Kaiser Permanente's My Health Manager.

Feb 05 2013

Patient Portals Provide Connected Healthcare for the Digital Generation

More healthcare companies are launching websites to help patients manage health, reduce office visits and lower costs.

In today’s fast-paced cyberworld, most consumers expect to interact quickly and conveniently with all aspects of their lives. They rely on mobile apps, websites and social media to gather information and interact with their workplace, families, retailers and service providers.

This same expectation of fast-and-easy access to information holds true for patients in most healthcare systems as well. This has prompted many organizations to launch patient portals, a secure website through which patients can access personal health information and often certain information from electronic health records (EHRs).

Portals typically enable users to complete forms online, communicate with their providers, request prescription refills, pay bills, review lab results and schedule medical appointments. These tools can benefit both patients and providers by enhancing patient access and increasing administrative efficiency and productivity.

Healthcare Needs a Digital Transformation

Healthcare providers and insurance companies are growing increasingly aware of the need for digital transformation, driven by patient demand, meaningful use requirements and the realization that the healthcare industry lags behind others in online access. But the potential benefits of portals go well beyond demand and compliance.

“This is an exciting time because the benefits [for patient portals] can be enormous,” says Craig Mathias, principal at Farpoint Group in Ashland, Mass., pointing to the analytical data that will eventually be gleaned from having test results, monitoring device data and doctor input all in one place.

“By looking at all this data, the patient and the physician can establish a plan that will be much more effective, both from a medical-outcome basis and from a cost-performance basis,” he says. “This is how we get healthcare costs under control. It’s all about information.”

Though relatively new, patient portals are slowly winning over users - many of whom are young, tech-savvy patients, or chronically ill patients who interact often with their healthcare providers.

About 15 percent of online consumers, polled by Manhattan Research, say they have used a patient portal in the last 12 months. And another 28 percent haven’t tried a patient portal yet but are interested in using them.

“This is a new phenomenon,” says Monique Levy, vice president of research. “There’s a healthy interest for future use, so you can expect to see these numbers swell as you get more education and more providers promoting portals,” she adds.

A Path to Better Patient Care

Long-time users of patient portals are already proving that awareness leads to greater adoption and improved healthcare. Kaiser Permanente (KP), a managed-care consortium, has used EHRs for more than a decade, and its patient portal My Health Manager went live in November 2007.

In 2012, the healthcare provider studied more than 500,000 of its members and found that patients with online access to their medical records and patient portals had an increased use of clinical services.

“Our clinicians have become sophisticated in their use of electronic health records to improve care coordination,” says Ted Palen, a clinician researcher at KP’s Institute for Health Research and lead author of the study.

“Our members have also become more mature in their understanding of and use of the online healthcare tools available to them,” he says. “Our future research will examine the impact of these tools on healthcare delivery models, patient health status and their health outcomes.”

KP’s patient portal is linked to its EHR system, called HealthConnect, so users can access their health records, view lab test results, email their physicians, request prescription refills, and make, change or cancel appointments. Nationally, more than 4 million KP members are registered for the portal.

“The use of patient portals is a transformative new element in the long history of healthcare delivery. We are seeing impacts on improved quality of care and patient loyalty. Survey results from previous research found that members and physicians believe secure email can save a visit to the clinic,” says Terhilda Garrido, vice president for health IT transformation and analytics at Kaiser Permanente. “Clearly there is so much more to learn.”

Imagining the Possibilities of Digital Medicine

Today, patient portals are most commonly used for scheduling appointments, viewing medical results and sending messages to doctors or nurses, Levy says. But many more advanced features are not only possible, but are available and waiting to be implemented.

This includes access to video chat with a healthcare professional, pre- or post-operative care instruction videos and consolidation of all of a patient’s medical data from multiple sources in one place.

For instance, mobile health technologies will feed patient data directly to the patient portal to improve care and treatment options.

“Mobile health devices, such as monitors in the home, can record and log directly into a portal,” says Dr. David Lee Scher, founder of DLS Healthcare Consulting LLC. “Whether it’s vital signs, blood glucose or mental health behavioral things – the portal is a big place for that.”

“It’s also good for adherence monitoring [by insurance companies],” Scher adds. By logging on the portal, whether a patient is going to the gym or losing weight, for example, insurance companies “can use those statistics to potentially incentivize patients and decrease their deductibles because of it.”

Patient portals can also help physicians. Secure patient communication with their providers leads to increased physician productivity, Scher adds. “In the past, a physician could play phone tag with a patient for a couple of days” trying to convey important information or test results.

“Direct messaging to a patient portal is instantaneous and makes physicians more productive,” he says. It also increases the satisfaction of patients when, for example, a patient is having a procedure and can get pre-surgery or post-surgery instructions. It also promotes adherence with treatment such as medications and appointments.

While most healthcare providers are in the early stages of adding advanced features such as video chat, financial assistance, patient education and multimedia engagement, the largest healthcare organizations, and more condition-specific care groups, are closer than ever.

“Health IT happens in certain pockets,” Levy says. “The average [healthcare provider] grows slowly,” taking an average of five years to see double-digit use in new technology. “But in some health systems, there is more rapid sophistication” such as diseased-based portals for diabetes or cancer, which can reach double-digit user growth in two years.

Build a Better Portal

The “wildcard” in portal adoption is user satisfaction, Levy says. “If satisfaction is low, you’ll see lower growth.” Portal developers should consider these steps when designing a patient portal.

Portals across industries are very similar, but in the healthcare industry, security poses special concerns and it is regulated by the Health Insurance Portability and Accountability Act (HIPAA).

Mathias advises portal developers to go beyond HIPAA regulations to ensure patient confidentiality with respect to encryption, permission to access data and under what circumstances, and the way in which data is tracked and logged.

“We generally recommend that for every portal,” Mathias says. “HIPAA doesn’t say, for example, that you must encrypt something a certain way. It doesn’t say that you have to say who has access and under what circumstances. And it doesn’t say you have to have two-factor authentication.”

He also recommends building a system that is capable of handling a large number of simultaneous inquiries.

“A lot of people design systems assuming that they’re not going to see high use, but often they do,” he says. “There might be, for example, a period of time where patients sign up for flu shots, or a health warning is issued and patients want to find out if they might be affected. You have to design for the peaks.”

Kaiser Permanente

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