Barriers to EHR Patient Portal Effectiveness
Patient engagement is a challenge for any clinician, especially in the digital world. Today, developers must focus on creating a patient portal that is functional, user friendly, and meets all the requirements for meaningful use stages. How can the IT community find a balance between federal mandates, provider needs, and patient expectations? We'll cover some of the challenges and recommendations for this critical EHR implementation objective.
How useful are patient portals?
If the modified objectives for patient electronic access are any indication, providers have faced challenges meeting Stage 2 of meaningful use. That translates into lower patient adoption rates than originally planned. A HIMSS Analytics study suggests that one disconnect could be the dichotomy between organizations meeting meaningful use objectives and providing true patient engagement that improves outcomes.
"They may only have capacity to get people to log into a portal, which doesn't necessarily mean that true engagement is occurring," said Kathleen Aller, Senior Healthcare Information Professional at InterSystems. "The short-term focus on meaningful use has often forced providers to take a sub-optimal path to the long-term goal."
The study also noted that while many portal implementations provided functionality for patients to communicate with providers, request medication refills, and view their records or lab results, they're still lacking the services and tools to lead to true patient engagement.
Improving patient engagement with next-generation portals
Rather than focusing on portal implementations that meet objectives but provide limited functionality, some industry leaders recommend focusing on improvements that will help patients take a more active role in their own outcomes.
Advanced functions such as e-visits and e-consults, health coaching, patient goals, and televisits will help create more of a partnership between patient and provider. But simply including advanced functionality won't be a cure-all. There are several key considerations that must accompany any portal implementation:
Ease of use
Because patients of all ages and technical experience levels will need to use the portal, the user interface should be intuitive and assistance should be easy to find. Otherwise, users will try it out and likely abandon it.
Timely responses to messages and appointment requests are essential, as is setting up timing expectations upfront. Patients will lose confidence in the portal system if they don't receive a response in a reasonable amount of time and have to contact the provider another way.
Marketing and education
Perhaps one of the most overlooked aspects is putting a program in place to make patients aware of the portal and providing training opportunities to acquaint them with the different tools. In fact, an athenahealth initiative found that in-office portal registration methods are far more successful than communication sent outside of office visits.
Ensuring Portal Security
As we've previously mentioned , security and privacy will continue to be a top concern in the healthcare industry. Security also plays heavily into portal engagement, as some patients remain cautious—or even suspicious—of sharing and transmitting information online.
Ideally, portals of the future will allow patients to input descriptions of symptoms, injuries, outcomes, or any other detailed information to their health record, and the system will analyze and extract key information to help give providers a more complete picture of the patient’s health status and history. Before this can happen, patients need to have complete confidence in the portal and any systems that house their information. Conversely, providers also need security measures in place to ensure that the patient is indeed the one who entered the information.
Interoperability: the skeleton key that unlocks patient portal value
Achieving the industry's vision of a "learning health system" requires a transparent health IT infrastructure that connects practices and systems to seamlessly share key data with the right people at the right time. But beyond simply data sharing, the Office of the National Coordinator for Health Information Technology (ONC) predicts that achieving interoperability will "support better health for all through a more connected healthcare system and active individual health management. Information sharing will be improved at all levels of public health, and research will better generate evidence that is delivered to the point of care."
Achieving interoperability, however, is not without its challenges. Software Advice cites vendor resistance, high data exchange fees, lack of vendor incentives, and varying EHR technology as reasons for the ongoing interoperability debate within the industry. And while patients are becoming increasingly comfortable with the idea, privacy and security concerns are still top of mind for many.
Despite these objections and concerns, industry leaders are pushing forward to look for solutions. For example, HIMSS has launched the ConCert by HIMSS program, which provides interoperability testing and certification for EHR and health information exchange (HIE) vendors. The program pilot concluded in December and resulted in four organizations receiving certification.
As technology advances further and the industry overcomes some of these barriers, patient portals will become a powerful tool to help patients become more of a partner in their own healthcare. Portals will also be an important factor in boosting provider effectiveness and contributing data for overall healthcare innovation and advancement.