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E-Patient Update:  Portal Confusion Undermines Patient Relationships

Posted on February 3, 2017 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

I’m not surprised that some medical practice staffers and doctors seem uncomfortable with their EMR system and portal. After all, they’re not IT experts, and smaller practices might not even have any full-time IT staffers to help. That being said, if they hope to engage patients with their healthcare, they need to do better.

I’m here to argue that training staff and doctors to help patients with portal use is not only feasible, it’s important to customer service, care quality and ultimately a practice’s ability to manage populations. If you accept the notion that patients must engage with their health, you can’t leave their data access to chance. Everyone who works with patients must know the basics of portal access, or at least be able to direct the patient immediately to someone that can help.

Start with the front line

If I have problems with accessing a practice portal, the first person I’m likely to discuss it with is someone on the front lines, either via the phone or during a visit. But front office staffers seldom seem to know Thing One about the portal, including how to access it or even where to address a complaint if I have one.  But I think practices should do at least the following:

* Train at least one front-desk staffer on how to access the portal, what to do when common problems occur and how to use the portal’s key functions. Training just one champion is probably enough for smaller practices.

* Create a notebook in which such staffers log patient complaints (and solutions if they have one). This will help the practice respond and address any technical issues that arise, as well making sure they don’t lose track of any progress they’ve made.

* Every front desk staffer (and every doctor) should have a paper handout at hand which educates patients on key portal functions, as well as the name of the champion described above.  Also, the practice should provide the same information on a page of their site, allowing a staffer to simply email the link to patients if the patient is calling in with questions.

* All doctors should know about the champion(s), and be ready to offer their name and number to patients who express concerns about EMR/portal access. They should also keep the handout in their office and share it when needed.

Honestly, I don’t regard any of these steps as a big deal. In fact, I see them as little more than common sense. But I haven’t encountered a single community practice that does any of them, or even pursued their own strategies for educating patients on their portal.

Maximizing your investment

For those reading this who think these steps – or your own version – are too much trouble, think again. There’s plenty of reason to follow through on patient portal support.  After all, if nothing else, you’ve probably spent a ton of money on your EMR and portal, so why not maximize the value it offers?

Also, you don’t want to frustrate patients needlessly when a little bit of preparation and education could make such a difference. Maybe this wasn’t the case even a few years ago, but today, I’d submit, helping patients access their data is nothing more than good customer service. Given the competition every provider faces, why would you ignore a clear opportunity to foster patient loyalty?

Bear in mind that a little information goes a long way with patients like me. You don’t have to write a book to satify me – you just have to help me succeed. Just tell me what to do and I’ll be happy. So don’t miss a chance to win me over!

Physician Practices Lack Good Models For EMR Adoption

Posted on September 14, 2016 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

“All happy families are alike; each unhappy family is unhappy in its own way.”
― Leo TolstoyAnna Karenina

When hospitals roll out an EMR, they go through complex and rich information-gathering process. Health IT leaders tackle problems of scale, systems integration and feature development with support from multiple leaders in other departments. There are best practices to consider and vendor selection processes to observe, references and case studies to collect, and user group meetings they can attend to fine tune their EMR rollout and answer questions.

But when it comes to physician practices, particularly the smaller ones that dominate the medical landscape, the way is not as clear. Often without even a full-time IT staff member to assist them in their selection process, EMR adoption by physician groups is far less structured. Sure, physicians may check references like their hospital colleagues do, explore customer case studies and participate in software demos, but in most cases their process is far less systematic and informed than that of a hospital.

What’s more, if their EMR implementation runs into trouble, smaller medical groups may have far less support than hospital IT leaders. After all, not only are they less likely to get much help in selecting an EMR, they probably don’t have a robust network of peers who can answer questions in context. Like any small business, they make their idiosyncrasies work for them, but when they get into trouble with IT they are unhappy in their own unique way.

Standardizing Physician EMR Adoption
Of course, practice leaders who are struggling with their EMR investment can turn to the vendor that sold them the system, but that can backfire pretty easily. While the vendor is obviously the last word on how the contract is structured, they may or may not have a strong incentive to address gripes and concerns, even if they are obligated to address outright failures of the system.

If the vendor offers a fairly open support model, practices may get some help as they evolve. But if their vendor charges by the hour for support, it’s unlikely many practices be willing to pay for the time to address anything but major problems. That may cut practices off from the knowledge and context they need.

Given these concerns, I’d argue that we need to develop a generalizable, reproducible model for physician EMR adoption and rollout. As I envision it, it should include:

  1. A standardized form smaller practices can use to identify their key needs, allowing them to pick and weight their priorities from an evidence-based list of key selection criteria
  2. A frequently-updated database, maintained by a third party, which collects physician ratings on how a given vendor meets these well-articulated needs
  3. A post-implementation form, once again drawn from research evidence, helping them identify and weight their EMR’s performance based on objective criteria

The idea behind all of this is to standardize physician groups’ EMR selection and rollout, and turn what can be a groping, uneven process into an evidence-based one. Not only will this help physicians from the outset, it allows for building a knowledge base which cuts across vendors, geographies, practice sizes and technical sophistication levels. If physicians had such tools, their process of learning would become iterative and collaborative in a far more effective way.

Don’t get me wrong, I know that virtually any software selection process will address issues that don’t make it into a model like the above.  But if you offer practices a more structured way to adopt an EMR, they are more likely to be happy with their overall results. This is going to become even more and more important as small practices switch EHR software due to EHR consolidation and other factors.