Perficient Digital Transformation Blog


If You Build a Patient Portal Why Won’t They Come?

Joe Jacobellis, a member of the Design Experience team at a client pointed out this interesting article about patient portals by Steve Wilkins.  It’s titled, “If You Build a Patient Portal Why Won’t They Come?”  Before you read it, let me give you some history:

  1. The Affordable Care Act mandates that all patients have access to their medical record (lab test, allergies, discharge instructions, etc.)
  2. In various stages, hospitals and clinics need to give you electronic access
  3. They also need to prove that at least 5% of the patients actually come to your site and look at their medical record
  4. If they don’t they face dire consequences that are $$ related.

A lot and I mean A LOT of hospitals, clinics, doctors, etc are spending many cycles getting it all to work.  Much of that work is brute force labor just getting a myriad of systems to talk to each other. In many ways, it’s a classic systems integration play.  However, even after you get a site up and running, you may face problems.  How do you actually engage the users of the patient portal to come and use it?

Steve Wilkins brings up some interesting issue the Mayo Clinic has had in increasing usage.

Upon reflection, Manley admits that “simply making services available doesn’t cut it.”

“Unless you are engaging patients, you won’t meet meaningful use requirements. [Messaging and other mechanisms] need to be a part of your practice.”

Manley is quoted as saying that “patient engagement has been a part of what Mayo has done for a long time.  Meaningful use, especially Stage 2, is a catalyst to kick it up a notch.”

In many ways, this challenge has more to do with classic consumer engagement scenarios faced by those who run commerce sites or who are trying to create a community.  I love the quote, “simply making service available doesn’t cut it.”  I think that quote hits it on the head. Steve does have three suggestions as to why just throwing out some data on a site won’t work:

1. Forcing patients to do anything is wrong and antithetical to the whole idea of patient-centeredness, even if you think it is in the patient’s best interest. Meeting meaningful use seems to take precedence over what the patient wants.  Manley is quoted as saying “just having it [information and portals] out there isn’t enough … it’s making the patient use them.”

2. Patients want to engage with other people regarding their health, particularly their physicians. Health after all is an intensely personal and social affair.  Mobile health apps and email just can’t give patients want they want – to be listened to and understood.  Plus, 85% of people want face-to-face access to their physician when they want it.  Patients know that HIT threatens to get in between them and their doctors.

3. The content on most patient portals is not particularly relevant or engaging after the first 10 seconds, at least from the patient’s perspective.   After all, cognitive involvement is a prerequisite of meaningful engagement and it tough to be interested and spend time thinking about information that is not in context (of a medical encounter), you don’t understand, find boring, completely inaccurate or irrelevant.

Now you should read the entire article because I only put a few snippets in.

But let me add my two cents on what would make a patient portal successful

  1. You have to make the medical record readable.  Don’t just throw out some data like a test result and expect the patient to be happy. Make it readable. Provide contextual suggestion on how to understand it. (e.g. your blood sugar is too high)
  2. You have to personalize the experience.  Based on what you know about them, suggest additional reading, communities of interest, content that’s relevant to their condition or stage of life.
  3. You must put in processes to not only measure your success or failure, you need to put in place processes to act on that information.
  4. Provide other valuable services the patient may want.  It can range from a health library, self-diagnosis tools like a symptom checker or blood pressure tracker
  5. Make the data you give a patient valuable.  Instead of just showing the last test result, show the trend of the last four blood draws.  I know this is hard.  Hospitals struggle to give this data to physicians let alone patients.

There are probably a number of other things to do but these are top of mind.

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One thought on “If You Build a Patient Portal Why Won’t They Come?

  1. Gary Dolsen

    Good stuff, Mike. Wholeheartedly agree with your conclusions. Too many healthcare orgs think that patient self-interest (i.e., the user’s own health) is enough to drive engagement, when in reality there are many simple, traditional consumer-based best practices that could help out.

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