Many practices have integrated patient portals into their practices over the past few years, and many others plan on doing the same in the future. I love the idea of a patient portal and have had one for over a year. The ability of a patient to send messages across a secure line is essential, especially for those who wish to remain HIPAA compliant. For patients, the portal is a great tool because they can schedule appointments and request refills without having to call in. In my practice, anyone who calls speaks to a live person but in some practices, navigating their phone trees can be a daunting task. It seems intuitive that all doctors and patients would want to utilize a patient portal. By Linda M. Girgis, MD, FAAFP
By Linda M. Girgis, MD, FAAFP
Many practices have integrated patient portals into their practices over the past few years, and many others plan on doing the same in the future. I love the idea of a patient portal and have had one for over a year. The ability of a patient to send messages across a secure line is essential, especially for those who wish to remain HIPAA compliant.
For patients, the portal is a great tool because they can schedule appointments and request refills without having to call in. In my practice, anyone who calls speaks to a live person but in some practices, navigating their phone trees can be a daunting task. It seems intuitive that all doctors and patients would want to utilize a patient portal.
Where Do Patient Portals Fail?
In order to have a patient portal that integrates with an EHR, an interface must be built between a website and the EHR software. In my office, for example, there were two different companies involved in creating this interface. They promised the integration would be functional within a certain time frame but continuously failed to meet that deadline.
They tried to sell us new software systems, new websites, and many other fixes, but in reality they did not want to work together because they each wanted to profit (from selling one of their products to use) for the endeavor. Finally, after 18 months, the process was completed when we changed our web host and the whole undertaking proved to be quite costly. So, while the idea of a patient portal sounds like it will revolutionize your practice, getting there is not so easy.
And then there are the log-in problems. In order for the patient to use our portal, they have to create a username and password. When they are unable to get in to the system, they start calling our office. We are not the technical support and we don’t know how to fix these log-in failures. We give out the phone number to the technical support but this ties up the phone lines. Sometimes, it is faster if the patient just calls in for their refill or appointment request rather than directing them to the appropriate support person.
The biggest danger in my mind is patients who review their test results and then decide to cancel their follow-up appointment because the results look good. However, sometimes negative test results can be very significant. Sometimes, my clinical plan includes doing further testing if the tests I ordered come back normal. Patients can fall through the cracks in this scenario.
Our lab interface syncs directly to the patients’ chart in the EHR and to the patient portal. Patients are able to see the results before the doctor does which can cause needless worry as the lab flags as abnormal every slight variance off of their set normal range. For example, a patient my see a sodium level of 147 flagged as abnormal when the normal range is up to 145. It may be that they just didn’t drink enough water that day, or they don’t fall in the 95 percent of people who make up the normal range. They may be in the 98 percent and the variance from the median is insignificant. But, they will call the office in a panic and we will bring them in for an urgent visit to ease their fears.
Yes, I absolutely believe patient portals are an essential tool in the practice of medicine. Everyone should adopt this technology. But, first, the technology needs fixed so that it works the way it is supposed to. We need a useful portal system, not just a functional one.
About The Author
Linda Girgis, MD, FAAFP, is a board certified family doctor with Girgis Family Practice. Dr. Girgis studied medicine at St. George’s University School of Medicine and served her residency at Sacred Heart Hospital in Allentown, PA.
