Online portals help local patients become engaged in health care

With a few clicks, Family Practice Medical Center patients can see their lab results online, review their medication list or peruse the doctor’s summary of their most recent visit. One year after launching a patient portal, it’s hard to find a down side, say clinic officials. The portal has made it easier to share information with patients. It’s helping patients become more engaged in their care.

Most of all, people appreciate the convenience, said Kari Mobraten, the clinic’s business manager.

“The patients like it. They like having that information at their fingertips,” she said.

A steadily growing number of medical groups are offering online patient access to the medical record.

There are financial incentives to do so. Providers that implement health information technology, including patient portals, can qualify for a meaningful use bonus payment from the U.S. Centers for Medicare and Medicaid Services. Additional payments become available as more features are added.

But the largest benefits are in patient care, said Stacey Zondervan, assistant administrator for patient services at Family Practice Medical Center. Patients increasingly want to be involved, she said. “I think they expect more - not in a bad way but they’re expecting we give them more information.

The providers are really starting to have to listen to the patient and ask, ‘What do you want? What is the goal for your health?’”

With the prevalence of health savings accounts and high-deductible health plans, patient motivation to participate in their care is at a tipping point, said Bill Jagow, chief information officer at Affiliated Community Medical Centers.

“This is really the patients who are engineering change,” he said.

ACMC introduced a patient portal last month to its staff. It will be rolled out to patients at ACMC’s 11 regional sites in time to meet federal requirements for stage two of meaningful use, which take effect Jan. 1, 2014.

Family Practice Medical Center launched its portal in the fall of 2012. One year later, 15 percent of the practice’s patients are enrolled as users, giving them access to lab results, doctor visit summaries and medication and allergy lists. Reminders for screenings, vaccinations and upcoming appointments are sent through the portal too.

Reviews are almost unanimously positive, said Zondervan and Mobraten.

“It’s been well-received. People like to do things on their own time and this is more convenient for them,” Mobraten said.

With the first year of implementation have come several lessons. One is that it takes some tech savvy (although not too much) for users to get comfortable with the secure portal.

“There’s a lot of teaching at times but that’s OK,” Mobraten said. “Once they get it, they’re all right.”

Clinic officials initially thought most users would be young. But the greatest use has come from patients over age 65, Mobraten said. “I think we were surprised by that.”

Most of all, the portal is enabling patients to be more involved in their care, which is apparent from the questions and phone calls to the clinic.

Zondervan recounted someone’s recent query about a drug on their medication list. “We realized people are reading that and looking at the information,” she said. “I think that helps from a medical standpoint to reduce medical errors and documentation errors.”

Compared to other industries, online portals have been slow to take hold in health care. That’s mostly because implementation is complex and early software programs weren’t very robust.

ACMC, for example, spent almost a year choosing a vendor and preparing for implementation, Jagow said. “We’ve looked at this off and on for the last seven years. We’ve always intended to go this route, but it was just a matter of what product we used and how we used it.”

Medical practices also must redesign their work flow to accommodate a patient portal. What information should be uploaded to the portal? Who should do this, and when? If two-way secure messaging is offered, how do providers ensure messages are read on a timely basis?

Family Practice Medical Center is taking the implementation in stages. For instance, patients eventually will be able to request prescription refills online and send secure messages, once processes are in place for staff to deal with these.

ACMC is introducing a portal that not only allows secure messaging and gives patients access to lab reports, medication lists, immunization history, a list of active medical issues and summaries of doctor visits and medical imaging results, but also includes up to 10 years’ worth of data going back to ACMC’s implementation of electronic health records.

“It’s a much richer data set,” Jagow said. “Having that data sets it up for delivering more value. We wanted to give the patient a tool that would be useful for them to manage their health care.”

Providers know not all patients will want to, or be able to, use a patient portal. Enrollment here, as at most medical practices, remains voluntary.

One barrier Family Practice Medical Center has encountered is lack of Internet availability. “There’s still a fair population that does not have Internet access,” Zondervan said.

Nor will everyone be interested, she said. “I think that is our challenge. There is a population of patients that desires not to be engaged.”

Overall, however, a shift is taking place toward more online information-seeking and more involvement in care, she said. The family practice group hopes to have 50 percent of its patients signed up for the portal by Jan. 1.

ACMC plans to track how many patients sign up for the new portal once it’s available. The ultimate test will be whether users find it helpful, said Jagow and Cassie Wieberdink, electronic health record application specialist at ACMC.

Wieberdink said she’s looking forward to seeing how the portal is used. Users will be able to see updates to their medical information, such as flu shots, appear within minutes, she said. “It’s neat to see that real-time information.”

Although sign-ups may initially be slow, Jagow thinks many patients are ready to embrace this mode of managing their health care information.

“We’ve had a fair amount of interest from people who’ve heard about it and are asking,” he said. “Everything came together this year saying this was the time.”