EHR and Health IT Consulting
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EHR and Health IT Consulting
Technical Doctor's insights and information collated from various sources on EHR selection, EHR implementation, EMR relevance for providers and decision makers
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Patient Engagement: Much Bigger Than Patient Portals

Patient Engagement: Much Bigger Than Patient Portals | EHR and Health IT Consulting |

There is no doubt that the topic of patient engagement has taken center stage in healthcare. It was the hot topic at HIMSS 2015 where a major national study was unveiled, Three Perspectives of Patient Engagement. And that was just one of the many sessions, events, and booths focused on patient engagement at the event.

Thanks to Meaningful Use, a lot of the focus on patient engagement has been around patient portals. It makes sense since practices have to meet specific thresholds in both MU2 and MU3 for portal use. They certainly play a key role in providing patients with access to medical records, test results, and even tools like online scheduling and billpay. The benefits have not gone unnoticed by providers. Over 80% of doctors believe a patient portal helps with patient satisfaction and 71% believe it helps with patient/physicians communication. The benefits haven’t gone unnoticed by patients either. Two-thirds of patients say they would be more loyal to physicians who provides a portal through an EHR.

Despite the undeniable value of portals, they are just one component of true patient engagement. This was clear in the presentation about the new national study released at HIMSS. According to the presentation, the biggest problem in creating patient engagement isn’t providing access to health information. The problem is shifting the attitudes and expectations of both clinicians and patients.

Resolving this problem requires a major culture change in healthcare. Despite the fact that patients and providers say they want improved access, communication, and outcomes and that patient engagement may hold the key, change is slow.

The reason is actually pretty simple. A shift in the culture towards a truly patient-centric model requires changes at every interaction and that involves every person across the spectrum. In many cases this means not only shifting attitudes but also the way things are done. That can require adding, changes, or maximizing technology. While technology plays this critical role, it is much bigger than portals alone.

It starts with finding the appropriate provider and goes all the way until the final bill is paid. The new patient-centric model looks something like this:

Patients can search for providers online, see patient reviews, and book an appointment from home.

Patients can easily find answers to questions about the practice on their website.

When the patient does call the office, the phone is answered quickly and so is the inquiry.

The patient receives a reminder through the means of their choice—text, email, or phone, and can complete pre-registration information to speed up check in and the encounter.

The patient doesn’t have a long wait time after check in, and if there is a delay, someone alerts the patient and gives them the option to reschedule.

In the exam room, the patient encounter runs smoothly as all the relevant patient information is at hand and the provider can refer to their mobile HER, which allows the physician to maintain eye contact and share information and images with the patient.

The patient receives education and a visit summary before leaving the practice.

The patient receives a follow text or email with directions to leave a review of the practice.

The patient can follow up on the patient portal to see lab results or review medical record information.

The patient receives an email or text with a link to their bill to pay online.

The patient has an ongoing connection to the practice through regular emails, social media, practice blog, and/or newsletter.

There are lots of other little things a practice can do to provide a positive experience that makes them want to come back and helps them feel more engaged in their own wellness and can even improve outcomes.

This consumer-like experience is really what patients want not just a portal. They want a strong relationship with their provider and to be in control of medical decisions or participate in shared decision-making with their doctors.

There is a huge opportunity here for all healthcare providers to begin shifting the way they relate to patients and provide care. It’s a chance to go beyond Meaningful Use and portals and look at the entire patient experience, including a new element to patient care—convenience.

As smaller practices are more nimble, they may find it easier to make these changes than large practices. This can be a unique competitive advantage that smaller practices can take advantage of.

Today, there are also a lot of affordable, easy-to-use solutions for patient engagement and practice marketing that can help. A practice can now easily create an engaging website, provide an online scheduling widget, share positive reviews, and send mass emails and texts with news and information. When combined with an electronic health record and best practices in billing, any practice can become a truly patient-centric practice. Then, the ability to meet those portal use thresholds becomes an easy to achieve by-product of a larger patient engagement strategy.

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Tech Tools to Boost Patient Collections

Tech Tools to Boost Patient Collections | EHR and Health IT Consulting |

With the proliferation of high-deductible health plans under the Affordable Care Act, patient payments have become a bigger chunk of many practices' revenue. As a result, experts say physicians should be developing more sophisticated collection strategies that take advantage of technology to help get money in the door.

Used effectively, technology can help smaller practices stay on top of patients' coverage and financial responsibilities under the new high-deductible plans, as they may be new to both practice and patient. Many newly insured patients are unaware of the service-level details of their policies. So it's important to give your staff readily available information about coverage, balances, and answers to frequently asked questions.

Technology can help you streamline processes at the front desk to facilitate collection at time of service, provided that you invest in staff training, said Colleen Fusetti, a director at FluidEdge Consulting in Malvern, Pa.

"You need to put a lot of emphasis on training staff to use the technology and understand patient balances and payment options so that they, in turn, can educate the patient," she said. "The ability to collect drops considerably after the patient walks away from the front desk."

Fusetti and other revenue cycle management experts also offered these tips for getting the most out of your technology tools to improve patient collections:

• Set up a patient portal. The portal allows patients to check their eligibility and claims data and view or pay their balances online.

• Integrate an insurance eligibility service into your practice management and EHR systems. Some services allow you to run a verification check on every patient scheduled for a visit over the next few days so that you can reach out to patients in advance to get new insurance information, if needed.

• Use an automated appointment reminder service. The services not only remind patients about upcoming appointments but also link patients to the portal where they can see any pending balances, make payments, and review their coverage before arriving.

• Consider online credit card processing. You can accept credit or debit card payments from any Internet-enabled device linked to a mobile card swiper.

• Set up automatic payments. Many merchant service companies offer an option to keep patients' credit card information on file securely. After discussing financial responsibility for a future procedure or service, patients can decide whether to authorize a one-time payment pending final calculation of their bill or set up a payment plan with recurring payments.

• Take advantage of online resources. The AMA offers a Point-of-Care Pricing Toolkit free to its members. The resource provides tools to help practices collect what patients owe at the time of service.

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Factors that Make a Patient Portal Successful

Factors that Make a Patient Portal Successful | EHR and Health IT Consulting |

Medical practices across the country are searching for that special ingredient that will get patients to sign up for — and keep coming back to — their portal. Unfortunately, it's proven to be very hard to find.

Still, some healthcare systems are finding it much easier to secure patient engagement than others.

Take Kaiser Permanente, for example. Currently 4.5 million of its members are using its portal, more than 90 percent are satisfied or very satisfied with the portal, and 98 percent would come back to the portal.

That's according to Judy Derman, director of member engagement in the digital services group at Kaiser Permanente, who presented at the Healthcare Information and Management Systems Society (HIMSS) conference in Chicago.

During her session entitled "Provider Perspectives on Patient Adoption of Portals, Secure Messaging," which she copresented with Susan Hull, CEO of Wellspring Consulting, and family physician David Willis, CMIO of CommunityHealth IT and medical director for the Heart of Florida FQHC, Derman shared some of the strategies Kaiser uses that may help your practice get patients engaged.

Marketing the portal
Kaiser's marketing strategy included promoting the portal through a variety of methods at a variety of touch points, said Derman. Just as everyone learns through different methods, there's no one-size-fits-all approach that works when marketing to a wide variety of people, she said.

"I think the key ... is the integration into every single contact, every newsletter, every article, every time you turn around," she said. "You just need to use every avenue."

Getting patients engaged
While great marketing might get patients to sign up for the portal initially, the tricky part for practices often arises when attempting to get patients to continue using it.

One way to get patients coming back is to offer the features that they respond to most favorably, such as online bill pay and secure messaging.

You also might want to consider providing patients with online access to test results as often as possible. In fact, this is one of Kaiser's most popular portal features, said Derman. While there are, of course, situations in which tests can't be released online, most can be and should be, she said.

Another popular portal feature among Kaiser's patients is the ability to share digital images via the portal, said Derman. While many physicians initially feared that patients might use the feature inappropriately, they were pleasantly surprised, she said. "Every single time ... they do use it appropriately."

Making it personal
If you feel like you've exhausted all your options in attempting to get patients to use your portal, you might want to try to shift your perspective.

During the presentation, Hull, who is also a nurse and co-leader of the ANI Consumer eHealth efforts and serves on the ONC's Content Standards Workgroup, stressed that while patients are slow to engage with the portal, providers and other clinicians' may also be slow to engage with the portal when they are healthcare consumers. In fact, only about 30 percent to 40 percent of nurses are actually using their own patient portals and personal health records, said Hull. 

To truly see the benefits, limitations, and barriers to portal adoption, providers may need to begin engaging with portals more when they, and their families, are patients, she said.

"I think patient adoption of portals and provider adoption of portals and our collective experience will drive one another ...," said Hull.

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Why Can’t Release of Records Be Automated Through A Patient Portal?

Why Can’t Release of Records Be Automated Through A Patient Portal? | EHR and Health IT Consulting |
I was in a recent discussion with one of the leading providers of release of information services, HealthPort about EHR’s impact on the release of health records. In our discussion, I asked why the release of health records can’t be completely automated through a patient portal. In my mind, meaningful use is requiring that healthcare organizations put a patient’s record up on a patient portal, so shouldn’t that mean that the release and disclosure of patient records would become obsolete?

Of course, I was applying a limited view to what’s required when a disclosure happens and who is making the records request. In most cases, it’s not the patient requesting the record and these third parties don’t have access to the patient’s portal. Plus, the release and disclosure of patient records often requires accessing multiple systems along with assessing which information is appropriately included in the disclosure. The former is a challenge that can be solved, but the later is a complex beast that’s full of nuance.

In order to clarify some of these challenges and explain why a patient portal won’t replace all records requests, here’s a short interview with Jan McDavid, Esq., General Counsel at HealthPort.

Q: What are HIPAA requirements around “charging” for copies of records, and what are considered “reasonable” costs?

A: HIPAA is very clear that its pricing applies only to copies provided to “individuals,, which HIPAA defines as the person who receives treatment—the patient. HIPAA guidance pertains only to patient requests for medical records, approximately seven percent of all requests received by healthcare providers.

The majority of records are requested by physicians for continuing care, governments for entitlement benefits, insurers, and inquiries from attorneys, according to internal data from HealthPort’s 2014 record release activity nationwide.

Within the realm of patient requests, providers can charge patients no more than their labor costs to produce the record, plus supplies and shipping. No upfront fee to search or retrieve records may be charged to patients.

Q: Why shouldn’t records just be free now that they are electronic?

While many believe the cost to produce records should be negated once information is digital, there are misperceptions and logistics that must be understood. The process of disclosure management (release of information) involves many steps that still require human intelligence and intervention—especially on the front end of the process (receiving, validating and approving the request). Here are three examples:

The authorization must be adhered to strictly, which often requires contacting the requester and explaining that some of the records they requested may not be available, or may require very specific patient authorization.

Information is commonly pulled together from multiple sources and systems (paper and electronic) to fulfill a request. While providers are working toward completely electronic environments, almost all still have a combination of paper and electronic. Depending on who makes the request, every single page of a record may require review.

Staff releasing records must be trained on HIPAA, HITECH, the Omnibus Rule, state and federal subpoena requirements, and specific state and federal laws for drug, alcohol, HIV/AIDS, mental health, cancer, genetics, minors, pregnancy, etc.

Q: If the EHR is in the portal, what other records aren’t in the EHR that HIM staff has been aggregating in a records request?

A: Not all patient information is automatically included within the patient portal view, nor should it be. Each provider organization determines what EHR information is posted to the portal and what patients can do within the portal (e.g. requesting refills, scheduling appointments, viewing lab results, etc.). HIM experts are key in these decisions.
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The Value of Healthcare Portals for Patient Engagement

The Value of Healthcare Portals for Patient Engagement | EHR and Health IT Consulting |

More and more, doctors and patients are relying on the internet to interact with each other. Using healthcare portals accessible on the web has revolutionized communication and substantially reduced the number of phone calls that are needed.

The experience of one Montana patient, is typical. He pointed out that, “If I need a prescription renewed or have a question for [the doctor], you hop on the portal, and his nurse usually has an answer back to you within an hour.”

Are Patients Willing To Use Portals?
According to, a survey conducted by Xerox showed that both boomers and millennials are very open to using healthcare portals to give and receive medical information. Millennials grew up with electronics and are at home with the internet. Over 43% said they would use their smartphones to access information. They showed the strongest interest, over 57%, in reviewing their medical records.

More than two-thirds of older patients have chronic conditions that require visits to the doctor. In fact they account for two-thirds of the U.S. healthcare budget. Over 50% of people in the boomer age group said they would be interested in getting access to medical care and information by using a portal.

There is no question that both patients and doctors want to use the portals. Here is a look at how they will continue to revolutionize the patient and doctor relationship in the coming years.

Communicate More Effectively
Having electronic records stored online lets both the physician and the patient look at what is recorded. Both can more easily spot trends. For example, blood sugar spikes or cluster headaches might be happening during periods of family upsets. Knowing the correlation can help with creating an effective treatment plan.

If a patient is worried about how his new prescription is affecting him, he can easily connect with the nurse or doctor to ask if what he is experiencing is normal. It is quick and easy, and lets the doctor makes changes early. If the process needs to be done by phone, the patient often just waits it out instead of calling because it takes so much effort.

Reduce the Number of Phone Calls
Patients can book appointments quickly online. This substantially reduces the number of calls the front desk has to field during the course of a day.

It helps streamline the process of working patients in for a visit, especially when combined with robo-calls to remind them it is time for their next appointment. While the ability to talk to a live person is appreciated by patients, having the ability to accomplish certain things online adds another great layer of customer service to patients.

Get Prescription Refills
With healthcare portals, it is easy for a patient to request that a refill prescription be sent to the pharmacy. He can do it online 24 hours a day, 7 days a week, whenever he becomes aware that he is running low.

Likewise, physicians and staff can approve refills at any time, making it more likely the pharmacist will get the ok for the medicine in a timely manner. It can also help to reduce patient wait times, since prescription refills can be handled outside of the patient’s office visit.

Share Records with Specialists
Portals simplify the process of asking a specialist to review a patient’s case. This results in better care and getting expert advice quickly. According to the blog on Healthcare IT News, the most advanced portals provide accurate, easy-to-use data for physicians, as well as the ability to share it securely with specialists.

Healthcare portals are making doctor-to-patient and doctor-to-doctor communication easier, quicker, and more accurate. It results in better diagnosis, more consistent care, as well as less frustration and more trust on the part of patients.

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Patient portals and EMRs: Each requires a different skillset

Patient portals and EMRs: Each requires a different skillset | EHR and Health IT Consulting |

Most readers know that an EMR (electronic medical record) is the back-end software that runs a health care organization. EMRs have been around for a while. Recently most large hospitals and health systems have begun building out the patient-facing version of their EMR; allowing patients to communicate electronically with their doctors, refill prescriptions, schedule appointments, and view clinical information.

I’ve written at length about the differences between B2B software and B2C software and how B2B software is generally not very good (particularly from a usability perspective). And it’s not very good simply because it can get away with not being very good. B2B companies often just need a good salesperson that can lock-in long-term contracts to be successful. Once the software is purchased, it’s not easy for users to switch.

B2C companies, on the other hand, need an incredible product to be successful. If your user experience isn’t flawless, you cannot survive in the B2C space. The switching costs for consumers are near zero — the user experience must be incredible. Product is much more important than distribution. B2C user satisfaction scores are significantly higher than B2C scores.

Applying this to health care, if you’re a hospital and your EMR is hard to use, your employees will still use it because they have to — they can’t easily switch to a competitor.

But if your patient portal is bad you will lose patients instantly. It’s too easy for patients to switch to something else.

The Healthcare Information and Management Systems Society (HIMSS) published a good report talking about patient portals.  They noted that despite the difficulty of building a wonderful online consumer experience and the totally different skill set required to execute on it, 80 percent of hospitals surveyed chose their patient portal vendor simply because it was the same vendor that provides their EMR (the top three portals were made by Epic, Cerner and McKesson). All of these vendors have been building B2B enterprise software systems for more than 30 years. They’re all wonderful companies. But they have no idea how to build a patient facing product. Their management, engineering talent, sales force, culture and DNA is all about B2B. They have almost no chance of building a world class consumer product. That’s not a knock on these companies; it’s just reality. You can’t be good at both.

As we transition to a world where the patient is in the driver’s seat, exposing patients to old-fashioned enterprise software code and interfaces is not a good idea. Hospitals shouldn’t let a piece of software touch their customers unless it’s been vetted and tested fully, and it’s clear that patients love it. If you check out the satisfaction scores for most patient portal apps, you’ll find that most patients despise them (one of them I looked at last week had 2,000 reviews in the iOS app store and more than 1,500 of them were only 1 star).

Patients are becoming consumers. They want slick, easy, mobile, beautiful, simple and seamless web experiences. If the software that touches patients doesn’t give them that they’re going to go somewhere that does.

Now, in defense of these hospitals let it be known that there aren’t a lot of great consumer-focused software companies building-out patient portals. So in the short term, they might have no choice. But I’d encourage CIOs that are making patient portal investments to consider the consumer and to cautiously enter into flexible and short term contracts with these patient portal vendors.

You should be careful about buying groceries from the company that fixes your car. And you should be careful about buying consumer-facing software from the company that built your EMR.

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Why Don’t 35% of Patients Know that Patient Portals Exist? |

Why Don’t 35% of Patients Know that Patient Portals Exist? | | EHR and Health IT Consulting |
Patient portals are becoming important tools for engagement and population health, but patients are largely unaware of the technology.

While patients are generally enthusiastic about viewing their EHR data and engaging with their providers online, a concerning number of patients are unaware of the possibilities of using a patient portal, finds a new survey from Xerox.  Among the 64 percent of patients who are not portal users, 35 percent did not know a portal was available to them, and 31 percent stated that their providers had never mentioned the technology to them.  Despite the widespread lack of knowledge, 57 percent of non-users said they would be more engaged and more proactive in their own healthcare if they had access to their data online.

“With providers facing regulatory changes, mounting costs, and patients who increasingly seek access to more information, our survey points to an opportunity to address issues by simply opening dialogue with patients about patient portals,” said Tamara St. Claire, Chief Innovation Officer of Commercial Healthcare for Xerox. “Educating patients will empower them to participate more fully in their own care while helping providers demonstrate that electronic health records are being used in a meaningful way.”

The survey indicates a generation gap when it comes to how patients use online tools.  While baby boomers are more likely to view patient portals as a utilitarian feature by making appointments online (70 percent), refilling prescriptions (58 percent), and communicating through emails with their physicians (60 percent), millennials view portals as an informational hub.  Younger patients want to see personalized information (44 percent), tailored care plans, details about related services from their providers (44 percent), and industry news that might relate to their issues and concerns (23 percent).

Perhaps surprisingly, baby boomers, aged 55 to 64, were among the most frequent users of patient portals.  Eighty-three percent of this age group indicated that they already do or would be very interested in communicating with their healthcare providers through a portal.  Millennials were more likely to want mobile access to online tools, with 43 percent stating their preference for smartphone and tablet interfaces.

Providers can help to shape patient engagement – and help themselves to meet the 5 percent patient engagement threshold included in Stage 2 meaningful use – by taking the time to educate patients about their options and opportunities.  Reinforcing the idea of signing up for a patient portal account at multiple points along the patients’ journey through the office, from check-in to follow-up, can help to secure a patient’s interest.  And physicians themselves should take the lead, St. Claire asserts.

“Physicians just aren’t having that dialogue,” she said to HealthITAnalytics.  “When we look at some of the best practices out there, we see that having that conversation multiple times along the patient’s path through the office is most effective.  And we think having that conversation directly with their physician is going to be most important.  People really want to hear it from their physician, because they’re that trusted source.  Even as medicine is changing, having that talk with the physician is probably going to have the most impact.”

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Three Vendors are Driving Patient Engagement and Portal Use

Three Vendors are Driving Patient Engagement and Portal Use | EHR and Health IT Consulting |

Driving patient engagement is still vital for the healthcare sector despite certain inconsistencies from the Centers for Medicare & Medicaid Services (CMS). Even though CMS has proposed new Stage 2 Meaningful Use regulations that drop the 5 percent requirement of patients viewing, downloading, and transmitting their health information to just one patient per provider, the organization still expects eligible professionals and hospitals to meet a much larger percentage – currently proposed to be 25 percent – of patients viewing their medical data through patient portals under the Stage 3 Meaningful Use requirements. As such, providers would be wise to continue integrating patient engagement strategies at their facility.

Vendors play a vital part in developing effective patient portals to assist providers in driving patient engagement among their community of consumers. A report from the research firm KLAS examined which vendors in particular have been most useful in moving forward patient portal adoption amidst healthcare providers.Driving Patient Engagement

Athenahealth, Epic, and Medfusion were reported to be at the top of their game when it comes to increasing portal adoption throughout the patient population. More than half of the customers under all three vendors report that at least 20 percent of their patients have accessed the patient portal. This is well above the previous 5 percent threshold that CMS initially unrolled under Stage 2 Meaningful Use regulations.

KLAS discovered these findings after interviewing 186 medical provider organizations on which vendors have really made a difference in meeting their needs and advancing health IT and patient engagement for a brighter tomorrow.

The KLAS report focused on three main areas regarding patient portal strategies: enterprise, ambulatory, and EMR agnostic. A variety of factors associated with increasing patient portal adoption were addressed in the report including product performance and vendor guidance.

“Value-based care is forcing patient portals to evolve from being merely tools for reactive regulatory compliance to becoming valuable instruments that allow patients to proactively engage in their own care,” said report author Coray Tate. “Providers report that vendor guidance and functionality that patients find useful, such as billing and self-scheduling, are the most effective ways to encourage portal adoption among patients.”

A study published by the American Health Information Management Association (AHIMA) further outlines the use of the patient portal particularly among teenagers and parents. The researchers studied the attitudes of these two groups through one teen digital bulletin board, one parent digital bulletin board, and two focus groups for each faction. Videos and transcripts from the sessions were then analyzed.

The results showed that both teenagers and parents found that patient portals are beneficial and should be used to help teens better manage their own healthcare. Some teenagers were concerned that physicians would not be keeping certain information private and will let their parents see data that is meant to be protected. One parent said: “This kind of access will help my teen become much more interested in her healthcare and also motivate her to take control. And that will be great.”

With greater teamwork between vendors, providers, and the patients themselves, there should be a rise in the use of portals and patient engagement.

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Shared Patient Portals Have Benefits and Drawbacks

Shared Patient Portals Have Benefits and Drawbacks | EHR and Health IT Consulting |

Leaders at a 100-physician practice in Kansas and a neighboring hospital system shared the same concern when they launched separate patient portal systems: What if patients chose to use one portal over the other? Patient choice could have a huge impact on both systems' attestation to CMS' meaningful use program.

That was the dilemma described by Laura McCrary, executive director of the Kansas Health Information Network (KHIN), a non-profit member health exchange, and a speaker at this year's Healthcare Information Management and Systems Society (HIMSS) Annual Conference.

But using the statewide patient portal offered by KHIN could have solved both organizations' problems, she said.

"If you share a portal, every time a patient looks at info in the portal it counts for [both the hospital and practice]" McCrary said. "It allows our providers to work together."

Statewide portals such as KHIN's are one solution to the emerging problem of patients accumulating multiple portal logins and passwords from multiple providers as more organizations embrace these electronic patient engagement solutions. They offer other advantages as well, including allowing organizations that couldn’t afford a portal of their own to use one and giving patients an easy to use and comprehensive portal for their health information.  But there are also technical and other challenges to creating a statewide portal system, explained McCrary.

 So far, 38 organizations of KHIN's 1,000 member organizations have opted to use the statewide MyHealtheRecords portal. The portal is one of two available in the state. Kansas required both of its private health information exchanges (HIEs) to offer a statewide portal.

Convenience for patients is a big benefit of a statewide portal like KHIN's system. Patients get all the information included in the summary of each patient encounter in one location. They can upload other information, and print out a pocket-sized summary of their medical information for emergency service providers, said Michelle McGuire, the senior project manager for KHIN. It also includes linked and searchable patient education materials from Healthwise. Individuals who are managing care for a child or older parent can also tie their portal accounts together.

Overcoming Challenges

But there were initially some challenges for providers who had to manually upload the patient summary and securely e-mail it to the patient, McCrary said. That step has since been automated. Physicians currently have to authenticate patients onsite in order for them to set up their account in the portal, but eventually patients will be able to self authenticate.

There were also technical challenges KHIN didn't anticipate. Currently, the patient portals query the HIE every six hours for new information. But now that more than 10,000 patients are using the system, this is becoming unsustainable, McCrary said. So KHIN is working on a way for the HIE to automatically push new data to the portals.

Another challenge was managing the links between parent and child portal. The system can automatically unlink a child's portal from their parents when they turn 18. But the state of Kansas allows children to have medical privacy from their parents as soon as they become sexually active, McCrary explained. So the system had to create a way for physicians to mark some information as only viewable by the child.

Going forward, several upgrades are planned for the patient portals, including adding more patient information.

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Patient Portals and Tracking Devices Driving Engagement

Patient Portals and Tracking Devices Driving Engagement | EHR and Health IT Consulting |

As EHR systems, patient portals, telemedicine, electronic prescribing, and other technologies continue affecting the healthcare industry, more stakeholders are considering how these tools are impacting patient engagement. For instance, a Harris Poll survey released by ambulatory healthcare IT vendor eClinicalWorks polled 2,000 adults across the country and found that 84 percent of respondents have access to a patient portal through their physician’s practice.

Another interesting finding from the poll is that adults older than 55 years of age are actually more likely to access their medical records through these tools than adults between 18 to 54 years of age.147504495

The use of patient portals is increasing, as 60 percent of respondents claimed to prefer scheduling doctor appointments via the portal or other secure website. The survey also examined how healthcare providers regarded patient portals.

The biggest benefit of the patient portal, according to three out of four polled physicians, was enabling patients to view their own medical record and creating a platform for sharing data among doctors. Sending alerts and appointment reminders to patients was also cited as a major benefit of the portal. More than one in two (56 percent) physicians also support the ease of appointment scheduling through the patient portal.

Wearable devices and telehealth initiatives are also impacting patients around the nation. The survey shows that 37 percent of people who wear a fitness tracking device tend to wear it every day. Additionally, almost four out of five people who use wearable devices at least twice a month find it essential for their physicians to have this information.

Along with questions on wearable devices, the survey also examined patient views on telemedicine. The results show that 64 percent of adults would sometimes prefer a telehealth visit over an in-person visit for following up with a prior health concern. Additionally, two out of three doctors found that fitness trackers, health apps, and patient portals have all transformed the typical conversation between patients and physicians.

As previously reported, Nuance Communications has also conducted a survey across Germany, the US, and the United Kingdom on the patient perspective of new healthcare technologies.

“One of the things that came out [of the survey] was that patients like the fact that their physicians are using technologies,” Dr. Nick van Terheyden, Chief Medical Information Officer of Nuance Communications, told “Obviously, it’s come with some challenges and specific problems. Our desire is to smooth that over and make the technology work better for the interaction.”

Some advice the CMIO offers is to rearrange the doctor’s office and to ensure physicians are more focused on the patient instead of note-taking. Whether using scribes or a laptop and facing the patient, physicians can incorporate the new technologies to engage the consumer. Dr. Nick van Terheyden also spoke about the benefits of tracking devices.

“We’re seeing this big move and explosion of these devices that are tracking information and I’ve heard pushback from my colleagues who say ‘I don’t want 1,500 blood pressure recordings from my patients’ and I would agree with that,” said van Terheyden. “What you are interested in is a high density representation of that in chart form that shows blood pressure is stable, or declining, or increasing. That’s highly valuable information.”

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How to Properly Implement Patient Portals for Meaningful Use

How to Properly Implement Patient Portals for Meaningful Use | EHR and Health IT Consulting |

Even though the Stage 3 Meaningful Use proposed rule is now dominating the public dialogue about the EHR Incentive Programs, many healthcare providers are still struggling to meet Stage 2 Meaningful Use regulations. One of the key issues that concerns providers is the difficulty of increasing patient engagement and the use of patient portals.

Having patients be more aware and have more control over their own health is necessary to ensure better patient outcomes and quality of care. The Centers for Medicare & Medicaid Services (CMS) state on their website these intentions as their primary reason for emphasizing patient engagement in Stage 2 Meaningful Use requirements under the Medicare and Medicaid EHR Incentive Programs.

Stage 2 Meaningful Use calls for more patient-centered care that includes providing patients with access to download and view their electronic health information through portals. Additionally, providers are encouraged to send patient follow-up reminders and preventive care correspondence.

Providers will need to ensure that more than 5 percent of their patients access their data through patient portals and utilize secure messaging tools to speak with their physician. In order to assist providers in meeting these requirements, the Office of the National Coordinator for Health IT (ONC) provides a fact sheet to assist in the implementation of patient portals.

First, ensuring a portal is user-friendly and engaging is key in meeting this requirement under Stage 2 Meaningful Use. Transitioning toward using this technology during clinical examinations or treatments may improve decision-making, patient-physician communication, and self-care support.

Often, the older population may not be as tech-savvy with regard to accessing their health data through a patient portal. ONC suggests training these patients to use the tools and services available through a portal.

Some key actions that providers should take to improve patient engagement is to implement proactive and engaging features as well as promote and expedite portal use. There are a variety of benefits providers gain from portals such as efficient and effective communication channels with patients, greater self-care initiative from patients, and higher patient satisfaction.

Stage 2 Meaningful Use requirements call for providing patients with clinical summaries, patient-specific education support, secure messaging tools, follow-up care or preventive health reminders, and access to their medical records.

When developing a patient portal, it is useful to have interactive features that are relevant to patient needs. A portal should go beyond merely scheduling features and a method for displaying lab results. Incorporating decision tools and secure messaging capabilities will catalyze the regular use of patient portals. For additional expertise in implementing patient portals, the ONC fact sheet recommends providers to seek the assistance of regional extension centers (RECs).

Currently, patient portals are expanding not only nationwide but also across the globe. A press release from Frost & Sullivan emphasizes the high adoption rate of patient portals in Africa.

“The ability of patient portals’ to optimize the operational and financial efficiency of healthcare providers and payers by leveraging time-saving technologies is a key purchasing factor,” Frost & Sullivan Healthcare Research Analyst Saravanan Thangaraj said in the company press release. “Further, it can ease some of the tedious and monotonous administrative, as well as data-entry, tasks that consume hospital resources. Patient portals also eliminate the need for additional staff and postage by enabling patients to perform functions online.”

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Not All Patient Portals Are Created Equal

Not All Patient Portals Are Created Equal | EHR and Health IT Consulting |

Patient Portals are a trending item in the healthcare industry, but what does the term “Patient Portal” really mean?  And more importantly, what can a Patient Portal do for you?

In reality, the patient portal moniker has become a confusing industry catch-all; patient portals from one vendor may provide entirely different levels of service and interactivity than another.  Adding to the confusion is the fact that both may still fail to offer the services that you as a provider are looking for.  The truth is, some portals are very limited, offering only a very basic login and access to patient history.  Other portals, however, are highly functional game changers that interact seamlessly with workflow and offer everything from intuitive check-in to patient reminders, self-registration and even payment options.

Five must-have features in a patient portal

So let’s clear the patient portal fog. Below are a few efficiency-making functionalities you should be looking for when in the market for a patient portal.

1)      Electronic Patient Entered Data & Interoperability

What is the point of a patient portal if your staff is still required to enter patient data?  This is redundant. To leverage the speed and efficiency of technology, information your patients fill-in should automatically and seamlessly get entered and verified in your existing systems of record. The portal could then pull information from your existing systems to provide access to your patients, even from past appointments. One powerful, efficient portal will interact with your entire office, no matter what technologies you already have in place.

2)      Pre-registration From Anywhere or Any Device

While patients are accessing the portal from home, they can also register for appointments remotely.  This allows patients to arrive for an appointment with registration complete and fully entered.  Additionally, higher-functioning portals allow document uploading and payment options so your patients can walk-in and focus on what matters most, getting treatment.

3)      Patient Estimates & Payments

Get accurate insurance, payment and co-pay estimates and accept payments through your portal. Some portals harness accurate estimation and eligibility software that makes billing less complicated and allows for quicker payments, by allowing patients to pay from anywhere while using the portal.

4)      Custom Workflow

Optimize and tailor your workflow and electronic registration to the fastest possible output of YOUR individual practice. Healthcare practices are highly individual and unique; no two offices have the same workflow.  It is likely an out-of-the-box portal geared for one practice will not sufficiently meet all of you needs. Quality vendors, however, will tailor your electronic registration process to match the exact needs of your practice.

5)      Patient Engagement

Quality patient portals automatically remind patients of appointment times, exams, billing etc.  Reminder intervals can be selected by staff or individualized by the patient to suit what serves them best.  Portal reminder features gives office staff freedom from phone calls, letters and email, and automatically notifies patients for you. This results in higher front office productivity and patient interaction, while significantly reducing over-bookings and the costly no-show appointment.

Armed with this knowledge, you can find a patient portal that is specifically geared to your office.  Quality patient portals meet unique needs and use seamless technology to interact with existing infrastructure to create a highly functioning, efficient office while adding immeasurable value to the patient experience and your bottom line.

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Accountable Care, Patient Portals Lag behind Expectations

Accountable Care, Patient Portals Lag behind Expectations | EHR and Health IT Consulting |

The slow uptake of accountable care reimbursement structures and the low implementation rates of advanced patient portals are among some of the top issues in healthcare over the past year, according to HIMSS Analytics, and present both challenges and opportunities for the industry as it moves forward into reforms that encourage patient engagement, individualized care, and higher quality outcomes.   While mobile technologies and telemedicine are enjoying widespread interest and use among healthcare providers, opportunities to increase adoption of health IT, improve patient engagement, and provide better patient care abound in the year to come.

“Patient engagement is more than just today’s hot topic – it is foundational to the future of healthcare,” said HIMSS Analytics Research Director Brendan FitzGerald.  Yet few providers who have patient portals have selected software that allows patients to truly engage with them, the organization found.  Sixty-two percent of hospitals are live on a portal, but just 23% can allow patient users to view their personal health record or lab results.  Without functionalities that encourage patients to visit the portal site on a regular basis or offer features that patients have expressed preference for, healthcare providers may find themselves struggling with Stage 2 meaningful use throughout 2015.

Despite the slow adoption of feature-rich portals, telehealth seems high on the agenda of many organizations.  Nearly half of organizations have adopted up to four different telehealth technologies, including two-way video conferencing, which is viewed as the best entry-level investment for providers looking to dive into the telehealth sphere.

“Organizations continue to strive toward a value-based rather than volume-based care model, and many telemedicine technologies can aid in that transition,” FitzGerald said in August. “However, the study found that organizational needs will vary based upon provider type while the numerous technologies under the telemedicine umbrella will add to the complexity of the market.  Regardless of these challenges, organizations will continue to look for and utilize technology to fill gaps and enhance initiatives in patient care.”

But adoption of those value-based principles continues to be slow for the majority of the industry.  Only a quarter of providers have a clear and defines strategy that centers on accountable care.  While the number of accountable care organizations is growing by the day, organizations may be more focused on attempting to successfully attest to Stage 2 meaningful use instead of shouldering more financial risk under a value-based reimbursement structure.

Instead, they may turn to mobile technologies as a simpler way to coordinate care, improve communication, boost efficiency, and cut waste.  “It’s one thing to state that mobile technology is cool; it’s another to determine what value it brings to the healthcare equation,” said David Collins, Senior Director, Health Information Systems for HIMSS North America.

Providers certainly see that value as increasing demands on their time make on-the-go access to EHRs, clinical decision support, and other information a necessity.  More than half of hospitals already use mobile devices such as smartphones and tablets, with 69% of providers using the technologies to access clinically-related apps.  Thirty-six percent of clinicians believe that mobile devices such as tablets and smartphones will be instrumental for reducing redundancies and improving efficiencies, which may indicate a bright future for pocket-sized computing in healthcare.

“The study found that organizational needs will vary based upon provider type while the numerous technologies under the telemedicine umbrella will add to the complexity of the market,” FitzGerald concludes.  “Regardless of these challenges, organizations will continue to look for and utilize technology to fill gaps and enhance initiatives in patient care.”

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Millennials want personal health records on the go | Healthcare IT News

Millennials want personal health records on the go | Healthcare IT News | EHR and Health IT Consulting |

Could younger patients be the key to achieving Stage 2 meaningful use patient access requirements? A new report finds strong desire for online medical records among the 18- to 34-year-old generation, with 43 percent of millennials saying they want to access their portals via smartphone.

In its fifth annual survey on the usage of electronic health records, Xerox sees more and more Americans expecting and demanding online access to health data. While aging Baby Boomers are showing keen interest in online access, Millennials are also increasingly expecting they can see their medical information where and when they want it.

The poll shows that the younger generation is much more interested in their medical records (to the tune of 57 percent) than any other content contained in online patient portals. They also say they'd like more personalized recommendations to improve their health and tips about additional services from their doctor (44 percent each).

The survey of 2,017 U.S. adults found that nearly two-thirds (64 percent) of those polled don't use online patient portals at all; still, more than half of that group (57 percent) say they'd be much more interested and proactive in their personal healthcare if they had online access to their medical records.

Many patients are unaware that such tools even exist, according to the report. Among those who don't use patient portals, 35 percent didn't know they were available to them and 31 percent said their physician had never mentioned them. Among Americans who do use PHRs, meanwhile, 59 percent say they have been much more interested and proactive in their personal healthcare since they received access.

"With providers facing regulatory changes, mounting costs, and patients who increasingly seek access to more information, our survey points to an opportunity to address issues by simply opening dialogue with patients about patient portals," said Tamara St. Claire, chief innovation officer of Xerox's commercial healthcare division, in a press statement.

With Stage 2 meaningful use's 5 percent view/download/transmit requirements still vexing many providers, the survey suggests that better educating both Millennials and Baby Boomers about portals could help increase patient engagement, accoding to Xerox.

If Millennials expect easy and mobile access to health records and wellness data, Boomers are more interested in using online access to manage their chronic conditions -- and in even greater numbers than younger, arguably more tech-savvy patients -- the poll shows:

  • Those who don't use PHRs say they'd be more engaged in their care if they received access to medical information online (56 percent of those ages 55 to 64, and 46 percent of those ages 65 or older).
  • Those ages 55 to 64 accounted for the highest percentage (83 percent) of Americans who say they already do or would communicate with healthcare providers via a patient portal.
  • Some 70 percent of Boomers say they do or would schedule appointments; 64 percent access/review medical records/test results; 60 percent ask their physicians questions; 58 percent order prescription refills, and 40 percent request a referral.

Providers able to guide "different generations to take advantage of the information available at their fingertips" could see gains in meaningful use readiness and chronic disease management, said St. Claire in a statement. "Educating patients will empower them to participate more fully in their own care while helping providers demonstrate that electronic health records are being used in a meaningful way."

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