We’ve been involved with patient portals for over a decade. We recall early articles reciting survey results. In one early memorable article, a survey by Harris interactive indicated that of patients who had internet access, 78% of patients want to use the internet to communicate with their doctors. But, are we there yet?
Last month, we read another article. Guess what. 78% of patients want to use the internet to communicate with their doctors. This is incredible. For sure, the number of internet users has dramatically increased over the past decade, yet the 78% figure remains constant and so does the question. So why aren’t we there yet?
It appears that regardless of study timing, the results continue within a similar and narrow range. Some surveys indicate low 70s, some state 80%. This much we know. What we don’t seem to know is how to get actual utilization to reconcile with desire.
Clearly the phone continues to ring off the hook and portals are underutilized. We see one of the Stage 2 Meaningful Use criteria of 10% of patients sending messages to their providers as a looming presence. 10% (of patients) is really not too much to ask for, but we aren’t close to achieving this rate. A number of reasons can be sited, but perhaps the most obvious is that when we make a phone call, we know that somehow, our request will be fulfilled within a reasonable amount of time, and, with the web, we aren’t as certain of that as yet.
In a past life as founders and owners of MediConnect, we learned at least one secret to providing successful and high quality call center services to doctors, hospitals – and oh yes, to patients too. That secret was the pronouncement of a response time expectation. A guarantee if you will, that each patient’s request has been heard; that the message will be forwarded to the proper person or department at the office, who could resolve the issue at hand; and most significant, confirmation that the message has been received and will be responded to within a specific reasonable timeline (just like Walgreen’s does it on their automated prescription system). By the way, some systems presume that with a standard, one response time fits all, ie. “someone will get back to them within 48 hours” (regardless of the message type), will work for all patient needs. And if patients experience that they do not get a response in the stated time or feel that the standard answer does not fit their needs, they will leave a message and pick up the phone, doubling the work for your staff. And this is not just our observation. In an January 30, 2012 AMEDnews post titled Patients as partners in health IT, the author Sheryl Cash quotes Dr. Deanna R. Willis who is a family physician in Indianapolis, associate professor at Indiana University and chief medical officer of quality and medical management for the 200-physician Indiana University Medical Group Primary Care. Dr Williams states, “a portal can be a very efficient way to communicate with a physician, as long as there are processes in place within the practice for reviewing and responding to new information.” She goes on to say, “if the office is not responding in a timely manner to a request placed in the portal, the patient is going to have to pick up the phone and call the physician’s office. Now the office has to deal with both the phone call and the new portal information.”
We’ve made tremendous progress in so many areas of healthcare, but efficient patient provider communications remains a laggard. Now, what do you think would happen if patients submitted a message through a portal, received a promise of a response time, and the office got back to the patient within the promised window? We believe that the successful interaction would ease the way for patients to make greater use of a portal as the primary communications method, instead of what many do now, which is phoning the office to confirm the message receipt.
We know 70+% want to use the internet to communicate with their provider but less than 10% do. We believe that when we finally make the patient a full partner, and tailor the technology to both patient and provider needs, portal usage will greatly increase. Then we’ll be able to say “YES’ to “are we there yet?”
