Lately, the medical profession has seen an increasing incidence of a new condition tentatively identified as “hyperportalotus” — marked by symptoms of confusion, impatience, wasted time and existential dread. Unlike many newly-identified medical problems, the cause for this condition is well understood. Patient simply have too many portals being thrust at them.
As a patient with a few chronic illnesses, I see several specialists in addition to a primary care doctor. I’ve also been seen recently at a community hospital, as well as an urgent care center run by a different health system. I have access to at least seven portals, each, as you probably guessed, completely independent of each other.
Portals in play in my medical care include two instances of Epic’s MyChart, the Allscripts FollowMyHealth product and an athenahealth portal. (As an aside, I should say that I’ve found that I like athenahealth’s product the most, but that’s a story for another day.)
Because I am who I am – an e-patient dedicated to understanding and leveraging these tools – I’m fairly comfortable working with my providers on this basis. I simply check in with the portal run by a given practice within a few days of my visit, review reports and lab results and generally orient myself to the flow of information.
Too Much Information
So, if I can easily access and switch between various portals, what’s the big deal? After all, signing up for these portals is relatively simple, and while they differ in how they are organized, their interfaces are basically the same.
The problem is (drumroll…) that most patients aren’t like me. Many are overwhelmed by their contact with the medical system and feel reluctant to dig into more information between visits. Others may not feel confident that they understand the portals and shy away reflexively.
Take the case of my 70-something father. My dad is actually pretty computer-savvy, having worked in the technology business for many years. (His career goes all the way back to the days of punch cards.) But even he seems averse to signing up for MyChart, which is used by the integrated health system that provides all of his inpatient and outpatient care.
Admittedly, my father has less contact with doctors and hospitals than I do, so his need to review medical data might be less than mine. Nonetheless, it’s a shame that the mechanics of signing up for and using a portal are intimidating to both he and my mother.
A Common Portal
All this being said, the question is what we can do about it. I have a theory, and would love to know what you think of it.
What if we launched an open source-based central industry portal to which all other portals could publish basic information? This structure would take proprietary vendors’ interest in controlling data out of the picture. Also, with the data being by its very nature limited (as consumers never get the whole tamale) it would answer objections by providers who feel that they’re giving away the store with the patient data.
Of course, I can raise immediate and powerful objections to my own proposal, the strongest of which is probably that we would have to agree on a single shared standard for publishing this data to the central megaportal. (And we all know how that usually works out.)
On the other hand, such approach has much to recommend it, including better care coordination and hopefully, stronger patient engagement with their health. Maybe I’m crazy, but I have a feeling that this just might work. Heck, maybe my father would bother looking at his own medical information if he didn’t have to develop hyperportalotus to do it.