Another key finding of the survey: providers are gravitating toward portals that are designed for and integrated with their EHRs. Patient portals that merely can be interfaced with a variety of EHRs, such as those from MedSeek and Intuit, are losing market share. In fact, not enough MedSeek customers were included in the survey sample to rank the product.
"Customers mentioned leaving MedSeek due to unmet product expectations, high costs, or an enterprise EMR strategy," the KLAS report said. "A quarter of Intuit's customers reported plans to leave -- three times higher than the market average."
It's unclear whether shortcomings in these and other third-party products are to blame for their decline. However, as in other areas of health IT, many providers seem to be following a single-vendor strategy for their EHRs, and that might include portals.
[ Read about New York's portal plans: Startup Will Build New York's Ambitious Patient Portal. ]
Among the companies with enough data to be ranked, EHR vendor Athenahealth led the field with a score of 92 out of 100. According to KLAS, Athenahealth customers "appreciate the ease of uploading patient information and the portal's flexible platform for educational content and patient messaging (via email, phone, or text). This has positioned Athenahealth as the leader for patient engagement."
The other ranked vendors were Epic (89.3), Allscripts/Jardogs (87.1), Cerner (83.7), eClinicalWorks (83.2) and Intuit Health (71.4). Not enough respondents used the portals of Greenway, NextGen or Vitera for KLAS to score them confidently.
Meaningful Use Stage 2, which begins Jan. 1, requires providers to allow patients to access their health records electronically. At least 5% of patients must "view, download or transmit" their information. In addition, providers must use their EHRs to send reminders for preventive and follow-up care to more than 10% of patients with two or more office visits in the last two years. They also must use EHRs to identify patient-specific education materials for more than 10% of unique patients seen during the EHR reporting period.
Current portals can easily be used for the record-sharing requirement, but KLAS noted that they're less adept at handling the patient engagement aspects. Only Athenahealth and Intuit scored above average for sending reminders and providing educational content, while Epic did well in the educational component.
In other areas of portal functionality -- prescription refills, online form completion, patient-entered data, bill payment, self-scheduling, mobile applications and patient data portability -- Allscripts and Athenahealth were the best performers.
Most of the respondents (95%) said that their patient portals included data from ambulatory EHRs. A third said their portals also provided data from inpatient EHRs. Fourteen percent included data from health information exchanges (HIEs) and 11% from other EHRs.
KLAS noted that little inpatient information is being made available on portals except for those of Epic and Cerner, which have the best-integrated hospital and ambulatory EHRs. Most of the HIE data came from the HIE offerings of vendors that also sell portals, including Cerner, eClinicalWorks, Epic and NextGen. Other portal vendors had some HIE connectivity, mostly through Medicity, owned by Aetna.
According to a recent Accenture survey, patients want more online access to their medical records and to doctors' practices than they're currently getting. More than a third of U.S. consumers said they have online access to various services, including medical record sharing, prescription refill and appointment requests, e-mail with providers and electronic reminders. Depending on the item, between 28% and 40% of doctors said these electronic services are available to patients.