Patient Portals are healthcare-related online applications that allow patients to interact and communicate with their healthcare providers, such as physicians and hospitals. Typically, portal services are available on the Internet at all hours of the day. Some patient portal applications exist as stand-alone web sites and sell their services to healthcare providers. Other portal applications are integrated into the existing web site of the healthcare provider. Still others are modules added onto an existing electronic medical record system. What all of these share is the ability of the patient interacting with their medical information via the Internet. The lines between an electronic medical record, personal health record, and a patient portal are blurring. For example, Google Health and Microsoft HealthVault, describe themselves as personal health records (PHRs), but can interface with EMRs and communicate via the Continuity of Care Record standard, and expose patient data via the Internet so it can be viewed as patient portal.
Contents |
The central feature which makes a system, or a part of a system, a patient portal, is the ability to expose personal, patient health information securely via the Internet. Virtually all patient portals allow the patient to interact in some way with the health care provider. Patient portals benefit both patients and health care providers by increasing efficiency and productivity. Patient portal applications might allow patients to register and complete forms online, which can streamline and shorten visits to clinics and hospitals. Many portal applications also allow patients to request prescription refills online, order eyeglasses and contacts, access medical records, pay bills, review lab results, and schedule necessary medical appointments. Patient portals also typically allow patients to directly communicate with healthcare providers by asking questions and leaving comments.
The major shortcoming that most patient portals have is that they are tied to only one organization. If a patient travels to many organizations for their healthcare they normally need to log into each organization’s portal to get access to their information. This results in a fragmented view of their data.
Portal applications for practices typically exist in tandem with patient portals, allowing access to patient information and records, as well as schedules, payments, and messages from patients.[1] Most patient portals require the practice to have some type of electronic medical record or patient management system, as the patient data needs to be stored in a data repository then retrieved by the patient portal.
Health care providers in the US are bound to comply with HIPAA regulations. These regulations specify what patient information must be held in confidence. Something as seemingly trivial as a name is viewed by HIPAA as protected health information. For this reason, security has always been a top concern for the industry when dealing with the adoption of patient portals. While there may be systems that are not HIPAA compliant, certainly most patient and practice portals are secure and compliant with HIPAA regulations. The use of SSL and access control patterns are commonplace in the industry. Patient access is typically validated with a user name and password.[2]
Internet portal technology has been in common use since the 90s. The financial industry has been particularly adept at using the Internet to grant indivdual users access to their information. Possibly because of the strictness of HIPAA regulations, or the lack of financial incentives for the health care providers, the adoption of patient portals has lagged behind other market segments.
The American Recovery and Reinvestment Act of 2009 (ARRA) in particular the HITECH Act inside the ARRA sets aside approximately $19 Billion for Health IT. The funding will offset, potentially pay for electronic medical records systems for practicing physicians. Because the conversion to EMR is typically complex, a likely upshot of the transition to EMR is a transition first to patient portals followed by a complete conversion to a full blown EMR.
At the same time as the conversion to patient portals and EMR systems, PHRs, personal health record systems, are becoming more common and available. Currently, an individual's health data are primarily in physicians' files. It is for this reason that patient portals exist - to give the patient a view into their information. Given the mobility of patients, and the development of clear interoperable standards, the best documentation of patients history could be data outside the physicians office. At that point we will begin seeing physician portals.
E-visits may soon be one of the most commonly used options of patient portals that are available. The best demographic for e-visits are patients who live far away from their clinics, have kids, or who don’t want to spend 2-4 hours for a trip to the doctor when all they need is a quick answer or diagnosis for a minor symptom such as common colds, sinus infections, urinary problems, coughs, diarrhea and back pain.
Providing a route for patients to take that does not require them to come to the clinic benefits them and your organization. Many organizations find that overall utilization drops when e-visits are implemented, in some places by as much as 25%. This makes e-visits a very interesting proposition for insurance companies, although few actually re-imburse for them currently. E-visits, with the proper functionality, also allow the patient to update their allergies, vital signs, and history information.
Providing e-visits allows the standard healthcare organization to offer a product that can compete on price with the retail clinics that are popping up in strip malls and Wal-mart.