Patient Portals: What’s the ROI?

Patient Portals: What’s the ROI?

The push for Meaningful Use(MU)has led to the development of more robust patient portals. For those of us who won’t be getting MU dollars, is there demonstrable value to implementation of a portal? I would give this a resounding: you bet!!!

Even as far back as 2004, I had a rudimentary patient portal. After 15 years of practicing pediatrics in a group setting, I was determined to strike out on my own and create a practice that delivered high-quality patient care, in an efficient manner, using technology as a foundation. I started with the premise that I wanted to take the top 20 reasons that parents call their pediatrician, and automate anything that was possible. These included: patient self-registration (which automatically populates our Pediatric EHR), access to immunization history (no more phone calls for “when was my child’s last tetanus shot?”), seeing pending appointments (“I lost my appointment card, when was I supposed to come in?”), requesting referrals and forms on-line, paying outstanding balances on-line.
We all know that the phone can be the lifeblood of a pediatric office. It also has the potential to completely take over the day. Every unnecessary phone call takes staff time and potentially interrupts them from a current task. How novel to have your staff available to answer calls for concerns that actually require their attention. Let them work on their electronic requests when they naturally have down time. So let’s talk reality.
Last week I had a patient who was seen by one specialist who referred her to another specialist because of some abnormal lab results. Can you say Medical Home??? Where was I in this conversation? (Yes, our practice is NCQA level 3 PCMH.) My “referral tracking coordinator” tracked down the specialist report and lab results. I tried to reach the mom on the telephone to discuss. (No luck, people are busy.) So instead, I sent her a message from inside the message center (attached to the patient chart), giving her my opinion, links to trusted web resources and instructions for additional labwork. This automatically generated a HIPAA complaint email (through our message distribution center) notifying her that we had placed a message on the portal. She responded with additional questions. When I got the lab results back, I sent her a follow-up message with more links to the definitive diagnosis and told her to print out the following to take to the appointment:
  • lab results (available on the portal)
  • growth measurements (available on the portal)
  • report from the original specialist (scanned image available on the portal)
  • our exchanged messages

No playing telephone tag. No staff interrupting me to speak with her. No need to mail/pick up information. It was an awesome exchange. Mom’s only complaint: “Why can’t MY doctor do this for me?”

Do patients value having their info? Ask my 12 year old patient who almost got an unnecessary tetanus booster while on vacation with her non-custodial parent. She convinced the ER doc to allow her to access her medical records on his desktop computer, and prove she just had a Tdap 6 months ago.
Does my staff like this feature? Oh my…they would never go back. Kindergarten registration? No one calls for proof of immunizations. Registering a new patient over the phone? We start them understanding the value of technology with self-registration from day one.
Current projects:
  • Going green: we will no longer be giving printed handouts for most well and sick visits. Instead these will be attached as standing orders to the patient department on the templates. Age appropriate Bright Futures Parent Information handouts will be published on the portal for all well visits. AAP Patient Education Online handouts will be attached to templates for common illnesses, and will remain there as a link for future reference. (Saves trees, printing costs, and my staff time to monitor our supply.)
  • Surveys before the patient visit: MCHAT will be added as a standing order to the patient chart for the 18 month and 24 month visits. We are adding a screening tool for maternal peri-partum depression, and eventually will add integration with a validated developmental screening tool.
  • Publishing patient statements on the portal instead of mailing (in beta testing)
  • Publishing school/camp forms on the portal as a pdf (close to production)
  • Notification of all normal lab results via the messaging center (we will still call abnormals)
Saving staff time, provider time, patient time, limiting phone interruptions…..priceless.
Now I have to think of ways for my staff to occupy their time doing things which will improve care and generate revenue….I’m thinking someone needs to be my asthma nurse educator, and someone else lactation consultant.