The Patient Portal Conundrum

Healthcare has two major challenges hanging over its head.  The first is how to handle newly empowered and engaged patients.  The second is how to lower the skyrocketing costs of healthcare.  At the Healthcare Forum, Ashwin Ram, PhD, looked at how both of these issues are impacted by the patient portal.

Dr. Ram pointed out that the internet is by far the leading source of health and wellness information.  However, patients aren’t looking to their doctors’ patient portal for this information.  Instead they’re looking to Facebook, Wikipedia, Twitter, and online patient communities.  Dr. Ram pointedly describes this shift:

The patient is the CEO of their health.  This stuff is happening.  It’s actually not a choice that we are going to make.  It’s already occurring and if we, the healthcare provider system and all the facets of it don’t drive this change, then some 20 year old kid in a Google garage will drive it for us and then we’ll wonder what happened.

Is healthcare going to drive this change?  Can patient portals be part of providers’ response to this change?

Dr. Ram suggested that “patient portals are great…if we can get people to use them.”  Therein lies the patient portal conundrum.  He offered a simple plan where EHR software gathers the information, patient portals garner patient engagement and then we see improved health as patients’ behaviors change.

Government regulations are pushing providers to engage with their patient through a patient portal.  Meaningful use requires organizations to not only make a patient’s health information available through a portal, but 5% of patients must view, download, or transmit their health information as well.   It is clear that providers need to not simply implement a patient portal, but also need to consider how they engage with healthcare consumers.  This will become even more important as we continue the shift away from fee–for-service to value based care.

Many people believe that most patients are passive consumers of healthcare, but a study by the CDC found that 68% of adults are actively trying to prevent at least one major chronic illness.   Dr. Ram described that we are “moving from this quick fix, reactive, I’ll see you when I’m sick mindset to a wellness oriented, proactive, let’s fix the problem before it occurs mindset. ”  Where are the patient portals that facilitate this kind of interaction?

People are not worried about sharing their health information online if they see value.  We know this because we see them using online patient communities every day.  However, we need to understand the user and their specific health needs so that we can provide information, coaching and resources highly tailored to that patient.  This highly tailored health experience is what could make regular patient portal use the norm and leads us down the road to behavior change.

To create engaged patient portals that drive behavior change, Dr. Ram asserted that, “It’s got to be mobile.  It’s got to be social.  You’re not going to change behavior without social pressure.”  Behavior change is social and that does not mean one person or a million people.  We need a small handful of people who care enough to be engaged in your life.  The technology that enables this is what will make the difference.

Furthermore, social pressures don’t all have to be human.  We can let the simple nudges happen automatically while we leave the higher value, more difficult things to humans.  This philosophy understands the value of automation while still embracing the value of human touch that doctors and friends provide.  Social rewards from both humans and computers matter more to the next generation of patients than money.

Healthcare is going through a fundamental software-based transformation.  Part of this has been driven through government regulation, but the more dramatic change will be driven by the empowered patient and the need to drive down healthcare costs.  The patient portal can play a key role in that transformation if healthcare providers use it to engage patients and leverage social pressures to effect behavior change.

Check out the full Healthcare Forum presentation by Ashwin Ram, PhD embedded below:

The Breakaway Group, A Xerox Company, sponsored this coverage of the Healthcare Forum in order to share the messages from the forum with a wider audience.  You can view all of the Healthcare Forum videos on The Healthcare Forum website.

About the author

John Lynn

John Lynn is the Founder of HealthcareScene.com, a network of leading Healthcare IT resources. The flagship blog, Healthcare IT Today, contains over 13,000 articles with over half of the articles written by John. These EMR and Healthcare IT related articles have been viewed over 20 million times.

John manages Healthcare IT Central, the leading career Health IT job board. He also organizes the first of its kind conference and community focused on healthcare marketing, Healthcare and IT Marketing Conference, and a healthcare IT conference, EXPO.health, focused on practical healthcare IT innovation. John is an advisor to multiple healthcare IT companies. John is highly involved in social media, and in addition to his blogs can be found on Twitter: @techguy.

1 Comment

  • Maureen,

    RE: “In making patient portals truly effective for promoting and enabling self-care and wellness the first place to start is [human-centered] information design that makes health data personal, relevant and actionable.”

    The pioneering work of both Tom Goetz and Ryan Panchadsaran are important components of the national efforts underway to enable the transformation from the unsustainable, fee-for-volume status quo to the participatory medicine model and a system based on fee-for-value, patient-centered, accountable care.

    The results of the billions of diagnostic tests performed on American patients each year is one indispensable type of health data that desperately needs human-centered information design. The hidden problem is that since American medical computing began in the 1960s, test results have been displayed first on paper and then by computer systems as incomplete, low quality, fragmented data.

    The practical solution for the redesigned user interfaces of EHRs, PHRs and HIE physician and patient portals is to display all cumulative test results as complete, integrated actionable information that is easy for physicians and their patients to view and share.

Click here to post a comment
   

Categories