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My first portal experience

Yes, after all these years of writing about EMRs, EHRs, PHRs, patient portals and the like, I have had my first real personal experience with a patient portal, courtesy of my internist.

He still has a small practice, with four other physicians, including one fresh out of residency. Those small practices are a dying breed, but this doctor is changing with the times, too. He recently offered a concierge option for a few hundred patients. I declined because I don’t need to reach him that urgently.

The portal has been in place for a couple of years, and I may have logged in once or twice before to set up an account, but didn’t really do anything other than look around. This time, prompted by an e-mail informing me of a new URL, I logged in and checked my medication list. I remembered that another doctor had changed the dosage of one of my medications a while back, so I fired off a secure message informing this practice of the change. (It was a new URL presumably because the EHR vendor formerly known as Sage Healthcare adopted the Vitera Healthcare Solutions name a year ago and was switching its customers to a common, white-labeled portal.)

I also looked at some of my test results from a year and a half ago just to confirm that everything was more or less OK then, though I did see one abnormality with my HDL cholesterol. I last went for a physical in March 2011, about a month after I ungracefully cut my face open on a bathtub in Orlando during HIMSS11, so I was probably due. This practice lets patients request appointments — not actually choose open slots — online, so I sent my request. Tonight, about 24 hours later, I got my confirmation, and I’ll be seeing the doc in a couple of weeks.

It’s not a perfect system, but it was convenient enough for a night owl like myself who might not remember to call during business hours to make an appointment or simply not want to wait on hold or press a bunch of buttons to navigate a telephone menu. I did not see the Blue Button option to download my record that the federal government is pushing private vendors to adopt, but I’m sure that will be there by the time the practice is ready for “meaningful use” Stage 2 in a year or two. I don’t have a PHR anyway, so I wouldn’t be able to do anything with the data other than print it.

I suppose I should set up an emergency PHR at some point, even though I doubt any hospital or specialist I might get referred to would take the time to download my data from a USB drive or log into someone else’s portal. Untethered PHRs simply don’t fit physician workflow. That might change in MU Stage 2 when providers will have to send electronic discharge statements and patient summaries during transitions of care, but I’m still not convinced a patient-controlled PHR will be the right vehicle for these data transfers.

 

October 31, 2012 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.

The dirty little secret about ‘Blue Button’

Since last summer, various government agencies, notably the Department of Veterans Affairs, have been touting the Blue Button Initiative as an easy way of  sharing electronic data with patients. Just click the blue button in the patient EHR portal and download data into a personal health record or a printout. Sounds simple enough.

Late yesterday, my successor at a publication I was the primary writer of until late last year, cited the importance of the Blue Button, particularly when coupled with Microsoft’s HealthVault PHR platform. (If I turned in my story as late as 4:52 p.m. for that client, I would have been docked at least $150, but that’s neither here nor there.)

The fact that HealthVault and other “untethered” PHRs are non-starters when it comes to the public notwithstanding, Blue Button has a serious, perhaps fatal flaw. It outputs data in unstructured text form that’s not easily readable by an EHR. There’s no Continuity of Care Record, no Continuity of Care Document, no form of Clinical Document Architecture at all.

Just. Plain. Text.

One techie doctor I know calls this data essentially useless.

UPDATE 10 a.m. EST: The techie doctor I mentioned is Dr. Enoch Choi of Palo Alto Medical Foundation, per his comment below. He tweeted about this last month.

February 22, 2011 I Written By

I'm a freelance healthcare journalist, specializing in health IT, mobile health, healthcare quality, hospital/physician practice management and healthcare finance.