• October 2008 FEATURE ARTICLES •
Thought Leaders
Patient Portals
By Peter Kuhn
According to the Deloitte 2008 Survey of
Health Care Consumers, over 70 percent of consumers want their
hospital to provide online access to an integrated view of their
medical information, including test results, doctor visits and
hospital stays. Yet the percentage of hospitals that have
deployed a true patient portal is still in the single digits.
Although it may appear that the healthcare
industry has been devoid of motivation for the past 10 years,
hospitals have been investing heavily in technology such as
hospital information systems, laboratory systems, picture
archiving computer systems and other solutions that enable
electronic connectivity for clinicians within the organizations.
These investments are already beginning to show results in terms
of productivity and cost savings.
However, this is just the start of the
process of patient data integration. Even though some hospitals
have successfully linked major disparate systems within the
hospital, few have fully integrated their environments, such as
pharmacy interaction for closed loop medication reconciliation
and seamless access to physician practice-based electronic
medical records (EMR), the source of the majority of a patient’s
encounter history.
Connecting to the multitude of EMRs can be a
real challenge for hospitals. For example, if there are 1,000
referring doctors in a given area, and approximately 300
different EMR solutions in the industry (depending on who you
ask), it is reasonable to assume that a hospital might need to
interface with 15 distinct EMRs within just one community.
Adding to the complexity is the fact that the average patient
sees three to five different providers. This is all compounded
by the relative newness of system and interoperability
standards, which has erected significant speed bumps for
risk-averse hospital systems.
Next Up ... Patients
Once hospitals link their inpatient hospital
systems with outpatient (physician) EMR systems (still a dream
for many healthcare systems today), the next step is to extend
the network to include patients. Several factors motivate
hospitals to accelerate this step. First, the expanding adoption
of high-deductible insurance plans by employers is forcing
fiscal and care decision making upon consumers. With this
increased level of responsibility, consumers are demanding
greater transparency in costs and improved value of the care
delivered by providers. This is well supported by industry
statistics: For example, the Deloitte 2008 Survey of Health Care
Consumers shows that 64 percent of consumers wish to use Web
sites to research the quality of hospital care, 62 percent wish
to verify the prices of hospital services and 59 percent wish to
view information about health conditions and treatments.
Consumers who are often drafted into the
consumer-directed healthcare model through their employers have
become empowered patients that expect value for their time and
money. As indicated in the Deloitte study, 68 percent are
interested in same-day appointments and 60 percent want online
appointment scheduling — and they are willing to pay for the
convenience. In fact, one in four consumers would pay extra for
online access to these integrated services and patient
information.
As insurer reimbursements continue their
downward spiral, this new source of incremental revenue is a
strong motivation for providers, as is the competitive advantage
that it supplies in the increasingly crowded marketplace.
Additionally, hospitals are beginning to realize that the more
extensive the integration of actionable patient information and
online access, the greater return on investment they experience.
Large hospital systems in cities such as Philadelphia, Chicago,
Seattle, Detroit and the Washington/Baltimore region are making
some of the greatest strides in this area.
Disruptive Technology?
An interesting development occurred with the
entrance of Microsoft and Google into the healthcare arena.
Their ubiquitous consumer outreach has introduced the masses to
the concept of medical information access at a rate and scope
not achievable by a healthcare organization without millions of
additional dollars spent in patient communications. Now, EMRs
and personal health records are some of the hottest concepts
within consumer media, compelling patients to approach their
physicians and hospitals to ask for the ability to view and
access their medical information and healthcare services.
Consumers now know that these services exist — and they want
them.
This situation is similar to the shake-up
that occurred in the travel industry, triggered by the
consumer-focused, online services provided by Expedia and
similar travel portals. Traditional agencies had to adapt and
offer comprehensive online services or be left behind. Google
and Microsoft have shaken the healthcare tree, and it’s time to
evolve or fall to the ground.
But even those two corporate behemoths are
not supplying all of the legs of the patient data stool. They
are offering free medical record storage, but with limited
integration to all the disparate sources of medical data. Their
solutions provide limited benefits related to enhanced clinical
workflow and productivity. But they do point the industry to
that which it lacks — access combined with actionable data.
Unfortunately, some hospital organizations
may pause once they provide basic access to data, without
providing a means to act upon that data. Patients wish to see
their test results, but then they need to schedule a follow-up
appointment, ask questions and request prescription refills.
This is the actionable functionality that is key to achieving
the maximum workflow, quality and safety benefits with these
integrated systems.
Significant Savings
We have seen a 3-to-1 variance when comparing
the use of phone-based services to online services. On average,
the provider’s staff spends three minutes on the phone
scheduling an appointment; yet that same action would take a
patient one minute to accomplish via a patient portal, without
requiring assistance from hospital personnel. Multiplied across
patients, the time savings for both parties is substantial.
Additionally, the patient has the convenience of scheduling an
appointment whenever they have time, whether it is at 2 a.m. on
a weeknight or at 10 a.m. on a Sunday. No wait, no hassle and
all the benefits of online services — e-mail reminders, online
calendars and more.
For clinicians and staff, these online
requests can be responded to during non-peak times so that
hands-on patient care can be their first priority, contributing
to improved patient outcomes and safety. Furthermore, the
streamlined workflow enabled by the portal enhances all phases
of the continuum of care.
Word of Mouth Goes Viral
Lastly, the satisfaction delivered to the
patients, as well as to the clinicians, should not be
underestimated. Just like the old-fashioned word of mouth, happy
patients will send links to helpful information found on patient
portals to their friends, relatives and colleagues. Some portals
even enable patients to provide family members with authorized
access to their private medical information. Otherwise known as
viral marketing, by encouraging patients to forward information
about the given hospital’s impressive patient portal services,
hospitals have tapped into one of the most powerful and
cost-effective marketing methods for attracting future patients.
Of course, any change will face some
resistance. Similar to traditionalists that prefer to walk
inside the bank and stand in line to deposit their checks, there
will be some patients that are not immediately comfortable with
online interactions. However, soon we will see corner store
kiosks where we can view and access our medical records, and
communicate with physicians and office staff. It’s already
started.
Peter Kuhn is president of MEDSEEK, a
provider of
enterprise eHealth solutions. Contact him at
peter.kuhn@medseek.com.
