January 21, 2014

Is an Online Patient Portal a Good Way for You to Communicate with Your Doctor? Probably.

A friend recently changed doctors. During his first office visit, he was encouraged to sign up for the free “patient portal” service, which required only his permission and email address. The service would enable him – among other things -- to communicate with his doctor via email, and to view his medical information, including test results, using a secured website. The promo – touting the new freedom from waiting on hold, listening to dreadful music or messages, and then playing phone tag -- explained: “Why call, when you can click?”

My friend signed up on the spot. He asked the receptionist, “Are all of your patients signing up for this service?” She answered, “Just about.”

At first blush, one might think doctors would want to avoid this new communication service like the plague. Wouldn’t they lose some control of the traditional (slower) pace and tempo -- THEIR pace and tempo -- of interacting with patients? Wouldn’t they feel tyrannized by the 24-hour-a-day torrent of emails from patients? Fearing malpractice litigation, wouldn’t they be wary of committing comments to writing that could later be used as evidence against them?

As it turns out, not really.

Consumer Reports Weighs In
The January issue of Consumer Reports ran an interesting article -- “The doctor will email you now: Five reasons patient portals can lead to better health” – that provided a key reason (the best reason?) why doctors would welcome the new concept: MONEY.

Under a program run by the Centers for Medicare and Medicaid Services, doctors and other health care providers become eligible for financial incentives if they:
  • Make electronic health records available to patients online, and
  • Communicate with patients online, and
  • Enroll at least 5% of their patients.
Based on what the receptionist told my friend, his doctor isn’t having any trouble meeting that 5% threshold. It seems unlikely any doctors would.

Patients can use these portals for more than viewing lab results and communicating with their doctors. Typically they can also:
  • Make appointments
  • Request prescription refills
  • Pay bills
  • Add info and comments to their own health records
  • Access educational information, monitoring tools, and health plans
As we’ve learned from the Affordable Care Act, there are bound to be glitches as healthcare professionals roll out this new internet service. Since the government program is voluntary – providers choose IF they wish to participate – not all doctors will offer patient portals.

Five Reasons to Sign Up
But if they do, Consumer Reports offers five reasons why patients – like my friend – might want to sign up.

1) “Portals Put Your Health in Your Hands”
I’ve spoken often about the importance of being the CEO of your own healthcare. I’ve got plenty of medical concerns, to be sure. But I feel I’m doing as well as I am in large measure because I’ve taken such an active role in my own health.

When we can see our medical data as our healthcare pros do -- when we can review our own lab results, track our own numbers, review doctor’s comments and make our own additions to the conversation -- it’s much more likely we’ll pay closer attention to our health, get recommended screenings, and make lifestyle adjustment to enhance our well-being.

Some material we find via these portals is bound to raise – not answer – questions. But we’ll be encouraged to pursue clarification – by email, phone, or follow-up office visit.

2) “They’re Convenient”
The patient-friendly convenience of these portals encourages people to use them. If we use them, we’ll be paying closer attention to our health. No brainer.

3) “Accurate Records”
Experts suggest we remember only half of what we hear in the doctor’s office or on the phone. Now, we can see our medical records, and refer to them whenever we want. It’s safe to say that most things doctors tell us never get entered into our official records. Email is “self-documenting,” there for us to see at anytime.

4) “Faster Feedback”
The government requires the doctor’s office to post lab results on patient portals within 96 hours of receiving them, even if the doctor hasn’t yet seen them. Since patients will likely see results before they speak with their doctors, it’s probably a good idea to ask the doctor ahead of time what to look for when the results become available. Follow-up emails, phone calls, or office visits will likely occur to make sure the patient understands test results.

5) “More-Rewarding Visits”
While virtual communication may seem impersonal, it’s likely these patient portals will result in better, closer relationships with doctors. If a doctor recommends or prescribes some therapy, she might want to check in with her patient in a few days to see if the desired improvements are occurring. Email makes that process much easier for everybody. Harvard Medical School’s Jan Walker said, “In our experience, having open records and doctors’ notes enhances trust between patients and doctors.”

But Is Your Information Secure?
These portals come with all the regular safeguards: encryption software, firewalls, antivirus software, and the usual user name and passcode requirements. Still, like all websites, they are not impenetrable.

If you’re not comfortable with a less-than-100% guarantee, don’t sign up. You can continue to communicate with your doctor in the usual way.

But it looks like most people will opt IN. For protection, online security experts at Consumers Reports offered these recommendations:
  • Use only your own personal computer, not one at work or one shared by others at home.
  • Use your own separate email account, not one you share with a spouse or partner.
  • If you don’t already have one, install a good anti-malware program. Free options include Avast and Avira.
  • Use password protection on all devices, even if you’re the only person (you think) who uses them.
  • Don’t use wireless connections in public places.
The option for patients and doctors to communicate via public portals is new, and so the jury is still out on their use. Nonetheless, it’s hard not to view their availability as a great step forward for patients eager to assume a greater measure of control over their own health. 

Can there really be good news in the healthcare arena . . . where everything recently has been so hotly – and acrimoniously – debated? 

We’ll take it.

Yesterday -- in a bit of news reminiscent of the Affordable Care Act website's roll-out --my friend told me the portal isn't working. He tried and was unable to set up a new appointment on the portal, and the results of a test taken over a week ago had not yet been posted to his private page. He had to call the doctor's office, then waited on hold for four minutes, listening to horrible music until a real person took his call.

Two steps forward, one step back.

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