It's 2017 — and patient portals still suck. But why? What do we do about it? Ask anyone who uses a patient portal day-to-day, and they will unanimously agree that they are not the best. There are new features and integrations being added as premium features, but fundamentally, the benefits don't stack up. At the end of the day, portals still suck. So what can we learn from them?
Why Patient Portals SUCK
Patients Don't Use Them
According to Eric Manley, product manager of global solutions at the Mayo Clinic, they are having a hard time getting more than 5% of all the patients who registered with the patient portal to actually use it. In order to actualize the benefits of Meaningful Use, people actually have to use the portal. You can't just have the portal exist, and (in Mayo’s case) have fewer than 12,000 unique patients actually use it.
Manley says that “simply making services available doesn’t cut it. Just having it [portals] out there isn’t enough … it’s making the patient use them.”
Patients Don't Use Them Because They Aren't Relevant
According to the Health Information and Management Systems Society, patients want technology that helps with these issues: viewing test results, corresponding with clinicians, registering as a patient, requesting appointments, sending prescriptions. Many portals and EHR systems lack the functionality that actually meets patient needs and desires regarding their healthcare management.
Steve Wilkins MPH for KevinMD writes regarding the patient portal experience: "After all, cognitive involvement is a prerequisite of meaningful engagement and it tough to be interested and spend time thinking about information that is not in context (of a medical encounter), you don’t understand, find boring, completely inaccurate or irrelevant."
Poor User Experience
Patient portals are not tools, but landing sites. These portals act merely as gateways to information, and are not truly solving any user's (patient or medical professional) needs. Not to mention most patient portals designed similar to a Microsoft Windows 95 desktop program.
While access to patient health information is a good start to data transparency in healthcare, HIT that improves patient engagement (both with their own healthcare decision-making and with various medical professionals) is preferable to out-of-context data.
Poor user experience with EHR systems even led to a lawsuit worth hundreds of thousands of dollars.
This lawsuit alleges Allscripts “misled its physician customers about the quality and functionality of MyWay” electronic health record (EHR) software which was sold to approximately 5,000 physicians across the nation from 2009 until Allscripts withdrew it from the market at the end of 2012. The cost of the software, according to the law firm’s website was “approximately $40,000 per physician to implement.”
As a physician or owner making HIT decisions in your practice, design and usability is an important factor often overlooked. In the next 5 years, well-designed HIT will beat out the traditional bulky counterparts.
Lack of Centralization
A patient has a dermatologist, primary care doctor and an OBGYN she sees on a semi-regular basis. Each office has a different patient portal. The patient's medical history is scattered. This is all too regular in the healthcare industry.
With technology that focuses on centralized platforms becoming the forefront of innovation for the next 5-10 years, the healthcare industry needs to adjust so that all an individual's information is in one place. Interoperability is not only necessary for better usability and adoption rates for portals, but also could feasibly improve quality of care. When all health information is in one place, physicians can diagnose and treat patients holistically within context.
You're Probably Losing Money
A study found that 16.4 percent of physicians associated with hospitals said that their EMR was limiting their ability to make more money.
These were the following reasons cited:
- Too much time spent on activities related to implementing, learning, training, and using EMR
- Time spent negatively impacted the amount of (billable) productive/clinical time they could spend with patients
- Prevents patients from scheduling face-to-face appointments
No More Excuses
With Meaningful Use reimbursement being a pretty sweet recompense for the headaches patient portal and EHR systems cause, it may be a thing of the past. Patient portals were a great prototype to introducing a more data-focused and transparent mindset into healthcare. It really was a good idea, in theory.
But, Meaningful Use may very soon be no more. According to this provocative tweet by Andy Slavitt, administrator of the Centers for Medicare & Medicaid Services (CMS) a few days ago:
"In 2016, MU (meaningful use) as it has existed — with MACRA — will now be effectively over and replaced with something better," tweeted Slavitt.
We're looking forward to seeing the playing field open up for healthcare technologies that are solving the challenges presented in the ever-changing healthcare dynamic between patients and doctors.