There undoubtedly is truth to both of these perspectives. Providers are recognizing that more effective patient engagement will be essential to changing these perceptions. Technology has come to the rescue for many; the introduction of patient portals offers them online access to key pieces of their healthcare record and enables them to do straightforward tasks, such as appointment scheduling and prescription renewal.
The government and payers are no dummies—they know who votes and which constituents pay insurance premiums. As a result, these influential blocs who ultimately sign the checks for providers have assigned accountability for improving patient communication to the provider in emerging accountable care organization models.
Similarly, the CMS has established provider responsibility for patient portal usage as a Stage Two requirement of meaningful use under the HITECH Act. While the CMS might maintain that setting portal utilization at 5 percent of all patients is a low hurdle, it still involves a significant provider investment and an aggressive timeline for luring patients online to access medical information.
The vendor community is being quite helpful by quickly bringing portal products to market, although in many cases, those products are built only to connect to the software offered by that specific individual vendor. For that reason, you'll hear jokes about three portals being in use in a single organization. It ain't no joke—that is exactly the case in my organization, and I can't even blame the vendors because all three portals are connected to multiple systems. Our two medical groups each have a portal of their own choosing, and our health plan still has a different one. We now recognize how confusing and inconvenient this must be for our patients and are beginning unification discussions, promising to be only slightly less complex and passionate than those surrounding the Middle East peace talks.
Several factors will be considered in our portal strategy (and these will be relevant to most organizations):
- How do we balance convenience to the patient with convenience to the provider? The successful approach has to favor the patient, but it should bring value to both. As a simple example, online access to care summaries would bring timely information to the patient while saving the HIM department the work of producing the documents.
- What really makes sense to include in our portal, and how do we prioritize the many possibilities? Download the “Patient Engagement Framework” produced by the National eHealth Collaborative from the NeHC website. This excellent model outlines five stages of increasing online engagement in a commonsense manner similar to the HIMSS Electronic Medical Record Adoption Model. NeHC also offers a readiness tool to track your progress and several opportunities to network and share best practices.
- Do we buy or build the portal? Similar to any software selection process, many factors must be considered. How much customization and interoperability are required? Can an internal team of developers keep up with the advances of the commercial products that our competitors have deployed? How do costs compare, both initially and over time?
- Last, but hardly the least important factor, how do we balance the interests of our many internal constituencies?
Sorting all this out definitely won't be easy, and it will require input from outside the walls of the IT department—this really becomes a strategy discussion that an organization, as a whole, must decide and then unequivocally embrace. However, if we all remember that the patient's interest is our first priority, we will arrive at a winning portal strategy.
Bill Spooner
Senior vice president and CIOSharp HealthCareSan Diego
