Electronic Health Records

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How to Improve Patient Portal Use in Emergency Care

By Vera Gruessner

- Initiatives around patient engagement and the push toward widespread patient portal use are continually being developed throughout the medical care sector. With the federal government establishing meaningful use objectives on patient engagement and requesting clinicians to report electronic clinical quality measures based on their patient care outcomes, healthcare providers are obligated to work toward increasing patient engagement with wellness and overall health on an ongoing basis.

Driving Patient Engagement

One physician who has spent his career emphasizing the need to increase patient portal use throughout healthcare systems is Dr. Tracy Lawrence, an emergency care physician at Henry Mayo Newhall Memorial Hospital. Dr. Lawrence spoke with EHRIntelligence.com and offered his perspective on patient engagement. Additionally, Dr. Nick van Terheyden, CMIO of the Healthcare Division at Nuance Communications, spoke with EHRIntelligence.com as well.

“I’m an emergency medical doctor and I work with the emergency department,” Lawrence began. “We have a portal and our goal is to get as many patients as we can using it. We first have our personnel start the process of encouraging patient portal use by getting email addresses from our patients. Upon discharge or at the bedside, our clinicians show patients how to go into the portal. This is one avenue we use to engage patients.”

When asked about any tips he had for doctors looking to increase patient portal use, Lawrence replied, “The most important thing, within the hospital setting, is patient education. Showing patients that portals have data to access and getting them excited about data [is important]. Often, patients don’t understand how to get onto the portal. It’s helpful to put it right in front of them and walk them through it.”

“Doctors need to make portals the ‘go-to’ place for information,” stated Dr. Nick van Terheyden. “Allowing patients to access their full medical record, view test results, and better yet, actually communicate with their doctor via the portal, would increase use and traffic dramatically. Usability is also key: portals need to be easy-to-use (for both patients and physicians) and that means they need to be accessible on mobile devices (i.e. a mobile app vs. a web page that is not mobile friendly). If patients are able to download their records, labs, and medical images from the portal, and get answers to their questions without having to make a separate doctor’s visit, the value of this type of technology increases dramatically. Additionally, doctors can make the portal available for telehealth consultations and use as an additional communication channel, which would also increase patient use.”

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“Patient engagement is critical as we move from fee-for-service to value-based care,” Dr. van Terheyden went on. “If more individuals take an active role in their care by following treatments, knowing their own medical history, and tracking symptoms, it is more likely they will stay out of the hospital, be more informed in the healthcare decision-making process, and avoid unnecessary tests and procedures because they will have access to their health data. This can only happen when patients are connected to their health, and the patient portal is a key pathway to achieve this.”

When asked about some other technologies that may affect patient engagement, Dr. Lawrence spoke about remote monitoring tools and wearable devices.

“For us, our hospital doesn’t have an integrated ambulatory EHR system, but we’re looking at home devices,” Lawrence explained. “Wearable devices are really big areas for patient engagement and for gathering data directly from the patient. More importantly, with the transition of care, when they leave the hospital, remote monitoring tools can track patients’ health. We’re looking toward the future [of home devices].”

Dr. Lawrence also discussed how mobile health devices and remote technologies boost patient engagement with their health and wellness.

“Right now, the mobile health field ranges from wearables, fitbits, the Apple watch, and even 3rd party apps with preexisting software to gather data,” Lawrence explained. “All sorts of different vendors are trying to get into the market. Another example is a blood pressure cuff that can transmit an email or text to a physician. Right now, there exists data access to information physicians never had before. To some extent, it may be too much information. Regardless, it is an exciting time on the horizon for wearables.”

“An estimated 69% of American adults today track areas of their health, such as weight, diet, exercise and symptoms, and 21% of them are using digital tools to do it,” Dr. van Terheyden mentioned. “The effective use of mobile applications not only has the potential to increase access to evidence-based care, but can also better inform patients of the care services available and actively engage them in their own treatment. There are several areas where mobile applications have proven to be extraordinarily effective in patient engagement, for example, there are tools that provide patients who have mental health concerns with 24/7 access to clinicians, who can support these individuals in a judgment-free zone.  Another example is leveraging mHealth apps for post-operative patients.  In fact, studies show these patients generally have a better recovery process when using this type of technology to track their progress and have real-time interaction with clinical staff. Recent studies on wireless fitness activity trackers also suggest that collecting up-to-date performance data can help patients regain functional independence and help hospitals determine the appropriate length of stay.”

“mHealth apps, interactive tools, and the wearable market are set to explode as a growing number of people look to manage their health. Mobile devices in healthcare are going to drive a behavior shift, as they have done in every other part of our lives. From simply speeding our ability to access information, to searching and accessing data on our conditions and symptoms, the great leveler of information is now available,” van Terheyden explained.

An additional question posed to the two doctors was: “When it comes to meaningful use objectives on patient engagement, what do you think providers are capable of achieving? Can they reach the 25 percent threshold?”

“I think anything is possible,” Lawrence answered. “The threshold is a struggle for some. However, providers need to ask themselves – is it a high enough priority to go from room to room teaching patients to use the portal? It also depends on resources and funding. It is attainable but it may be a struggle.”

“I think the key is, like with most new technologies, is to educate and show what the technology is capable of and how it benefits them,” Lawrence provided some final advice for physicians interested in improving patient engagement. “Show patients that the portal has a plan of care for them to get them engaged. Help them understand that this is something that will give a significant return on time invested.”

“I don’t think the question is can they achieve it; instead, we should be focusing on how to achieve it,” Dr. van Terheyden proposed. “To quote Leonard Kish, we know that the patient engagement is the blockbuster drug of the century, so even if Meaningful Use incentives and payments were not already tied to patient engagement, we should all be charging towards it (and beyond) with as much energy, effort, and resources as possible. If we can successfully accomplish this, we can help contain the burgeoning costs of healthcare, improve people’s health, and save money.”

“The reality is that making information available in a trusted format and via a portal relieves the extensive burden on our already-overwhelmed physicians and healthcare systems,” van Terheyden concluded. “Once their health information is available and patients understand how to leverage the portal, they will be able to research and seek guidance on their own. This greatly relieves the pressure on physicians, frees up their time, and helps them focus on more complex queries and problems their patients may have, and truly practice the art of medicine.”




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