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- Your Health Information, Your Rights

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Office of the National Coordinator for Health IT

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Video 1 -  Your Health Information, Your Rights

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A brief overview

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Updated: Health IT for You: Giving You Access to Your Medical Records When and Where They're Needed

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Updated: Health IT for You: Giving You Access to Your Medical Records When and Where They're Needed

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Medical Records Access

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Office of the National Coordinator for Health IT

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Updated: Health IT for You: Giving You Access to Your Medical Records When and Where They're Needed

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Patient Portals - Why It Matters

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Office of the National Coordinator for Health IT

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Patient Portals

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Patient Access - Setting Up Expectations for Patients

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Two Minutes: What's the Risk? Patient Portals

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Today's patients appreciate the convenience of accessing their health records online through a secure patient portal. Ensuring the privacy and security of these electronic records is paramount. Director of Risk Resource, Brandy Boone, helps you understand important issues around patient portals. Nothing in this video is intended to provide legal or medical advice.

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Physicians, Providers and Health Systems explain patient portals

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Personal health records and patient portals

Personal health records and patient portals are powerful tools for managing your health.
By Mayo Clinic Staff
If you're like most people, you have a number of health concerns and may visit multiple doctors and pharmacies. Keeping track of it all can be a challenge. With a personal health record, you can gather - and manage - all that information in one easily accessible location.

What is a personal health record?

A personal health record is simply a collection of information about your health. If you have a shot record or a folder of medical papers, you already have a basic personal health record.

And you've probably encountered the big drawback of paper records: You rarely have them with you when you need them.

Electronic personal health records (PHRs) remedy that problem by making your information accessible to you anytime via web-enabled devices, such as computers, smartphones and tablets.

What information goes into a PHR?

In general, your PHR needs to include anything that helps you and your doctors manage your health - starting with the basics:

Your doctor's names and phone numbers

Allergies, including drug allergies

Your medications, including dosages

List and dates of illnesses and surgeries

Chronic health problems, such as high blood pressure

Living will or advance directives

Family history

Immunization history

You can also add information about what you're doing to stay healthy and prevent disease, such as:

Home blood pressure readings

Exercise and dietary habits

Health goals, such as stopping smoking or losing weight

PHRs, EHRs and patient portals

PHRs are not the same as electronic health records (EHRs), also called electronic medical records (EMRs), which are owned and maintained by doctors' offices, hospitals or health insurance plans.

EHRs typically contain the same basic information you would put in a PHR, such as your date of birth, medication list and drug allergies. But EHRs contain more extensive information because they're used by health care providers to store visit notes, test results and much more.

A PHR that is tied to an EHR is called a patient portal. In some but not all cases you can add information, such as home blood pressure readings, to your record via a patient portal. If that's the case, you may not want to create a separate, standalone PHR.

However, you may want to consider having at least some basic information on hand in case of emergency, including advance directives, which outline your decisions about health care, such as whether to use life-support machines.

You could use an app such as the Health app for iPhones, which includes Medical ID, which makes critical information available via the lock screen for use by first responders in an emergency. Medical ID can display medical conditions, allergies, medications, blood type and emergency contacts. You can also use it to indicate if you're registered to be organ donor.

It is important to make sure any apps you use are secure so that your information is kept private. Make sure any app you use requires you to enter a password and that your phone has a firewall or encryption software. Research all apps before you download them to your phone and enter your personal information.

Similar apps are available for other smartphones as well. Or you could go low tech and keep a card in your wallet or wear a medical alert bracelet.

What are the benefits of a PHR?

Having a PHR can be a lifesaver, literally. In an emergency you can quickly give first responders vital information, such as diseases you're being treated for, medications you take, drug allergies, and contact information for your doctor.

If you see multiple doctors and they don't use the same EHR system, a PHR is a good way to keep all of your health information in one place.

A PHR also empowers you to manage your health between visits. For example, a PHR enables you to:

Track and assess your health. Record and track your progress toward your health goals, such as lowering your cholesterol level.

Make the most of doctor visits. Be ready with questions for your doctor and information you want to share, such as blood pressure readings since your last visit.

Manage your health between visits. Upload and analyze data from home-monitoring devices such as a blood pressure cuff. And remind yourself of your doctor's instructions from your last appointment.

Get organized. Track appointments, vaccinations, medications and preventive or screening services, such as mammograms. In fact, studies have shown when parents use personal health records for their children, the children are more likely to get their preventive well-child checkups on time.

Are there drawbacks to PHRs?

Building a complete health record takes some time. You have to collect and enter all your health information. Only a minority of doctors, hospitals, pharmacies and insurance companies can send information electronically to a PHR that isn't part of a patient portal.

In most cases, you will have to update your PHR manually each time you see the doctor, fill a prescription, have a test or go to the hospital.

Even if you use a patient portal, you still need to review the information that's added to it. The process of transferring health data electronically isn't always perfect and mistakes can happen.

Will my information be kept private?

Perhaps the most common concerns about PHRs are about privacy and security. To address these issues, reputable PHR systems follow industry best practices, such as making their privacy policies public and submitting to monitoring by independent organizations. In addition, federal laws have been put in place to protect the security of personal health information.

How do I get started?

If your primary care doctor offers a patient portal, use it. The staff at the front desk should be able to tell you how to register for it. (If your doctor doesn't offer one, ask if one will be available in the future.) Then start taking advantage of its features. Most portals offer the following:

Appointment reminders

Medication list

Appointment summaries, sometimes with associated educational material

Secure messaging with your provider

Test results

Show references

See more In-depth

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Personal health records and patient portals are powerful tools for managing your health. By Mayo Clinic Staff If you're like most people, you have a number of health concerns and may visit multiple doctors and pharmacies. Keeping track of it all can be a challenge.

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More Patients Are Using Patient Portals

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Four out of five consumers take advantage of their healthcare provider's patient portal, according to a 2016 survey on consumer access to health information released by the American Health Information Management Association (AHIMA).

The survey findings, based on survey responses from 167 consumers, demonstrate the opportunity for healthcare providers and health information management (HIM) professionals to better engage consumers in accessing and using their personal health information (PHI), according to AHIMA.

"Providing individuals with access to their health information is necessary in delivering high-quality care," Kim Murphy-Abdouch, clinical associate professor of health information management at Texas State University, said in a statement. "With the age of technology, healthcare providers and health information management professionals must adapt to accommodate the increase in demand for PHIs, both electronic and paper."

The availability of electronic health records has increased significantly since 2009, when the Health Information Technology for Economic and Clinical Health (HITECH) Act was signed into law, allowing consumers to access their healthcare information in a meaningful and secure manner.

The survey results revealed a significant reduction in charging consumers for access to their medical records; a significant increase in portal availability; and a moderate rate of usage of Personal Health Records (PHR). Those results in comparison with a similar 2013 survey of HIM leaders showed the following key data:

Eighty-two percent of consumers accessed their electronic health record through their provider's patient portal in 2016, compared to generally less than five percent in 2013.

Among the respondents who used portals, the uses for portals included viewing lab results (35 percent), requesting medication renewal (19 percent), requesting appointments (22 percent), secure messaging (19 percent), and other (5 percent).

Patient portals were available to 83 percent of the respondents, and 90 percent of the portal users were satisfied or very satisfied.

In 2016, only 10 percent of consumers were charged for copies of their personal health information when they were requested compared to 65 percent in 2013.

Less than half of consumers (49 percent) surveyed reported that they maintained a PHR in either paper or electronic form.

Survey results also uncovered consumers who had healthcare experience were no more likely to use a patient portal or maintain their PHR than consumers without healthcare experience. "In fact, opportunities exist to educate not only consumers, but also other healthcare professionals about how to access their information," the survey report stated.

"Although we have seen a dramatic improvement in patient engagement with their PHI, there is always room for improvement," AHIMA interim CEO Pamela Lane, said in a statement. "Health information management professionals have an obligation to continue to assist patients and others in accessing and maintaining their own personal health record."

The results of the survey were released as part of a presentation, "Patient Access to Personal Health Information: An Analysis of the Consumer's Perspective," taking place at AHIMA's 89 th Annual Convention & Exhibit in Los Angeles this week.

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Survey: Patients Increasingly Using Patient Portals to Access Health Records

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Four out of five consumers take advantage of their healthcare provider's patient portal, according to a 2016 survey on consumer access to health information released by the American Health Information Management Association (AHIMA).

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Patient Portals, Data, Consumer Preferences Top HIMSS17 Trends

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As healthcare pros prepare for HIMSS17, they can look forward to talks about patient portals and other top patient engagement strategies.

Source: Thinkstock

Healthcare professionals are gearing up to converge on the Sunshine State and preparing to immerse themselves in this year's HIMSS conference. As stakeholders continue to hear industry and regulatory calls for better patient engagement, attendees can look forward to plenty of talk about patient portals, patient data access, and patient-centered care.

The conference, taking place in Orlando, Florida, between February 19 and 23, will highlight not only emerging patient engagement technologies, but also best practices for utilizing those tools.

Through a series of panels and open discussions, healthcare professionals can expect to hear about how to integrate these tools into their workflows while keeping care personalized and consumer-centric.

Patient portals, patient engagement technology

Technology is the name of the game this year at HIMSS, and patient engagement is no exception.

On February 22 at 10:00 AM, clinicians can head to the Orange County Convention Center to learn more about how patients and their providers can leverage health technology per ONC standards.

The talk will center on ONC's history of working with patients and providers to develop best practices for health IT use, and will highlight the agency's current resources for care improvement. ONC will discuss its resources for population health management, interoperability, consumer engagement, and practice transformation.

Later that afternoon, clinicians and hospital technology executives can sit in on a talk about patient portal use and adoption factors led by Jon P. Burns, MHA, and William C. Reed, FHIMSS, FCHIME.

The presentation will acknowledge that healthcare professionals face barriers to facilitating widespread patient portal adoption, despite regulatory requirements and promises for the technology to improve patient engagement.

Burns and Reed will provide strategies for providers to overcome their challenges and drive better patient portal adoption rates.

Care coordination, interoperability

Care coordination is a key theme surrounding strong population health management and patient care. Ensuring that all members of the care team, including the patient, are working together is essential for driving outcomes.

To kick off the conference, stakeholders from the C-Suite to clinician level can sit in on a presentation from the non-profit Medical Home Network detailing how it integrates disparate providers to deliver patient-centered care.

The talk will also touch on the use of predictive health and behavioral analytics to help providers drive better outcomes and touch the patient at the appropriate point of care.

In the afternoon of February 21, Max Stroud, MSW, CPHIMS, and Irene Elizabeth Stroud, MDiv, STM, will offer a patient's perspective on the importance of interoperability. The pair will provide a narrative of a patient's relationship with her health data, and the importance of that data flowing seamlessly from provider to provider to ensure quality healthcare.

The presentation will highlight gaps in interoperability for both patients and their providers, as well as the differences in health data access needs for patients and providers.

Consumer-centered care

The healthcare industry has continued to recognize the patient as a health consumer with buying power, underscoring a need to meet patient preferences. In order to thrive in an increasingly consumer-centric landscape, healthcare professionals must understand the patient's role in healthcare and incorporate that knowledge into their workflows.

On February 21 at 1:00 PM, attendees can gather to learn more about how to shift their organizations to be more consumer-centric, and the potential benefits of doing so.

This talk, led by Mason Beard, MA, Harm Scherpbier, MD, MS, and Stephanie Kovalick, will address the challenges of incorporating consumer needs into healthcare and the tools necessary to overcome them.

The following day, clinicians can tune into a talk led by Robert Van Tuyl, Josh Newman, MD, MSHS, and Jitendra Barmecha, MD, concerning the "person behind the patient."

This presentation will focus on personalization in healthcare, assisting providers in tailoring care to unique patient preferences. Additionally, presenters will discuss how they utilize technology to uncover and incorporate these wishes into patient care.

Taken together, these sessions will provide attendees with an inside look into how leading healthcare professionals - including government agencies, software experts, and clinicians - incorporate patient centered care into their practices.

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Patient Portals, Data, Consumer Preferences Top HIMSS17 Trends

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Source: Thinkstock Healthcare professionals are gearing up to converge on the Sunshine State and preparing to immerse themselves in this year's HIMSS conference. As stakeholders continue to hear industry and regulatory calls for better patient engagement, attendees can look forward to plenty of talk about patient portals, patient data access, and patient-centered care.

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What Can Improve?

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Patient portals and health apps: Pitfalls, promises, and what one might learn from the other

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Widespread use of health information technology (IT) could potentially increase patients' access to their health information and facilitate future goa...

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Helping Patients Buy In

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Patients can be slow or reluctant to enroll in patient portals - but you can take steps to get them enrolled and on board. The ONC Patient Engagement Playbook tells you how.

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Of Patient Portals

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Principal Findings

The current principal driver of patient portal development is CMS and Medicaid EHR incentive program meaningful use (MU) criteria [ 6]. While MU criteria clearly outline requirements of basic functionality and targeted adoption rates, they do not delineate the steps or features required to engage patients in a sustained and relevant way. Presently there is no clear definition of patient portal adoption beyond the minimum use requirements outlined in the MU criteria. However, in order for health care institutions to track the success of patient portals in terms of patient engagement, a multi-dimensional definition of portal adoption should include both motivating factors for initiation and use over time A definition of this kind would inform a set of universal quality and efficiency reporting measures beyond the current minimal MU criteria to include more relevant patient engagement data.

Current research has demonstrated that patients' interest and ability to use patient portals is strongly influenced by personal factors such age, ethnicity, education level, health literacy, health status, and role as a caregiver. Health care delivery factors, mainly provider endorsement and patient portal usability, also contribute to patients' ability to engage through and with the patient portal.

While health literacy has been identified as an important factor in the successful use of patient portals, few studies have used validated health literacy measures, making it difficult for future research to build on the findings. Research demonstrates that specific aspects of health literacy, mainly numeracy and familiarity with medical terminology, greatly impact the ability of patients to accurately input data and interpret the information provided in the patient portal. The direct relationship between health literacy and effective use of the patient portal supports the argument for the use of specific health literacy heuristics as part of overall usability testing.

Research also demonstrates that objective testing (as opposed to solely subjective) should also be a part of patient portal usability testing. Although objective usability testing is expensive and time consuming, studies demonstrate the need for continued work in this area in order to ensure patient portal interfaces promote patient comprehension and data entry accuracy. The promotion of content accuracy and patient comprehension impacts the overall usefulness of the information for both patients and providers.

The perceived usefulness of patient portals from the providers' perspectives cannot be underestimated. Provider endorsement is one of the most influential factors impacting patients' initial adoption, as well as its continued use as a tool for collaborative communication [ 20]. Yet, current research demonstrates the difficulty in aligning information management tools, such as the patient portal, with current provider workflow and care delivery priorities.

While current development and research is focused on demonstrating feasibility and efficiency of medication reconciliation and SM reminders, the research has revealed roadblocks to successful implementation rooted in the lack of provider workflow adaptations A greater understanding of the essential adjustments in provider workflow, including potential changes in the roles and responsibilities of the care team overall, is necessary in order to translate findings into practice. Few studies have focused on exploring how patient portal use should unfold within the context of the patient-provider interaction, or how it might impact the overall organization and workflow of the health care team including potential liability concerns, reimbursement, and relationships with patients.

Ultimately, successful implementation requires health care institutions to invest time and resources to systematically assess the health needs of their specific patient and caregiver populations, their individual stages of readiness to adopt a patient portal, and the types of assistance needed to do so [ 140]. Ideally, interactive sites would collect information on individuals' health, health behaviors and personal goals, and assess health literacy and functional ability, which would then inform the adaptation of the patient portal to accommodate the needs of the individual and/or what additional or alternative resources may be useful [ 2]. Such adaptations include personalized content and tailored data presentations specifically designed to enhance interpretation and comprehension of key personal health concerns and timely and pertinent action steps.

In addition, external environmental and contextual factors, such as distance between patient and clinic, and complexity and trajectory of health concerns, may impact which form of access is preferred for a specific person, provider, location, and situation. Future directions of research should focus on identifying specific populations and contextual considerations that would benefit most from a greater degree of patient engagement through a patient portal. This information could then lead to the creation of health care service policies that promote the use of a patient portal by both providers and patients within the most appropriate settings.

Conclusions

If institutions are to engage patients via the patient portal in a way that encourages them to become active members of the care team, support their competence in making health-related decisions, and help them to act on those decisions, institutional leaders must consider the contributing factors that impact efficacy and sustained use of patient portals. According to this review, these factors include attention to the topical areas of patient adoption, provider endorsement, health literacy, usability, and utility. Ultimately, adoption by patients and endorsement by providers will come when existing patient portal features align with patients' and providers' information needs and functionality. Conceptualizing patient portals as a dynamic component of the patient-provider relationship and health care delivery system as a synergetic whole, rather than an isolated repository of information or a set of disconnected functions meant to collect patient data for provider use, may help to inform future research, improve patient portal design, and efforts to promote adoption and effectiveness.

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Patient Portals and Patient Engagement: A State of the Science Review

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The current principal driver of patient portal development is CMS and Medicaid EHR incentive program meaningful use (MU) criteria [ 6]. While MU criteria clearly outline requirements of basic functionality and targeted adoption rates, they do not delineate the steps or features required to engage patients in a sustained and relevant way.

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What Measures Are In Place

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What to Anticipate- The Future of Patient Portals

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Patients are more likely today than in the past to seek care from multiple sources: their primary care physician, the local urgent care center, retail clinics, and even online. They're also generating more healthcare data on their own, through fitness trackers or at-home devices like glucometers and blood pressure cuffs.

As a result, patients want technology that consolidates all that information and allows them to access and share what they need, when they need it. Patients will look for physicians who provide them with the online experiences that they're used to and expect in other aspects of their lives.

"Over time, the customer is going to gravitate to providers based on convenience," says Don Rucker, MD, national coordinator for health IT with the Office of the National Coordinator (ONC) for Health Information Technology.

Patient portals-intended to provide that improved engagement and outcomes-have yet to deliver on the promise. But that's expected to change within the coming decade as portals become more patient-centered.

In the years ahead, experts expect portals will move beyond the limited functionality they have today and transform into a user-friendly technology that put a patient's whole health history into one easy-to-navigate online portal.

"We're going to see a highly personalized portal, one that aggregates data from multiple sources, that can contextualize the data, run analytics on it, and that can empower patients as they navigate their health journey," says Mark Gilbert, MBA, director of research at Gartner Inc., a Stamford, Conn.-based IT research and advisory firm. "And I think 10 years out, we'll find these tools will become a critically important part of a precision health model."
A frictionless experience
Even though today's portals typically have limited functionality, physicians still say they see them as the primary tool for engaging patients, says Adam Cherrington, MBA, research director of patient engagement at KLAS Research in Orem, Utah.

"[Physicians] call it the highway to the patient," he says, "but they also tell us that adoption is still low. It's still a challenge to get patients to log in."

Cherrington says that the vast majority of healthcare providers (both systems and individual practices) have implemented patient portals, yet studies show less than 20 percent of patients on average log in and use them. And those patients who do use portals generally do so only to check appointment times, send or receive messages, or check lab results and healthcare records-even though some portals already offer more advanced functions such as online scheduling and even telemedicine options.

Health IT leaders point to a poor user experience as a significant reason for the low rates of use by patients.

"It's a pain point we hear a lot from patients," says Margeaux Akazawa, a public health analyst at ONC. "We can see patient portals as a success in getting patients access to their data, but they're very limited. Not only are they very static, but they're not designed with the user in mind."

Cherrington predicts technology vendors will develop portals that are easier for patients and physicians to use, which he says should spur higher levels of adoption.

Similarly, health IT experts say technology vendors will increasingly optimize portals for mobile device use, because studies show people overwhelmingly use smartphones and tablets to access online information.

"What we know is mobile is the dominant platform for consumers today, so that has to be the predominant platform [for portals]," says Walter Jin, CEO of Pager, a New York City-based company that sells a mobile app to insurance companies to help guide their members through the healthcare system.

Making the user experience smoother and optimizing it for mobile use are critical steps that will help increase adoption rates, experts say. However, those steps are just the start of the improvements in portal applications expected in coming years.
Future functions
EHR vendors are not the only ones developing patient-centered technologies.

Software companies outside the healthcare industry are introducing portal-like products, too, with experts pointing to the January 2018 announcement from Apple Inc. about its Health Records app as an example.

As these software makers create new features, physicians and patients can expect future portals to:

Deliver more information and support more interaction between patient and provider. Health IT leaders say portals will be the main tool physicians use to remind patients about upcoming visits, the protocols they need to follow between appointments, and other critical healthcare recommendations. Likewise, they see portals making it easier for patients to send emails, search information, schedule appointments online, and even securely exchange text (the preferred method of communication for many younger patients). Experts note that portals typically have these functions now; however, they're not widely used nor are they always easy for patients and physicians to navigate.

Organize and summarize patient data from multiple EHRs and consumer devices such as fitness trackers. This will be done in a way that the average person can understand, and provide details and insights on what the patient's healthcare data means for them. For example, portals will provide action plans from the patient's physicians and links to appropriate guidelines or follow-up treatment guides. Portals will also use artificial intelligence-enabled self-management and self-diagnostic tools. "There is the potential for healthcare that's happening in the doctor's office to move back to the patient," says Edward Yu, MD, a primary care physician and medical director of quality at Palo Alto Medical Foundation.

Automate more actions. Patients will be able to initiate and conduct a virtual visit with a simple click from the portal. In turn, portals will make it easier for patients to provide relevant information in advance of both virtual and in-office visits via automated questionnaires contained within the portal, says Stephen Dart, MBA, senior director of product management with AdvancedMD, a South Jordan, Utah-based vendor of cloud software for independent medical practices.

Offer more resources, including connections to support groups or communities focused on their specific health conditions or wellness concerns. "Portals will become richer as they're able to incorporate other capabilities that patients want," says Peter Kilbridge, MD, senior director for research at The Advisory Board Co., a healthcare research and consulting firm headquartered in Washington, D.C. For example, physicians could use portals to connect patients to nutrition programs or deliver ongoing content that helps motivate patients with chronic conditions to stay on track with their care programs. Taken all together, "the future of the portal is about getting the right data to the patient in an understandable format to help them engage and improve their ability to follow a healthcare plan," says Ripley Hollister, MD, a board member with the Physicians Foundation and a primary care practitioner in Colorado Springs, Colo.
CHALLENGES TO IMPLEMENTING BETTER PORTALS
Such a future state isn't that far off , according to health IT experts. Some portals already have advanced capabilities, such as telemedicine functions, online scheduling options, and the ability to access physicians' notes. But those are the exceptions. Moreover, the technologies that will enable future features already exist.

Application programming interfaces, or APIs, and the Fast Healthcare Interoperable Resource (FHIR) standard already enable interoperability between systems. AI is being used to help physicians make diagnoses and plan the best courses of care. And many patient portals can be accessed by smartphones, even if they're not all existing portals are yet optimized for mobile devices. Still, there are challenges to creating the more advanced features described above and achieving widespread adoption of them, health IT leaders say.

For starters, EHRs can't yet easily share data with other EHRs. Similarly, many EHRs can't readily accept or share data with patient-owned apps. Additionally, some providers don't want to share all their notes directly with patients. Many others don't want to open up their schedules for patients to set up appointments online without staff screening to determine the urgency of the patient's needs.

Questions about how and how much physicians will be reimbursed for services offered via patient portals-such as telemedicine visits or text exchanges-could slow adoption of anticipated future features, Hollister says. "There's a cost to this technology and the maintenance of it. Who will pay for those costs? Will the physician be reimbursed?" Hollister asks.

Physicians will also need time to incorporate the advanced patient portal capabilities into their practices, Hollister says, explaining that physicians will have to establish for themselves and their patients what types of information is appropriate to share via the enhanced portals of the future and what communication will remain best done via in-office visits.

Cherrington acknowledges that these challenges could stymie the patient portals of the future, with a lot of developments having to come together in order to see the high level of patient portal adoption that can then impact healthcare outcomes. However, he says, his research shows that optimism regarding future improvements is high in light of Apple's entry into this market and other advancements.

Physicians and other healthcare providers see a future where this technology can help with interoperability by providing a conduit for sharing data as well as making data more accessible and thereby allowing patients to really take charge of their healthcare. "Providers want to not only have a vehicle to connect with their patients, but they want their patients to participate in their care by making it easier to navigate it," Cherrington says.

And patients want this too, he adds, in the form of a tool that makes their experience smooth and easy when seeing their healthcare team. "That's what has to happen, Cherrington says. "And whether we call it a portal or patient guidance tool or something diff erent, I don't know. But it's going to have to be something significantly useful for the patient and as that happens the value alone will keep patients coming back to it."

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Patients are more likely today than in the past to seek care from multiple sources: their primary care physician, the local urgent care center, retail clinics, and even online. They're also generating more healthcare data on their own, through fitness trackers or at-home devices like glucometers and blood pressure cuffs.

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Additional Perspectives

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Patient engagement technology is moving beyond patient portal use into more specialized patient-centered tools.

Source: Thinkstock

- Health IT has long been considered integral to the push for better patient engagement, with healthcare experts asserting that technology will improve the patient experience through seamless data access, care management, and patient activation in care.

But expectation hasn't always been reality, according to Cynthia Burghard, a research director with IDC Health Insights. Patient engagement technology hasn't garnered the enthusiasm of patient populations, and has left them just as frustrated with the healthcare system has they were before the insurgence of these tools.

"There are three things that patients hate besides the cost of healthcare," Burghard told PatientEngagementHIT.com in an interview. "Healthcare's inconvenient, it's inconsistent, and it's not personalized. And it's, in part, a flaw in the technology, frankly."

Patient engagement tools, although certainly intended to make healthcare more convenient and patient-centered, are actually making more work for patients, Burghard added. Take, for example, the patient portal.

Healthcare providers began adopting the patient portal primarily because of meaningful use requirements. The notion that a more informed patient will be a more engaged patient came as an added benefit.

READ MORE: Patient Engagement Technology Comes to Forefront in Healthcare

But too often clinicians adopted patient portals just for the sake of having them, rather than designing the tools with features that will truly benefit patients.

"The concept was, 'if we build it they will come,'" Burghard said. "But when a patient is trying to get on to a payor or health system portal, but it's not a fun experience. The portal can be difficult to navigate, and you have to remember the password."

The patient portal often lacked functionality and highly personalized information, two elements Burghard suggest would be key to a better patient experience. And while it is reasonable for medical professionals to want patients to have access to their lab results, that data doesn't always have the context necessary to spur patient action.

"And even when it came down to trying to help patients manage chronic illness or the post-hospitalization time period it was really manual," she added. "The portal required the patient to go and do something. But the paradigm is starting to shift and there's starting to be an understanding that it's not about adding one more burden to the patient."

What Burghard, who recently authored an IDC report about the trends in patient engagement technology, has observed is that some of the most functional patient engagement tools are beginning to crop up outside of the patient portal.

READ MORE: Patient Engagement Technology, EHRs Influence Patient Satisfaction

Instead, they're on mobile device applications, such as a dynamic medication adherence app or an appointment reminder system. While the patient portal has the potential to house all of these functions, the fact of the matter is a patient is more likely to access tools conveniently located on their smartphone instead of a less operable portal.

"Regardless of what one's age is, no one goes anywhere without a mobile phone," she pointed out. "We do so much of our business with a mobile phone or a tablet. If I can use a mobile device to schedule an appointment, why would I go to the portal and have to remember all the nonsense that you have to remember when you use the portal?"

Until the patient portal can catch up with these other tools - for example, becoming mobile-optimized or making other usability fixes - it will become obsolete, Burghard predicted.

But if the patient portal is phasing out as the prominent patient engagement technology, what will take over? According to Burghard, more targeted tools that deliver personalized medicine are coming to the forefront.

"Currently, medicine is not personalized," she noted. "How do I get information that's about me, not just a generic, 'call your doctor in the morning, take two Advil?' Those are some of the issues that consumers have and we're starting to see technology respond to that."

READ MORE: How Patient Portals Improve Patient Engagement

For example, tools that analyze patient data to deliver care instructions will help patients better manage their treatments. A tool that tells a patient how to prepare for a surgery based on the patient's specific procedure and comorbidities will be more engaging than one that gives the generic instructions for all operations.

Instrumental to this personalized medicine approach will be machine learning and artificial intelligence, Burghard posited.

One tool Burghard has looked at uses artificial intelligence to cater recovery and care management instructions to real-time patient needs. The tool will ask the patient what their pain levels are, for example. Using that information, along with data about when the patient received what procedure, the machine will make a specific care recommendation.

"It's because of the artificial intelligence that the machine is able to understand who the patient is, what the context of her question or response might be, and answer appropriately," Burghard explained.

Medical professionals are also turning to wearables and remote patient monitoring tools to deliver more personalized patient care. A wearable can detect whether a patient is adhering to a care management program, such as getting a certain amount of exercise.

And using telehealth, medical professionals can make the care journey more convenient for patients.

These technologies have been around or in development for some time, Burghard acknowledged. However, the time is ripe for them to spread throughout the healthcare industry.

For one, use cases are demonstrating that more dynamic approaches to patient engagement are paying off. Healthcare organizations that have deployed automated text message appointment reminders are seeing patient no-show rates go down by nearly one-fifth, and are recuperating costs in the near millions.

"If we see those use cases emerge, we'll see hospitals and physicians realize it's not just a government requirement that they engage patients," Burghard asserted. "It is really part of their practice and it's going to reflect on them negatively or positively in terms of getting and maintaining patients."

Cost has also been a considerable factor in the evolution of patient engagement technology. While in previous years the notion of deploying artificial intelligence may have seemed an insurmountable financial burden, these tools are now becoming realistic for more organizations.

And as more organizations create value-based care payment agreements, connecting with the patient in a meaningful way has become easier and more important. Organizations are seeing more payers willing to reimburse for tools like telehealth and remote patient care.

And organizations are seeing the pay off - a patient who has meaningful connections to their care and providers will likely maintain overall wellness for a longer period of time.

As more providers work to partner with the patient throughout the care journey, Burghard predicted technology will follow suit to make that possible.

"All of these things are being proactively delivered to help patients get through the really complicated, difficult process of navigating the healthcare system either administratively or clinically," she concluded. "And we're beginning to see some return in essence with these technologies."

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What Is the Future for Patient Engagement Technology, Health IT?

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Source: Thinkstock - Health IT has long been considered integral to the push for better patient engagement, with healthcare experts asserting that technology will improve the patient experience through seamless data access, care management, and patient activation in care. But expectation hasn't always been reality, according to Cynthia Burghard, a research director with IDC Health Insights.

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A tethered PHR is attached to a patient portal or EMR.⁴ PHRs became popular in 2008 with the introduction of Google Health (Mountain View, CA) and Microsoft HealthVault (Redmond, WA).⁵ Both were untethered, which initially limited their value. Google Health ultimately retired in 2011; while Microsoft HealthVault evolved to include options for data sharing between patients and providers. (Rodriguez, 2018)

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Are there different types of personal health records (PHRs)? | HealthIT.gov

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There are two main kinds of personal health records. Learn more about standalone personal health records and tethered personal health records.

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Literature Review

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