- New York City Health + Hospitals (NYC H+H) is among the majority of health systems enjoying the patient-centered benefits of patient portal adoption. Now, the health system is facing its latest challenge – getting more patients enrolled on the portal and use it to drive patient activation.
Dubbed the Goe Project, NYC H+H’s patient portal implementation resolved some system-wide hurdles. Prior to implementation, NYC H+H used a fragmented network of patient portal functions, which amounted to a lack of mature patient portal option.
In 2013, the system bought its Epic Systems suite, which included the MyChart patient portal. NYC H+H went live with the system in two of its locations – Queens and Elmhurst – in April 2016 and has since seen its benefits.
The new patient portal includes many of the typical patient portal functions – secure direct messaging, patient health data access, and medication refills. The tool also allows patients to update their own medication and allergy lists, and includes a separate secure log-in for teenage pediatric patients looking to become more involved in their care as they mature.
Ultimately, this new portal and EHR implementation have improved the patient experience because it has streamlined priorities across NYC H+H’s many care facilities, which was one of the health system’s major goals, according to Senior Assistant Vice President for the Epic program Pamela Saechow.
However, the transition to the new patient portal is not yet complete, Saechow acknowledged. In addition to rolling out the portal in the rest of the NYC H+H care sites, Saechow and her team need to drive more patient activation.
Patient portal use across the country has been lagging. According to 2015 data from the ONC, 90 percent of meaningful use participants offered patient portal access to their patients, but patients simply are not picking up the technology.
For all of the efforts hospitals are putting forth to host robust patient portal technology, many of them – NYC H+H included – are facing a bit of a “now what?” situation.
“Many of our patients haven’t signed up for the system, so it does take some time and effort to make sure they understand the benefits of it,” Saechow said in an interview with PatientEngagementHIT.com.
Although she hasn’t been hearing negative feedback about the portal, it isn’t catching on as much as one might expect.
“People don’t object to it, but they haven’t all bought into it either,” Saechow explained.
To be clear, NYC H+H’s patient portal activation numbers are not at zero. At the start of 2017, a little over 10,000 patients had registered for the patient portal, according to an NYC H+H press release. In May, that number grew to 14,261, a 45 percent increase, the health system found.
However, that is a far cry from the 100 percent activation numbers Saechow and her team want to have.
“Our goal is for every patient who has an active record in our hospitals to have a MyChart account in their patient portal,” Saechow asserted.
The road to full patient portal activation will not be easy, Saechow recognized. Patient motivation is rarely simple. In this case, NYC H+H must convince a diverse and vulnerable patient population to sign up for an online account that they may or may not have access to via a personal computer or smartphone.
Patients with limited technology access or use may have trouble seeing the benefits of the patient portal, so it is up to NYC H+H to educate patients about the patient portal.
“We have a very diverse and vulnerable population in New York City,” Saechow said. “We have to do a lot of educating our patients, marketing the benefits to them and show them the features they have access to when they log in.”
In this push for patient education, it is important to keep the information relevant to patients. Why will the patient portal support patients specifically? Saechow and her team are trying to answer that question from the patient perspective, not as health system administrators.
“We have to sell to them from the patient experience point of view,” Saechow pointed out. “The patient portal can reduce the number of times patients have to go into the hospital or clinic. It is automated as much as possible so patients actually get the medication refill without any clinician intervention.”
NYC H+H is also working on driving adoption at the point of care. The health system has tapped patient portal liaisons, who communicate these portal benefits to patients and help them sign up for their accounts on site.
The patient portal liaison can set up the patient with an instructional packet and direct them to a set of computers specifically slated for patient use to enroll for the patient portal. Patients also have the option to take those packets home with them and activate their accounts on their personal computers.
Currently, Saechow and her team are working on how to follow up with those patients. While she is considering email and telephone follow-up options, Saechow acknowledged that she will have to re-communicate the benefits of the portal so that patients actually use the tool and not sign up and allow their account to sit dormant.
“We want to pursue every avenue to help patients understand the value to them in signing up for the patient portal,” Saechow explained. “In addition to that, we also want to increase the uptake of getting those accounts activated.”
Improving patient portal activity will require engaging providers as well as patients, Saechow explained. As with any overhauling and system-wide project, the patient portal adoption requires a cultural change that will affect how clinicians do their jobs.
“We rely on our providers very heavily on the patient portal rollout because they have to be responsive to looking at their inboxes for critical results and patient messages,” Saechow pointed out. “That was new for them. We had to present the change to them, we had to follow-up to make sure providers understood the tool, so that they are very responsive to our patient needs.”
Saechow credited success with provider buy-in to a meaningful change management plan.
“One of our greatest strengths was to focus on the change management for our organization to drive cultural and behavioral changes in a standard and efficient way to deliver the best care possible to our patients,” she stated. “We really had to spend time as much with the providers as with the patients.”
NYC H+H was also successful because it leveraged a system-wide technology solution. As noted above, prior to 2016 the patient portal and related tools were very fragmented and not yet mature. Using a single tool across the entire system, which was previously very autonomous, has allowed Saechow and her colleagues to implement a standard set of best practices.
This standardization of care has put NYC H+H on the path for stronger patient portal adoption and activation, Saechow said. However, it has also allowed the health system to create system-wide cultural change that will result in quality care in all care sites, which is ideal for any wide-ranging health system.
Improving care quality will ultimately drive the patient experience and invite more patients to receive their treatment at NYC H+H, Saechow noted.
“We want our patients to select us,” she concluded. “Wherever they live and whichever borough they go to see one of our facilities, we want them to have a consistent and great experience. Our aim is to provide high-quality care, consistently, every time.”