Shared Patient Portals Have Benefits and Drawbacks

Leaders at a 100-physician practice in Kansas and a neighboring hospital system shared the same concern when they launched separate patient portal systems: What if patients chose to use one portal over the other? Patient choice could have a huge impact on both systems' attestation to CMS' meaningful use program.

That was the dilemma described by Laura McCrary, executive director of the Kansas Health Information Network (KHIN), a non-profit member health exchange, and a speaker at this year's Healthcare Information Management and Systems Society (HIMSS) Annual Conference.

But using the statewide patient portal offered by KHIN could have solved both organizations' problems, she said.

"If you share a portal, every time a patient looks at info in the portal it counts for [both the hospital and practice]" McCrary said. "It allows our providers to work together."

Statewide portals such as KHIN's are one solution to the emerging problem of patients accumulating multiple portal logins and passwords from multiple providers as more organizations embrace these electronic patient engagement solutions. They offer other advantages as well, including allowing organizations that couldn’t afford a portal of their own to use one and giving patients an easy to use and comprehensive portal for their health information.  But there are also technical and other challenges to creating a statewide portal system, explained McCrary.

So far, 38 organizations of KHIN's 1,000 member organizations have opted to use the statewide MyHealtheRecords portal. The portal is one of two available in the state. Kansas required both of its private health information exchanges (HIEs) to offer a statewide portal.

Convenience for patients is a big benefit of a statewide portal like KHIN's system. Patients get all the information included in the summary of each patient encounter in one location. They can upload other information, and print out a pocket-sized summary of their medical information for emergency service providers, said Michelle McGuire, the senior project manager for KHIN. It also includes linked and searchable patient education materials from Healthwise. Individuals who are managing care for a child or older parent can also tie their portal accounts together.

Overcoming Challenges
But there were initially some challenges for providers who had to manually upload the patient summary and securely e-mail it to the patient, McCrary said. That step has since been automated. Physicians currently have to authenticate patients onsite in order for them to set up their account in the portal, but eventually patients will be able to self authenticate.

There were also technical challenges KHIN didn't anticipate. Currently, the patient portals query the HIE every six hours for new information. But now that more than 10,000 patients are using the system, this is becoming unsustainable, McCrary said. So KHIN is working on a way for the HIE to automatically push new data to the portals.

Another challenge was managing the links between parent and child portal. The system can automatically unlink a child's portal from their parents when they turn 18. But the state of Kansas allows children to have medical privacy from their parents as soon as they become sexually active, McCrary explained. So the system had to create a way for physicians to mark some information as only viewable by the child.

Going forward, several upgrades are planned for the patient portals, including adding more patient information.

"We are always looking for ways to expand and make it better," said McGuire.

For more information on how KHIN assists physicians, visit "Health Information Exchanges: A Progress Report."