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Footing the Bill: Patient Portals, Part I

April 27, 2009
by Daphne Lawrence
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Not an end unto themselves, portals need to be part of an overall patient-relationship plan

Deborah Kohn

Deborah Kohn

Patient portals have come a long way in recent years. The technology that once offered limited functionality is now multi-dimensional, and smart CIOs are cashing in. In this two-part series, we'll look at how hospitals are benefitting from tying portals to EMR, billing and scheduling systems, and how some organizations plan to push the technology even further.

Ken Lawonn

Ken Lawonn

In the financial department, we'll examine how portals have evolved past simply offering bill pay to include myriad services that can lead to significant savings. The administrative department, here, will explore how the technology is being leveraged to improve staff efficiency and consumer satisfaction by placing tasks such as scheduling in the hands of patients.

We'll also look at how portals are helping patients better manage their health, which is at the core of any hospital's strategy. It's a technology whose time has come.

In the fast growing world of portal technology, CIOs need to remember that the financial end of a patient portal is more than just paying a bill. Useful business results in this space can run the gamut from insurance pre-authorizations to improved collections, and from significant savings in call center workload to appointment scheduling. The blossoming of consumerism is making the patient portal ever more important - and tying the financial functions into the overall portal strategy is key.

“A portal is nothing more than a gateway to customer service,” says Deborah Kohn, principal at San Mateo, Calif.-based Dak Systems. “It's a gateway whether your customers are your patients, your physicians or your employees.”

Kohn says that since so many hospitals focus initially on physicians portals, they often don't realize the financial benefits of patient portals right away. “In crafting a portal strategy, we determine what's the most important thing to a hospital,” says Kohn. “And for most of my customers, that is their physician.” And that, she says, is where most hospitals start.

But the patient portal and its financial savings are part of an overall portal strategy as well; and for many hospitals, an easy place to start-especially when looking for a concrete ROI.

Ken Lawonn, CIO of eight-hospital Alegent Health System in Omaha, Neb., found those savings when he implemented his patient portal; it took financial functions he had established on the Alegent Web site to the next level. “We didn't do anything new in the financial world out of the gate, but since we established this patient account, we now have the information stored, so we don't have to ask the patient that information again.”

He says there are a few savings components to the portal - once is the efficiency component of staff taking the patient calls and registrations. “There is some cost savings there, and if we can collect some payments upfront, or get people to pay online, we can work more quickly.”

Lastly, he says that for at least a segment of his population, he can capture some volume because it's the way some patients prefer to interact.

Similar savings were realized by Asif Ahmad, vice president and CIO at Duke University Health System in Durham, N.C. - who turned a simple observation into a portal strategy. “We knew that one of the biggest spikes in our call volumes was at the beginning of the year, around January,” says Ahmad. The reason? Patients wanted actual information on their past spending in order to set upcoming flexible healthcare plan deductions. “From the financial side, that was the trigger,” he says. “Our call center would get bogged down with people looking for summaries of their spending.” Ahmad and his team decided to put it all online through a patient portal. “Oh, and while we're at it, why don't we let them pay their ongoing bills?” he says. “That's where it started.”
Asif Ahmad

Asif Ahmad

The portal at Duke, started two years ago, went from zero to 20,000 patients in a couple of months. And the collections began immediately. Duke currently collects close to $900,000 a month on the portal and expects to pass the $1 million mark shortly - results that please Ahmad, he says. “We have 95,000 patients online interacting with us, which accounts for 20 percent of our repeat patient population, and we haven't even actively marketed it yet.” And he has already begun tracking the impact on no-show rate and revenue.

However, most agree the key to success with a financial portal is having it fit into an overall portal strategy.

For Ahmad, that strategy was about becoming more accessible to patients, especially since Duke is such a large, multi-hospital organization. “We have 20 parking garages alone,” he says, “So our sheer size is overwhelming to a patient. We said ‘How can we be more high touch,’ and the portal was part of that.”