How to Increase Patient Portal Engagement: The Patient Perspective

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According to research from the Annals of Family Medicine, only 25% of primary care patients will sign up for and use a patient portal when their doctor makes one available.

These aren’t great numbers.  Especially when you consider Meaningful Use Stage Two requires that a certain percentage of your patients view, download, and transmit their health information, and also send a secure electronic message through a patient portal.

Electronic Health Information.

Many doctors are struggling with patient adoption of their EMR’s portal, or they’re having issues themselves using it to communicate with patients.

To see how to fix these issues and encourage adoption we interviewed patients who are currently using a patient portal, or have used one within the last couple years.

Here’s what we found.

1. The portal needs to be easy to use

This sounds obvious, but we encountered plenty of patients who had difficulty using the system their doctors provided.

For instance, Tracy Vega, co-founder of a self-defense consultancy, started using her doctor’s patient portal six months ago, but found that, “It’s not easy to navigate, it does not alert you/send an email when you have a message waiting. You have to continuously log back in and check manually for any new messages or replies.”  The system also requires her doctor’s staff to be available for a password reset (meaning it can’t be done after hours or on weekends, when patients are most likely to be checking records).

Kimberli Taylor, with a California law firm, had a similar experience with her physician’s patient portal.  She said, “Frankly, I found the system to be frustrating. You’re supposed to be able to view lab reports, schedule appointments and communicate with the doctor’s care team. I wasn’t able to do that.”  She still had to call for an appointment, wait for referrals, and then wait for the doctor to get her lab results.

Kimberli concluded, “I found it useless and I haven’t used it again.”

There were, however, patients that found their doctor’s portal easy and convenient to use, and who thus were more likely to be engaged.

Esther Conrad signed up for UBMD’s patient portal and found it “very convenient. I used my Gmail account to create a logon so I don’t have to remember an additional username and password. It doesn’t have limited hours of being open… Also, my future appointments are right there online for me to access at anytime.”

How easy to use is your patient portal?  Does it follow medical software usability best practices, or is it just a headache for your patients?

2. You need to explain the portal to patients

Even if the portal is easy to use, you can’t just tell patients it exists and expect them to use it.

Many of the patients we spoke to explicitly called out the guidance they received from physicians (or lack thereof) as a key factor to how engaged they were with the portal.

As an example, Katie Franklin was in two different hospitals over the space of a month with her husband.  The first hospital she visited “actually signed us up while we were in the ER and talked us through the system. The second hospital we were at two weeks ago for a major surgery had a portal as well (I believe) but didn’t talk to us about it or sign us up. We were at that hospital for four days.”

She and her husband used the patient portal of the first hospital extensively, tracking blood tests, lab work, and specialist visits.  She didn’t use the patient portal of the second hospital at all.

Julie Rains, a freelance writer and blogger, uses her doctor’s patient portal, but thinks that “it would help if the physician and office would provide some guidelines on how best to use the system. There are general guidelines like ‘don’t use the system in an emergency’ but more personalized instructions could be helpful.”

Thoughts like this are backed up by the findings in the Annals of Family Medicine, which saw higher adoption rates when practices made “patient portals part of their normal meaningful workflow” and had systems for teaching patients how to use them.

3. Patients need to see it as secure

With stories about health data breaches becoming commonplace, assuring your patients that their data is secure will make them more likely to trust and use a patient portal.

Ryan Satterfield, a web security consultant, was concerned when he learned his doctor was using an online patient portal.  At the doctor’s request he tested the portal’s security, and found it wanting.

“Within exploring the site for a few minutes I found reflected cross site scripting, which is a good indication that there are far worse issues that endanger the customer information.”

Make sure your EMR provider’s portal has undergone extensive security testing, and that they have the certifications to prove it.

4. Patients with chronic conditions are more likely to use a patient portal

Fully 40% of the patients we spoke to who used a patient portal regularly do so because of a chronic medical condition.  For these patients, portals are a huge timesaver as they can replace costly visits, or lengthy games of phone tag.

For Bill Balderaz, President of a healthcare company himself, his doctor’s patient portal has done wonders, “I have rheumatoid arthritis and an underlying immune system disorder.  I use my patient portal at least once a month and love it. I can reach my physician quickly without playing phone tag, I get questions answered that I normally would not ask until my next appointment and I check my lab results. It really has helped to improve my care.”

For practices having a high level of chronically ill patients, a patient portal can not just save time for doctor and patient alike, but can improve the quality of the care that the patient receives as well.

5. You need to use it, too

Making sure a patient portal gets used is a two-way street.  Because doctors and medical practices are responsible for uploading lab results, updating the software, and responding to patients, their engagement (or lack thereof) can have a direct effect on how good an experience patients have.

It’s an issue Katie Franklin ran into when using the patient portal of the first hospital:

It was helpful because it kept track of all procedures and medication, however, there was a significant delay in when items were added to the portal. Also, they had not been adding the full reports post-procedures, which is something that we really needed. I also wish they had added all of his genetic blood tests and the daily lab work. Instead, I had to have the hospital staff print me off the lab work daily so that I had a track of how his levels were improving (or not).

Your experience?

Has your practice implemented a patient portal?  What have you done to raise your patient portal engagement?

Looking for Electronic Medical Records software? Check out Capterra's list of the best Electronic Medical Records software solutions.

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About the Author

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JP Medved

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J.P. was formerly content director at Capterra.

Comments

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Well, it’s not like the patients have to use portals only, Meaningful Use just states the information should be exchanged in a secure way, which can now also be enabled by patient mHealth apps.

Answering the question on engagement, whether it is a portal or an app, it can be measured in order to make fact-based improvements. Sure, usability is a key to widespread use and patients need an intro on portal / app use beforehand as well as they need to trust that their information is secure. Still, there is a number of measurable values that allow to segment patients according to their engagement level and then reach out to them. At ScienceSoft, we elaborated on this topic in our recent research article: https://www.scnsoft.com/blog/patient-engagement-analytics-its-measurable

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I (a CPA) and the physicians in my condo have discussed portals in Western New York at length and agree in our area they are frankly useless. There are on 4 different systems that do not connect to one another. We receive many requests to “join” but are given no idea which physician that we see are in the groups represented by the individual portal. When we join we receive information that is incorrect but our doctors are unable to correct the diagnosis and medication misinformation which is then spreading to other doctors. Lab tests are given in a language and format that I do not understand.

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I couldn’t agree more. Good patient portals are hard to come by and they require effort from both the patient and the provider. My friend recommended I try drchrono and their patient portal, onpatient. I did some research and found it promising. Patients can easily communicate with their provider’s office by scheduling appointments, sharing their latest wellness data through Healthkit and securely send and receive messages. Additionally, they can view their lab results and appointment summaries (uploaded by the provider) and view their entire list of medications, allergies and medical conditions. It appears that both the provider and patient are constantly interacting, which improves patient satisfaction.

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