Are you making the most of your patient portal?

Many physicians have been struggling to meet the Stage 2 Meaningful Use patient engagement threshold, requiring that more than 5 percent of patients view, download or transmit their health information electronically.

A study published last September in Health Affairs found that only 24 percent of physicians routinely provided patients with that ability. It’s no wonder, then, that many stakeholders applauded the changes proposed by the Centers for Medicare & Medicaid Services (CMS) last April to relax the requirements.

Acknowledging “significant challenges,” CMS proposed replacing the 5 percent requirement with only one patient who uses the technology. The agency also proposed replacing the 5 percent threshold of patients sending a secure message using certified electronic health record technology with a “yes” or “no” acknowledgement that they can. The final rule is expected to be released in August.

Patient engagement isn’t going away

While CMS may relax the rules, practices should continue to encourage patient use to make the most of their portals. Patient engagement isn’t going away because physicians will still need to provide access to information electronically to meet not only Stage 2 but also Stage 3.

There are efficiency benefits to a practice when a substantial number of patients actively use a portal. For example, the number of distracting phone calls and phone tag can be reduced. In addition, staff time can be freed up from tasks like locating and copying lab or imaging reports for patients, as well as mailing the reports.

A patient portal can facilitate coordination of care. Patients can directly share their health information electronically with other physicians, such as specialists. Patient portals also can increase patient satisfaction, in turn benefiting a practice’s reputation.

If you build it, will they come?

Offering a patient portal doesn’t mean patients will sign up or use it. For the most part, simply having a wall poster up or giving patients a handout about the portal as they leave the office doesn’t work.

Practices that have been relatively successful in engaging their patients have some of the following tactics:

• Give patients an activation code. At Cleveland Clinic, patients are given an activation code for the portal at their first appointment. The code does not expire, and patients are told that the portal is the preferred mode of communication except in emergencies.
• Link use to the time of an action. Experience has shown that linking a benefit of portal use to an action at an appropriate time enables a patient to see the value of establishing an account. For example, when a patient is given a prescription for lab work, explain that results will be available online within a few days after the test is done – no need to wait until the next appointment.

If a patient calls with a question, the emailed response should include a link to additional information available on the portal. (Emails from office personnel should have the physician's name on it, rather than the practice name, since patients are more likely to open an email from an individual they know.)

• Identify patients who can benefit most. Many experts note that people with chronic conditions or those who are undergoing regular or complex treatments are more likely to benefit from and use a patient portal. Identifying these patients and promoting the portal to them is especially important.
• Make the portal relevant to patients’ needs. Go beyond offering online appointments, refills and lab results by including interactive decision tools and personalized messages. HealthIT.gov says a patient portal can be used to assist in self-management tasks through tools for interactive monitoring and coaching.
• Involve the staff in portal promotion. Informing patients about the portal can begin at the front desk, be noted by the doctor during face time and be suggested at checkout. Employees at one practice wore buttons reading “Ask me about our patient portal!”
• Engage patients through regular use. Patients can become more accustomed to communicating with the practice electronically if they receive email confirmations of upcoming appointments, referral authorizations and reminders for regular testing.

In whatever way you increase awareness, however, patients will not use a portal if their email to the office doesn’t get a timely response. Also, a portal should be easy to navigate. Confusing features create patient frustration and lead to low usage rates.

According to a survey by Software Advice, Inc., a software advisory company, unresponsive staff (34 percent) and confusing portal interfaces (33 percent) topped the list of what patients find most irksome about patient portals.