promoting Interoperability. Stage 1 of meaningful use was the kickoff to the adoption of EHR usage in the healthcare industry, with the goal of improving patient care through the electronic capture of data and the ability to share this information. With the implementation of EHR systems the patient portal was introduced. This allowed patients greater access to their information and tried to encourage patients to take a more active role in their healthcare and coordination of care. Stage 2 focused on patient engagement, care coordination, and clinical decision support. The measurement of clinical quality was reported on initiatives such as health outcomes, patient safety, care coordination, population and public health, and clinical guidelines. Patient data that is now captured and shared can be manipulated so that the healthcare organization can analyze and use the information to improve quality and lower the cost of healthcare. Stage 3 again focuses on more coordinated care efforts as well as patient engagement. One of the measurements of meeting this initiative is that patients have electronic access to health information and education materials to view, download, and transmit in a timely manner. Allowing patients to have information at their fingertips in a timeframe that may be sooner than their physician doesn’t always sit well when the patient is calling the physician and he/she hasn’t even seen the results that patient is referring to.
The patient portal has some room to grow with the addition of various modules that will allow a greater array of functions than that of just getting information. I work in a traditional HIM department and think about all the patients that come to our window for their records; if they could just look at these in the comfort of their own homes and be able to share this with other providers, it would at least save them a trip and filling out yet another authorization for the release of their own records. The offer of signing up for the patient portal is always there. And although usage remains low, the addition of more services and functions to make the portal more of a one-stop-shop might just tip the scales a bit on usage and engagement measures.
Amanda Wickard is director, health information management services department at Wood County Hospital.