Patient Portal Preferences
IndustryView | 2014
Making health information easily accessible is a critical part of keeping patients involved and informed in their care. Online patient portals, which are secure websites commonly integrated with EHR systems, provide patients with an easy way to schedule appointments, view test results, pay bills and communicate with doctors and staff, among other things.
Increasing physician interest in adopting EHR systems that have patient portals can be traced to requirements for achieving meaningful use set forth by the HITECH Act. Meaningful use stage 2, which focuses on patient engagement and education, requires providers to have a patient portal that’s used by at least 5 percent of patients in order for providers to successfully fulfill the requirement and receive financial incentives.
In order to select a portal your patients will actually use, it’s important to know what features are most important to them. To find out, we surveyed a random sample of 1,540 U.S. patients, collecting a minimum of 385 responses to each question. Here, we highlight our most important findings.
Only one-third of respondents in our sample said they have access to a patient portal. The remaining two-thirds either don’t have access to one, or are unsure whether they do or not.
This data suggests that using a patient portal may be a new experience for many, which means patients may require extra direction from providers on how to access portals for the first time. It also supports recent findings that show providers have been slow to adopt patient portals and successfully promote them to their patients.
The fact that 33 percent of patients are unsure if they have access to a portal is problematic, and indicates that providers who do offer portals need to do a much better job communicating both their availability to patients. Examples of possible outreach include having doctors or office staff verbally remind patients during office visits, emailing patients a link to the portal and/or distributing printed cards with the portal’s Web address and instructions on how to use it.
Next, we wanted to know which common patient portal features patients want most. Our survey found that the most requested feature is online scheduling, with 24 percent of respondents expressing a desire for this.
Online scheduling systems have been shown to have numerous benefits for medical practices. Automatically generated appointment reminders, for example, can help significantly reduce no-show rates. For patients, these systems provide a more streamlined experience while eliminating certain hassles of making appointments over the phone, such as long hold times.
Viewing test/lab results was the second most desired patient portal feature, with 22 percent of respondents expressing a preference for this. Kaiser Permanente is one example of the benefit this feature can have: when it added a feature to its portal allowing patients to view test results, registration jumped from 9 to 27 percent.
Another 21 percent of patients in our sample wanted a portal that would allow them to view and pay bills online. This data aligns with a recent study by Intuit, which found that 77 percent of patients would be willing to pay medical bills online if the option was made available to them.
Checking prescriptions and requesting refills was favored by 19 percent of patients; a finding that has positive implications for patient outcomes. One study, for example, found that diabetic patients who used an online portal to request refills were more likely to take their medication.
While exchanging emails with staff is often cited as one the most common uses of patient portals, surprisingly, just 10 percent of patients in our survey expressed a desire for it. This may be a result of frustration stemming from prior attempts at communication; e.g. patients may have sent messages to staff via a portal in the past that went ignored.
After determining the most requested patient portal features, we then wanted to know which features cause patients the most frustration and lead to low usage rates. Unresponsive staff (34 percent) and confusing portal interfaces (33 percent) topped the list of what patients find most irksome about patient portals.
One reason for slow staff response times may be the relative novelty of patient portals. A 2014 study by the Centers for Disease Control and Prevention (CDC) for example, found the number of doctors using an EMR increased 60 percent from 2001 to 2013. Figuring out how to incorporate the demands of technology into an already packed day may prove challenging; even more so considering some physicians are resisting these changes.
Veronica Combs, editor-in-chief of MedCityNews and a new patient portal user herself, says the portal she recently joined had a confusing user interface, and lacked clear organization. Information she expected to find in one place, for example, was located in another. The site navigation was also unclear, which made it both annoying and time-consuming to use the portal.
Automatic emails, often viewed as annoying and impersonal, were also disliked by patients, with 22 percent citing this as the most frustrating feature. Finally, while the use of medical jargon in patient notes is often cited as a point of confusion, only 11 percent of patients surveyed said it would frustrate them most when using a portal.
Dr. Richard Loomis, director of medical informatics for Practice Fusion, says that other sources of patient frustration include not being able to locate important information, or patients having to input health information themselves to add to their record. This, he says, is a huge impediment for doctors seeking more engaged patients.
Upon drilling further into the data, we noticed a difference between male and female preferences for patient portal features. Among male patients, for example, online scheduling and checking prescriptions/requesting refills were the most popular, while female patients primarily expressed a desire for viewing test/lab results and viewing bills/making payments.
A survey of Kaiser Permenante’s 3 million users of its patient portal system, My Health Connect, found that 60 percent of current portal users are female, suggesting doctors may want to give slightly more weight to their preferences, depending on their practice’s unique demographics.
Our findings also found considerable differences in feature preferences between age groups. Patients in the 18-24 age range, for example, were more interested in viewing test results than older patients, who expressed a greater desire to view prescriptions/request refills and schedule appointments online.
Since older patients tend to take more medications and have more mobility issues than younger patients, online portals have the potential to improve medication adherence among the elderly and assist them in scheduling their own appointments.
Our findings indicate there are clear preferences for certain patient portal features, which can vary greatly by age and gender. To ensure your practice selects a portal that has the functionality and ease-of-use patients are looking for, here are a few tips:
Ensure features align with practice demographics. Our survey revealed distinct preferences across age and gender lines. If you have a predominantly female practice, consider investing in a portal that allows you to view test/lab results and view/pay bills. For a predominantly male practice, portals that allow online scheduling and viewing/refilling prescriptions may be best. For practices with primarily older patients (55+), evaluate systems that offer online scheduling and viewing/refilling prescriptions. If younger patients (18-24) make up the majority of your visits, consider a system that allows them to view test/lab results.
Take it for a test drive. Combs suggests using the portal first yourself to see how intuitive and easy-to-use it is in order to prevent some of the interface issues she experienced. Another option is to ask fellow doctors or current patients about their experiences using a patient portal to learn what they like most and least. Finally, HealthIT.gov recommends testing your portal out on a small group of patients before offering it more widely to identify potential problems in advance.
Consider future patient preferences. A final point of advice when selecting a patient portal is to think about what features your patients may want down the road. For example, Dr. Loomis predicts that mobile integration and interactive educational features, such as videos, will become increasingly valuable. An increasing number of insurance companies are also beginning to cover teleconsults, which are highly desired by patients for non-emergent issues and could be incorporated into patient portals in the future.
Keeping an eye on what features patients increasingly desire will help ensure they continue to engage with your patient portal—both now and in the future.
To find the data in this report, we conducted a three-day online survey of four questions, and gathered 1,540 responses from random patients within the United States. We worded the questions to ensure that each respondent fully understood their meaning and the topic at hand.
Sources attributed and products referenced in this article may or may not represent partner vendors of Software Advice, but vendor status is never used as a basis for selection. Interview sources are chosen by searching the Internet for authorities on the topic, and software choices are selected based on popularity and relevance.
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