Patient Portals – Tips and TricksWednesday, November 12, 2014

Disclaimer: Nothing that we are sharing is intended as legally binding or prescriptive advice. This presentation is a synthesis of publically available information and best practices.

Patient Portal Statistics

• According to an August 2014 survey by Software Advice:

– 1/3 of patients have access to a portal

– 24% of patients want ability to schedule online

– 22% of patients want ability to view lab results online

– 21% of patients want ability to pay bills online

Patient Portal Complaints

• According to an August 2014 survey by Software Advice:

– 34% complained of slow responses

– 33% complained of portals being confusing to navigate

Requirements – MU 1 2013 (Flex Rule)

Menu Measure 5

• Definition: At least 10 percent of all unique are provided access to their record within four business days.

• Exception: EP does not order labs, enter problems, enter med allergies, or enter medications.

Requirements – MU 1 2014

Core Measure 11

• Definition: More than 50 percent of all unique patients are provided access to their record within four business days online access to their health information, with the ability to view, download, and transmit to a third party.

• Exception: EP does not order labs, enter problems, enter med allergies, or enter medications.

Requirements – MU 2

Core Measure 7(1)

• Definition: More than 50 percent of all unique patients are provided access to their record within four business days online access to their health information, with the ability to view, download, and transmit to a third party.

• Exception: EP does not order labs, enter problems, enter med allergies, or enter medications.

Requirements – MU 2

Core Measure 7(2)

• Definition: More than 5 percent of all unique patients seen by the EP during the EHR reporting period (or their authorized representatives) view, download, or transmit to a third party their health information.

• Exception: EP does not order labs, enter problems, enter med allergies, or enter medications OR 50 percent or more of his or her patient encounters in a county that does not have 50 percent or more of its housing units with 3Mbps broadband availability.

Requirements – MU 2

Core Measure 17• Definition: A secure message was sent using the

electronic messaging function of CEHRT by more than 5 percent of unique patients (or their authorized representatives) seen by the EP during the EHR reporting period.

• Exception: An EP who has no office visits during the reporting period OR 50 percent or more of his or her patient encounters in a county that does not have 50 percent or more of its housing units with 3Mbps broadband availability.

Requirements – MU 3 (Proposed)

• 24 Hour turnaround

• 10% secure messaging

• Blue Button Initiative

• Ability to contribute information electronically

Benefits

• Patient Engagement - Patient preventative care and disease management reminders

• Patient Compliance – Remind patients of follow up plans

• Operational Efficiency – Calls replaced with messages which can be handled outside of clinic hours

• Brand Loyalty – Well utilized portals assist in patient retention

Native vs Third Party

• Portals created by EHR vendors have greater workflow integration and are required to meet certification requirements.

• Third party portals are sometimes optimal if multiple EHRs are in use or vendor EHRs do not meet functionality requirements. However, additional steps are needed to integrate the portal and EHR in order to meet MU requirements.

Challenge - Enrollment

• Challenge: Difficulty in getting patients engaged.

• Suggestions:

– Auto enrollment meets requirements for Stage 1 and Stage 2 (first measure).

– Rewarding for use (be careful of inducement laws and contracts).

– Outward emails to patients encouraging interaction.

Challenge – Foreign Languages

• Challenge: Portals typically support a limited number of languages.

• Suggestions:

– Designate English speaking care giver.

– Use third party portal with additional languages.

– Language specific engagements.

Challenge – Lack of Access

• Challenge: Patients lack computer access.

• Suggestions:

– Provide terminals in waiting room.

– Ensure portal has a smart phone app or is mobile friendly.

Challenge – Age of Patients

• Challenge: Patients are older and not comfortable with technology.

• Suggestions:– Designate caregiver.

– Ensure portal has a smart phone app or is mobile friendly.

– Refer to or provide computer classes.

Challenge – Specialties

• Challenge: No face to face interaction with patients.

• Suggestions:

– Portal enrollment is still required – use auto enrollment more heavily.

– You may be exempted from messaged requirements.

Challenge – Specialties, continued

• Challenge: High propensity of patients have physical or mental disability which presents use of portal.

• Suggestions:

– Designate care givers.

– Provide extra training for accessibility (how to increase font sizes).

Case Study 1

• Medicare Advantage clinic in Miami with high geriatric and non-English speaking population.

– Implemented Spanish patient portal.

– Collected care giver emails.

– Auto enrolled patients.

– Already had computer training classes as part of their socialization classes. Added patient portal as part of the curriculum.

Case Study 2

• IPA in San Francisco’s Chinatown providing care to non-English speaking, older, and less affluent population.

– Implemented Chinese patient portal.

– Collected care giver emails.

– Auto enrolled patients.

– Worked with a local non-profit who received a grant for computer training. Added patient portal to the curriculum.

Recap

• Patient portal is required for MU.

• Secure messaging is required for MU2 and above.

• Selecting the correct portal for your population is incredibly important.

• Proactive planning and budgeting is needed well before attestation period.

Q&ABen.quirk@quirkhealthcare.com