Patient portals are an underused and unappreciated asset available as part of an EHR. I have blogged about them in the past (see: Next Step in Patient Portals: Secure Messaging and Administrative Functions; Publishing Test Results in Patient Portals: Holding a Tiger by the Tail). Below is an excerpt from a recent article suggesting that patient are "fed up" with them (see: GAO finds further proof patients are fed up with portals, EHRs):
Despite the fact that close to 90 percent of providers participating in meaningful use offer their patients online access, only about one-third of patients actually log in to see their data, according to the...[GAO]. On the GAO's WatchBlog, the agency explored some of the reasons for that (see: Online Access to Your Health Record). Part of it has to do with the confusion of keeping tabs on separate portals for different providers....Patients often receive access to a different portal for each provider they visit, and must manage separate login information for each one...The patients we interviewed were frustrated with the amount of time and effort it took to set up these portals, understand each portal’s user interface, and manage all the different passwords....[M]any patients say the information available to them was incomplete and inconsistent across providers, and were unclear about whether it could be electronically downloaded, transmitted, or aggregated in one place. Those patients who did use online portals said they liked being able to communicate with their physicians, schedule appointments online, refill medications and share their own data with other providers. But more needs to be done to encourage active patient engagement with their health records.
In general, I think that hospitals are usually not adept at patient engagement strategies which are (or should be) embedded in their marketing plans. Patient portals problems are thus only one facet of hospital marketing ineptitude (see: How Hospital Marketing Improves Patient Engagement, Outreach). I think the problem stems in part from the fact that many hospitals do not face much competition in their markets -- their major problem is managing reimbursement rather than attracting more patients. Also, few hospital executives are trained in the for-profit sector where marketing strategies are more important. A newer facet of hospital marketing is the use of social media like Twitter which is also largely ignored (see: Tweeting and Treating: How Hospitals Use Twitter to Improve Care; Facilitating Engagement of Consumers using E-Health Tools Like Twitter).
Regarding education about patient portals, I think that it's insufficient merely to provide brief instructions to patents about, say. how to log-on to a portal because they will immediately be faced with columns of data such as lab test results which they don't always comprehend. There needs to be some educational support built into such systems. For example, links can be provided to web sites that will assist them in the interpretation of test results like HCT and MCV in a CBC report. Hospitals spend large sums teaching their physicians and nurses how to use EHRs, sometimes without sufficient "gratitude" in return (see: What do physicians hate about EHRs? (infographic)). They need to also devote time and resources to coaching patients about patient portals.
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