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.
I’m intrigued by your analysis of the online appointment booking. Just yesterday Shahid and I talked about creating that type of functionality as part of Physia.com. I’m glad your reasoning matches what we’re talking about. Plus, it seems that so few EHR are actually making this functionality possible.
They’ll have to make it possible in Stage 2. Right now, I think a lot of organizations are still trying to figure out how they are going to do it.
Hi Neil: I found your site through Dr. Walker’s twitter feed. Interesting….I to am working toward more comprehensive patient education and the goal that the patient will take resposibility for their health care.
As you were looking at your online EHR and viewing your medication list, would you think there would be any advantage to being able to click on the name of the drug you want to learn more about…and then you can listen to a 6-8 minute file that talks about all of the OBRA 90 specific pharmacy counseling information about that specific medication?
Check out http://www.auiblerx.com
Thanks
Steve
John, I wish it weren’t the case that every online patient portal was considering creating its own scheduling system. What we need are shared scheduling systems, or at the very least systems that talk to each other and to calendars. I am a board member of CalConnect (http://www.calconnect.org) which is one industry effort to help portals stop reinventing the scheduling wheel, as it were.