Monday, March 29, 2010

How to Health 2.0-ize Your Patient Portal

(Tips for Techie Docs and EHR Vendors)

First, we need to define the terminology. Patient Portals are software or web services accessible in real time by both physicians and patients. Patient Portals come in two flavors: tethered to an EHR and untethered.

Tethered Patient Portals are just a different view of the doctor’s EHR. This is a restricted view of a patient chart and it includes the ability to communicate with the clinic in a secure fashion.  Some EHR vendors provide their own Patient Portals, while others offer full integration with third party Portal vendors. In both cases, physicians use their EHR to communicate with patients.

Untethered Patient Portals are standalone Portals used for secure communications only. Patients can send and receive messages to/from their physician, but they do not have a complete view of their chart. Physicians cannot initiate communications directly from their EHR. Instead they need to log into a separate Portal application.

There is a third type of software/service usually mentioned in this context, and that is the Personal Health Record (PHR). The best known providers of this type of service are Microsoft Health Vault and Google Health. PHRs, however, are directed to aggregation of patient data from multiple sources and less concerned with real time communication between patient and doctor. PHRs are outside the scope of this discussion.

What is Health 2.0? The term derives from the better known Web 2.0 terminology. There are many definitions for Web 2.0, but generally speaking it is the new generation of web applications that are interactive (as opposed to static), collaborative, user centered and very social in nature. The most ubiquitous examples of Web 2.0 and its power are social networks liked Facebook, Twitter, You Tube and even Google Apps.  Health 2.0 means pretty much the same thing for health care oriented applications. The newer EHR technologies that are delivered over the web, the various online patient communities, telemedicine, and remote monitoring devices are all examples of Health 2.0 applications.

A Patient Portal has all the makings of Health 2.0, but it lacks a social aspect. If a Patient Portal could allow the creation of patient communities and facilitate social interaction of patients with similar conditions or interests, it would be the ultimate Health 2.0 application, and much more powerful than larger internet communities of patients. The reason for this is that a Patient Portal community is also a physical community – people who have the same doctor, usually reside within a commutable distance. A Patient Portal Community could create relationships and support systems not just in cyberspace, but in the real world as well. For example, a Diabetes community could bring together folks that may decide to go for walks together every Saturday; dialysis or cancer patients can arrange for carpools; young moms can get together for play-dates or outings at the mall….. The possibilities are endless.

How does a doctor or vendor facilitate such benefits? The answer is very simple: by adding Forum capabilities to your Patient Portal. Forums are websites where one can go and ask questions, receive answers, start a conversation and get to know other people with similar interests. There are multiple options for free Forum software you can download or have hosted for pennies a day (see below). For privacy and security reasons, Forums should not be integrated with your EHR, but should be accessible from your Patient Portal. Even if you don’t have a Patient Portal, you probably have a website for your practice. You can add a link to the Forums right there. The hard part for the doctor is to configure Forums for the conditions you see most often, to encourage your patients to sign up, and actively participate in the conversations, at least initially. Your patients will more than likely take it from there. If you feel up to it, you may even add a blog to your Forums where you can provide guidance and advice, promote health and wellness and empower patients and families to participate in their own care.

While global Internet communities have obvious advantages in their sheer size and diversity, small local communities have the ultimate power of transcending the Internet and affecting real change on the ground, and isn’t that what Family Practice is all about?

Sample Free Forum Software:
PHPBB - http://www.phpbb.com/
SMF - http://www.simplemachines.org/ 

Forum Software Reviews
http://www.forummatrix.org/
http://www.forum-software.org/forum-reviews

6 comments:

  1. Looking for a patient portal for a pediatric website. Can you recommend some solid providers? I'd be interested in knowing the learning curve for the practice staff as well as usability on the visitor's end. No EMR in place to date. Any comments on cost and integration would be helpful. Thanks.

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  2. Hi Randi,
    The one I'm most familiar with is RelayHealth. It is now a division of McKesson and it's one of the more popular standalone portals. It is not Peds specific and it has lots of functionality that brings it very close to being a lite EHR, particularly now that they teamed up with Quest Labs to offer diagnostic services.
    You don't have to purchase all the services though. You can start with just a plain portal for your patients to communicate with your office.
    This is of course a web application and I like the simplicity of its user interface. One of the nice features they added a while ago was the ability to have web visits (and get paid for them). May be very useful for non emergency pediatrics.
    If you eventually get an EHR, they can integrate with the better known ones, although I'm not certain what the price would be.

    There's a quick online demo here
    https://www.relayhealth.com/general/onlineQuickTour/default.aspx

    You should contact them for a full demo though. I have not checked their prices lately, but a couple of years ago they were very reasonable.

    Another large portal vendor gaining popularity lately is Medfusion. I don't have direct experience with them, but it may be worth a call.
    http://www.medfusion.net/

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  3. With the finalization of the Meaningful Use Criteria to become eligible for the HITECH Act Stimulus, the language clearly indicates that the preferred method for providing patients electronic access to their records is via a web-based portal.

    For providers that have already made a significant investment in deploying an EMR solution but id does not support patient access, I2Qmed has the answer for you. Their standalone portal solution, I2QmedEP Patient Portal, not only meets MU criteria for electronic access, it can work in any EMR or non-EMR environment and best of all it’s FREE

    For more information go to www.i2qmed.com

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  4. The ideal solution seems to be a combination of the 3. An EHR patient portal (http://www.healthfusion.com/patient-portal.asp) that allows patients to view their PHR as well as their doctor's notes, and free ability to communicate with the physician away from the office. Some patient portal, like the Web-based MediTouch EHR (http://www.healthfusion.com/web-based.asp (http://www.healthfusion.com/web-based.asp), allow patients to begin their encounter at home prior to visit, saving everyone's time. The patient portal should be the doctor's assistant in the patient's home(TM).

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  5. The ideal solution seems to be a combination of the 3. An EHR patient portal that allows patients to view their PHR as well as their doctor's notes, and free ability to communicate with the physician away from the office. Some patient portal, like the Web-based EHR by MediTouch, allow patients to begin their encounter at home prior to visit, saving everyone's time. The patient portal should be the doctor's assistant in the patient's home(TM). Not to mention, with Stage 2 of EHR Meaningful Use, a patient portal will be required.

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  6. Every healthcare provider should switch to an EMR solution. Paper based records and prescriptions are a thing of the past now and it would be best for both doctors and patients to take advantage of their features and accessibility.

    Medical Billing

    ReplyDelete