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The Main Problems Hospitals Face When Adopting Patient Portals


"An EMR company could slap something together, or a group could build their own, and it was enough to get by. We got stuck with these bad solutions.”

Patient portals have become a key tool that health systems can use to give patients better access to their healthcare and appointment information. As with many new technologies that the industry has begun to adopt, however, the implementation of portals has so far been imperfect.

“If you look at some of the top health systems in America, and the actual functionality that is in their apps and portals, no one can say that this market is where it should be,” John Deutsch told Healthcare Analytics News™ in an interview. “We are so far behind and the largest health systems should be leading through innovation.”.”

Deutsch (pictured) is CEO of Bridge Patient Portal, and he formerly worked in the electronic medical records (EMR) industry. Good patient portal implementation requires 4 elements, according to Deutsch:

  • Meaningful Information: "Clinical and financial data from siloed systems must be brought forward through powerful interfaces to share with the patient."
  • Accessibility: "The portal or app must be easy to find, register with and use."
  • Promotion: "The portal must be promoted wherever possible and there must be buy-in from providers and staff."
  • Staff: "Designated staff are needed to support the influx of requests generated from the portal. Expecting existing staff with other responsibilities to manage the many facets of the patient portal is likely to fail, creating liability and poor user experiences."

Interoperability is a major factor. Healthcare systems have been consolidating quickly in recent years, adding different EMR platforms to large systems that may’ve already been using multiple. Since many existing patient portal solutions are EMR-based, patients who see multiple specialists within the same health system may have to access more than one portal to track their health information, which can be unintuitive.

“It’s very realistic that patients would be downloading or accessing 3 different patient portals—and it doesn’t work,” Deutsch said.

Cybersecurity for patient portals is also important. They provide access to a lot of specific, personal healthcare information from an EMR, and a lot of portals may not be HIPAA- or Payment Card Industry-compliant. Deutsch told HCA News that that’s an issue, but it won’t become more apparent until portal adoption increases and a few systems fall victim to hacking.

Another issue is sharing. It’s very common that caregivers will end up accessing the portal on behalf of a family member, and doing so simply by using their username and password. Deutsch's thinking is consistent with recent research letters that have called for caregivers to be given their own logins and given only certain privileges to their loved ones’ information.

“Sharing is the elephant in the room,” he said. That’s primarily because little thought was put into many patient portal applications, Deutsch believes. The mere adoption of a patient portal was incentivized by the Centers for Medicare and Medicaid Services’ Meaningful Use standards.

“That’s the problem with this market. There were incentives, which were well-intentioned, but the requirements were so basic that really an EMR company could slap something together, or a group could build their own, and it was enough to get by,” he said. “We got stuck with these bad solutions.”

But an industry-wide issue is one that Deutsch believes is self-inflicted: “HIPAA paranoia.” He said a lot of health systems don’t have a clear enough understanding of the regulations and decide not to implement or expand patient portal programs because they’re unsure of how to be compliant.

Still, the Bridge CEO thinks the patient engagement technology landscape is improving: The combined annual growth rate for the market over the next few years is supposed to be nearly 20%, more than double that of EMR and revenue cycle management technologies. It's why he left the EMR business, and he believes his company can help drive change in the market.

“We’re entering into the second generation of patient portals, where it’s not just about attesting for Meaningful Use, but actually listening to the patients and providing comparable solutions to what one might expect with their bank,” he told HCA News.

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