Thursday, October 09, 2008

Thought Leader Series | "Patient Portals"

by Peter Kuhn | October 08, 2008

According to the Deloitte 2008 Survey of Health Care Consumers, over 70 percent of consumers want their hospital to provide online access to an integrated view of their medical information, including test results, doctor visits and hospital stays. Yet the percentage of hospitals that have deployed a true patient portal is still in the single digits.

Although it may appear that the healthcare industry has been devoid of motivation for the past 10 years, hospitals have been investing heavily in technology such as hospital information systems, laboratory systems, picture archiving computer systems and other solutions that enable electronic connectivity for clinicians within the organizations. These investments are already beginning to show results in terms of productivity and cost savings.

However, this is just the start of the process of patient data integration. Even though some hospitals have successfully linked major disparate systems within the hospital, few have fully integrated their environments, such as pharmacy interaction for closed loop medication reconciliation and seamless access to physician practice-based electronic medical records (EMR), the source of the majority of a patient’s encounter history.

Connecting to the multitude of EMRs can be a real challenge for hospitals. For example, if there are 1,000 referring doctors in a given area, and approximately 300 different EMR solutions in the industry (depending on who you ask), it is reasonable to assume that a hospital might need to interface with 15 distinct EMRs within just one community. Adding to the complexity is the fact that the average patient sees three to five different providers. This is all compounded by the relative newness of system and interoperability standards, which has erected significant speed bumps for risk-averse hospital systems.

Next Up ... Patients
Once hospitals link their inpatient hospital systems with outpatient (physician) EMR systems (still a dream for many healthcare systems today), the next step is to extend the network to include patients. Several factors motivate hospitals to accelerate this step. First, the expanding adoption of high-deductible insurance plans by employers is forcing fiscal and care decision making upon consumers. With this increased level of responsibility, consumers are demanding greater transparency in costs and improved value of the care delivered by providers. This is well supported by industry statistics: For example, the Deloitte 2008 Survey of Health Care Consumers shows that 64 percent of consumers wish to use Web sites to research the quality of hospital care, 62 percent wish to verify the prices of hospital services and 59 percent wish to view information about health conditions and treatments.

Consumers who are often drafted into the consumer-directed healthcare model through their employers have become empowered patients that expect value for their time and money. As indicated in the Deloitte study, 68 percent are interested in same-day appointments and 60 percent want online appointment scheduling — and they are willing to pay for the convenience. In fact, one in four consumers would pay extra for online access to these integrated services and patient information.

As insurer reimbursements continue their downward spiral, this new source of incremental revenue is a strong motivation for providers, as is the competitive advantage that it supplies in the increasingly crowded marketplace. Additionally, hospitals are beginning to realize that the more extensive the integration of actionable patient information and online access, the greater return on investment they experience. Large hospital systems in cities such as Philadelphia, Chicago, Seattle, Detroit and the Washington/Baltimore region are making some of the greatest strides in this area.

Disruptive Technology?
An interesting development occurred with the entrance of Microsoft and Google into the healthcare arena. Their ubiquitous consumer outreach has introduced the masses to the concept of medical information access at a rate and scope not achievable by a healthcare organization without millions of additional dollars spent in patient communications. Now, EMRs and personal health records are some of the hottest concepts within consumer media, compelling patients to approach their physicians and hospitals to ask for the ability to view and access their medical information and healthcare services. Consumers now know that these services exist — and they want them.

This situation is similar to the shake-up that occurred in the travel industry, triggered by the consumer-focused, online services provided by Expedia and similar travel portals. Traditional agencies had to adapt and offer comprehensive online services or be left behind. Google and Microsoft have shaken the healthcare tree, and it’s time to evolve or fall to the ground.

But even those two corporate behemoths are not supplying all of the legs of the patient data stool. They are offering free medical record storage, but with limited integration to all the disparate sources of medical data. Their solutions provide limited benefits related to enhanced clinical workflow and productivity. But they do point the industry to that which it lacks — access combined with actionable data.

Unfortunately, some hospital organizations may pause once they provide basic access to data, without providing a means to act upon that data. Patients wish to see their test results, but then they need to schedule a follow-up appointment, ask questions and request prescription refills. This is the actionable functionality that is key to achieving the maximum workflow, quality and safety benefits with these integrated systems.

Significant Savings
We have seen a 3-to-1 variance when comparing the use of phone-based services to online services. On average, the provider’s staff spends three minutes on the phone scheduling an appointment; yet that same action would take a patient one minute to accomplish via a patient portal, without requiring assistance from hospital personnel. Multiplied across patients, the time savings for both parties is substantial. Additionally, the patient has the convenience of scheduling an appointment whenever they have time, whether it is at 2 a.m. on a weeknight or at 10 a.m. on a Sunday. No wait, no hassle and all the benefits of online services — e-mail reminders, online calendars and more.

For clinicians and staff, these online requests can be responded to during non-peak times so that hands-on patient care can be their first priority, contributing to improved patient outcomes and safety. Furthermore, the streamlined workflow enabled by the portal enhances all phases of the continuum of care.

Word of Mouth Goes Viral
Lastly, the satisfaction delivered to the patients, as well as to the clinicians, should not be underestimated. Just like the old-fashioned word of mouth, happy patients will send links to helpful information found on patient portals to their friends, relatives and colleagues. Some portals even enable patients to provide family members with authorized access to their private medical information. Otherwise known as viral marketing, by encouraging patients to forward information about the given hospital’s impressive patient portal services, hospitals have tapped into one of the most powerful and cost-effective marketing methods for attracting future patients.

Of course, any change will face some resistance. Similar to traditionalists that prefer to walk inside the bank and stand in line to deposit their checks, there will be some patients that are not immediately comfortable with online interactions. However, soon we will see corner store kiosks where we can view and access our medical records, and communicate with physicians and office staff. It’s already started.

Peter Kuhn is President of MEDSEEK, a provider of enterprise eHealth solutions.

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