A patient portal should not be confused with an electronic personal health record (PHR), such as Microsoft Health Vault. PHRs are under the control of the patient, are largely populated by information the patient has self-reported or collected on her own. PHRs may or may not be able to interact with the physician's EHR system. The key feature of a patient portal integrated with an EHR is that it enables patients to interact with the physician and his or her medical office.
While it is possible for a practice without an EHR to install a patient portal that functions as a standalone web site, it makes more sense to have the application fully integrated into an EHR system. This enables patient medical records, schedules, care instructions and billing information to be easily uploaded and shared.
Here are five ways a patient portal can help an orthopedic practice:
1. Strengthen physician-patient relationships. A patient portal can include email, allowing patients to ask physicians about routine medical information or to request prescription refills. Apart from email, portals enable physicians to provide patients with reminders, test results and medical education information. For example, a patient who has undergone knee surgery could be supplied with detailed rehabilitation instructions and weekly reminders.
A study reported in InformationWeek magazine found that 73 percent of those surveyed would like to communicate with their physicians online to make appointments and get test results. At the Cleveland Clinic, which has had a patient portal for two years, 25% percentof the patients are now using the system. The clinic reports that the most active user segment is women between 40-60 years old, described as the "active moms."
2. Reduce staff workflow. Patient portals can be used to send individuals registration forms, insurance forms and bill payments. Portals enable patients to schedule appointments anytime without office phone calls. First-time patients can pre-register through the portal and fill out forms about demographics, medical history and prescriptions; this speeds check-in and reduces time spent in the waiting room.
3. Improve billing administration. Several studies have shown that medical practices must remind patients two or three times about an invoice before a payment is sent. Portals enable these reminders to be sent directly to the patient on scheduled basis (e.g., 30 and 60 days). Many portals can also facilitate online payments.
Savings on postage alone can be considerable. For example, the annual cost of mailing one piece of paper to 40 patients per day ($0.44 postage x 40 mailings x 250 workdays per year) is $4,400 per year per physician; this does not include labor costs. Patient portals can significantly reduce such costs.
4. Improve clinical quality. Patient portals enable patients to submit and to review their medical histories. This reduces the potential of handwriting errors and facilitates the sharing of accurate medical information with other physicians.
For orthopedic patients, information about how to prepare for and recover from common procedures such as knee or shoulder surgery can be very helpful. Information transmitted can include anatomical drawings or animation.
Also, the portal can provide patient access to accurate, up-to-date information about new procedures such as hip arthroscopy and general medical topics such as the benefits of good posture or prevention of sports injuries.
5. Help qualify for meaningful use incentive payments. Under the current program to encourage "meaningful use" of EHRs, participating physician offices must provide clinical summaries to patients within three business days. For many busy orthopedic practices, it is difficult to complete and print the needed documents before the patient leaves the office. Printing and mailing the summary later — within three business days — is an option, but costly and time consuming.
Patient portals offer a cost-effective alternative to meeting this requirement. With an EHR-integrated patient portal, staff can quickly upload the clinical summary to the website to be viewed by the patient. Note that the current meaningful use standards do not require that patients read or download this clinical summary; it just needs to be "provided," generally interpreted as sent electronically.
Close integration of the EHR and the patient portal application is important. If it takes six clicks of the mouse to send or upload the patient summary from the EHR to the portal, and you see 50 patients a day, that can add an extra 30 minutes of work each day for staff.
More uses in the future
As healthcare technology advances, the advantages of patient portals will only multiply. Kaiser Permanente and other large medical groups have already added remote monitoring capabilities for patients with hypertension, diabetes and other diseases. Medical devices in the patient's home can upload data such as blood pressure, glucose readings and weight. The information can be sent via the patient portal to the physician for review.
While these kind of advanced technologies are still in the future for most orthopedic practices, patient portals offer many immediate benefits. These advantages include increased patient satisfaction, improved staff workload and a help in meeting the EHR meaningful use requirements.
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