- Although most hospitals and providers offer patient portal access, there is still more to be done. Meaningful patient portal adoption is lagging as more providers look to their patient portals asking how to proceed.
Ninety-five percent of hospitals offer some sort of patient portal tool that meets meaningful use requirements, as do 87 percent of providers, according to ONC data. Despite adoption levels nearing 90 percent, only 15 percent of patients are using the tools in some sort of meaningful way, found a recent assessment from the Government Accountability Office.
GAO suggested that the problem could lay with ONC or HHS, two organizations that should be keeping track of how many patients actually use the portal.
But solutions to limited patient portal uptake could also lay with providers, who need to use stronger motivation tactics to get their patients to use the portal for a prolonged period of time and not just for a single log-in.
That dichotomy was visible at the Virginia-based Prime Care Family Practice, where patient portal activation was nowhere near where it should have been. Even though Prime Care had a great product, it could not drive active patient use, said practice owner Amar Shah, MD, during a recent interview with PatientEngagementHIT.com.
“In terms of the portal access, we initially had a strong campaign within our office to get email addresses and get patients on the patient portal when we first adopted it,” Shah stated.
“That was a fairly robust exercise, but we had some problems with that process because we had limited buy-in from our front desk, we had limited buy-in from the medical assistants, and even the providers and some of the leadership here at Prime Care.”
Even though Shah and his team had a patient portal available, the practice continued to be inundated with patient phone calls and messages to nurses.
Patients weren’t receiving their appointment reminders via the portal, which led to significant no-show rates or late appointments. Patients experienced serious gaps in care and lagged behind in their preventive health services.
Shah and his team knew they needed a different approach. Simply collecting patient email addresses and reminding patients about the portal were not enough, he said.
“In January of 2017, we decided we needed to have a new direction in how to engage the patients better,” Shah explained.
The practice collaborated with its patient portal vendor, eClinicalWorks, which offered a patient relationship management service. This program first required Prime Care to develop a new, more meaningful definition about true patient portal access.
Next, Shah and his team had to identify the advantages the patient portal gave to patients that could motivate patient adoption.
Reframing Prime Care’s patient portal buy-in campaign hinged on the portal’s mobile option, which Shah said most patients prefer to use. For reference, the number of Americans with smartphone access is increasing, with 77 percent of patients saying they have a smartphone, according to the Pew Research Center.
Seventy-three percent of Americans have a computer with broadband access, according to separate Pew data. This number may potentially decrease, as technology users recognize the utility and cost efficacy of mobile tools such as smartphones and tablets.
At Prime Care, offering a mobile-optimized patient portal helped overcome many major barriers to portal use.
“We have more of our patients using the app now since our initiative in January just because the ease of the app and how mobile it is,” Shah pointed out. “Patients would forget their passwords or logging in on their computer because the password was long. With the app, it’s just a four-digit code.”
“Secondly, a lot of our patients don’t even have computers and they only have smart phones and so that was another barrier that we tried to break down,” Shah continued. “Lastly, getting text messages and email notifications directly on their phone kept the patients more engaged and kept them logging into the app to see what messages we were sending out to them and what updates we were giving them.”
But Shah and his team did not solely rely on the mobile functionality to increase patient portal adoption and use. The staff also used different strategies throughout the practice to encourage patient portal adoption.
“The first step was to start developing some meaningful definitions about what true portal access means and what the app can provide in terms of better accessibility to the office on a different platform rather than just phone calls,” Shah recalled.
Additionally, Shah and his team created a multi-faceted plan that motivated more patient portal adoption.
“The biggest factor was to have the ability to have patients activated on the portal at multiple areas in our office,” Shah said. “Not only the front desk, but the medical assistants and even the providers were educated on how to activate the patient on the portal and on the portal.”
Shah and his team have created patient portal adoption touchpoints throughout the practice.
At check-in, front office staff discuss how the app will support patient education and care management. During the visit, doctors and nurses explain how patients can access their own medical information, direct messages, and prescription refills. During check-out, front office staff discuss how patients can book appointments on the app, as well as find reminders and visit summaries.
Throughout the office, Prime Care allows patients to use digital tools to help patients to self-enroll on the portal and become acquainted with the technology.
Patient portal champions serve as touchpoints for both patients and providers. Champions answer questions about portal use and enrollment, and set a positive example for staff and leaders working to improve patient portal use rates.
Providers also have their own set of incentives. Staff members who sign 50 patients onto the app in one month can receive a prize or bonus at the end of the month. This facilitates prolonged efforts for more patient portal activation, Shah noted.
Prime Care has also been careful not to cater its patient portal campaign to a certain type of patient. Although the practice’s data shows that 22 to 55-year-olds tend to be more active portal users, Shah said there is utility for all patients and efforts should reflect that.
“In no way do we want to restrict our education and our patient engagement to those patients,” he explained. “We try to help every single age group in the office about Healow and how much benefit they can get from it.”
The reformulated campaign to create better patient portal buy-in ended up having positive results, Shah concluded. More patients actively use the tool, creating better patient engagement at the practice. And since more patients use the tool, which pushes out preventive service reminders, Prime Care sees fewer gaps in care.
Ultimately, creating sustained patient portal usage will require sustained efforts on the part of the providers. Offering a tool that has long staying power in patients’ lives, such as a portal app housed right on the smartphone, can ensure that patients will always easily access the portal.
Creating adoption incentives and highlighting how patients can use the portal for the duration of the healthcare journeys will also close usage gaps.