After years of the patient portal being pushed as the answer to engagement between patients and care teams, the results are lacking for both engagement and behavior change. Regulatory incentives did not lead to beneficial, or even extensive, interactions. The ongoing discontent and disconnect are strong signals to pivot to better options that meld the tech touch and human touch.
Implementing new solutions that are specifically designed for robust engagement is a more impactful approach than trying to artificially force utilization of a tool (the patient portal) primarily designed to meet regulatorily driven minimum incentives.
The State of the Patient Portal
As we know, the electronic health record (EHR) functions as a digital repository of data primarily to support billing. The patient portal is simply an outward-facing component of the EHR. The patient portal was not necessarily designed for the purpose of creating holistic interactions between patients and the care team. As a result, since inception, patient and care team uptake of the portal, if it is even offered, is low.
Think about the last time you accessed your own patient portal, if you’ve even tried to access it. What did the experience look and feel like?
In my personal experience, the portal is limited. In fact, it is not usually even mentioned during a visit with my care team. Instead, the portal functions as a depository of dense information from my last office visit. If I have any questions, the only option is to message the care team through the portal application. Also, there isn’t a clear method for uploading information to share with the care team or for receiving any additional education or insights that can empower me to take action.
Sometimes, there are options to “schedule” a visit. However, selecting that option really just initiates a callback at a later time. Since it is not fully integrated into the scheduling workflow, I usually just pick up the phone and make the call. The only convenient component of the portal, again if it is offered, is the option to pay a bill electronically within the portal.
Given the concern about patient portals falling short of most peoples’ needs, the Office of the National Coordinator for Health Information Technology (“ONC”) analyzed survey data from a group of adults related to patient portal and smartphone application utilization. Though the results are interesting, keep in mind that the sample size was limited and then extrapolated to reflect the broader population.
Below are some of ONC’s key findings along with color commentary:
Only 38% of patients who were offered access to a patient portal actually used the portal.
Major caveat: not all patients even received the offer to access, so the group that used the portal is a subset of a subset.
When offered access, roughly 64% accessed the portal at least once in the year.
Once-a-year access fails to demonstrate consistent engagement.
The data is quite confusing. A previous statistic said only 38% of patients who were offered access did so, but then (somehow) 64% of those who were offered access, did it at least once.
55% and 58% of people used the portal to view notes and send messages respectively.
The numbers imply a desire for more digital engagement and interaction.
50% of people had a smartphone and a health app, of whom 85% used the app at least once in the past year.
The health app question referred to non-portal apps, suggesting patients’ desire to use better-designed apps and to be more proactive in their own health.
Lessons
As noted in ONC’s report, while offers of access increased from prior years, the data demonstrate a recent plateau. There is still a lot of untapped connections to be fostered and promoted. For example, utilizing solutions that integrate and aggregate analytics and automation can reduce staff burdens through the reduction of urgent issues and the establishment of a regular interactive flow. Tools that create an inviting experience for both the patient and care team will open doors to new possibilities by meeting user expectations and desires. People want to connect to their care teams and overwhelmed care teams want a better way to connect to the individuals that they care for. The right platform designed with those goals in mind will drive a new model of engagement.
Developing Technology for True Engagement
A more holistic and impactful experience can be established when the technology platform is developed and implemented from an experience-led design methodology, in consideration of both users – patient and care team.
From the patient perspective, the platform must be easy to use, offer seamless interactions, mirror user interfaces seen in non-healthcare apps, and provide insight. In other words, make it simple and provide clear value. From the care team perspective, the platform must also be easy to use, integrate with other sources of truth, facilitate patient interaction, and provide actionable insights on collected data.
If developed through human experience design methodologies, what could a platform look like? It looks like a solution that is flexible, scalable, and usable as a true virtual front door.
Currently, patient portal use feels transactional with little consideration of the patient experience. The explosive growth of digital health and virtual care solutions beg for a broader approach where the new technologies enable engagement and interaction between the patient and the care team. For example, a platform can:
be a primary point of virtual contact;
result in the collection of data during the course of an individual’s daily life;
analyze the data being collected to spot trends or a concern earlier than before;
push information proactively that can spur changes or alleviate concerns;
facilitate communication across a multitude of modalities; and
hook into the EHR to supplement the information in the EHR while also enhancing workflows, and so much more.
The EHR will not be replaced, nor should it be. Investment in the EHR is significant and brings value to a particular need. Layering in new tools to complement the EHR will chart a new path towards better evidence that leads to more informed clinical decision-making. Solutions can work together, just like care teams and patients, rather than force exclusivity.
Examples of the New Approach
The platform developed by Carium exemplifies a more engaged approach. Instead of deploying a singular, static approach, Carium provides building blocks that can be configured to fit the specific goals of the group implementing it. The building block mentality takes advantage of the thoughtful design approach that focuses on establishing a user-friendly experience for all, whether clinical or individual.
Once patients access the platform, the ease and impact of use keep patients coming back. Specifically, Carium’s experience-centric design results in at least 87% monthly engagement by patients. Ongoing engagement means patients are in the platform – continuously feeding data and permitting the care team to capture insights gleaned from within the patients’ daily lives. The ability to see progress, interact with the care team, share data, and gain insights enrichens the healthcare experience beyond what a standard patient portal could do. And for patients, feeling engaged is feeling empowered. Empowered patients are more apt to take positive action, adopt better behaviors and increase trust in their care team.
Let’s take a look at an example of how Carium – a platform driven by engagement – can facilitate change. A physician practice wanted a single platform to reach patients in a variety of ways that reduced burdens on the care team. The practice engaged our team to leverage the numerous communications options possible within the platform – from in-app messaging to texting to video visits. The goal was to enable all interactions to occur in one place, creating convenience for both patients and care teams.
The practice also sought an ability to collect and analyze data to drive better insights and understandings of what patients are experiencing, which in turn modifies care interaction. This process becomes a self-feeding loop to engender confidence that the practice knows its patients and can reach them.
When a practice starts to understand what is happening with its patients outside the walls of the office on a regular basis, they are poised to drive more timely interventions. This is foundational to providing value-based care. In taking advantage of that foundation, the practice could transition to an at-risk payment model where knowing patients and keeping them healthier are essential to success.
The Future
The pivot occurring in healthcare right now is a chance for everyone to rethink old approaches and seize the opportunity to pursue new directions. The future of healthcare will rely on proactive, real-time engagement that helps each individual maintain good health and wellbeing, rather than scrambling to recover after a health problem becomes more severe. Goals of that nature can only occur when patients and care teams work together seamlessly. Carium enables, empowers and enriches the collaboration, making the patient experience –and the care team experience –dynamic, impactful and trust-centric.
The future can be now with Carium. Discover the benefits of patient care beyond practice walls.
