What makes a patient portal successful? Is it really worth the time and effort involved in integrating multiple systems into one cohesive view? Should you allow patients to view their medical records online? Will patients sign-up and use such features? Is the workflow change for my staff worth the effort?
These are common questions I commonly hear from our clients…My response is “What would your patients say?” I like being in a strategic position with our clients where we don’t have a product to sell or a framework for developing a cookie cutter solutions. Most vendor portal’s that I have seen are very much tied to a specific product and can’t take full advantage of all the features most requested by patients and their family members. As most who read this blog know both Google and Microsoft have made strides in providing a repository for your health data. This is not a new concept as we were designing this functionality back at HealthAnswers.com in the late 90’s (yes before the bubble burst). Patients have come to expect online services from the vendors it visits most. I hear age and patient demographics as common reasons as to why such initiatives would not be of much value. Nonsense. This may have been true 8-10 years ago but regardless of your social or economic stature most patients have or know of someone who has Internet access and uses it frequently to access information online. I’ve worked on projects for several Academic Medical Centers in Houston, Indianapolis, and Richmond and have seen and interviewed the full spectrum of patients that have great payer mixes to the indigent population that depend entirely on care from residents at a nearby teaching hospital. Navigating health care services is far more difficult when you are poor and unemployed than it is when you are a middle-class taxpayer with a good insurance policy. The value from patient portals comes in the diverse range of patients you can serve effectively with the integration of a patient portal.
I spoke at length with the Microsoft team at HIMSS (Health Information Managment Systems Society) about their efforts in the PHR space. Not surprisingly they opted out of providing a front end solution to capture this information but chose instead to let third-party vendors create front-end solutions and letting Microsoft provide the infrastructure for storing and transmitting this data securely from system-to-system. My experience with this is that a lot of vendors provide export capabilities in their product for patient information however there are not a lot that import this data making it a one way street. Microsoft and Google are hoping to change this and create a more extensible way to exchange this data. One of our clients purchased a portal product for GE’s Ambulatory EMR application which provided export capabilities compatible with the Continuity of Care Record (CCR) Standard (E2369-05). The problem with this is that the patient doesn’t know what to do with a text file full of XML tags. I designed a web enabled reader for our client that would parse this data and format it in such a way that would at the very least allow the patient to view their personal health record instead of opening IE or notepad to stare at seemingly endless strings of data. Vendors need to enable the inclusion of style sheets (XLST) into the CCR document so that patients can have this data formatted for them properly and it wouldn’t be a stretch to embed formatting and logo references to tailor it to a specific customer. Again, this is a little effort would make a big difference in the overall patient experience.