One thing’s for sure about patient portals: They’re a hot commodity.
What’s less clear is how much good they’re doing for health care.
The popularity of patient portals stems from Meaningful Use Stage 2 patient-engagement requirements. The market for the products is expected to approach $900 million by 2017, up from $280 million in 2012, according to a report from Mountain View, Calif.-based research firm Frost & Sullivan.
Patients like at least one aspect of the portals — the ability to access their own medical records. In a recent Accenture study, more than 40 percent of consumers who can’t access their own records online said they’d consider switching doctors in order to get access.
But several recent studies suggest that currently available products have a way to go before they can consistently improve care, reduce costs or perhaps even increase patient engagement.
In a review of 46 studies, researchers found little evidence that portals were helping much of anything. The doctors from Veterans Affairs Greater Los Angeles Healthcare System and other institutions wrote that it’s “unlikely that patient portals will have substantial effects on utilization or efficiency, at least in the near term.”
Some of the limitations of the products, they wrote, included “disparities in who accesses these portals and instances of suboptimal patient attitudes of their worth.” The portals typically gave patients options such as looking at their test results, refilling prescriptions and communicating with doctors.
Patient portals likely are most beneficial, the authors wrote, when they’re part of a more comprehensive quality-improvement strategy.
Another study also found that patients, in many cases, fail to see the value of a portal — or at least some parts of it. In questions about hypothetical features, consumers showed interest in “back-office” tasks such as seeing their own medical records. But clinical digital communication capabilities, such as online video consultations with doctors, failed to impress.
The bottom line was that patient portals “may act as a complement to health-care service delivery, while substitution for clinical in-person interactions may not be viewed positively.” In other words, most people just don’t seem to be ready to give up face time with their primary-care physician.
When MU2 starts on Jan. 1, physicians will be required to give their patients electronic access to their health records. The requirement went into effect for hospitals in October.
The U.S. health care system is, with government prodding, investing a huge sum in patient portals. The idea sounds empowering for patients. But given the lack of solid evidence for a benefit at this point, it’s concerning to think the money might be better spent on something else. Let’s hope that vendors and providers are soon able to turn portals into something with tangible benefits for quality care.
I am a bit surprised you didn’t cover the obvious angle for this story…
As an Epic MYCHART user a pt. portal gets my test results faster, helps me learn what the results mean to me (though understandable consumer friendly medical information) and helps me keep tabs on my common clinical record as well as my year to year wellness biometric data, all in one place.
So I guess if the Los Angeles VA literature states “it is unlikely that patient portals will have substantial effects on utilization or efficiency…”, my guess is the VA is the last place that would be measuring for satisfaction (although they should) My experience is that it benefited is my own patient satisfaction with my health system. In an industry that ranks 3rd for customer satisfaction (right behind Airlines and telecommunications) don’t you think there is value in a bit of transparency for the consumer?
I don’t doubt a patient portal can be useful.
I do doubt how much they’ll be useful.
Part of this depends on the EHR vendor.
Part of this depends on the provider.
But, once again, meaningful use will make a mockery of what might be good.
Practices will have to “game the system” to ensure they meet appropriate MU numbers.
“increase patient engagement”
“most people just don’t seem to be ready to give up face time with their primary-care physician”
Well, well, whadaya know. Can’t computerize a doctor.
I also note that increasing patient engagement means there has to be someone on the other end — a doctor, nurse, pa, aprn — someone. If you haven’t noticed you will soon: those primary care folks are in short supply.
What about a patient being able to complete all of their registration online in the privacy of their HOME instead of when they arrive at the doctors office? The patient will fill out the information required more completely and accurately if done at their leisure. For me, I hate filling out the information on a clipboard in the lobby of a physicians office. I’m sure most folks feel the same way. In addition, if done correctly, the information can auto populate into the practice management/EHR system with NO staff time required. One could say that this benefits the provider more than the patient, but I beg to differ. If the staff and doctors are not entering data manually into their system, they CAN spend more face time with the patient! And the information is more likely to be correct and complete!
I spoke with a colleague a couple of weeks ago who told me she loved the patient portal at her doctors office. She said that after a visit to her doctor, she was able to view her test results online. In addition, on another occasion after she called her pharmacy to request a refill of her medication, they sent her a reminder that her prescription had been e-prescribed and was ready to be picked up at her pharmacy.
Yes, I know this is anecdotal. But if the providers will direct patients to use their portals whenever possible, it will be a win-win for both provider and patient.
Bill,
You’re right about what you describe. I’ve often said that if we could enter our health data one place and then never have to fill out a form in another doctor’s office, we’d all go to that one place to fill out our health data.
The problem comes when you try to get thousands of independent thinking doctors to allow the data that I filled out in that one place into their office. Every doctor wants different data filled out. One wants the allergies in red, the other wants it in green. All of this uniqueness makes it hard (if not impossible) to scale a solution for this.
The option as you describe is for every doctor to have a patient portal and we have to fill out every patient portal every time we see a new doctor. Barely an improvement over filling out the paper form in the office.
That’s the story of my life. I couldn’t tell you how many things I log into for my work. About 10, I think. (I’m a writer with various clients, and a lot of them have things that I need to log into. I just logged in here! Not complaining. This one is pretty painless.)
I know that it’s like that for all of us in our work and personal lives. Banking, filling out expense sheets, etc. If someone can invent a universal log-in based on some kind of biometrics, that should be a real moneymaker.
Anyway, I think part of the issue is that the people who would be most interested in a patient portal are those who are older and in poorer health. So they’re exactly the people who are most put off by having to log on and figure out the system. They might not be from a tech-savvy generation or they might just not feel like typing their birthdate, their address and a password with a number, an uppercase letter and a symbol. Younger people might be a little more willing, but on average if they’re healthy they won’t find nearly as much that interests them in the portal. In my opinion, you have to be visiting the portal with a certain degree of frequency to make it worthwhile to set up an account, learn your way around the system and remember your password. All of that is more of a barrier when you’re sick and older.
Very true John. One universal portal would be terrific. But because of the reasons that you have already mentioned, and the fact that there are so many different specialties that require different information to be gathered, it would be virtually impossible to achieve a “one portal fits all” portal. I have heard however, that some of the EHR vendor portals interface with Microsoft Healthvault. Have you heard this?
Yes, filling out the same info over and over is certainly not optimum, but I would still much rather fill it out online at my convenience.
Bill,
A lot of portals do interface in one way or another with Microsoft Healthvault. Or at least you can export your data into it.
@ Bill
I agree it is crazy that “we” can’t fill out forms online ahead of time.
Nobody can say with a straight face that 80% plus of what a doc asks for NO MATTER the specialty, is the same.
Of course, then what will we do when we show up on time (or even early) to our appointment and have nothing to do while we wait and wait?
@James
Yes, just like the failure of PHRs, patient portals will generally be used by those with health issues.
Offices will have to create “techniques” to push their patients to check the portal at least annually to ensure the meet the Meaningful Use bean counter requirements.
@JL
Ran across this company the other day. I think they used to be called Registerpatient.com Now they are ingagepatient.com They appear to have a robust portal offering.
@JB
What do we do while we’re waiting? That’s why we have all of our gadgets and gizmos. Perhaps we can send the physician a secure message to the portal from our smartphone and tell them we are tired of waiting!
A primary care doc told me the other day he would love it if patients could enter things like chief complaint and HPI. He said it would save him and the patient time, but like many things, theory and reality are two different things.
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