readying for an MRI
Patient portals have improved customer care and provider support, yet only 29 percent of patients sign up for them PHOTO: Ken Treloar

I called my physician’s office last week to ask if I should continue my current medication. I had the bloodwork done right before setting out on travels and wouldn't be seeing the doctor for a month. I just needed a simple yes or no answer.

They sent me to a portal.

In fact I am a member of more than a dozen healthcare-related portals. You probably are too. So my question is ... how many portals does it take to deliver good health care?

To answer that question I looked at the latest trends in healthcare portals, and some lessons learned from their science fiction counterparts.

Value-Based Care Is Transforming the Industry

Digital healthcare portals are being created at an almost alarming rate as the US healthcare industry moves toward a value-based care model. This is creating a wave of adoption of digital technologies and portal approaches to help transform in the face of major disruption.

The implementation of value-based care pushes providers to demonstrate increased clinical productivity and financial efficiency. Meaningful Use, with its specific objectives that eligible professionals (EPs) and hospitals must achieve to qualify for Centers for Medicare & Medicaid Services (CMS) Incentive Programs, has been a driving force for provider portal creation.

It is no surprise then that we now face a proliferation of portals.

The Role of Portals in Care Delivery

What role in care delivery do all these portals fulfill from the patient perspective?

To help answer that question, let’s look at another kind of portal — the kind that appears in science fiction. I know what you all are thinking: science fiction portals are exciting, mind expanding, and at times quite dangerous, and nothing like the real world of healthcare portals. Not so fast!

In science fiction, portals are gateways that connect two locations separated by space or time. Sci-fi portals are designed to enable the transport of people, objects and information.

In healthcare, portals are secure websites that give patients convenient 24-hour access to personal health information and the ability to perform care-related tasks from anywhere with an internet connection. Healthcare portals are created for better communication and interaction with the patient, designed to improve patient outcomes.

Portals Provide Access to Patient History

In the Star Trek episode titled "All Our Yesterdays," Mr. Atoz and his Atavachron support a time portal that connects to his planet Sarpeidon's past, documented on his library's discs. [Spoiler Alert: The Enterprise crew enters the portal and just barely makes it back before the dying planet sun goes supernova.]

With healthcare portals, patients gain access to personal health information management, if only for a specific provider or network. Patients can view their health information history such as doctor visits, medications and lab results, and can even schedule future appointments (since it is highly unlikely their provider is about to go supernova).

Portals Enable Safe, Clear and Secure Patient Care

Harry Potter fans will be familiar with another kind of portal, Portkeys: enchanted objects that  transport to specific locations like the 1994 Quidditch World Cup. To the uninitiated, traveling by Portkey can cause disorientation and nausea. However Portkeys are safe and secure, as the Department of Magical Transportation in the Ministry of Magic regulates them.

Oddly enough healthcare portals may also be disorienting to the uninitiated, but indeed in these highly safe and secure — and yes, regulated — environments, patients can exchange secure email with their healthcare teams, download and complete forms, and even make secure payments. 

In the future, telemedicine advances may well let clinicians deliver diagnoses and care instructions to wizards and muggles alike.

Portals Deliver Significant Benefit to Providers

Patients can benefit from portals, but perhaps the strongest case for portals lies in the healthcare providers’ business.

Portals can support clinical staff in improving care quality, as well as mitigate the factors contributing to provider burnout. Portals can also help to support team-based care.

Research from athenahealth, with insights based on 3500 medical groups and 7.5 million patients across the US, found primary care provider practices retained 80 percent of new patients who signed up for a portal account within 30 days of their visit. In fact, “if you can register a patient on a portal in that first visit, they are 13 percentage points more likely to return.”

Portals are a provider tool for enhancing patient loyalty and patient attachment. And getting patients onto portals drives an increase in accounts receivable and reduces the accounts sent to collections.

Good for patients, great for providers, portal usage should be through the roof, right? Well, the research found that while 87 percent of patients want electronic access to their health records, the average overall portal adoption rate across the country is only 29 percent.

What exactly is impeding patient adoption?

Portals Need to Connect the Worlds of Patients, Providers and Payers

To understand why patient portal adoption is lagging, let’s once again turn to lessons from science fiction where we find a third kind of portal — a dimensional portal. 

This portal links parallel worlds as a different kind of doctor, Doctor Who, experiences in the "Doomsday" episode, when he and his traveling companion Rose move through a portal between connected worlds. [Spoilers Sweetie: They are ultimately parted forever trapped in separate parallel universes when the void between must be closed.]

Just as with dimensional portals, healthcare portals are at their best when they connect parallel worlds ... so that patients can request prescription refills and check benefits and coverage. Trapping patients in separate multiple views is not helpful, portals need to be able to connect.

It is time for the industry to use digital to transform from transactions to holistic patient views. There are certainly many integration technologies out there, and all kinds of healthcare formats and “standards,” like HL7, FHIR®, CCDA, NCPDP, X12, IHE, DICOM and more. 

The focus needs to be on creating patient-centric portals — not plan-centric, not clinician-centric — that are virtually linked to provide a single view for the patient.

Take Two Aspirin and Call Me in the Morning

As the very old adage goes, when you call your doctor in the evening because you aren’t feeling well, the invariable response is “take two aspirin and call me in the morning.”

We are certainly better off now in our care delivery with the full scope of communication and information possible with portals. But at the end of the day, it is the disconnected and ever-growing set of patient portals that has created confusion and adoption resistance.

Just as Amazon has provided the alternative to logging onto multiple retail sites, and Trivago­­­­ the same for hotel reservations, what we need is patient portal connection and collaboration.

So how many portals does it take to deliver good care? One!