That approach didn't work for us. We are a small rural facility in a county with about 20,000 residents. More than 55% of our patient population is covered by Medicare, and more than 15% are covered by Title XIX of Medicaid. We found that our goal to have 50% of our patients in a portal account was unachievable with our patient mix.
After trying nearly everything, we found that barely 30% of our patient population had email addresses. While some of our patients had work-only email addresses, or were reluctant to tell us those addresses, the most common response was that they simply didn't have an email account. That shouldn't be a shock, considering that this is an aging, primarily rural patient population.
We and several of the vendor's clients that were encountering the same email conundrum talked to our vendor about our plight; they listened and responded quickly. Another mechanism had to be established through which portal accounts could be created. The solution involved establishing a way for patients to set up their portal account at discharge. Further, this alternative mechanism could be used at any time after discharge to assist patients in setting up and using a portal account. The vendor delivered the solution in mid-February—not a bad turnaround time. Even better, it works great.
What does this anecdote have to do with the topic of heavy lifting? We didn't see this problem coming. Because email was the first entry point designed for patient portal engagement, and we had the patient and the authorized representative as possible contacts for each registration, I never dreamed that this would be a significant problem, but clearly, it was a deal-breaker issue for us.
My message is this: Don't underestimate the work to be done to reach Stage 2. It will be tough. Start now and work hard at it. We also found challenges with care transitions and with computerized physician order entry, in radiology, of all places. Both of these challenges required workflow modifications that took some time—unexpected time.
Some advice: Study the requirements, get your certified 2014 code installed and begin to address issues at once. We must attest to Stage 2 in 2014. If you are in the same boat, time is getting short. Even if you have more time, engage immediately. For a small organization like ours, the challenge is doable, but it takes some real heavy lifting.