Wednesday, April 15, 2015

It Seems That Patient Portals Like The PCEHR Do Not Work Very Well. I Thought We Knew That Already!

This appeared a few days ago:

Survey: Portals Not Achieving True Patient Engagement

APR 8, 2015 7:58am ET
Designed to allow patients to view personal health and billing information as well as schedule appointments, patient portals have thus far proven to be disappointing in terms of increasing patient engagement, improving clinical outcomes and reducing costs.
That’s the finding of new HIMSS Analytics online survey of executives from 114 healthcare organizations and a focus group including nine executives. According to the survey, the top drivers for patient engagement are to enhance and improve the health of the community (77 percent), the quest to build brand loyalty for patients (77 percent), and meeting Meaningful Use requirements (60 percent).
Patient portals are often touted as the ultimate patient-centric tool aimed at improving engagement by allowing patients to be the source of control and fostering transparency. However, what’s needed are next-generation portals with functionality that will enable patients to become partners in their own care, according to those surveyed. Specifically, respondents say they are seeking functionality such as e-visits or e-consultations (80 percent), interoperability across multiple providers (70 percent), health evaluation and coaching (70 percent), and tele-visits (50 percent).
About two-thirds of survey respondents are using portals provided by their electronic health record vendors. In theory, EHR systems can help facilitate these objectives via the use of patient portals.
According to the survey: 71 percent of respondents who have an engagement strategy are using portal technology to meet current minimum Meaningful Use requirements for functionality and data sharing from a single source; 54 percent are using portals that offer a combination of patient services, technology and content; and 51 percent are using portals as a configurable, interoperable information exchange platform for data sharing from multiple sources.
More here:
Interestingly, highlighted in bold, we note all the things patients would like in a portal are not common are especially are absent from the PCEHR on-line portal.
More evidence that the PCEHR may not have been as well thought out as might have been hoped.


Anonymous said...

"More evidence that the PCEHR may not have been as well thought out as might have been hoped"

The understatement of the year.

It hasn't been thought out at all - it's just a dumb repository of a jumble of data that helps nobody.

Dr Ian Colclough said...

Don't forget the Health & Hospitals Commission in the first instance didn't mention anything to do with eHealth and ICT. Then as a belated afterthought in response to critical comments from many directions they suddenly proposed building a PCEHR with no understanding of what they were recommending or the consequences of their recommendation. Those of us who did understand shook our heads in horror as the snowball gained momentum on its way down the mountain.

Eric Browne said...

I'm afraid David that the picture in the US is far worse than painted in your referenced article.
Thousands of hospitals in the US have created patient portals to their EMRs - quite probably for chasing the Meaningful Use bait. According to the article below, 2/3 (i.e. 2,472 hospitals) had ZERO attempted patient accesses in the MU defined assessment window.

Anonymous said...

It is important to note that the USA centric article linked above is referring to portals tied to a single EMR (ie something very different to the pcehr). Not to say that the pcehr is perfect, far from it, but you can't put it in the same basket as the american EHRs.

I recently read the following on the NEHTA web page:

"For a general practice having undertaken clinical data cleansing exercises in readiness for eHealth they were able to more efficiently identify their diabetic patients. As a result, those diabetic patients were able to be booked in for diabetes care planning appointments. At these appointments, patients were registered for an eHealth record using the Assisted Registration Tool and a Shared Health Summary was uploaded by the GP into their newly created eHealth record. As of December 2013, the practice now reports improved glycaemic control of those patients with a recorded HbA1c. 76% have an HbA1c recorded reading <7%, and 90% of diabetic patients have an HbA1c <8%. " (South Australian Rural Practice Manager. Link:

Terry Hannan said...

Anonymous, your comments highlight the discussion trend that has occurred this week in Pulse+IT over the Bendigo HIT implementation.

Anonymous said...

April 16, 2015 2:49 AM I would submit the improved result in the management of diabetic patients in the Adelaide practice to which you refer has absolutely nothing to so with the PCEHR. Rather it is the result of the practice increasing its focus on what and how it manages and analyses its patient data. Reading between the lines it is my guess (and I could be wrong) that the practice uses PEN's software to achieve those results.

Anonymous said...

Yes and similar results in improving and managing diabetes have been achieved over the last few decades using very low cost ehealth initiatives, developed and implemented by the old Divisions of General Practice.
An old example is the CARDIAB system developed in NSW 2 decades ago. There have also been a number of initiatives to improve the quality of data in general practices - again many of these driven and supported by staff in the Divisions of General Practice.
We need to be careful of any hype that tries to attribute these sorts of benefits to the PCEHR. It is always a little vague when NEHTA and the DOH refer to 'e-health' as though they invented it, or equate it to one system (the PCEHR). E-Health has been around for a for quite a while before any of the DOH and NEHTA bureaucrats got involved.