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The Opportunity for Health Information Exchanges (HIEs) to Untangle Health Records

Posted on February 6, 2018 I Written By

The following is a guest blog by Monica Stout from MedicaSoft

As the government’s Meaningful Use incentive program accelerated the adoption of Electronic Health Records, it also increased the use of patient portals and PHRs to meet MU patient engagement measures. You see this today when you’re offered a portal login at your doctor appointments. Other encouraging trends developed around the same time:

  1. Studies proved that engaged patients tend to exhibit more positive health outcomes at lower costs.
  2. Interest increased among patient populations to be involved in their health and wellness, including a desire to see (and even contribute to) their electronic medical records.
  3. Technology innovations flourished to support health (wearables, health devices, applications, etc.).

Despite these trends and the relative success of MU-driven deployments, the patient portal and personal health record landscape leaves much to be desired for their primary users and audience – patients. Many of these tools were created simply to satisfy MU requirements and while they do this, they don’t completely tie together patients’ complex health histories, include data from multiple providers, or travel with the patient from visit to visit. Instead, patients have many different portals – a different one from every different provider. Who wants 10 different portals? Nobody has time for that!

Patients need help assembling a single view of their health records. HIEs are unique in that they work with many different health systems, hospitals, and providers in their regions. HIEs represent an opportunity to be a true integrator of health information between providers and their patients. This can be a regional solution now, and with efforts like the Patient Centered Data Home (PCDH), there is greater opportunity for HIEs to share data across state and regional lines, further expanding their reach and extending real benefits to patients who want their data in one place.

HIEs can leverage their unique position into a meaningful benefit for patient by first creating a single patient record or universal health record (UHR). This UHR or platform works seamlessly with PHRs. By making PHRs available to providers in their exchange, they can then share health data among every provider they link up with and the connections grow from there when you add in PCDH connections in other regions and states. Once there is a platform in place that is truly interoperable, sharing data between providers, patients can start using PHRs that have useful, relevant health data from all of their providers. HIEs can then start building in other capabilities like analytics, population health, care quality metrics, and more.

A patient’s medical journey involves multiple providers and different physical locations as their lives and health evolve. Their health information – in a single, universal health record – should evolve with them. HIEs can play a significant role in making that happen.

About Monica Stout
Monica is a HIT teleworker in Grand Rapids, Michigan by way of Washington, D.C., who has consulted at several government agencies, including the National Aeronautics Space Administration (NASA) and the U.S. Department of Veterans Affairs (VA). She’s currently the Marketing Director at MedicaSoft. Monica can be found on Twitter @MI_turnaround or @MedicaSoftLLC.

About MedicaSoft
MedicaSoft  designs, develops, delivers, and maintains EHR, PHR, and UHR software solutions and HISP services for healthcare providers and patients around the world. MedicaSoft is a proud sponsor of Healthcare Scene. For more information, visit www.medicasoft.us or connect with us on Twitter @MedicaSoftLLC, Facebook, or LinkedIn.

Patient Portals and Chronic Disease Management

Posted on January 16, 2018 I Written By

The following is a guest blog by Monica Stout from MedicaSoft

Half of all U.S. adults, roughly 117 million people, have one or more chronic health conditions. 1 in 4 people have two or more chronic conditions. As a nation, we need some help addressing the chronic disease epidemic. Many patient portals today give patients access to pieces of their health information – lab results, for example – and some will flag upcoming appointments or refill a prescription, but where are the tools and the data in a portal to actually help patients manage chronic conditions, thereby improving their overall health and wellness? Sadly, many patient portals provide a very narrow view, with few opportunities to link data to actions to results in a way that closes the loop between patients and caregivers. Without a complete view of a patient’s health measures, wellness goals, and plans of action – and the tools to manage them – it is very difficult to connect health and wellness to address the whole patient.

Chronic disease management represents one of the best opportunities for a personal health record to link both wellness and healthcare together to affect positive health outcomes. What does it take to improve and maintain wellness? First, you need patient engagement. You need motivated patients who want to do a good job of actively tracking their conditions and working toward wellness goals. How do you convince a chronically ill patient to do this? Start by offering a tool that’s easy for them to track their data – complete with a workflow and user interface that makes it a breeze to enter and distill information at a glance and when they are on the go. Use technology similar to what patients use in their daily lives on their smart phones and laptops. Give patients tools to understand their health and take action based on how they are doing and what their health goals are! Provide a portal that allows the integration of popular wearable devices and lets the patient decide who should have access (Spouses? Caregivers?) to help them enter and manage their information.

Effectively managing chronic disease requires changing poor habits and forming good habits. Sometimes people need a gentle nudge or a push outside of the exam room. A platform that can send out reminders, gamify the experience, and even call a patient can go a long way in helping steer chronic disease patients in a more positive wellness direction. It’s not all about reminders, either. Texts and calls informing patients when they are doing a good job managing their daily wellness habits can also help.

Beyond helping patients, there’s an added benefit to coupling wellness capabilities with a PHR for providers – it has the ability to not only affect chronic disease factors, but to collect the data providers need to participate in the Quality Payment Program; the Merit-based Incentive Payment System (MIPS) and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). To quickly review, the Quality Payment Program allows clinicians to be rewarded financially for providing high-quality and high value care through Advanced Alternate Payment Models (APMs) or MIPS that are based on various measures. These measures can be integrated into the PHR, allowing physicians to track their patient populations, run reports, submit information to the Quality Payment Program, and receive merit payments.

What are your thoughts? Would you use a PHR to manage a chronic condition you are experiencing? Would you encourage your loved ones to use one? As a provider, how do you feel about a PHR making it easier for you to track MIPS/MACRA measures?

About Monica Stout
Monica is a HIT teleworker in Grand Rapids, Michigan by way of Washington, D.C., who has consulted at several government agencies, including the National Aeronautics Space Administration (NASA) and the U.S. Department of Veterans Affairs (VA). She’s currently the Marketing Director at MedicaSoft. Monica can be found on Twitter @MI_turnaround or @MedicaSoftLLC.

About MedicaSoft
MedicaSoft  designs, develops, delivers, and maintains EHR, PHR, and UHR software solutions and HISP services for healthcare providers and patients around the world. MedicaSoft is a proud sponsor of Healthcare Scene. For more information, visit www.medicasoft.us or connect with us on Twitter @MedicaSoftLLC, Facebook, or LinkedIn.

Patient Portal Use Rising Rapidly

Posted on October 25, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new study has concluded that patient portal use has shot up over the past few years, with a substantial majority of patients reporting that they use provider portals if possible.

The purpose of the study, results of which was published in Perspectives in Health Information Management, was to examine how healthcare consumers saw their interactions with provider portals, their use of personal health records and their take on the process of releasing health data.

According to a 2015 study cited by the article’s authors, 53% of HIM professionals reported charging consumers for both electronic and paper copies of their health information. Thirty-eight percent said they had a patient portal, but less than 5% of patients were using it.

Over the last two years, however, the picture has changed a great deal. Researchers conducting the current study found that only 10% of consumers were charged for their health information. In addition, 49% reported that they maintained a personal health record. Eighty-three percent of respondents said that their providers had portals, and 82% said that they were taking advantage of their provider’s portal where available.

Patient uses for portals included viewing lab results (35%), requesting medication refills (19%), requesting appointments (22%), secure messaging (19%) and other (5%). Among portal users, 53% were very satisfied and 38% were satisfied with their experiences.

Meanwhile, 49% of respondents said they maintained PHRs, with top record format being combined paper and electronic (46%), followed by paper only (35%), electronic only (18%) and other (1%).

It’s important to note that the study population was especially healthcare-savvy. Participants chosen were campus-based and online students enrolled in a College of Health Professions course, alumni of BA programs in HIM at the researchers’ university, local AHIMA members and the researchers’ family and friends.

The article argues that because the participants were all current healthcare consumers, they were qualified participants. That may be so, but the high concentration of HIM-friendly respondents probably stacked the deck somewhat. (To be fair, the authors admit this.)

That being said, even these relatively sophisticated respondents weren’t completely comfortable with the health data access they had. Complaints cited by consumers included a lack of interoperability between physicians’ offices and electronic PHI, as well as the difficulty of getting data into the portal or updated when already present. Others reported having concerns about health data security.

All told, it looks like the hoped-for growth in patient health data use is taking place over time. I suspect that a direct comparison between less-informed consumers from 2015 and today would show less pronounced changes, though.

 

Health IT Continues To Drive Healthcare Leaders’ Agenda

Posted on October 23, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new study laying out opportunities, challenges and issues in healthcare likely to emerge in 2018 demonstrates that health IT is very much top of mind for healthcare leaders.

The 2018 HCEG Top 10 list, which is published by the Healthcare Executive Group, was created based on feedback from executives at its 2017 Annual Forum in Nashville, TN. Participants included health plans, health systems and provider organizations.

The top item on the list was “Clinical and Data Analytics,” which the list describes as leveraging big data with clinical evidence to segment populations, manage health and drive decisions. The second-place slot was occupied by “Population Health Services Organizations,” which, it says, operationalize population health strategy and chronic care management, drive clinical innovation and integrate social determinants of health.

The list also included “Harnessing Mobile Health Technology,” which included improving disease management and member engagement in data collection/distribution; “The Engaged Digital Consumer,” which by its definition includes HSAs, member/patient portals and health and wellness education materials; and cybersecurity.

Other hot issues named by the group include value-based payments, cost transparency, total consumer health, healthcare reform and addressing pharmacy costs.

So, readers, do you agree with HCEG’s priorities? Has the list left off any important topics?

In my case, I’d probably add a few items to list. For example, I may be getting ahead of the industry, but I’d argue that healthcare AI-related technologies might belong there. While there’s a whole separate article to be written here, in short, I believe that both AI-driven data analytics and consumer-facing technologies like medical chatbots have tremendous potential.

Also, I was surprised to see that care coordination improvements didn’t top respondents’ list of concerns. Admittedly, some of the list items might involve taking coordination to the next level, but the executives apparently didn’t identify it as a top priority.

Finally, as unsexy as the topic is for most, I would have thought that some form of health IT infrastructure spending or broader IT investment concerns might rise to the top of this list. Even if these executives didn’t discuss it, my sense from looking at multiple information sources is that providers are, and will continue to be, hard-pressed to allocate enough funds for IT.

Of course, if the executives involved can address even a few of their existing top 10 items next year, they’ll be doing pretty well. For example, we all know that providers‘ ability to manage value-based contracting is minimal in many cases, so making progress would be worthwhile. Participants like hospitals and clinics still need time to get their act together on value-based care, and many are unlikely to be on top of things by 2018.

There are also problems, like population health management, which involve processes rather than a destination. Providers will be struggling to address it well beyond 2018. That being said, it’d be great if healthcare execs could improve their results next year.

Nit-picking aside, HCEG’s Top 10 list is largely dead-on. The question is whether will be able to step up and address all of these things. Fingers crossed!

E-Patient Update: Sometimes Tech Gets In The Way

Posted on September 22, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Being such an enthusiastic tech user, I tend to assume that adding technology to the healthcare equation is a plus in almost any situation. Why not automate scheduling?  Data gathering? Pharmacy?

To me, it’s always seemed like a no-brainer that tech adoption works to my advantage as a patient. The more I can avoid going through basic motions manually, the better processes work, giving me more time to spend with my clinicians. Right?

Apparently, not so right. When you take patients into account, sometimes doing transactions the old-fashioned way may actually be more efficient – or at least more flexible – than running things through an automated process. If nothing else, it may be easier to accommodate patients if you don’t have to run them through your workflow.

That, at least, is the lesson I’ve gleaned from studying the day-to-day flow at Kaiser Permanente, where I get all of my healthcare. After watching Kaiser employees work, and asking a few unobtrusive questions, I’ve come to believe that going offline may actually be better in some situations.

Tech-friendly, but not tech-dependent

Now, make no mistake: Kaiser isn’t in the stone age technically. For example, it seems to build most of its clinical operations around what is reputed to be the mother of all Epic installations. (Back in the day, it was rumored that Kaiser spent roughly $4 billion to roll out Epic, a massive sum even by national organization standards.)

Throughout my care process, the fact that clinicians and support staffers are all on Epic has played to my advantage, particularly given that I have a few chronic illnesses and see several specialists. I’ve also benefited from other Kaiser technology, such as kiosks which automate my check-in process for medical visits.

In addition, I’ve gotten a lot of benefits from using Kaiser’s robust web portal, which offers the capability to exchange email messages with clinicians, set appointments, pay premiums and co-pays, order and track prescriptions and check test results.

All that being said, I’ve encountered manual processes at many steps in my journey through the Kaiser system. While some of these processes seem wasteful – such as filling out a standard pre-visit form on paper – others turn out to be more useful than I had expected.

‘People forget their card’

One situation where technology might not be needed is taking people into the doctors’ suite for consults. In theory, Kaiser could set up an airport- or DMV-style ticker letting people know when their doctor was ready to see them, but having nurses yell last names seems to work fine. I’d file this under “if it ain’t broke don’t fix it.”

The pharmacy is another area relying on a mix of low- and high-tech approaches. Interestingly, the pharmacy offers an airport-like board displaying the names of patients whose meds are ready. But when it comes to retrieving patient info and dispensing drugs, the front-line staffers enter the patient numbers by hand. I would have expected there to be a barcode on the membership card, but no dice.

According to one pharmacy tech, it has to be this way. “People forget their [Kaiser member] card all of the time,” she said. “We can’t assume members have It with them.”

These are just a couple of examples, but to me they’re telling. I may be missing something here, but it seems to me that Kaiser’s approach is practical. I’d still like to automate everything in my healthcare world, but obviously, that doesn’t work for everyone. Clearly, offline patient management models still matter.

E-Patient Update: Enough Apps Already

Posted on September 1, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

New data suggests that while app use is becoming a core activity for mobile, the number of apps people use is dropping. In fact, over the longer term, analysts say, most businesses will need to slim down the number of apps they deploy and do more to retain app users.

Speaking as someone who relies on apps to manage her health, I certainly hope that this happens among healthcare providers.

Maybe you think of my contact with your organization as a series of distinct interactions, and the data something that can be reintegrated later. All I can say is ”Please, no.” I want every digital contact I have with your organization to be part of a large, easy-to-navigate whole.

In fact,  I’ll go further and say that if your organizations offer a single, robust app that can offer me broad access to your administration, clinical departments and patient data I’ll choose you over your competitors any day.

Health app overload

As you may know, the number of health-related apps available on the Google Play and iTunes stores has grown at a dizzying pace over the last few years, hitting approximately 165,000 across both platforms as of two years ago. Most of these are were created by independent developers, and only a small percentage of those apps are downloaded and used regularly, but it’s still a stat worth considering.

Meanwhile, new data suggests that the field is going to narrow further among apps of all types. According to research from Business Insider, somewhere between 10% and 12% of app users remain engaged with those apps within seven days of installing them. However, that percentage drops to around 4% within just 30 days.

These trends may force a change in how healthcare organizations think about, develop and deploy apps for their end users. As users think of apps as utilities, they will have little patience for using, say, one for your cardiology department and another for sleep management, not to be confused with a third portal app for downloading medical information and paying bills.

If you’re part of an institution with multiple apps deployed, this may sound discouraging. But maybe it’s not such a bad thing after all.  Consumers may have less patience for a fragmented app experience, but if you produce a “power tool” app, they’re likely to use it. And if you play your cards right, that may mean higher levels of patient engagement.

My ideal health app

Having slammed the status quo, here’s what I’d like to see happen with the apps developed by healthcare organizations. I believe they should work as follows:

  • Providers should offer just one app for access to the entire organization, including all clinical departments
  • It should have the ability to collect and upload patient-generated data to the EMR
  • It should provide all features currently available through existing portals, including access to health data, secure email connections to providers, appointment-setting and bill payment
  • It makes all standard paperwork available, including informed consent documentation, pre-surgical instructions, financial agreements and applications for financial aid and Medicaid
  • It generates questions to ask a provider during a consult, before an imaging procedure, before, during and after hospitalization

I could go further, but I’m sure you get the idea: I’d like my providers’ apps to improve my health and foster my relationship with them.  To make that happen, I need a single, unified entity, not a bunch of separate modules that take up space on my phone and distract me from my overall goals.

Of course, one could reasonably observe that this turns a bunch of small lightweight programs into a single thick client. I’m sure that has implications for app coding and development, such as having to ensure that the larger apps still run reasonably quickly on mobile devices. Still, smartphones are ridiculously powerful these days, so I think it can still happen.

Like it or not, consumers are moving past the “there’s an app for everything ” stage and towards having a few powerful apps support them. If you’re still developing apps for every aspect of your business, stop.

Hospitals Aren’t Getting Much ROI From RCM Technology

Posted on July 24, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

If your IT investments aren’t paying off, your revenue cycle management process is clunky and consumers are defaulting on their bills, you’re in a pretty rocky situation financially. Unfortunately, that’s just the position hospitals find themselves in lately, according to a new study.

The study, which was conducted by the Healthcare Financial Management Association and Navigant, surveyed 125 hospital health system chief financial officers and revenue cycle executives.

When they looked at the data, researchers saw that hospitals are being hit with a double whammy. On the one hand, the RCM systems hospitals have in place don’t seem to be cutting it, and on the other, the hospitals are struggling to collect from patients.

Nearly three out of four respondents said that their RCM technology budgets were increasing, with 32% reporting that they were increasing spending by 5% or more. Seventy-seven percent of hospitals with less than 100 beds and 78% of hospitals with 100 to 500 beds plan to increase such spending, the survey found.

The hospital leaders expect that technology investments will improve their RCM capabilities, with 79% considering business intelligence analytics, EHR-enabled workflow or reporting, revenue integrity, coding and physician/clinician documentation options.

Unfortunately, the software infrastructure underneath these apps isn’t performing as well as they’d like. Fifty-one percent of respondents said that their organizations had trouble keeping up with EHR upgrades, or weren’t getting the most out of functional, workflow and reporting improvements. Given these obstacles, which limit hospitals’ overall tech capabilities, these execs have little chance of seeing much ROI from RCM investments.

Not only that, CFOs and RCM leaders weren’t sure how much impact existing technology was having on their organizations. In fact, 41% said they didn’t have methods in place to track how effective their technology enhancements have been.

To address RCM issues, hospital leaders are looking beyond technology. Some said they were tightening up their revenue integrity process, which is designed to ensure that coding and charge capture processes work well and pricing for services is reasonable. Such programs are designed to support reliable financial reporting and efficient operations.

Forty-four percent of respondents said their organizations had established revenue integrity programs, and 22% said revenue integrity was a top RCM focus area for the coming year. Meanwhile, execs whose organizations already had revenue integrity programs in place said that the programs offered significant benefits, including increased net collections (68%), greater charge capture (61%) and reduced compliance risks (61%).

Still, even if a hospital has its RCM house in order, that’s far from the only revenue drain it’s likely to face. More than 90% of respondents think the steady increase in consumer responsibility for care will have an impact on their organizations, particularly rural hospital executives, the study found.

In effort to turn the tide, hospital financial execs are making it easier for consumers to pay their bills, with 93% of respondents offering an online payment portal and 63% rolling out cost-of-care estimation tools. But few hospitals are conducting sophisticated collections initiatives. Only 14% of respondents said they were using advanced modeling tools for predicting propensity to pay, researchers said.

Providers Work To Increase Patient Payments By Improving RCM Operations

Posted on June 29, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A growing body of research on healthcare payment trends is underscoring a painful fact: that consumers are footing a steadily growing share of their medical bills, and sometimes failing to pay. In response, providers are upgrading their revenue cycle management systems and tightening up their collections processes.

A new analysis by payment services vendor InstaMed has concluded that consumer spending on healthcare services should grow to $608 billion by 2019. This is a fairly substantial number even given the high volume of U.S. healthcare spending, which hit $3.4 trillion in 2016.

The growth in patient spending has been fueled by the emergence of high-deductible health plans, which are saddling consumers with increasingly large financial obligations. According to CMS figures cited in the report, the average deductible for covered workers with single coverage has doubled over the past several years, from $735 in 2010 to $1.487 in 2016.

But despite the increasing importance of consumers as healthcare payers, providers don’t seem to be doing enough to inform them about costs. More than 90% of consumers would like to know what the payment responsibility is prior to a provider visit, but they often don’t find out what they owe until they get a bill. What makes things worse is that very few consumers (7%) even know what a deductible, co-insurance and out-of-pocket maximum are, so they’re ill-prepared to understand bills when they receive them, studies have found.

Providers are waiting longer to collect what they are owed by patients, with three-quarters waiting a month or longer to collect outstanding balances from patients. And problems with collecting patient accounts are getting worse over time.  In fact, a new study from TransUnion Healthcare found that about 68% of patients with bills of $500 or less didn’t pay off the full balance during 2016, up from 49% in 2014.

Meanwhile, patient financial responsibility for care has risen from 10% to 30% of costs over the last few years, with more increases likely. This has led to expanding levels of consumer bad debt for medical expenses.

In attempt to cope with these issues, providers are buying new revenue cycle management systems. A survey released last year by Black Book Research, which included 5,000 management and user-level RCM clients, found that many healthcare organizations are rethinking RCM technology and demanding better performance.

Forty-eight percent of responding CFOs told Black Book that they weren’t sure they had the budget they needed to upgrade to an end-to-end RCM system this year.  Nonetheless, 93% of CFOs said they planned to eliminate RCM vendors, financial and coding technology firms, that are not producing a return on investment, up from 79% with similar plans in Q4 2015.

In addition to investing in newer RCM technology, providers are making it easier for patients to pay via whatever medium they choose. Not only are providers issuing bill reminders via text, and accepting payments online and by phone, they’re also adding new channels like PayPal payments, bank transfers and mobile payments.

Patients Message Providers More When Providers Reach Out

Posted on April 26, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

A new study has concluded that patients use secure electronic messaging more when their primary care providers initiate and respond to secure messages.

To conduct the study, the research team worked a large database stocked with information on health care transactions and secure messaging records on 81,645 US Army soldiers. The data also included information from almost 3,000 clinicians with access to a patient portal system. The dataset encompassed the 4-year period between January 2011 and November 2014.

The data, which appears in a paper published in the Journal of Medical Internet Research, suggests that current provider-patient exchanges via secure messaging aren’t that common. For example, during the study period just 7 percent of patients initiated a secure message during a given month. Meanwhile, Providers initiated an average of 0.007 messages per patient each month, while responding to 0.09 messages per patient during a month.

That being said, when physicians got more engaged with the messaging process, patients responded dramatically.

Patients who knew their providers were responsive initiated a whopping 334 percent more secure messages than their baseline. Even among patients whose providers responded infrequently to their messages, the level at which they initiated messages to their clinicians was 254 percent higher than with PCPs who weren’t responding. (Oddly, when PCP response rates were at the “medium” level, patients increased messaging by 167 percent.)

In fact, when clinicians communicated more, there seemed to be spillover effects. Specifically, the researchers found that patients messaged PCPs more if that provider was very responsive to other patients, suggesting that there’s a network effect in play here.

Meanwhile, when PCPs were the ones prone to initiating messages, patients were 60 percent more likely to send a secure message. In other words, patients were more energized by PCP responses than clinician-initiated messages.

Of course, for secure messaging to have any real impact on care quality and outcomes, a critical mass of patients need to use messaging tools. Historically, though, providers have struggled to get patients to use their portal, with usage levels hovering between 10 percent and 32 percent.

Usage rates for portals have stayed stubbornly low even when doctors work hard to get their patients interested. Even patients who have signed up to use the portal often don’t follow through, research suggests. And of course, patients who don’t touch the portal aren’t exchanging care-enhancing messages with their provider.

If we’re going to get patients to participate in messaging with their doctor, we’re going to have to admit that the features offered by basic portals simply aren’t that valuable. While most offer patients access to some details of their medical records and test results, and sometimes allow them to schedule appointments, many don’t provide much more.

Meanwhile, a surprising number of providers haven’t even enabled a secure messaging function on their portal, which confines it to being a sterile data receptacle. I’d argue that without offering this feature, portals do almost nothing to engage their typical patient.

Of course, physicians fear being overwhelmed by patient messages, and reasonably fear that they won’t have time to respond adequately. Even though many organizations including the research of Dr. CT Lin has shown this just isn’t the case. That being said, if they want to increase patient engagement – and improve their overall health – secure messaging is one of the simplest tools for making that happen. So even if it means redesigning their workflow or tasking advanced practice nurse with responding to routine queries, it’s worth doing.

E-Patient Update: Reducing Your Patients’ Security Anxiety

Posted on March 31, 2017 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

Even if you’re not a computer-savvy person, these days you can hardly miss the fact that healthcare data is a desirable target for cyber-criminals. After all, over the past few years, healthcare data breaches have been in the news almost every day, with some affecting millions of consumers.

As a result, many patients have become at least a bit afraid of interacting with health data online. Some are afraid that data stored on their doctor or hospital’s server will be compromised, some are afraid to manage their data on their own, and others don’t even know what they’re worried about – but they’re scared to get involved with health data online.

As an e-patient who’s lived online in one form or another since the 80s (anyone remember GEnie or Compuserve?) I’ve probably grown a bit too blasé about security risks. While I guard my online banking password as carefully as anyone else, I don’t tend to worry too much about abstract threats posed by someone who might someday, somehow find my healthcare data among millions of other files.

But I realize that most patients – and providers – take these issues very seriously, and with good reason. Even if HIPAA weren’t the law of the land, providers couldn’t afford to have patients feel like their privacy wasn’t being respected. After all, patients can’t get the highest-quality treatment available if they aren’t comfortable being candid about their health behaviors.

What’s more, no provider wants to have their non-clinical data hacked either. Protecting Social Security numbers, credit card details and other financial data is a critical responsibility, and failing at it could cost patients more than their privacy.

Still, if we manage to intimidate the people we’re trying to help, that can’t be good either. Surely we can protect health data without alienating too many patients.

Striking a balance

I believe it’s important to strike a balance between being serious about security and making it difficult or frightening for patients to engage with their data. While I’m not a security expert, here’s some thoughts on how to strike that balance, from the standpoint of a computer-friendly patient.

  • Don’t overdo things: Following strong security practices is a good idea, but if they’re upsetting or cumbersome they may defeat your larger purposes. I’m reminded of the policy of one of my parents’ providers, who would only provide a new password for their Epic portal if my folks came to the office in person. Wouldn’t a snail mail letter serve, at least if they used registered mail?
  • Use common-sense procedures: By all means, see to it that your patients access their data securely, but work that into your standard registration process and workflow. By the time a patient leaves your office they should have access to everything they need for portal access.
  • Guide patients through changes: In some cases, providers will want to change their security approach, which may mean that patients have to choose a new ID and password or otherwise change their routine. If that’s necessary, send them an email or text message letting them know that these changes are expected. Otherwise they might be worried that the changes represent a threat.
  • Remember patient fears: While practice administrators and IT staff may understand security basics, and why such protections are necessary, patients may not. Bear in mind that if you take a grim tone when discussing security issues, they may be afraid to visit your portal. Keep security explanations professional but pleasant.

Remember your goals

Speaking as a consumer of patient health data, I have to say that many of the health data sites I’ve accessed are a bit tricky to use. (OK, to be honest, many seem to be designed by a committee of 40-something engineers that never saw a gimmicky interface they didn’t like.)

And that isn’t all. Unfortunately, even a highly usable patient data portal or app can become far more difficult to use if necessary security protections are added to the mix. And of course, sometimes that may be how things have to be.

I guess I’m just encouraging providers who read this to remember their long-term goals. Don’t forget that even security measures should be evaluated as part of a patient’s experience, and at least see that they do as little as possible to undercut that experience.

After all, if a girl-geek and e-patient like myself finds the security management aspect of accessing my data to be a bummer, I can only imagine other consumers will just walk away from the keyboard. With any luck, we can find ways to be security-conscious without imposing major barriers to patient engagement.