Two weeks ago I was out running with my 4-legged BFF (George) a large, muscular 2-year-old Lab mix. Just as we were getting back to the house, I decided to show him I had another even faster gear he wasn’t aware of. He got very excited about that! So excited, in fact, he cut right in front of me at a full sprint on the pavement, and well… my feet didn’t downshift. At full speed, my entire body weight crashed shoulder-first onto the pavement. Ouch! My night would be spent in an E.D., which confirmed I had a profoundly separated shoulder (AC).
After visiting both the E.D. and an orthopedic specialist, I have received multiple emails from each with instructions on how to enroll in their patient portals. But the emails arrived while I was on pain meds, and when I didn’t need anything from the portal, so I have yet to log in. Based on the difficulty many hospitals are having attaining >5% View/Download/Transmit activity, it appears I’m in good company. The main question is, “Why aren’t patient portals seeing much action and are they the best way to meet the patient engagement goals of CMS?”
Many providers we work with tell us patient portal use (or rather non-use) is their greatest Meaningful Use challenge. They say the majority of patients either aren’t interested or don’t want to go through the rigors of enrollment. Some patients don’t have an email address and would rather skip the hassle of getting one for the sake of enrolling in the portal. Still others don’t have a computer and don’t care to learn how to access the portal from their smartphone.
In my case, it’s even worse. I work for a software vendor that has created and deployed scores of patient portals, and I completely see the value in them. Heck, back in 2007 when we began talking about building one, it was MY baby!
But other than enrolling in these portals for the sake of doing so, and viewing the report that says my shoulder is separated, what would I gain by logging in right away? I have no chronic illness. I’m not waiting on lab results. I don’t need a prescription refill – in fact I don’t take any medications on a regular basis. Signing up for a portal sounds good in theory, but in reality it requires intentional action on my part, and because life is busy, the portal falls down the priority queue.
From what I can tell, providers are doing the right things to engage patients. Hospitals have marketed their portals, distributed brochures, implemented additional staff for portal enrollment and even provided training. Overall, hospitals have put forth a great effort (at no small expense) to encourage portal usage.
So it bears asking, “Have we just completely missed the mark with patient portals?” Were we aiming at the wrong target all along, i.e., passive, website access to patient health records? Or were we (as the Daughtry song says) "shooting with broken arrows,” i.e., using the wrong “engagement” technology?
Probably a combination of both.
I believe that the better patient engagement strategy with today’s culture and technology is the use of smartphones and “push" technology to actively engage patients where they live, work, and play. All day long, smartphone users feel the familiar buzz of their device and read the notification of the moment. So why not feel that same buzz and see that you have a new report – click to view – and and take a few seconds to view it.
All that might take a few seconds, integrated into your daily routine and still add a point on the scoreboard for VDT. This would only be scratching the surface in terms of how providers and patients can engage each other once this type communication becomes commonplace. More on that in a different post…
I can already hear the protests of, “But not everybody has a smartphone.” True enough. But north of 5% would be a great starting point, so why let perfection get in the way of much better. The Pew Research Center in a Dec 2014 survey found that 64% of Americans own smartphones (almost doubling since 2011) and ironically, a growing number rely on their smartphones for Internet access (hmmm… that part doesn’t work as well for portals).
This amazing multi-purpose device is rarely more than a meter from our physical bodies and has become integrated into our lifestyles. Through it we learn, socialize, record life, and communicate in a myriad of ways. It buzzes, and we respond. But if the answer is so obvious, why isn’t this the de facto patient engagement technology today, and will we ever get there?
I do believe the market is starting to figure this out. It shouldn’t take very long (months, not years) before we see a number of mobile, active patient engagement type applications that meet the spirit of Meaningful Use, but exceed today’s results.
Even incumbent portals, in order to keep market share, will likely offer companion products for those who want the push-type smartphone experience. I can tell you, a mobile application would have made a big difference in my case.
If for example, I had enrolled my mobile device during those four hours in the E.D., I would have done so out of boredom alone – or at least to take my mind off the pain. Today, I would have my imaging report, diagnosis and electronic discharge instructions in my pocket and available for the next provider. Instead, I guess I need to stop procrastinating, find those emails and figure out how to log in to those portals...