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Commentary

Patient Portals Aren't Very Patient Centric

It's time to put some excitement and creativity into e-patient education.

Since the introduction of the Meaningful Use Incentive Program, many hospitals and medical practices have been working hard to meet Stage 1 and 2 regulations on patient engagement.

In Stage 1 MU, for instance, providers have had to provide patients with electronic copies of their diagnostic test results, medication lists, allergies, discharge summary, procedures, and related information -- if they request them. They've been required to provide this information to more than half of all patients who request it within three business days.

Stage 2 takes patient engagement to the next level. The regs say more than 50 percent of all unique patients seen by clinicians (those who the rules refer to as eligible professionals) should be offered timely online access to their health information. More than 5 percent of all unique patients seen by a health professional actually have to view, download, or transmit their data to a third party.

Many practices attempt to meet these requirements by setting up a web portal where patients can access this information. But frankly, a lot of offices aren't making patient engagement a top priority.

A recent HIMSS survey found that two out of three people would consider switching to a physician who offers access to medical records through a secure site. But only one in five practices actually offers access to medical records through a patient portal, according to Derek Kosiorek of the Medical Group Management Association.

The portals that many practices have set up are plain-vanilla snoozefests, offering basic statistics, current medications, upcoming appointments, and the like. There is so much that practices could do on these sites to grab a patient's attention and provide much needed education on a variety of important issues.

David Chase, an e-patient education specialist whose work I admire, recently discussed the efforts of several physicians who know how to make portals patient centric. Granted, most offices don't have the deep pockets to create the kind of impressive portals that Kaiser Permanente and the Cleveland Clinic have assembled. Nonetheless, with the help of an IT consultant -- or a tech-savvy co-worker -- even small practices can wow their patients -- often on a shoe-string budget.

Chase mentions Wendy Sue Swanson, MD, for instance, who uses YouTube videos and blogs to create content on growth charts and vaccines. There's also Ryan Neuhofel, MD, who has learned enough about video production to create engaging tutorials on hemoglobin A1c, the lab test used to monitor diabetes. Similarly, Howard Luks, MD, has done an impressive job of creating videos to explain various orthopedic procedures for his patients.

These videos aren't Hollywood productions, just bare bones educational tools. But they certainly do more than present the dry fact, and producing these tutorials doesn't require a degree in computer science.

But to be fair, many physicians are so busy trying to care for patients and so overwhelmed with new federal regulations and insurance red tape they can't find the time for even these no-frills additions to their patient portals. What they really need is a tool that would make e-patient education almost effortless, which begs the question: Where's the killer app that will transform patient engagement?

If iTunes can revolutionize the music industry and Netflix can turn the video entertainment industry on its head, why hasn't some disruptive, irreverent entrepreneur shaken up the world of patient education yet?

Where is the equivalent of iTunes for healthcare?