The patient portal is a 24-hour internet application that the patients use to access their personal health information. The first patient’s website was established in 1998 but the patient portal was rolled out in August 2010. The patient portal implementation was to support patients as partners and this was after implementation of many Electronic health record systems in the past years. The website is now becoming a commonplace for many patients since people are embracing the technology. The portal provides information such as recent doctor visits, lab results, access appointment notes, email exchange with staff, make or view bills, among other things. The patients interact and communicate with their physicians and health care providers using this online application. He/she logs in to the patient portal using their username and password to access the information from anywhere the patient has a connection to the internet. Most of the registered users of this technology are patients with chronic conditions, adults taking care of elderly parents, and young parents. These patients need an ongoing relationship with the healthcare providers and with the technology they interact with their providers any time .Patient portal are integrated with EHRs and have a significant impact on patients and their health care providers/organizations. The online application increases care efficiency engages patients and families in care with their healthcare providers and thus, improves management of chronic diseases such as diabetes. The portals offer a broad range of benefits such as cost savings to the patients since they cut costs on transport cost on for example during appointment visits, and they acquire more efficient care.
Medical practice has changed with the advancement of technology which led to patient portal implementation in August 2010. Patients First Leadership decided it was important to support patients as partners and the NextMD patient portal implementation took place. The patient portal was to serve the following functions:
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Provide patients with an electronic health information summary
Provide secure communication through emails and messaging between the patients and healthcare providers
Provide access to lab results in time
Although patient portals have many benefits; however, there is low enrollment on users of this portal because of several barriers. The main barrier to patient portal enrollment is unawareness of its existence and lack of internet access. Most healthcare providers do not discuss the possibility of utilizing electronic health application with their patients probably because they assume the patients will not get satisfaction accessing health information online . Older patients, uneducated or those with lower education and patients with less knowledge on their health find it challenging to use the patient portal. Computer literacy is the main impact on the use of patient portal in different environments. Another barrier was the cost on the healthcare providers. Implementation of the patient portal meant that the staff needed retraining, added work to the doctors and thus requires an increment in their salaries and the doctors had the fear the product would fail. A challenge to the users is that the patients may also find it challenging finding the specific information they are looking for and finally interpreting the data (Ronda, Dijkhorst-Oei, & Rutten, 2014).
With the increased technological health systems, healthcare organizations are trying to institute their use in a way that it will satisfy both the physicians and the patients. Many patients are happy that they can access their healthcare information online and use services such as earlier visits booking or request for repeat prescriptions if they do not remember. The main goal of patient portals development is to increase the communication engagement between patients and their health practices. Patient portal creates greater accuracy in the provision of patients’ records and information and encourages patient self-care and empowerment. Patient portal enhances general health practice of the patient thus improving general health care. The technology enables the patient to see their health data and they therefore have the ownership of their well-being. This application provides convenient access to health information and practices, and the patient can manage their health care (InteliChart Connected Health, 2015).
There are noticeable changes since the implementation of the patient portal such as communication between patients and healthcare providers through emails is quick and efficient as compared to before its implementation. It takes less time responding to emails than processing telephone calls and routing them. It also reduces phone tag which often leads to miscommunication and delays in information delivering. Using the patient portal ensures secure patient message and they ask precise questions, and it is more advantageous to the patients as they can ask questions in-between visits and request for medication online. Healthcare providers and the staff experience less call volumes and thus they do not have to work overtime. However, patient portal results in multiple step registration process, and there are no read receipts for confirmation that the patient has read the message or the patient uses the portal. To the patients, it is a challenge to some to remember and manage their accounts which result in the numerous registrations. The CMS announced on August 23, 2012 to govern Stage 2 of the Medicare and Medicaid EHR Incentive programs. The meaningful use Stage 2 was to promote patient engagement with their providers by providing secure online access to their healthcare information.
The patient portal has improved health care in many ways. Using patient portal has improved the cost, quality, and efficiency of health status and provision. There is the assurance that the health information is complete and accurate, therefore, providing quality care since the patient communicates directly with the physician. With the use of patient portals, health professionals can amend incorrect information; the patient can also contact the general practice in the case of inaccuracy and incomplete health records/information. Patient portals also save time for health care providers and staff by reducing phone calls and tags, reducing paperwork, and it enables the GP to focus on the patients who needs emergency care or face-to-face appointments (HealthIT.gov, 2011a).
Patient portal improves communication with patients and providers by reducing call volume. With this improvement, the clinicians and staff have more time engaging with the patients and the patients becomes better informed. All records and communication such as appointments and lab results are saved electronically to the EHR. This saving ensures that the patients receive a complete and accurate documentation and therefore trust and communication increases between patients and providers.
The patient portal has improved the preventive care by offering prevention recommendations such as reminding the patient to get a flu shot. The doctor and the patient perform as a team to manage the health of the patient and reach their personal health goals. Patients use this portal as a mechanism to organize their health care practices and needs as it is convenient since it is a 24hr online service, and there can contact their provider at any time. Preventive care focuses on staying healthy by improving and maintaining one's health status. Preventing and detecting diseases early is important as it reduces the risks of serious health problems (HealthIT.gov., 2011b).
Volume and demographic of users of patient portal
Patient portal use is becoming popular in the healthcare industry with many hospitals giving their patients access to download, view, and transmit their health data.
Geisinger Health System. This health system launched a patient portal in 2002. It has approximately 25% of the patients registered with the patient portal and around 2,000 patients register every month.
Kaiser Permanente. This delivery system has approximately 8.5million members and by 2009 about 25% patients were registered with the portal. More than 3million members use Kaiser’s patient portal, known as My Health manager.
Veterans Affairs (U.S department). The department of Veteran affairs offers an online personal health portal , My HealtheVet, to active duty soldiers and veterans. It has over 976,000 registered users and received over 38 million as of March 2010.
Healthspace. By October 2010, approximately 0.13% individuals activated their patient portal account. The low uptake was due to the cumbersome registration process and low interest by patients.
PatientSite Web portal. This patient portal introduced in 2000 at a teaching hospital in Boston and over 18,000patients enrolled. (Emont, 2011)
Some people feel that a patient portal reduces the amount of time assigned for face-to-face patient appointments with the health care providers feeling that they take a lot of time to reply to their messages. Some patients want a real talk with a real doctor and feel the online forums are not a substitute for the presence of a real doctor (Govette, 2013). Although to some, communication through emails is an advantage to them stating they have a stronger relationship between the patient and the provider. Some providers appreciate the improved connectivity with the patient and increased communication proficiency. Some people misuse this technology, for example, a parent may use one account to inquire information for her two kids who have a different health history.
Some studies documented on adolescent populations and their use of patient’s portals raises concern on the implementation of a portal allowing the patients and their parents access to a personal health record called MyChildren’s. This portal will have the same features as the patient portal such as secure messaging, scheduling appointments, access to PHR and billing. However, the information is accessible by the patient or the guardian. A large number of patient portal users with chronic illness is diabetic. The portal (HealthTrak) offers these patients with online tracking of their entered glucose, physical activity, and blood pressure.
Emont, S. (2011). Measuring the Impact of Patient Portals: What the Literature Tells Us. California HealthCare Foundation. Retrieved from http://www.chcf.org/~/media/MEDIA%20LIBRARY%20Files/PDF/PDF%20M/PDF%20MeasuringImpactPatientPortals.pdf
Govette, J. (2013). Failure of the Patient Portal, Poor Doctor-Patient Engagement. Retrieved from https://getreferralmd.com/2013/10/patient-engagement-patient-portal/
HealthIT.gov. (2011a). Patient Portal Implementation Improves Quality of Patient Care and Strengthens Preventive Care. Retrieved from https://www.healthit.gov/providers-professionals/dover-case-study
HealthIT.gov. (2011b). Patient Portal Benefits Patient Care and Provider Workflow. Retrieved from https://www.healthit.gov/providers-professionals/patient-portal-benefits-patient-care-and-provider-workflow
InteliChart Connected Health. (2015) . Features. Retrieved from http://www.intelichart.com/patient-portal-features#!/
Ronda, M. C., Dijkhorst-Oei, L.-T., & Rutten, G. E. (2014). Reasons and Barriers for Using a Patient Portal: Survey Among Patients With Diabetes Mellitus. Journal of Medical Internet Research , 16 (11), e263. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4260081/