Patient Portals – Not Just For Big City Practices

BigSandyHCWhile practices in metropolitan areas tend to adopt EHR systems at a more rapid rate, it’s important to acknowledge that implementing an efficient, customizable system can be done by practices of any size and in any part of the country.  In fact, data show that patient portals are especially critical to practices in rural areas for a number of reasons including improving communications and increasing convenience for patients who may live long distances from the physician’s office.  Of course the Stage 2 objectives of Meaningful Use, focusing on online patient portals and health information exchange, also mean that portals will now play a more significant role for all practices looking to receive incentives from this government program.

Implementing a patient portal in any area can be a challenge, but especially so in some rural locations. One of the top issues to consider when preparing to implement a patient portal, particularly in a rural area, is initially considering the level and quality of Internet connectivity in the area.  Additionally, in order for the system to be effective, patients should have personal email addresses, and it is imperative to educate the patients about the benefits by marketing the portal properly before its actual launch.

There is no arguing the convenience of a patient portal and in many cases, usage can become a family affair. First and foremost, the portal provides patients with first-hand, convenient access to all of their own medical records. They are able to take the reigns of their own health care management and access what they want, when they want from the comfort of their own home. Taking it one step further, a patient portal is also extremely beneficial if a patient’s care has been placed in the hands of a spouse, child or other family member. Via the portal, the third-party caretaker can access all of the patient’s records and results and truly manage their relative’s progress remotely and on their schedule. When used properly, a portal can allow a caregiver to schedule follow-up appointments, request refills, receive test results, track patient conditions and get answers to medication-related questions.

Additionally, if patients wish to send specific monitoring information from devices, such as blood sugar levels or blood pressures, they can do so via the portal and have that data become part of their electronic medical record.  This type of access is particularly useful for those with chronic conditions, such as diabetes and arthritis, that need to be monitored on an ongoing basis.

Implementing a patient portal in a rural area is not without its challenges, with one of the major factors being a primarily older patient population, many times with complex medical conditions. In addition, these older patients living in rural areas tend to have lower rates of Internet access and use, often relying on smaller, regional telecommunications companies that may not be able to provide a broad network.  In areas that are less populated, it is also often more difficult for offices to find qualified and skilled IT professionals to assist them with meeting their technology goals.  That being said, there are many success stories of rural practices implementing effective patient portals and an important component to making sure that patient portals are being used effectively is running periodic audits of the system.  This should be done at regular intervals and analyze objective data, for example the timeframe in which patient messages are being addressed.  This way, any issues with the portal can be taken care of right away and the vendor and practice can work together to implement any necessary improvements.

Meditab Software works with practices large and small across the country to implement systems that will best work for the unique way they each run their office.  One of Meditab’s great successes in working with a rural practice has been with Big Sandy Health Care (BSHC), a federally qualified health center in eastern Kentucky that services a rural, older and primarily lower-income patient population.

After deciding that a portal would greatly benefit their patients, BSHC chose to utilize a Plan-Do-Study-Act (PDSA) approach to implementation.  BSHC first conducted a needs assessment to determine what functionalities would be of top priority in their portal and how these changes would impact practice workflow. They then trained staff and pilot tested the portal with about two dozen interested patients and received a tremendous amount of useful feedback from loyal patients who were championing the portal’s success.

After a few tweaks and readjustments, BSHC slowly began to introduce the portal to patients several months in advance of the actual launch. They used posters and flyers around the clinics as a way to get the majority of their patient population comfortable with the idea that the portal would be a positive change and a useful tool to improve their care. BSHC also began a systematic collection of patient e-mail addresses to enable them to reach patients more efficiently. Once patients began using the portal, BSHC accumulated user feedback on the tool through a pop-up survey on the portal. Responses have been amazingly positive, with an impressive 96% saying they would recommend using the portal to others. BSHC reports that they now have over 900 patients signed up on the portal and continue to gather feedback through a brief survey so they can always work on improving the experience. Because the practice provides access to its IT team to walk users through the process over the phone, they even have some patients who are in their 80s using the portal.

We are very proud of our work with Big Sandy Health Care and the way we’ve developed a mutually beneficial relationship with them. It was very fulfilling to have our team assist them through the whole portal implementation process and enjoy their success right along with them.

Kal Patel is COO of Meditab Software, which specializes in EHR and practice management software for more than 30 specialties.

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