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Readers Write: How to Actually Get Patients to Engage with a Portal

August 6, 2014 Readers Write 9 Comments

How to Actually Get Patients to Engage with a Portal
By Zach Watson

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From increased interoperability requirements to percentage benchmarks for online patient usage of digital assets, Meaningful Use Stage 2 has several requirements that are making eligible professionals sweat. Let’s address the latter of the two.

From a high-level view, getting more than five percent of patients to download, transmit, or view health information online should be low-hanging fruit. But as the Mayo Clinic famously found out, simply creating this type of functionality doesn’t guarantee engagement. Of a reported 240,000 patients who signed up for portal accounts, less than 12,000 had actually logged in 2013. In contrast, Nashville’s own Vanderbilt experienced significant success with getting patients to interact with their portal. During 2012, they reported 193,969 unique logins.

And for truly outrageous engagement numbers, one need look no further than Kaiser Permanente. A reported 4.4 million of Kaiser’s 9.1 million members use the online portal.

Meeting Stage 2 engagement requirements is doable. The disconnect arises from providers simply implementing technology without truly integrating it. Online portal access should be introduced in the context of the patient-physician relationship, not as an extra feature that patients can access should the compulsion strike.

Here are three actionable methods for crossing the five percent chasm:

  1. Get a mobile app. It’s well known that electronic health record functionality varies by product, so it’s natural that patient portal capabilities will too. Part of granting patients greater access to their medical records lies in the intuitiveness with which they can retrieve said information. If they are asked to type in a username and password from the web browser on their phone, it’s unlikely they’ll go through the trouble. Mobile applications are becoming standard across all business verticals because they are formatted for ease of use. If a patient portal doesn’t come with a mobile app for patients to download, the physician implementing it should demand one. Kaiser launched their mobile app in 2012. Patients downloaded it over 450,000 times last year.
  2. Do a walk-through. Patient satisfaction is inherently tied to interaction with the physician or other clinician. To create an environment in which patients will be receptive to new information, have a knowledgeable staff member walk patients through how to login and use the portal. Explain the benefits of scheduling appointments and refilling prescriptions online. Perhaps even have the patients navigate the portal for 60 seconds or so to make sure they’re comfortable finding all the information. Will this affect clinic time? Yes. Will it help meet Stage 2 criteria? Absolutely.
  3. Create some marketing. It doesn’t have to be anything too spectacular, but some signs in the waiting room detailing the benefits of patient portals can certainly spark some interest from patients who are waiting.

This type of online access isn’t unexplored territory. Patients already enjoy this freedom with their bank accounts, credit reports, and so on. They want to be able to schedule appointments online. Make sure they know that they can.

Who knows, maybe they’ll download the app while they’re in the waiting room.

The key is to embrace patient portals – and other information technology for that matter – as a foundational element to the way healthcare works going forward. It’s already a reality. Patients simply need to be shown how easy it is to use.

Zach Watson is an analyst at TechnologyAdvice of Brentwood, TN.

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9 Responses to “Readers Write: How to Actually Get Patients to Engage with a Portal”

  1. 1
    flpoggio Says:

    Here’s a sure fire way…used by every retailer…

    “You may have already won a trip to Hawaii (or Paducah?), just go to our patient web site and review your information. That’s it.” click here…

  2. 2
    Cheryl Says:

    Signs in the waiting room are not compelling enough. There is no real motivation. It’s outbound marketing. Asking a busy office personnel to walk patients through sign up should not be the the responsibility of the doctor’s staff. If I were a doctor, I wouldn’t want to pay my staff to spend my salary dollars teaching every patient how to use a vendor’s product. Save it for those who really may need help. I think inbound marketing strategies would be more effective.

    Portal companies should create a short walk-through video to show how easy it is to sign up. It would be a better use of the ‘healthcare’ TVs often found in waiting rooms. Yawn, snooze, ignore. For those with smart phones, signup would likely be completed before “the doctor is ready to see you”. For those going home to sign up from a computer, they would at least have the lesson in their head. That is, if signup really is that easy. My last doctor’s portal was impossible. FWIW.

  3. 3
    @cascadia Says:

    Arggh this topic is so old and so easy. – portals are just an example of a culture that meets the patients needs.. It has everything to do with culture and yes your staff is paid to help people get online in the same way you pay them to answer the phone

    Cheryl sounds like the classic example of someone who doesn’t realize that the patient portal is just the tool to extend the doctor office outside of the clinic walls and has nothing to do with the vendor.

    You also don’t need a mobile app – places like Kaiser and Group Health Cooperative reached their numbers long before their mobile apps..

    It is really simple – you provide people with a service that saves them time or effort.. Online appts, Lab results, email to their care team.. This isn’t new or rocket science it is basic customer service – find out their need and meet it..

    If you don’t know how or need help hire people who have done it before or at the very least learn from those who have. It really isn’t all that hard.

  4. 4
    Mr. Natural Says:

    Enticing users to your portal is tricky, and there are many variables along the path. I once worked with a health system who provided separate portal technology for ambulatory and acute visits, dependent upon your encounter. This was an indicator of failure because of patient confusion.

    Another variable is determining your audience. Instead of focusing efforts on enticing all patients, focus on a sub-set of patients based on diagnosis or propensity to use the portal. I hate to be ageist, but you are more likely to entice those under 60 to a portal. The older the population the less chance it will be used. (yea, its a generality)

    Another variable is consistency. When you chose a portal designed by your EMR/EHR vendor you are adopting that technology as the “face” of your business to the public. What will become of that face if you de-install the EMR and must also change the portal. Usage will suffer. If it was my decision I would insist on reviewing third-party solutions that will work with any EMR/EHR.

    I am curious about the statistic on return users. Many portals implementation have good success attracting new sign-ons, but fall short on repeat sign-ons. Why? Because there are too few incentives that can’t be handled over the phone. So what new incentives can be offered?

    Consider thinking about the portal as much of a pre-visit tool as a post-visit tool. Your patients should be able to use the portal to ease the registration process and eliminate the god-awful paperwork that is required upon arrival. Once you start doing this you can begin to fast-track patients upon arrival.

    I would like to see a provider offer some financial incentives to create new and repeat visits. Would you as a patient use the portal if there was a promise of reducing your copay or deductible? Perhaps we need to entice payers to put more skin in the game to enable this technology.

    Consider portals that provide content that is specific to the patient’s condition. If there is connectivity between your EHR and portal then it should be easy to convey diagnosis information to the portal, and if the portal has this information the logical next step is to provide content specific to that diagnosis. If the patient is diagnosed with CHF, the portal should provide content on how to manage that disease with easy to view and informative videos, games and support groups.

    Just some random thoughts…I could go on.

  5. 5
    @cascadia Says:

    portals are just an example of a culture that meets the patients needs and yes your staff is paid to help people get online in the same way you pay them to answer the phone

    Cheryl sounds like the classic example of someone who doesn’t realize that the patient portal is just the tool to extend the doctor office outside of the clinic walls and has nothing to do with the vendor.

    You also don’t need a mobile app – places like Kaiser and Group Health Cooperative reached their numbers long before their mobile apps..

    It is really simple – you provide people with a service that saves them time or effort.. Online appts, Lab results, email to their care team.. This isn’t new or rocket science it is basic customer service – find out their need and meet it..

    If you don’t know how or need help hire there are lots of people who have done it before or at the very least learn from those who have. It really isn’t all that hard.

  6. 6
    NYC IT Guy Says:

    The topic of this article needs to be changed. “Mobilizing” apps, walk throughs and marketing is about gtting patients to sign up, not engagement. Engagement comes when patients have a compelling reason to use the app. People didn’t begin using bank apps when they could only view their account balances. It took off when they were able to pay bills, deposit checks, etc. Allow patients to book appointments, communicate with their providers and share their CCDs with other providers electronically – that will bring engagement.

  7. 7
    Jane Says:

    My concern is for the folks in rural communities served by critical access facilities. I agree with some of the earlier submissions regarding the ease with which one can access the portal, especially in an urban setting. However, an elderly patient in rural ND may not have the same experiences with mobile banking, etc. Discussions need to address to the lowest denominator when it comes to access (on multiple levels) and I feel that many times this point is missed.

  8. 8
    Zach W Says:

    Thanks for your comment, NYC IT Guy.

    I slightly disagree with your dismissal of access to information as non engagement. While expanded functionality like bill pay and deposits undoubtedly increased mobile banking usage, intuitive access to an account balance affords users significant benefit in terms of time saving. The alternatives of driving to an ATM, calling the bank, or calculating one’s current balance manually all seem anachronistic because of the accessibility of balance information from mobile devices.

    That said, the ease of use afforded by mobile devices factored into the first point on the list. Many of the online banking features you mention are available on mobile, consequently increasing the likelihood of customers using the application. Secondly, a walk-through would illuminate all of the engaging features we both agree would benefit the user, which theoretically reduces barriers to adoption and engagement.

    However, your point about expanded functionality is well taken: the more compelling the power of the technology, the more likely users are to engage.

  9. 9
    Jean Says:

    I went through a lengthy, convoluted process to get access to my primary care patient portal. I was very irritated to find, after wasting all of that time and effort, that all it offered was a list of diagnoses and the ability to submit refill requests, both of which were useless to me. I had my account closed. If you want people to visit the portal so providers can get their stage 2 incentives, you should consider making the info available to patients USEFUL. I was annoyed enough by that experience that I won’t bother going through anything like it again at a doctor’s office. When you tell everyone to sign up but offer useless information, you’re really just asking us to waste our time so you can get money and that is disrespectful.

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