Practice success with patient portals requires teamwork
One the biggest challenges facing practice executives in the future is meaningful use Stage 2 attestation. I overheard the following statistic at the 2014 MGMA Annual Conference, which I thought was mind-blowing: Only about 9% to 10% of eligible providers (EPs) will be able to successfully attest for Stage 2. In fact, MGMA is petitioning Washington to review these rather demanding criteria, which are proving to be quite impossible to meet.
Around the end of August 2014, my medical group decided to take on the challenge. Our hospital-affiliated group had 69 EPs who were eligible for stage 2, and the health system gave us a $1.2 million budget (including stage 1 and stage 2 providers) to achieve the full dollar amount for all 69 to successfully attest. Needless to say, we were under significant pressure to meet the measures. For many medical groups, the measures surrounding the patient portal are the most challenging, due to aging patient populations, rural areas and, to some extent, the fear patients have of allowing their medical data to be accessed online.
These measures require 5% of unique patients (or their authorized representatives) for an EP to sign up for the portal, log in and communicate with their providers using secure, direct messaging during the EHR reporting period. To address this challenge our group formed a steering committee with physician champions, personnel from the information technology and marketing departments and senior administrators. The team met weekly until the end of 2014 as our attestation period was Oct. 1 through Dec. 31, 2014. The steering committee drove the creativity and implementation behind the initiative. Ideas and implementation flowed from the committee to individual office managers of each site. Here are some of the ways we helped our 69 providers successfully attest:
- We hired three temporary employees and trained them as patient portal representatives in high-volume practices. We routed all patients to them after checkout to enroll in the patient portal and send messages through the portal before they left the office.
- We bought IPads and laptops for all locations for patients to register while they waited for appointments. Staff was available to assist as needed.
- We used several marketing tactics, including:
- Employee buttons that read: "Ask me about our patient portal!"
- Informational posters displayed on exam room doors with general information, such as how patients can check labs, request refills, etc. Posters also addressed security concerns, such as a promise the practice would not sell patient information.
- We offered $10 gift cards to patients who sent us a message by Dec, 31, 2014.
A key component to success was consistent communication and distribution of scorecards. Every week, practice managers at each site got a report card with a comparison of physicians and their progress in meeting stage 2 criteria, which created competition among providers and between offices. The progress reports prompted our providers to push themselves beyond the 5% patient goal and some providers reached 15% and 20% of patients who actively used the portal. To encourage staff, we had monthly contests for the top three offices and provided catered lunches to the winners.
The true success of this project was teamwork. Establishing the steering committee set the right tone and I would suggest that every practice of any size develop the same dynamic. Administrators, frontline staff and physicians pulled together to make this a success. You must have that level of engagement from all staff before you can have engagement from patients.