For most practices implementing an EHR Patient Portal is a new experience. The Meaningful Use Attestation guidelines are putting more and more emphasis in utilizing an EHR Patient Portal in order to create better communications between doctor and patient.
EHR Patient Portal and Meaningful Use Criteria
More than 5 percent of the patients were to view, download or transmit information, via the EHR Patient Portal. The revised 2015 measure removes the 5 percent requirement; however it is anticipated that this may be required in the 2016 criteria. The original Meaningful Use Stage 2 measure required that more than 50 percent of all patients seen are provided timely online access to their health information.
An EHR Patient Portal must also have the capability to send and receive secure messages from patients. The original Stage 2 Meaningful Use measure was to have more than 5 percent of the patients send a secure message. That requirement has been reduced; however, it is anticipated that this too will be the minimum in 2016.
The Fox Group, LLC has consulted with many providers who have asked: “Now that I have implemented the EHR Patient Portal how can I drive the use of it?” A better question would be this: “Now that I have implemented an EHR Patient Portal, how can I use it to provide better patient care, increase my revenue and reduce costs?”
EHR Patient Portal and its Evolution
Before we delve into the answers to these questions, I want to point out a little bit about the evolution of the EHR Patient Portal. Back in 2001 my software company, Westland Medical Systems, Inc., actually created an EHR Patient Portal in conjunction with a 60-physician Pediatric practice, which allowed patients to schedule, in real time, their well-baby checkups and inoculations. Once implemented, the practice realized a reduction in staffing costs since practice schedulers did not have to handle as many appointments. By the way, do not think that installing this feature allowed patients to see the practice’s appointment book. There were – and are – ways to offer patients open appointment slots without showing them any private data.
There was one issue: How do you get the word out to the patients (or in the case of Pediatrics the patient’s parent) to use the EHR Patient Portal to schedule the appointment? Yes, the practice put up notices in the office and messages on the bottom of statements, but was there another way to get even more people to use the EHR Patient Portal? We solved this problem and the answer will be revealed below.
EHR Patient Portal to save costs and increase quality
So what are some of the ways to get more out of your EHR Patient Portal and realize both cost savings and better patient care? Before you start sending messages to patients via an EHR Patient Portal, you will need the patient’s email, and a documented consent to communicate with the patient via email. A HIPAA compliant authorization/consent form specifying communications method is required. And most EHRs send patients a welcome message when they agree to use the EHR Patient Portal.
Then you must give the patients a reason to use the EHR Patient Portal. Posting the patients laboratory results to the Patient Portal is a no-brainer. I realize that if there is an abnormal result you will need to discuss it with the patient before they see it; however appropriately communicating the availability of these types of results can normally be managed in an EHR Patient Portal.
Most EHR’s will make it necessary for a clinician to review a result before it gets posted into the EHR Patient Portal. Three common ways to efficiently utilize the lab result review function include:
- Normal results: sign off to post to the EHR Patient Portal along with an automated message such as “The results of your lab tests were normal. If you have any questions about any of the results please reply to this message with your questions”. Notice that we did not say call the office!
- Abnormal results that are not critical: you still might want to sign off on the result and post it to the EHR Patient Portal but craft your own message such as, “Your cholesterol was just a little high. Please make an appointment to discuss ways to control this condition.”
- Urgent/critical results: you will probably want the patient to come back into the office for a discussion. Sign off on the result but mark it to not be published to the EHR Patient Portal. Instead you can post a message about calling the office and/or making an appointment soon to discuss the result. And use the patient follow-up/recall feature discussed below to ensure the staff follows up to get the patient back in!
EHR Patient Portal and prescription refills
Most practices still have a lot of patients who call the office rather than use the EHR Patient Portal. Patients like being able to see their active medications on the Portal. Make sure your patients know that they can look up their current medications and request refills via the EHR Patient Portal.
EHR Patient Portal and Follow-up and Recall
This is the area where you can definitely make the EHR Patient Portal pay off. I already mentioned how the pediatric practice used their EHR Patient Portal to allow patients to make appointments via the Portal. The key to getting the patients to participate was to send them recall ticklers via the portal. In this way, the patients get a message via the Portal about an upcoming appointment or some other service. So send reminders to patients through the EHR Patient Portal. For pediatrics I gave the examples of well-baby exams and inoculations. Other types of recalls would be annual exams, influenza vaccinations, pap smears, mammograms, colonoscopies, etc. A great work-flow would be to send the recall via the EHR Patient Portal and have the patient make an appointment request via the Portal or, if you have the capability, actually make the appointment over the Portal. If the patient does not make the appointment, then you should be able to create a tickler list for follow-up phone calls.
Implement your EHR Patient Portal with the above noted capabilities and you will soon think of this tool as a valuable cost and quality tool, rather than just a feature that is necessary for Meaningful Use attestation.