Written by Madeline Hyden, MGMA-ACMPE web content writer/editor
Web-based patient portals that interface with your EHR can further improve your practice’s productivity, streamline patient communication and ultimately improve patient satisfaction.
Involving your patients in their own care means enhancing communication and accessibility. Web-based patient portals provide a secure way to connect patients to your practice 24 hours a day and have the potential to cut down on patient call volume. Here’s what you need to know:
Connecting to your EHR
Cherie Stutesman, MGMA-ACMPE member and director of operations, Mt. Baker Planned Parenthood, Bellingham, Wash., implemented her practice’s patient portal two years after implementing an EHR.
Stutesman’s portal has the functionality for patient-clinic communication, lab results, medication lists, problem lists, online bill pay and prescription renewal requests. Once an item in the EHR is electronically signed by a provider, it’s available for viewing on the patient portal in a summarized format.
“It’s changed the way we look at communicating with patients,” she says. “It’s learning about what they want and how they want to get it.”
Stutesman says her practice’s portal allows patients to manage their health on their own time.
”We found right away that most of our patients are on the portal from 10 p.m. all the way to 3 or 4 a.m. making payments, sending messages and requesting appointments,” she says. “It works for them because they don’t have to wait until we’re open and risk sitting on hold.”
Avoid information overload
Stutesman’s portal summarizes notes from the EHR, so patients only see a limited amount of their health information, but other systems have the ability to upload a duplicate of the patient’s chart to the portal.
Robert Tennant, senior policy advisor, MGMA Government Affairs, says practices should be careful when determining what information to allow patients to access from the portal.
“There can be issues with giving unfiltered information to patients,” he says.
Giving patients too much information without explanation from a clinician, such as negative test results, can unnecessarily worry them and may encourage more phone calls, Tennant says, which is the opposite goal of a patient portal.
“Give your patients plenty of context for the information you provide,” he adds. This may include providing high, normal and low guidelines for measures such as blood pressure or cholesterol.
Establish a process for informing patients about portal
Once you implement your patient portal, the next challenge is to get patients to use it regularly.
Wendy Peterson, MGMA-ACMPE member, practice administrator, Women’s Health Specialists, Yuma, Ariz., randomly offers a gift card to a portal user every month as an incentive for people to submit their patient paperwork online.
To help market her portal, Stutesman plans to include messaging about the portal in all patient communications, including appointment reminders, follow-up letters for annual exams and immunizations and bills.
Stutesman also says implementing a portal included establishing the practice protocol for all of the portal features.
“We had to look at every step that a patient could take on the portal and make sure there’s someone on the practice end to facilitate that request,” she says.
This means developing a way to triage messages from the portal (front office vs. clinical), manage prescription refills from the portal and accommodate appointment requests.
Patient portal functions may include:
- Appointment requests
- Appointment pre-registration
- Prescription renewals
- Access to lab results
- Access to medical records
- Patient education and self-management tools
- Medication lists
- Pre-screening and surveys
- Bill paying
- Secure online communication
- Online office visits
Also, be sure to explain to patients that while the portal is a secure environment, access to their health information is now available outside of the practice.
“We have a lot of patients seeking confidential services,” Stutesman says. “So it was important that we explained that someone could access their health record if they reset their password via email and someone else read it.”
Stutesman has each patient sign a consent form before setting them up in the portal that explains all potential risks associated with the portal as well as what information is available to them. She also includes portal audits in her practice’s risk management plan and established “lock out” protocols for entering an incorrect password too many times.
The proposed rule for Stage 2 of the meaningful use EHR incentive program includes providing patients with the ability to view online, download and transmit their health information within four business days of the information being available to the eligible professional (EP). Utilizing an online patient portal is one option for meeting this requirement.
Practices may see this as an incentive to implement a patient portal by the 2014 deadline. However, Tennant recommends that practices take a close look at the cost-benefit of implementing a patient portal.
“For example, if a patient portal costs $25,000, it might not be cost effective for the practice to implement a portal. They might be better served exploring other options of meeting this meaningful use requirement,” Tennant says.
Tennant also encourages practices to assess their patient demographics before considering implementing a patient portal.
If you have a significant elderly patient population, he says, do you anticipate that they will take advantage of online portal functionality? Be sure to ask your patients if a portal is something they would benefit from and whether it’s worth pursuing.
Know the difference between a PHR and a patient portal
The key difference between a patient portal and personal health record (PHR) centers around ownership of the data. Typically, once data is entered into a PHR from a patient or provider, it belongs to the patient in a system of the patient’s choosing, whereas patient portals are managed by the medical practice and they continue to control ownership of the data.
MGMA-ACMPE partnered with several healthcare organizations to create two brochures, one for patients and one for clinicians, to educate them about the benefit of PHRs. The brochures include screen shots of PHRs and testimonials from patients and industry organizations.