In today’s digitally savvy world, consumers-patients-members expect to interact with healthcare organizations across a number of mobile devices whilst on the go, just as they do with organizations across other industries. As a result more and more healthcare providers and payers are leveraging mobile apps to connect with consumers-patients-members to make their services more accessible and efficient.

You may have a patient or member portal app with secure access to medical records, communicating with physicians, managing health benefits, healthcare costs, and more. General information apps are also popular with useful information on location directions and parking, find a doctor tools, health library information and many others.

Other mobile apps within the healthcare industry include ER wait times or service-line specific apps. Regardless of the type of mobile app(s) that forms part of your holistic digital experience, each and every digital interaction across these impact the overall satisfaction levels of your consumers-patients-members. As a result, it’s imperative to measure the performance of mobile apps.

Understanding user engagement, satisfaction, and app performance are critical to measuring the success of your mobile app. By monitoring mobile app analytics in addition to performing deeper dives into mobile app data this will assist you in identifying areas for improvement and optimization of the mobile app digital experience to create delightful experiences for those that use it.

Below are some essential metrics that you should be tracking and closely monitoring. Engagement metrics such as:

• Number of Downloads – it’s important to know how many times the mobile app has been installed. If you notice this decline from month to month, you might want to focus your efforts on promoting the mobile app to let your audience know it’s available to use.
• Average Visit Time – this will help you understand what the average duration time is for a session. Any changes in these behavior patterns can alert you to look deeper into the data to identify why changes are occurring.
• Screen Views per Visit – this metric informs you of how many mobile app screens are interacted with during a session. This is useful information to be mindful of as you are working on optimizing your app with any enhancements or new features to assist in user experience design.
• Retention Rate – with this metric you know how many users return to your mobile app after their first visit. You will also find the remaining percentage is your churn rate; those who do not continue to use the app after the first visit.
• Number of Active Users – an insightful metric to really understand your most engaged users. You may want to do this by week or month to tell you the unique number of people who have used (opened) your mobile app over a certain time-frame of those that have installed it.
• App Event Tracking – if you have specific features or conversion funnels within your mobile app tagged with events, this metric will allow you quick access to understanding the performance of those features so you know the actions users take, such as:
  • Find a doctor
  • Find a location
  • Make an appointment
  • Searches performed
  • Patient or member portal log in
  • Contact
• Customer satisfaction metrics, including:
  • App Ratings and Reviews– regularly monitor what your mobile app rating is in app stores as this will leave a first impression on those that download your app. In addition to this, listen to the feedback you are receiving across these platforms and use any user challenges as enhancements that form part of your product backlog.
  • Touch Heatmaps – know where users are tapping on mobile app screen views and identify any user experience issues. You’ll quickly identify any challenges if users are tapping in places which aren’t interactions within the app.
  • In-App Feedback – use surveys that are delivered within mobile apps for a quick way to receive direct feedback. These tools can be easy to implement and you can ask targeted questions.
• App performance metrics, for example:
  • App Crashes – at a minimum this mobile app performance metric should be monitored. You need to know how often your app abruptly closes while a user is using it and should be something you are actively working towards reducing.
  • App Speed – it’s crucial to understand how fast your mobile app loads and runs. Poor mobile app experience due to these issues can result in mobile app abandonment and should be a metric to focus on improving.
  • App Latency – this metric tells you how long it takes your mobile app to request and receive a response from an API. Any long delays here can also further impact mobile app experience.

The above will give you a comprehensive understanding into how your mobile app is performing. Don’t just monitor these metrics but analyze them and dig deeper into the data to uncover trends and patterns. Use the insights from your healthcare mobile app data to select 3 or 4 key areas to work on improving and let this guide the decision making to keep your efforts focused on mobile app optimization.

For example, you may decide to work on reducing your crash rate in upcoming updates, or improving your retention rates by creating an onboarding process highlighting frequently used features of your app on first mobile app load, or increase conversions for a particular funnel by resolving user experience challenges uncovered from feedback and data to complete a specific task. Using the data to determine where to focus your efforts on problems that are likely to have the highest return on mobile app performance and user satisfaction is where you need to start focusing your efforts.

I would love to hear the challenges or success you’re experiencing in measuring your mobile app performance.

Once again we have compiled our trends guide for healthcare providers and this year the top 5 healthcare provider trends in 2017 focus on the importance of leveraging the power of data. These trends will help identify and prioritize technology investments in order to transform data into powerful knowledge that can enhance the patient experience and improve your overall business. Lets take a look at the first trend, Handing the Patient Portal Reins to the Patient.

Given that most industry changes leading to patient data access came by way of Meaningful Use, the dismantling of Stage 2 gave us all the opportunity to pause and reflect. In our 2014 Connected Health trends report, we estimated that between 2015-2017 there would be a major shift in the state of patient portal. Here we are in 2017, and we could not have imagined how right we would be.

During the Meaningful Use Era, we were using a checklist to determine the features best suited for engaging with the patient when really we needed to be looking for the market-driven features that would truly create a habit forming technology on the part of the patient. The market-driven patient portal era is where we find ourselves now, but what would those habit forming components include?

Download our guide, Top 5 Healthcare Provider Trends for 2017 to take a closer look at this trend.

Attending HIMSS17? Stop by and see us at booth #3831 and lets talk healthcare industry trends. More on Perficient at HIMSS here.

How healthcare can use the leading customer experience platform to deliver the ideal patient experience.

If you are in the healthcare business – data, and how it is utilized, is likely something you face weekly. For that matter, you may have even read some of our own Healthcare Industry Trends. Healthcare is rich with patient data, and there are many visions of how it should used going forward. In this article I am not going to predict the “what” and “when,” but rather, show HOW a specific aspect of the patient journey can be improved with meaningful data.
Whether on a secure patient portal, a provider’s corporate website, or a specific practice’s education site, the experience should be focused on the patient and not the way the business is organized. While I realize it’s somewhat taboo to say so, patients are consumers. Outside of their healthcare experience, they are shopping, comparing, and purchasing as consumers. And that experience that they traverse everyday (as an average consumer) affects their expectations across all journeys. Amazon, and similar customer experience leaders have set the bar, and just because you are not selling electronics, stand mixers or the latest fashion does not exclude you from providing a streamlined user journey.
Delivering on this expected norm, or even surprising patients with advanced personalization is something the healthcare industry can glean from leading retailers. This relevance drives trust, and that trust is certainly a commanding emotion when making an important health decision no matter where they are in the process.

Source: McKinsey & Co., 2014

Here are 5 Ways Sitecore can deliver on a world-class patient journey.

1. A one-to-one view of your patients’ journeys: As each patient enters your site, Sitecore will track their journey
   without the need of any tracking script. This is not a sample of visitors, this is every visitor, and every interaction. With a little planning and very minimal effort, you can score pages to weight their importance; A form completion page – 100 points, sign-up for newsletter – 50 points, social link click – 10 points, as examples. With this simple scoring in place you can start to see which users are taking more “valuable” journeys and start to see patters and work to provide better paths to the higher value pages. These values can then also be associated with campaigns.

2. Speaking of campaigns: With ease, you can set up campaigns and group them for easy management and detailed reporting. Track keyword campaigns, create and email campaigns, social, print and so on. You can even create campaigns that are built off of a certain behavior or set of activities. With these in place, you can track by campaign and campaign group and continue to define a picture of what is working and what is not (for refinement).

3. Start to personalize content: With the picture I painted above, you can start to define your users. How do you show content for a patient, how do you show it for a healthcare professional? This can start simple: change banners; show different classes to convert to a sign up; change content for return visits or logged in vs. logged out. These grow over time to a level of sophistication that will ultimately result in delivering a relevant, connected experience for each patient, every time.

4. Drive engagement plans: Create simple to very complex rules based engagement plans that automate processes and simultaneously deliver a better patient experience based off of evolving data. A certain value of page score could send a trigger to change page content – say, a newsletter signup form. Enrolling in a class could alert a nurse through email. Collected data could be pushed to another internal system. The possibilities are endless and can by layered. The questions will be: What does your healthcare business want to do to improve efficiency and how will it affect your patient experience?

5. The single point of truth: Your patients’ journeys will evolve over time and your view of each user will develop in their xFile. This clear vision of each users’ experience in time can include: a timeline of activity including mobile, or desktop; what outcomes occurred; what campaigns were triggered; what was the source of each interaction; what type of user is this and what are they most interested in – just to name a few. All of this information can be synced with other systems, resulting in a fully connected patient journey.

 All of this takes time, and admittedly, I am providing a quick look at some of the potential. Importantly, we understand the steps that can be taken to crawl, walk, run and ultimately fly with Sitecore. There are best practices to make for quick wins that will also inspire your organization’s journey to a better patient experience and a deeper understanding of each individual user. If you are attending #HIMMS16, stop by and say, “Hi” to Perficient in the Microsoft booth – #3832, where we can provide more depth and discussion around business pain points, and we can talk about how we could help you deliver on the ideal patient journey with Sitecore. Learn more: http://www.himssconference.org/
 

We are all aware of the enormous impact Government regulations have had on healthcare and while they are in place to improve healthcare, in some cases they may be hindering progress. For example, to meet Meaningful Use requirements healthcare providers must provide electronic health records to their patients and for most organizations the vehicle for doing so is a patient portal. Many organizations have implemented patient portals that are “good enough” to meet the Meaningful Use requirements in order to receive incentives from the Government. That being said, there are healthcare organizations that are looking beyond the Meaningful Use requirements and want to implement a patient portal that empowers patients and provides a vehicle for communication and engagement.

Hospital Corporation of America (HCA) is one of those organizations. HCA is the nation’s largest provider of healthcare services with more than 165 hospitals and 115 surgery centers in 20 states and England. They selected Perficient to develop and deliver their MyHealthONE patient portal because they wanted to provide an enhanced patient experience by offering additional services that go beyond the Meaningful Use criteria.

IBM WebSphere Portal provides a platform to deliver a single patient experience that integrates patient data from a variety of clinical systems and allows patients to manage their health from anywhere. The result is an intuitive and evolving system that meets the needs of facilities, clinicians and patients.

In addition to meeting an important patient satisfaction goal through features like find a doctor, schedule an appointment, bill pay and register for a class, the MyHealthOne patient portal also helps HCA meet a major requirement of the federal government’s ongoing Meaningful Use criteria around electronic record keeping and access. The new portal is a big part of the personalized care path that HCA is creating.

Learn more about the new patient portal here.

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Diagram from – http://www.hcatodayblog.com/2015/05/08/doorway-to-better-care/

We have compiled a list of the top 10 healthcare content assets of 2015. If you haven’t downloaded these valuable information assets you may want to do it now. Check them out below:

#10. Guide – 7 Features of a Market-Driven Patient Portal
As healthcare reform and transformation advances, providers will seek new ways to engage patients and influence behavior using connected health and will increasingly look for more advanced solutions that are proven to consistently motivate sustained behavioral change. These solutions are referred to as “Patient Portal 2.0.”

#9. Guide – Precision Medicine in Life Sciences and Healthcare
Treating disease has long entailed much trial and error: Start with a commonly prescribed medication and see if it works; if not, adjust the dosage and/or try different medicines until you figure out an effective solution. Trial and error can be damaging to patients’ bodies and psyches, as well as costly for insurance companies, and can lead to dissatisfaction with and distrust toward physicians and drug companies.

#8. On-Demand Webinar – Leveraging Technology to Empower Patients and Reduce Healthcare Costs
Telehealth, once reserved for the chronically ill, is now being used to drive increased revenue by creating services that scale beyond traditional geographic boundaries. In this webinar, Perficient and KP OnCall discuss how telehealth is impacting healthcare and how the nation’s leading telehealth provider is leveraging innovative technologies to meet business objectives.

#7. Guide – How to Enable Value-Based Care and Clinical Integration with Epic Cogito
We examine support for a value-based care initiative via the build out of IT enablers that leverage the native capabilities of Epic, such as Cogito, Epic’s data warehouse, Healthy Planet, Identity, and Radar in addition to other Epic and non-Epic analytics tools.

#6. On-Demand Webinar – IBM Watson Content Analytics: Discover Hidden Value in Your Unstructured Data
We demonstrate how to extract insights from unstructured data to increase the accuracy of healthcare decisions with IBM Watson Content Analytics. Leveraging years of experience from hundreds of physicians, IBM has developed tools and healthcare accelerators that allow you to quickly gain insights from this “new” data source and correlate it with the structured data to provide a more complete picture.

#5. Guide – Top 10 Connected Health Trends for 2015
As the healthcare industry continues to evolve, consumers remain at the center of the transformation. Consumer engagement continues to be a high-priority for healthcare organizations and connected health tools are the key to empowering healthcare consumers. In this guide, we will take a look at the top 10 connected health trends for 2015.

#4. On-Demand Webinar – A Real Retail Strategy for Healthcare
With a focus on providing high-quality, lower-cost care, the healthcare industry has been looking to the retail industry for strategies used to engage and empower consumers. Lessons learned include how to use the retail setting as a medium for providing care and how to engage consumers outside of the care setting by using technology.

#3. Guide – Gearing Up for 2015: 10 Technology Trends Impacting Healthcare
Technology is a major player in the dynamic healthcare environment, and organizations are increasing their health IT budgets to adapt to the “new” industry. Having the right technology in place can enhance patient experience, help meet regulatory requirements and provide key insights that reduce costs and improve outcomes.

#2. On-Demand Webinar – How Northwestern Medicine is Leveraging Epic Cogito to Enable Value-Based Care
Our webinar covered how Cadence Health, now part of Northwestern Medicine, is leveraging the native capabilities of Epic to manage their population health initiatives and value-based care relationships across the continuum of care.

#1. Guide – 10 Healthcare Analytics Trends for 2016
In this guide, we take a look at ten analytics trends healthcare executives need to be thinking about in 2016 and beyond. We identify technology strategies and solutions that will help healthcare organizations succeed in a data-driven, digital world.

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When it comes to patient portals most provider organizations are focused on meeting the Meaningful Use requirements rather than creating a patient portal that truly engages their patients. While healthcare organizations have been making steady progress towards Meaningful Use (MU) Stage 2 attestation, the lack of patient engagement continues to be problematic. Creating a patient portal that engages and empowers patients outside of the four walls of the care setting requires organizations to look beyond MU2. Engaging patients through a portal will drive increased revenue streams by creating services that go beyond traditional geographic boundaries. The below infographic depicts the 7 features that can turn your MU patient portal into one that is driven by market demand.

To learn more about the 7 features of a market-driven patient portal read our recently published white paper.

Let’s face it: The web is one of the most powerful tools available to life sciences companies for connecting with patients and physicians. The more empowered patients become to act as their own advocate, the more they search the web for information. The busier physicians become, the less time they have for pharmaceutical reps, so the more time they spend researching treatments on their own. 

An engaging and compelling digital experience is paramount in our industry. I don’t just mean cool interactive features (even though they help!). I mean really clear, useful, fresh – and compliant – content. This kind of content calls for a lot of hands on deck; content contributors and reviewers can come from all over the company and, depending on the size of the company, can number in the hundreds or even thousands.

How can you effectively manage your digital presence with so many people involved? According to a recent report from Forrester Research, one of the best answers out there is the Sitecore web content management (WCM) platform.

The Sitecore WCM platform is a single solution for managing your organization’s entire digital experience, whether it’s your external website, employee Intranet, patient portal, or any other personalized marketing message you want to get across.

Sitecore functionality is rich in customizable content permissions and workflow features, which make it especially helpful for managing the constant influx of content without overburdening the team(s) responsible for the digital experience. Sitecore administrators can give content contributors access to certain areas of the system and allow them to publish content with or without an approval workflow, depending on how the system is configured.

When giving more users the ability to work directly with your WCM platform, ease-of-use is critical, and more often than not, a requirement for most companies. The bottom line is this: If you can use Windows, you can use Sitecore. There’s no question about it. Its familiar structure makes navigating, creating, uploading, scheduling, and posting content a cinch.

In a day and age in which we’re expected to produce web and digital content by the minute to stay relevant and top-of-mind, it’s critical to leverage solutions that are simple to use, yet flexible and scalable. And that’s just one area where Sitecore succeeds.

If you’re a life sciences company looking to better engage with your constituents, patients, healthcare professionals or simply the general public, let us know. We’d be happy to discuss Sitecore as a possible solution for your needs.

Most industry changes leading to patient data access came by way of Meaningful Use. In the future, changes in the patient portal market will be driven by a series of marketplace dynamics. What does the market think of patient engagement? For the answer to this question it is best to refer to a report by Frost & Sullivan entitled “U.S. Patient Portal Market for Hospitals and Physicians: Overview and Outlook, 2012-2017\0x2033.

“The need to fully engage patients as a member of the care team is fundamentally about encouraging individuals to become more involved with their healthcare, so they will be motivated to make behavioral changes that can positively impact their health status. That need will only grow as the healthcare system moves towards accountable care and value-based reimbursement. The importance of this movement cannot be underestimated.”

While it is predicted that hospitals will continue to make steady progress towards MU2 attestation, they will receive low patient adoption rates, which will force the industry to rethink patient engagement. Here are 7 features the market wants to see in your patient portal:

• Telehealth that moves beyond the virtual visit
• Dynamic scheduling:
• Social collaboration
• Gamification and serious games
• Avatars for personalized health coaching
• Health information exchange across diverse care settings
• Integration of clinical and financial data

Analysts have suggested that by the end of 2019, 66% of health systems will offer digital self-scheduling and 64% of patients will book appointments digitally. This will result in $3.2 billion in value in cost reduction. It’s estimated that 75% of all hospital readmissions are preventable.

There was a lot of talk about Healthcare and Patient Portals in 2014.  Health insurance exchange portals started to mature a little bit with healthcare.gov finally coming on line.  The Affordable Care Act requires providers to provide access to medical records for patients and many have looked to implement patient portals.

Looking back, here are some important lessons that we learned.

Healthcare Informatics said that despite many challenges facing patient portals, patient portal usage continues to grow.  In an October 2014 story, Survey: Patient Portal Usage Growing Despite Reservations, Gabriel Perna talks about a survey conducted by HIMSS that “More healthcare provider organizations are adopting patient portals, much of it facilitated by the electronic medical record (EMR) vendor.”  Still, cultural issues were identified as the biggest challenge to patient engagement initiatives.

Patient Portal Awareness. Source: TechnologyAdvice.com

Janice Jacobs, Healthcare Life Sciences (HCLS) Social Media Director, Dell Services wrote an article called Best Practices for Patient Portals. She lists the following components as necessary for best-in-class patient portals:

• Branding and user experience are key.  You have to focus on functionality as well.  I’ll take this one step further and say you need to really design based on personas.  Most patients will never use your patient portal.  Some chronic-disease patients will use it all the time. And some people will use it while they are in treatment periods and forget it when not.  The experience has be tailored for each of these types of users.
• Information display – you have to “deliver and display the information in a way which is most intelligible and actionable to patients and caregivers.” She shows an example of test results that show the results, but provide no context or guidance about what the results mean.  A better approach is lay out the results so they are easier to consume, provide context (i.e. this number is too high), and are more graphical for the lay person.
• Use appropriate language.  This applies to all healthcare portals too.  Providers and insurance companies tend to speak in their language or medical terms too often.  Lay people may not understand that when they want to see an eye doctor that they have to look up Ophthalmology, which is even spelled funny.
• Anticipate obstacles for patients.  As mentioned before you will have all different types of users, some who may be very familiar with your portal and others who are not.  Find out what are the barriers that people encounter and come up with a plan to fix them.

Finally, I presented “Healthcare Portals: 5 Core Needs for a Great Experience” at two IBM conferences in 2014.  You can see the slides referenced here in a blog post by Michael Porter.

Eugene Sefanov has a nice post on the value of a patient portal for those who use a specialty drug or drug device.  He goes into some detail on the possible use cases with that kind of portal.  I like the approach  he takes.  Just being prescribed a drug doesn’t mean you are going to get the right outcome.  Anything you can do to ensure the patient has all the support he or she needs will improve that outcome.

An effective way to provide patient support is through a portal that is specific to a particular drug or medical device. A good case study revolves around a patient portal that Eisai, a pharmaceutical company with a focus on Alzheimer’s disease, epilepsy and metabolic disorders, implemented for their weight-loss medication called BELVIQ. The portal is designed to help patients reach their weight loss goals, sustain their efforts, as well as provide safety-related information.

Users of BELVIQ can access Eisai’s portal for free and leverage a variety of educational resources and tools including:

• Articles and tips on how to manage weight issues through eating and staying active

• Overview of the drug

• Important drug safety information and how to report adverse events

• Customized meal recipes

• Access to a mobile application for tracking calories and exercise

• Savings card and coupons

Euguene goes on to list other possible uses of the portal so be sure to check out the entire post.

In a recent chat with the VP of a large health system, I learned what keeps him up at night. His organization, like many across the nation, has invested mountains of time and money in Meaningful Use Stage 2. Like most health systems (all but 11% says research groups like KLAS) they chose to invest in the patient portal modules available through the EHR vendor. This is largely because most Meaningful Use patient portal decisions are being made by IT, as opposed to business. At the top of the list in IT decision making criteria is integration with EHR. So, VPs like my new friend at this large health system are able to cross off the features required via Meaningful Use quite easy. All except one…

They are having a heck of a time getting patients to actually adopt the patient portal technology.

It appears as though the “if we build it they will come” concept hasn’t quite held true in the case of patient portal. In fact, the statistics are rather staggering. Recent research discussed in the HealthData Management article entitled “Patient Portals Not Yet Go-To Platform for Patients” reveals:

• Almost half of patients don’t even know if their physician has a patient portal
• 11 percent are confident their physician “does not” offer one

And here is the kicker for a recovering marketer like myself:

• Less than half of those surveyed–49.2 percent–report actually being shown a patient portal by their primary care physician either during a visit or outside a visit

And why is this keeping folks like my VP friend awake at night? Well, first and foremost it is because healthcare providers like him are fans of patient engagement and want to provide patients with the tools they need to stay healthy. Taking it a step further, Meaningful Use Stage 2 is a financial incentive. The criteria for getting those incentive dollars are not met when you build a patient portal. They are met when a critical population of patients adopts the technology. Early results are in, and patients are not adopting.

So, what’s the the underlying problem here? Well, it’s multifaceted, but much of the error falls in building patient portals that are not user centric. he user, the patient, is and should be the center of our universe. However, it is oftentimes not the department of IT, the department largely in charge of Meaningful Use, that invests in stores of knowledge like user experience. I’ve also been met with many blank stares across conference room tables when I ask healthcare provider portal teams about campaigns their marketing team have created to drive attention to the portal and journey maps that have been created across their patient digital experience to drive patients into the portal. In my opinion, Meaningful Use is one of the biggest marketing fails I’ve seen in my career thus far. There is not alignment between IT and the rest of the organization on the measures needed to drive patient engagement. In my opinion, which has now been validated by this research, a campaign that does not also consider physician adoption of portal technology is a campaign waiting to fail. If the physicians are not using it, then their patients will not either.

This is why I began the dialogue a few of months back on what the market says you need in your patient portal. The market, which in reality is simply cumulative actions of patient populations, is the most important input into the creation of a successful patient portal. You can see some of the components of a user centric patient portal in that series:

• Telehealth Beyond the Virtual Visit
• Dynamic Scheduling
• Gamification & Serious Games
• Avatars for Personalized Coaching
• Integration of Data
• HIE Across Diverse Care Settings

CIO.com has an interesting article about why patient portals just aren’t popular.  I think the author, Brian Eastwood, gets some things right but also misses some key reasons or challenges.  Here’s what he got right.

1. Adoption just isn’t very high. No one is using the patient portals that are out there.
2. Doctors don’t use portals………….and they don’t have patients who use portals.  In other words, if a medical provider still thinks the best way to communicate is when someone is sitting in front of them then things won’t change.
3. The features don’t match what your users want………. and herein lies the rub.

Now I don’t disagree with what Brian says. I think he makes a number of great points.  But I also take issue with one point he makes:

So what will get patients to use a portal? It’s not as hard as providers may think. The functionality that patients told Software Advice that they want – scheduling appointments, paying bills, viewing lab tests, refilling prescriptions and emailing staff – should sound familiar (on the face of it, at least) to anyone who regularly uses ecommerce applications.

Here’s the reality.  Patient portals are hard. They are harder than many ecommerce or consumer sites that sport similar functionality.  Frankly, they aren’t that much harder from a technical perspective but there are a number of issues getting in the way.  Let me name a few of them.

1. Healthcare in general is still coming up to speed in their technology evolution.  You don’t just launch a bill pay option without a hook to both your billing back end system and a payment gateway.  Both are foreign concepts to many healthcare providers.   By providers I mean doctors and hospitals.  So slapping a front end onto something isn’t going to solve your problems.
2. Healthcare is a mishmash of systems that never wanted to communicate with each other and weren’t architected to do so.  I can tell you about hospitals who have a patient pre-register online and then pay someone to key that data into their EMR because the EMR doesn’t have any hooks. I can tell you about trying to pull certain data from an EMR and then missing key information demanded by MU2.  Many companies are springing up whose sole job in life is to allow you to schedule an appointment online because of the variety of systems without proper hooks.
3. Healthcare is comprised of many, many, many separate entities.  You may find a doctor on a hospital site or an insurance site but they are only affiliated to the doctor at best. That doctor won’t support a common standard to let you query their scheduling system and make an appointment.  This disjointedness leads to challenges.
4. Doctors don’t like spending money on technology.  Yes, there are exceptions but most would far rather build a new office, add on a hospital wing, or buy a cool surgery robot.  Many think of technology from the standpoint of their tablet or computer and don’t understand the complexities of multiple server systems supporting high uptime, disaster recovery, security, etc.  Lack of funding until very recently means you have so much further to climb.
5. Conflicting government rules make it difficult to create a good patient experience.   HIPAA demands you keep all patients data intact.  MU2 demands you open up that data to your patients.  Specific rules within both conflict.  People in charge of security within these healthcare organizations tend to take the least risk approach and demand multiple levels of security that adds to the expense very quickly.  Let me give you the most common example of how this can go wrong.  I know of multiple hospitals that only let you register for the patient portal in person and with your id.  Using your patient id, unique number from your last discharge, and common questions from your credit report all fail the test.  Only an in person visit will do.   If you want to see and manage healthcare for your child, that only adds to the complexity.  This means that in order to run a successful patient portal, you have to modify your business processes to have front office and discharge people do one more thing and do it in a secure fashion.
6. Most out of the box patient portals………and I use out of the box very lightly here, only support you accessing your medical record.  They don’t even do a great job of that. These EMR based portals let you see your lab results but they don’t help you interpret them.  They are sometimes very hard to read.  These portals don’t provide access to bill pay, find a doctor, pre-registration, classes and events, or schedule appointments.   They don’t personalize the experience and tell you about your care team.   Many of these portals have no plans to add these types of functionality into their patient portals because adding these features is hard given the diverse number of systems out there.

I want to make one final comment which Brian gets right in his article.  I think that with lots of room for improvement comes a lot of opportunity for healthcare providers to truly engage their patients.  A lot of these providers are looking to the future and asking what it will take to do true patient engagement and to add in features like sensor uploads, better reporting, proactive personalization that helps you understand what’s in your medical record etc.  So while it’s an uphill slog, the future is bright.