That was my takeaway from the report, HHS Should Assess the Effectiveness of Its Efforts to Enhance Patient Access to and Use of Electronic Health Information, issued by the U.S. Government Accountability Office (GAO). The findings were that 88% of hospitals and 87% of professionals who were eligible for Meaningful Use have given consumers access to their own health care data—yet only 15% of consumers in hospitals and 30% of consumers in other care settings have actually used the available data portals. Similar but slightly different findings from the Office of the National Coordinator for Health Information Technology (ONC) found that 52% of consumers have access to a patient portal and 50% of that group used the service—representing roughly 28% of the U.S. population (see Individuals’ Use Of Online Medical Records And Technology For Health Needs).
The original intent of patient portals was to support transparency and consumer engagement by providing access to personal health information. Lack of use of patient portals is a symptom of lack of consumer engagement—and that is something managers of health and human service organizations should be concerned about. Engagement is essential for “activated consumers”—those who act on improving their health (see From Consumer Engagement To Consumer Activation). Engaged and activated consumers have been shown to lead healthier lives, compared to those who are not. A recent analysis found that these consumers had more positive care experiences (see What The Evidence Shows About Patient Activation: Better Health Outcomes And Care Experiences; Fewer Data On Costs); fewer complications from chronic diseases; better care coordination; and fewer hospitalizations and emergency department visits (see When Patient Activation Levels Change, Health Outcomes And Costs Change, Too).
If your organization has a patient portal, do you know how many consumers use it? And the reasons why consumer do (and don’t) use the portal? The ONC study and others have analyzed why consumers don’t use portals (see What Keeps Patients from Adopting Patient Portals, Health IT?). They have reported a few key reasons :
- Prefer to talk to health care professionals (76% of consumers surveyed)
- No need to use portal (59% of consumers surveyed)
- Portals are confusing and medical “jargon” in portals confusing (41% and 21% of consumers surveyed respectively)
- Slow response of health care professionals in portal settings (26% of consumers surveyed)
- Privacy concerns (25% of consumers surveyed)
I think there is one additional item to add to this list—most portals have only a sliver of your personal health information. I have three or four patient portals with the various health care provider organizations that I have used over time and none of them combine my health information so that it is available in one place. I’ve had to do that myself, which makes use of the portal only relevant for the occasional email message.
So how do management teams increase use of their patient portals and up their consumer engagement factor? There are several tactics, depending on the feedback from the consumers you serve.
Make them mandatory—Often a key first step in getting consumers to use portals is getting them to sign up for the tool in the first place. Making sign up mandatory is a good way to get consumers into the system and starts them on the path to using that portal as the preferred method of communication.
Integrate the portal into each phase of the consumer experience—Mandatory use by your staff is also key to making sure the portal is integrated into daily operations. Managers need to make “the portal” part of every conversation with consumers. This means that staff, from the reception area to the clinical team to the billing staff, need to change their workflow and consumer instructions to incorporate the portal as a primary method of communication. OPEN MINDS Senior Associate Sharon Hicks noted:
My educated guess is that most of the use of patient facing portals are in a family medicine/primary care environment and are related to reviewing test results, scheduling appointments, and refilling prescriptions. Consumers are looking for convenience and consistency with those tasks.
Make them indispensably convenient—Make the portal the center of convenience for your organization’s consumer. The portal set up by my primary care physician’s organization allows me to schedule appointments, request prescriptions, review medical results, ask real-time questions, get a quick consult, and much more. OPEN MINDS Senior Associate Joe Naughton-Travers explained that being responsive is key to getting consumer engagement:
Consumers want convenience. If they send a message through the portal and your staff don’t respond in a timely manner, they will look for other options. Set expectations for your staff-they should always send some response within a day, whether it is for appointment scheduling, prescription refills, laboratory results, or questions for our health care professionals—the most common reasons we use portals.
Show and tell—Giving a consumer a tool and expecting them to use it simply won’t work. Provider organization managers need to take the time to introduce each individual consumer to the portal, and then provide “a hands-on approach” to training them on how to use the resource. Mr. Naughton-Travers explained:
The key issue for consumers using portals in active training and involvement by health care and ancillary staff members. If during a healthy care visit, someone took the time to show us the portal, the benefits, and how to use it, I believe usage would climb significantly.
Always improve—Provider organization executive teams need strategies for improving the consumer experience and increasing consumer engagement, and those strategies should include your portal. Those strategies need constant monitoring and improvement. Management teams should test the tools provided to consumer through the portal. The presentation of information and ease of use. Consumer experience testing is a “must.” Ms. Hicks noted:
One of the big lessons that seem to be missed in the development of outward facing health technology is that you need to build what the consumer is asking for. But the public policy model that has been used to date has been based on what health care professionals think people are asking for, or, even worse, what health professionals think people should be looking for.
So, step one in increasing the use of these tools would be to ask consumers, family members, and advocates what they are looking for from the tool. In my opinion, one of the reasons that this has not been done, is that what consumers really want is not something the health care industry has been willing to provide.
While I don’t know what the future holds for tech-enabled consumer interaction and consumer engagement, this topic should be high on the list of approaches for improving consumer experience and reducing administrative costs (see What Tool Can Your Management Team Take From Netflix, Amazon, Lyft, Uber & Walmart?). I think “next generation” patient portal swill need to consider interoperability and being the “home” for all of a consumer’s clinical records. But that’s a subject for a different day.
For more on informing your consumer engagement strategies, check out these resources from the OPEN MINDS Industry Library:
- Social Media Listening As Consumer Engagement Strategy
- Consumer Satisfaction, Consumer Engagement & Shared Decisionmaking
- Is Consumer Engagement A Habit At Your Organization?
- Consumer Engagement Is The Missing Piece In Population Health
- From Consumer Engagement To Consumer Activation
- The Inescapability Of Your Virtual Presence
- Virtual Mental Health Delivery Systems Evolve
- Keeping Consumers Engaged-The ‘How To’
- Keeping Consumers In The Equation: Best Practices In Consumer Experience & Engagement
- Successful Self-Direction Is Successful Consumer Engagement
For more, be sure to join us at The 2019 OPEN MINDS Strategy & Innovation Institute in June in New Orleans, where Lynda Zeller, Senior Behavioral Health Fellow, Michigan Health Endowment Fund will discuss performance and strategy development for the new market in her keynote address, “Harnessing The Power Of Analytics To Create Innovative Solutions For Complex Consumers.”
And stick around after the institute for on June 6 for The 2019 OPEN MINDS Consumer Engagement Technologies Summit, featuring Andrea Auxier, Ph.D., Senior Vice President, Product Development, New Directions; Chris Thompson, Chief Operating Officer, Monarch; Davis Park, Executive Director, Front Porch Center for Innovation & Wellbeing; Larry Smith, Chief Operating Officer, Grand Lake Mental Health Center; and Neal A. Bowen, Ph.D., Chief Mental Health Officer, Hidalgo Medical Services.