A few weeks ago, I was referred to a specialist. Because this was my first visit with that physician, I had to provide some information. That part I anticipated. What I didn’t count on was having to fill out about a dozen pages of questions, some of which asked for information that I wasn’t prepared to provide (including very specific questions about family history and past procedures). The whole time, I kept thinking, ‘Wow, it could’ve saved a whole lot of time if I had been able to do this before the appointment.’
That’s the idea (or at least one of them) behind patient portals — that patients who can more easily communicate with providers and access health information are more likely to take an active role in their care.
So why is a technology that has the potential to drive patient outcomes still stuck in first gear? Patient portals aren’t exactly a new concept. Why haven’t they gained more traction by now?
According to recent data, there are a few reasons. One of them, interestingly, is that researchers haven’t been able to gauge just how interested patients are in utilizing portals.
A 2010 survey by Intuit found that 72 percent of patients would use a tool to help them pay their medical bills, communicate with physicians, make appointments, and obtain lab results online. The patient portal developed by Kaiser Permanente is used by more than 3 million members, according to a report from the California HealthCare Foundation. What Kaiser found is that women between the ages of 40 and 60 were the most common users of portals, along with individuals who have chronic diseases.
But as the old disclaimer goes, these results aren’t typical (and who wants to be compared to Kaiser, a mammoth organization with more resources than the New York Yankees?).
In fact, research published this month in the Journal of Health Communication found that less than a quarter of patients at risk for colorectal cancer logged on to a portal with information about disease screening. The target age group? Women between the ages of 50 and 59. Of the study participants, 83 percent indicated that they spend an average of one hour per day on the Internet, so it isn’t like they were a bunch of technophobes. However, the authors also found that, of the patients who were given access to print materials, 42 percent indicated they had looked at the literature at least one time, and 30 percent said they looked at it at least twice.
As it turns out, this patient group seemed to favor print education. But that isn’t necessarily a reflection of all women in that particular age group — or all of those with chronic diseases. Some patients simply prefer to get their information the old-fashioned way.
Another study by the University of Pittsburgh found that in patients with diabetes, interest in portals appeared to be linked to dissatisfaction with the patient-provider relationship, and disinterest in the patient portal appeared to be linked to satisfaction with the relationship. “These findings underscore the importance of maintaining the patient-provider relationship even when (or especially when) health information technologies are introduced to improve medical care,” the authors wrote.
What that tells me is that portals can’t take the place of the provider relationship, but they can be an effective supplement to care. At the University of Missouri Health Care, the patient portal is part of a larger strategy focused around leveraging technology to enhance patient engagement, said CIO Joanne Burns in a recent interview. The organization is investing resources to determine how patients can get the most out of all interactions — with both computers and physicians — to improve outcomes.
When it comes to portals, there isn’t an easy answer, but I’m guessing an approach that involves researching how to make technology work for patients, and using technology to enhance the patient-provider experience, is a pretty good formula. Maybe it will help portals get off the ground once and for all. As a patient, I can attest that my experience would have been much better — and the records my physician collected much more complete — if I’d had access to a portal.