Online Patient Engagement Requires Practice Buy-In

Patients are taking a greater role in their healthcare than ever before, and a growing array of electronic tools are available to help physicians engage them, according to Shannon Vogel, director of health information technology at the Texas Medical Association during the Healthcare Information and Management Systems Society (HIMSS) 2015 annual conference.

Nearly 90 percent of U.S. adults use the Internet and nearly three-quarters of them have used the Internet to search for health information, according to 2012 data collected by Pew Research Center. Additionally, 58 percent of U.S. adults own a smartphone and more than half of smartphone owners have used their device to access health information. Vogel summarized the growing tool chest of electronic patient engagement options for practices, including patient portals, personal health records, Health Information Exchanges (HIEs), direct protocol e-mails, and health applications, and their respective advantages.

Vogel explained that the use of all health information technology in practice is still in its infancy, but patient demand and CMS meaningful use incentives are driving rapid growth in the use of these technologies. A survey by the Texas Medical Association found that between 2005 and 2014, the use of EHRs in Texas grew from 25 percent to 69 percent of practices.

Patients often want e-mail reminders, online scheduling, the ability to e-mail their physician, and online access to test results and their records. The most common way practices are working to meet these demands is by creating patient portals, Vogel said.

Patient portals are often part of the practice's electronic medical record, Vogel explained. All portals offer secure messaging between the practice and patient and a summary of the patient's clinical information. They may also include appointment scheduling, bill paying, or customized options.

Portals can help to reduce a practice's administrative costs and streamline workflows. They can also help practices meet meaningful use requirements, such as patient access to their medical records, patient reminders, and secure messaging, Vogel said.

"It's a great way to bring value back to the practice," said Vogel.

But one downside of portals is that patients with multiple physicians may wind up with multiple portals. One option that has emerged to help patients keep all their health information in one place is the patient health record (PHR). Patients can upload medical records from their physicians into their PHR and they can also enter information about supplements, data from health apps, and other information into the record. Patients can share access to this record with their physician. But Vogel said use of PHRs so far has been low. She explained that they may not help physicians meet meaningful use requirements, though CMS is looking into ways to help with this drawback.

Some practices are offering secure e-mail messaging only, Vogel said. And in some states, HIEs are beginning to offer some electronic engagement functionality. Additionally, practices may make use of the growing array of health apps that patients can use to track their health data. She noted that physicians might use these tools to ask patients to call or schedule an appointment if the patient's readings are outside of certain parameters.

No matter what electronic tools practices chose, Vogel emphasized that it is important for the physician and practice staff to become very familiar with the tool and familiarize themselves with the patient interface. She also noted that while some patients are eager to reach out online, others may not be comfortable with this or may lack access.

"Many patients are interested, but not all have the desire, time, and access to the tools," she said. "We need to meet them where they are."

For more insight from Vogel, visit "Evaluating Six Electronic Patient Engagement Tools."