Shannon Vogel, MS, FHIMSS Texas Medical Association
Patient Portals Evaluating WHY Header PATIENT Six Electronic PORTALS? Patient Engagement Tools Pro: "Every physician participating in meaningful use has one set up because he has to." Con: "If you have a patient, especially one with comorbid conditions, he might see multiple physicians, which means separate portals, separate log ins and passwords at every physician s office. That can become burdensome for the patient."
Pro: "As we go to new care models, where you might have a health navigator helping with care gaps, maybe that person would want to view [app data] on a regular basis. Reviewing app data might also work in an environment where someone is homebound and a home health nurse stops by, can scroll through, and say to the physician, 'We have some outlier numbers here I think you need to review. " Con: "In a primary-care model, where a patient has a direct feed and sends information to the physician for review at a set time, that could again become overly burdensome for the patient. I think there is real potential for health apps, but it's a little premature in the current primarycare environment, and we still have a lot to learn about how well [apps] can work as trusted sources of data." Apps
Apps Pro: "This is another great tool physicians can take advantage of to share information with patients in a secure way without having to rely on the patient portal. I think, again, for patients with chronic or comorbid conditions, it would behoove these patients to set up a personal health record (PHR) and ask their physician to use Direct to send clinical summaries, lab reports, and other key data through Direct." The Direct Protocol (secure health e-mail) Con: "PHRs have been around for a while, but I don't think we've seen PHR adoption rates get to 10 percent. So how much are patients really demanding this? Some patients are glad and willing to do it and you may have a patient demographic that expects it, but certainly, not all of them do."
Pro: "HIEs are setting up patient engagement tools, or even patient portals. We could see some good metrics come out of HIEs with patient portals." Health Information Exchanges (HIEs) Con: "[For it to work,] the community needs to really take on the HIE model and you've got to have enough data contributors to really be a powerful tool for physicians and patients to contribute data. Then the HIE can handle the metrics of how that data is tracked for meaningful use, or other programs, or which patients are accessing that data."
Pro: "It's interesting to me. I think as you start to put things out there and see what sticks, it's good to have options, [like Bluebutton], available to patients." Bluebutton (health data download) Con: "Even though it has been popular with the [U.S. Department of Veterans Affairs], I don't think there is large uptake outside of that."
Practice Websites Pro: "It may be obvious to some, but maybe not necessarily all: If you are going to have a patient portal, there has to be an entry point. It's also a great time to get with the times and have a more robust website with a lot of different addon features, such as online bill pay to help patients pay bills or address those high-volume call topics, like hours and directions to the practice." Con: "There is a lot of opportunity, but it can be missed if the website isn't well-planned or userfriendly. And, there are other things that websites might lack, such as addressing varying patient reading comprehension levels and different patient primary languages."