You’ve set up a patient portal in your practice, but are your patients using it? Are they even aware you have it?

According to the results of a recently released survey of Arkansas Medicaid enrollees, most respondents said their providers did not offer patient portals. This response is concerning since the overwhelming majority (80%) of responding providers who were surveyed during this same time period said they offer patient portals. Additionally, 87 percent of providers reported giving verbal instructions to patients about the portal; most (85%) offered some assistance with portal registration.

“Patient portals, especially when part of an electronic health records system, let patients quickly communicate with their health care providers, see their medical records, get test results, refill prescriptions and schedule appointments,” said Dr. Chad Rodgers, AFMC’s chief medical officer. “This technology offers an efficient and secure way for patients to engage with their health care provider 24/7 and assume a more active role in their own health.”

Survey results revealed that most (63%) of the Medicaid patients who are using portals said they use it to see office visit summaries and to view lab tests and results. Fewer than 10 percent of survey respondents use portals for making payments, asking billing questions or accessing educational materials. More than 38 percent said viewing lab results was the most valuable use of the portal, followed by 18 percent selecting office visit summaries as the most valuable use.

The 2016 Patient Engagement Satisfaction Survey results were recently released by the Arkansas Department of Human Services’ Division of Medical Services (DMS). The survey included both patient and provider responses. DMS contracted with AFMC, a National Committee for Quality Assurance- (NCQA) certified Healthcare Effectiveness Data and Information Set (HEDIS®) survey vendor, to conduct the study. The two organizations are working together to develop patient engagement strategies to increase the use of health information technology and patient portals by the state’s Medicaid population.

The patient satisfaction survey was mailed to 8,007 beneficiaries with equal representation from ConnectCare, ARKids First A and B, and the private option (soon to be Arkansas Works) health plans. The provider survey was emailed to 1,190 Arkansas health care providers. The analyzable sample size was 6,639 beneficiaries and 1,145 providers. Most of the physicians who responded were PCPs or in a small practice, and had achieved or were working towards achieving Meaningful Use (MU).

Patients who had never used their provider’s portal were asked why they had never tried it. About a third of beneficiary respondents said they were not interested in accessing their records electronically. Almost 25 percent said they do not have access to the internet or a computer; 23 percent expressed concerns about online privacy and security.

Patient are considered “engaged” when they are actively involved in the management of their own health care and overall health status. One of the requirements of MU is to motivate patients to use technology to become engaged. However, this can present challenges for providers whose patients don’t want to or can’t use technology.

Best practices

AFMC recommends the following best practices for more effective patient engagement:

  • Physicians need to be “on board” with technology, especially the use of electronic health records (EHR) and patient portals. If you don’t like it, your patients won’t use it. The most effective way to encourage patient use is to speak to patients about the portal. Because of the long-term relationship you have with many of your patients, you have an enormous influence over their use of the portal.
  • Portal implementation must be clinic-wide. From the front desk and billing office to the exam and waiting rooms, every employee can promote and educate patients to better utilize the patient portal. Appointments made through the website provide an opportunity to create a portal login. The front desk can email patients to explain how to link to the portal and log in. The nurse can remind patients to log in to request prescription refills. Lab technicians can encourage patients to log in for their lab results. Office visits provide another opportunity to mention all the ways that patients can get their health information quickly and easily, or ask questions.
  • Develop a formal portal adoption policy to automatically enroll patients in a portal account. This will communicate that portal registration is part of your patient care process. The policy should include an opt-out for patients that wish to do so.
  • Be sure to repeat your portal usage reminders and keep messages positive and encouraging. Use every opportunity to educate patients about the benefits of portals and how to use them. Try postcards, business cards with the patient portal login information, and posters in waiting and exam rooms, the lab and restrooms.
  • Emphasize the free benefits of using the portal to the patient.
  • Develop talking points to address concerns about the security and safety of the patient portal.
  • See the ONC Patient Engagement Playbook for more strategies and best practices.

Patient portals are crucial to maximizing the functionality of EHR systems to improve patient outcomes and reduce health care costs. A majority of providers and patients are interested in using portals. Enhanced awareness could increase the numbers that actually use them.