How useful are patient portals for increasing patient engagement?

Posted by Ella Buitenman | November 27, 2013

Lately we hear a lot about so called ‘patient portals’.  On November 12th we had a conference about elderly care in the Netherlands. Patient portals were mentioned. A few days later an article about the portal MijnGezondheid.net appeared on a Dutch website about ehealth.

The most obvious reason for the creation of a portal is to increase the involvement of patients in their own health and well-being. But is a patient portal actually suitable for this?

The added value of a patient portal can be viewed from two sides: that of the patient and that of the caregiver.

When I look at my own health care use, there are some things that I would like to arrange online. I want to:

• Make appointments online.
• Can request prescription refills.
• Get an answer to a question from my doctor or any other reliable source on the Internet.
• See my patient record and communicate about the content with my doctor.

With a patient portal I actually seem to be able to do these things.

But would I also give access to different care providers? No, not if it means that they all can automatically see everything. Suppose a pedicure and a psychiatrist treat me, I could then imagine that I would not want the pedicure to read about my last visit to the psychiatrist. Access and viewing is fine, as long as I can determine who sees what. And this is where control still lacks at the moment, from what I understand.

For caregivers, the added value is, I believe, in the relief of some administrative tasks. Such as scheduling appointments and writing down repeat prescriptions and sending them to the pharmacy.
And maybe the number of contact moments at the practice can also decrease with online patient consultation.

Conditions to be fulfilled

ZonMW, a Dutch organization that funds health research, lists the following issues regarding patient portals: policy, technology and security. Furthermore, they consider the embedding of the systems in (the workflow of) the organization a problem.

At the conference, we asked a number of case managers what problems with online collaboration they experience now.
They identified the following two issues. Firstly, the timing: during the moments the nurse would want to collaborate with family members, those family members are at work themselves and thus unavailable. Secondly, GPs experience barriers to work online.

From this we can conclude several things.

• Policies should be geared to the use of new resources and changing attitudes. Processes in the medical health organizations will have to adapt to new opportunities.
• The technology must be easy to apply, for patient and caregiver alike.
• Excellent security is a must.
• Good integration with the systems caregivers use on a daily basis seems an essential prerequisite as well. Otherwise there is a risk that a portal will become yet another system in addition to this daily system.

In addition a mental turnaround is necessary. Not only in the patient who will have to bear more responsibility. But also the caregivers resistance to collaborate online, this may or may not be through a portal, has to disappear.

Expectations about patient portals

It’s all about self-management. Can caregivers use a portal to encourage self-management and autonomy in the patient?
A story, held at the elderly care conference, showed that after an excited start the enthusiasm in the elderly soon began to decline. The successful use of the patient portal actually depended on continuous promotion and push by health care providers. The caregivers kept encouraging the patients to keep using the portal.
The question then becomes how much is expected from the use of patient portals when it comes to patient involvement and whether these expectations are not too high. A patient portal is nothing more than a tool that can be deployed in the raising of the involvement of patients in their own health. The most important element when it comes to patient involvement, according to Porter Research, is a good relationship and rapport between the caregiver and the patient.

 

Category: Healthcare