July 16, 2013

Despite many healthcare organizations employing patient portals, the portal remains an underutilized resource. This low rate of adoption may stem, at least in part, from first-generation solutions developed in years past that offer little more than a website for patients and providers to communicate. As such, many healthcare organizations are overlooking more sophisticated, next generation portals that facilitate more advanced benefits, such as health information exchange, data analytics and population health management.

The first generation patient portals that emerged over the last decade were intended to facilitate communication among providers, patients and healthcare organizations. Without a functional electronic health record (EHR) infrastructure at that time, however, these portals provided little more than a way for patients and providers to communicate via electronic messaging. Essentially, they were advanced email systems spawned from hospital or practice websites.

As healthcare organizations gradually began implementing EHRs, portals became a technology afterthought. Although there are a myriad of reasons why first generation portals were sparsely adopted, it is most likely due to their limited offerings and features.

Beyond the immediate benefits

Unlike first generation portals, next generation portals can be much more than just a complementary technology to an EHR. Those built on a health information exchange (HIE) platform present many workflow efficiencies for providers, offer empowering tools for patient engagement and facilitate meaningful and relevant information exchange for healthcare organizations. Tasks such as renewing medications, receiving specific test results and scheduling appointments can all be done at the click of a button through portals.

Beyond these time-saving benefits, advanced portals provide a logical, organized platform for HIE. Although a healthcare organization may initially launch only the patient-provider communication portion of the portal, it already provides the integration and infrastructure necessary for HIE. By simply turning on additional functionality, organizations can achieve HIE capabilities without additional technology or staff.

Unlike most EHRs that merely collect and retain data, some portals can act as sophisticated data repositories. By methodically normalizing and mapping data, they provide standardized, structured and aggregated data sets ready for the kind of analytics that can open the doors to greater efficiency, potential ROI, and better patient care. Organizations can use the data, for example, to take a targeted approach to patient engagement, coordinate care transitions and more easily manage patient care at the population level.

Identifying advanced portals

As with any technology investment, it is essential for organizations to conduct a thorough evaluation and selection process if they wish to maximize any patient portal application. The key is to ask questions designed to determine whether a solution offers benefits beyond basic workflow efficiencies and patient–provider communication.

Hospitals and healthcare organizations should look for technologies enabling greater continuity among their various divisions by asking:

• Will the portal meet both the hospital’s needs and the needs of its ambulatory practices? Both patients and health systems want to utilize one portal for both acute and ambulatory purposes. Having one piece of technology to connect a hospital with its outpatient practices is important for sustaining adoption by providers as well as patients. A single solution presents a consistent data access point for all users—this is especially helpful for streamlining the patient experience.

• Can it generate aggregated information? An aggregated data repository on which the patient portal operates is important for patients, as it allows them to utilize one portal to connect to all of their providers and their hospital. An aggregated repository is important for organizations, as it facilitates the “next steps,” which are right around the corner, such as HIE, care coordination and population health management.

• Can the portal generate aggregated lists that patients can interact with? In other words, can a patient see one medication list and one appointment list from their providers using different vendor EHRs? Can patients request refills and schedule appointments from the aggregated lists? When patients can interact with important information from all their providers through a single portal rather—than a separate portal for each provider and another for the hospital—they are more likely to remain engaged.

• When patients initiate communication or requests via the portal, are they automatically routed to the appropriate hospital, practice and provider? Utilizing one portal to communicate with all healthcare providers is convenient for the patient. As such, it is important that the portal “keeps it simple” for the patient and automatically routes requests to appropriate practices and providers. One of the many benefits next generation portals offer is the ability to streamline communication by automatically directing requests to the appropriate staff.

Practices interested in investigating potential workflow efficiencies should inquire:

• What is the portal’s sign-up methodology? Few practices have the resources needed to create a patient portal account for each and every patient. Therefore, some advanced portals allow patients to create accounts remotely from home and mobile devices, providing initial access to schedule appointments and complete forms. Once patients receive an authentication token sent from their practice, they will then have complete access to their records.

• What are its scheduling capabilities? Although many solutions allow patients to request appointments, advanced portals offer the ability to allow patients to schedule appointments directly in the practice’s scheduling system.

• How does the portal facilitate electronic form delivery and completion? First generation portals typically offer simple form delivery using PDFs. By contrast, next generation portals capture patient entered information as discreet/structured data allowing it to populate EHRs and practice management systems. Not only can patients complete forms at home, but the data they enter does not require scanning or re-keying. Sophisticated solutions are also capable of automating the delivery of forms to patients based on configurable criteria, which significantly enhances practice workflows and leads to more targeted patient engagement.

• Is it easy to access? Patients are more likely to adopt technology that fits with their lifestyles. Portals with mobile applications, for example, make it even easier for patients to access health information and communicate with providers.

Unlike one-dimensional first generation portals, advanced solutions offer longer-term benefits for healthcare organizations. Far more complex than simple web technology, they are complete platforms that standardize and aggregate data in addition to providing valuable connectivity. Through a single solution, healthcare organizations, providers, and patients can not only exchange information seamlessly, but act on it to achieve better outcomes.


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