I’ve been working on a variety of portals this year but Patient Portal tops them all right now in terms of interest and effort. I’ve learned that patient portals represent some of the most complex portal sites out there today. They are complex for a variety of reasons. This and my next few posts on the subject will focus less on the features and functions of a patient portal and more on what makes it so complex. So without further ado, let me give you the reasons why it’s a fairly complex beast.
Base Parameters
You are probably asking why a “simple” portal could be so complex. It’s complex because the I refer to the cadillac of portals. This isn’t just a site that you login to view your medical records. This is the portal where you do the following (Yes, I know I just broke my rule about not talking about features and functions).
- View my medical record
- View my bills
- Pay my bills
- Schedule recurring payments on my bills
- Find a doctor
- Define my favorites for my care team
- Schedule an appointment with my doctor, surgery, MRI, etc.
- Register for classes
- Easily cancel my class
- View videos teaching me about a variety of topics
- Do self-help on physical therapy through videos
- Participate with a community of like minded people who have similar health challenges
- Find the closest facility while I’m out and about
- Do online consultations to determine the best mode of care before I go to the emergency room or schedule an appointment
This list is long but you get the point. Many hospitals just want to launch a portal that meets government regulations. However, failure to build out a site that addresses at least 70% of the items I mention above means that hospitals won’t meet their 5% of patients viewing their record threshold. Let’s face it, if you don’t give people a reason to visit your patient site, they won’t. Your medical record is probably not the top reason people visit the site by the way.\
According to a study by Decipher for Intuit Health in 2010, 72% of patients say that they would like to connect with physicians online, and they say that the ability to do so could influence their choice of provider.
The Challenges
As I talk to hospitals, they tell me about their challenges. The first is that they are neither the first nor the ultimate owner of a patient relationship. The doctor owns that relationship. The hospital provides the facilities for the doctor to do the things he cannot normally do. It’s kind of like Apple only being able to sell through someone else’s store where the store tells you exactly where you should go to pickup your new computer. Under this analogy, you don’t even ask about which computer is better the one with more RAM and a bigger monitor or the one with the tiny screen. In the hospital world, you don’t ask whether that MRI is 30 years old or a brand new machine with 3X the clarity, you just go where your doctor or your insurance told you to go.
The second challenge is that most people are not incented to think in terms of the best facility or the cheapest costs for that procedure. Yes, we are seeing a big consumerism trend but when you start at 2% of consumers taking control of their healthcare and you double it to 4%, it’s still a small number.
Third, most hospitals have spent far more on billion dollar facilities, million dollar robotic surgeons, and that expensive set of billboards than on a robust and mature IT department. Frankly, most doctors would rather buy that cool new medical tool than pay to implement a back end integration platform that lets you pass all that data around. One translates directly to better patient outcomes you can see, the other gives great outcomes but no one ever sees it. That means that many (but not all) hospitals have to build out the expertise to manage complex IT projects while they start complex projects.
Fourth, the web has turned the hospital marketing and operations world upside down. It’s a new world where your people use the web to find your facility, the doctors related to you, and the reasons why you are better. Healthcare providers in general have been slow to take this up. Yes there are leaders who have many of the pieces in place but many hospitals are still struggling to maintain a decent content based site rather than a personalized portal that lets you do many things.
So yes, these challenges add to the complexity.
Next, I’ll take a light hearted look at regulation, the first of the nine topics.