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Patient Engagement Technology: Moving Beyond Patient Portals?

October 6, 2016
by Heather Landi
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Traditional methods of digital patient engagement by healthcare providers typically entail a patient portal where patients can access their health records, look at test results or refill prescriptions. There has been data to indicate patients are interested in digital health tools, such as mobile apps, yet industry data also indicates that patient portal usage remains fairly low.

As previously reported by Healthcare Informatics, a Harris Poll survey released in June found that only 9 percent of 2,000 polled adults use a portal to set up appointments, with 13 percent of millennials using portals to book appointments. The Harris Poll survey found that more consumers are using portals to get test results (23 percent) and to get prescriptions and refills (11 percent). Almost a third of respondents (29 percent) report using a portal to look at their current health data.

Additionally, a survey by NEJM Catalyst, which is part of the NEJM Group that produces the New England Journal of Medicine, found that most healthcare organizations are still in the pilot or planning stages for the next wave of patient engagement in order to increase patients’ meaningful participation in their own care. According to that survey, 88 percent of healthcare leaders surveyed said their organizations currently use or have plans to implement a patient portal, but with regard to other approaches such as patient-generated data, social networks and wireless/wearable devices, and it seems most efforts are still in pilot or planning stages.

According to Brian Eastwood, a lead analyst with Chilmark Research, a Boston-based health IT research and advisory firm, the current model for patient engagement—the patient portal—is outdated, does not encourage behavior change and should be replaced with a broader engagement technology model. During a recent webinar, Eastwood addressed the need for broader patient engagement tools and presented findings from a recent Chilmark insight report examining how to use technology for improved engagement.

In the report, Chilmark researchers contend that market pressures as well as government regulations force consumers to take more responsibility for managing their health and paying for their healthcare. However, “effective, easy-to-use tools for helping consumers choose the right high-deductible health plan, find the right in-network physician, and make the healthiest choices are few and far between,” according to the Chilmark report.

Patient portals typically are built by electronic health record (EHR) vendors to serve as patient engagement tools, but compared to other digital tools that consumers use on a daily basis, the patient portal is outdated, according to Eastwood. “Even the most advanced portals pale in comparison to the multimodal experiences offered by familiar firms such as Amazon, Apple, Facebook, Google and Netflix,” he said.

“If you look at the typical patient engagement model at healthcare organization, they implement the portal and hit the bare minimum metrics, and move on,” Eastwood said, while also noting that portals are not optimized for the type of care that organizations want to provide moving forward. Patient portals are typically tied to a health system, not the individual, and don’t encourage behavior change, he said.

“[Portals] are systems are record, they are not systems of engagement. Portals capture information about episodes of care but they are not built for coordinated care and are inadequate for population health management,” he said.

Outlining why current patient portals fall short of meaningful patient engagement, Eastwood said patients with chronic conditions might have 10 specialists and 10 different patient portals and the information in a patient portal does not include what patients do in between care episodes. “It’s a disjointed model and doesn’t encourage engagement. It's not optimal for coordinated care that a lot of healthcare organizations are moving toward in the transition to value-based care,” he said.

Eastwood sees the healthcare industry moving toward a model where engaging with patients as consumers is the first step down a road that includes education, activation and empowerment. “The end goal is to create an environment where patients can change their behavior for the better, feel like advocates and feel a shared responsibility to live healthier lives,” he said.

While there are digital health tools that address the education and activation phase of the model, he asserted there are currently few tools on the market that empower consumers. “The ones that do are outside the larger healthcare system. This is a challenge that a lot of organizations are facing, and will face, as they try to transition to more coordinated care and more value-based care,” he said.

There are a multitude of factors that will make replacing the current patient portal platform with a new technology platform very challenging. According to Eastwood, those challenges include multiple entry points to healthcare, limited IT resources, a long learning curve and healthcare’s perpetual pilot phase for technology innovation.

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