Patient portals facilitate the exchange of information between patients and physician practices. What was once considered a nice option for your EHR is becoming a necessity. Unfortunately, not all patient portals offer the same features. Failure to acquire an adequate patient portal could limit your EHR benefits and increase your costs.
Patient portals can help you get updated patient demographic information, and new insurance information as well as coordinate appointment scheduling, and process payments. Clinical patient portal features include requesting refills, exchanging messages, reminding patients about treatment plan items, and accessing patient exam notes. Patient portals can also collect patient family/social history and even history of present illness as well as monitor patient wellness on a periodic basis. Clinical information may be accepted directly into the patient note for editing by the doctor or staff. Thereby, you save time documenting patient conditions and history.
From a product development standpoint, patient portals have paralleled the EHR industry. Originally, most patient portals were developed as stand-alone products that were painstakingly interfaced with EHR and medical billing systems. Many EHR vendors have now established joint marketing programs with patient portal vendors or purchased patient portal products. In other words, your ability to pick “best of breed” patient portals to work with your EHR is rapidly diminishing.
The lack of patient portal choices is not a trivial issue. Not all patient portal strategies are based on the same principles or support the same features. Indeed, many vendors have patient portal strategies that meet the minimum for Meaningful Use and not necessarily present an efficient or effective way to collaborate with patients. For example, some patient portals only support medical billing exchanges and do not deal with any clinical information.
Patient portal evaluations should consider the following key issues:
One of the surprise patient portal issues is the pricing model. As EHRs have become very competitive on price, patient portal costs have shot up. Typically, practices look at patient portal add ons after the fact and do not completely consider patient portal costs.
Patient portal costs may include upfront software, installation, annual maintenance, and a per transaction fee. Transaction costs may be assessed for each transaction through the portal. For example, you may pay a transaction fee for each patient reminder, message and released office note. Transaction costs could grow into a significant portion of your computer costs as the patient portal is deployed for use. The patient portal costs need to be effectively projected to understand the full scope of the EHR financial commitment.
Meaningful Use –
Patient portals are a convenience under Meaningful Use Stage 1, and a necessity under Meaningful Use Stage 2. Stage 1 includes a core measure to provide clinical summaries for office visits. There are a number of clinical summary delivery options including paper summaries, CD, and secure email as well as patient portal. However, looking at the costs and logistical issues of providing summaries, a patient portal provides the most cost effective and patient service oriented strategy to fulfill this MU measure.
Stage 2 of Meaningful Use includes patient messaging which will require a patient portal strategy.
EHR Working Strategy –
Patient portals have a number of different EHR working strategies. In some cases, the patient portal sends messages which must be manually interpreted and processed by the medical staff. In other cases, the patient portal generates targeted messages that are connected to the relevant EHR information and features. For example, some patient portals will send a message that a patient has requested a refill of a particular drug. The clinician has to locate the drug in the patient chart to issue the refill. Other patient portals will connect the refill to the patient medication record. When you look at the patient summary, you see the refill request message and the highlighted refill drug on the medications list.
Patient portals may dramatically differ in the supported features and interactions. For example, some patient portals only support secure messaging to fulfill Stage 2 Meaningful Use. Other patient portals products support a complete exchange of specific information on patient care issues. For example, some patient portals can present condition specific forms for patients to fill out. The information on the form can be accepted into the patient chart by the doctor or nurse.
The patient portal features may affect your implementation strategy and EHR use. For example, patient portals that are limited to messages would frequently be implemented after the EHR was in use for the majority of active patients. However, patient portals that accept information on family and social history as well as history of present illness will be an invaluable tool to help introduce a patient to the EHR.
An expanding list of patient service agendas requires a patient portal strategy and effective workflows between the patient portal and your EHR. Unfortunately, many practices have not carefully examined the patient portal strategy of their EHR vendor and the implications of the patient portal to their EHR strategy and use. EHR buyers should understand the specifics of the companion patient portal to their EHR options and consider the features and costs of such portals in their evaluation as well as their EHR implementation strategy.
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