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Most Hospitals Offer Patients Online Access To Medical Records

Posted on July 27, 2016 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

New research from the American Hospital Association suggests that nearly all hospitals now offer individual patients online access to their medical records, and most offer them the ability to perform related tasks as well.

According to AHA research, 92% of hospitals gave patients access to their medical records in 2015, up from 43% in 2013. Also, 84% allowed them to download information from the record, 78% let them request changes to their record and 70% made it possible for them to send a referral summary. (The latter has seen the biggest change since 2013, as only 13% could send such a summary at that time.)

In addition, hospitals have begun giving patients the ability to schedule appointments, order prescription refills and pay bills. As the AHA notes, progress on this front isn’t universal, as organizations need to integrate data from revenue cycle, pharmacy and scheduling systems to make it happen. But as hospitals invest in integration engines they will have a greater ability to roll out these options.

As of 2015, 74% of hospitals let patients pay bills online, up from 56% in 2013. However, progress on other consumer-friendly functions has been slower. Only 45% of hospitals let patients schedule appointments online, a modest increase from 31% in 2013, and just 44% let patients refill prescriptions, up from 30% in 2013.

Meanwhile, hospitals are slowly but surely expanding tools letting patients communicate with physicians. The AHA found that 63% let patients securely message care providers, up from 55% in 2014, and 37% let patients submit self-generated data, a big jump from the 14% who did so in 2013.

All of this suggests that rollouts of patient portal tools are likely to continue well after Meaningful Use has landed in the dustbin. After all, research suggests that dollars spent on these technologies will pay off, especially under at-risk value-based care models.

For example, an eye-opening study appearing in Health Affairs found that use of patient-physician email at Kaiser Permanente is associated with a 2% to 6.5% improvement in HEDIS performance measures like HbA1c levels, cholesterol and blood press screening and control. The same study noted that users of its My Health Manager were 2.6 times more likely to remain KP members than non-users, a phenomenon which may well apply to providers.

On the other hand, hospitals need to evaluate any potential portal solutions carefully. According to a study by research firm Peer60, many solutions have serious limitations that could lead providers to violate state laws or limit parent and minor engagement. Also, some organizations might not be ready to support patients who have issues adequately. Concerns like these might explain why 28% of the 200 healthcare execs surveyed by Peer60 said they weren’t looking at portal technology at the moment.

HIM Professionals and the Patient Portal

Posted on October 21, 2015 I Written By

Erin Head is the Director of Health Information Management (HIM) and Quality for an acute care hospital in Titusville, FL. She is a renowned speaker on a variety of healthcare and social media topics and currently serves as CCHIIM Commissioner for AHIMA. She is heavily involved in many HIM and HIT initiatives such as information governance, health data analytics, and ICD-10 advocacy. She is active on social media on Twitter @ErinHead_HIM and LinkedIn. Subscribe to Erin's latest HIM Scene posts here.

One of the hot topics in healthcare that has been consistently developing and growing over the past few years is the patient portal. Since many different EMRs and portal platforms are used across hospitals and physician offices, each facility is left to develop policies and procedures for what will be released through the portals and how they will be used. There are no specific standards for patient portals, aside from those needed to meet Meaningful Use requirements, which results in different experiences and functionality for end users.

HIM involvement with patient portal implementations has been a little spotty over the years from what I gather from my peers. I heard someone say we “missed the boat” on patient portals. I don’t necessarily agree but I do see inconsistencies in the level of HIM involvement. When it comes to developing policies governing the content that will be released through the portal, HIM professionals are the experts on this initiative. HIM professionals have always been the stewards of the medical record and keeping release of information processes secure and appropriate. There has been a focus on encouraging patients to keep a personal health record long before EMRs and patient portals came to exist. So how could some HIM professionals get left out of the patient portal process?

My first assumption is that patient portals came to exist mostly, although not solely, as a result of Meaningful Use initiatives. If you have had similar experiences to mine, you have witnessed Meaningful Use initiatives typically being handled by IT professionals. As a result, patient portals have fallen under that umbrella from a technology standpoint but I see great opportunities for HIM professionals to be involved to optimize the content shared for the end users. Since the main intent of patient portals is to encourage patients to be engaged in their own care, these portal initiatives have much more benefit beyond attesting to Meaningful Use and should be incorporated into organizational strategic plans for patient engagement.

There has been a lot of discussion around the struggle of increasing patient portal participation. A common factor in patient portal adoption is the lack of patient competencies in using the technology involved. Some patient populations do not frequently use computers, email, or mobile applications which are all a part of the patient portal functionality. To address this at my facility, we created a position within the HIM department to coordinate all patient portal functions including enhancing the user experience by creating frequently asked questions and answers, troubleshooting issues that patients may have when attempting to login, and resetting portal passwords as needed among many other initiatives. Policies were developed to address who can have access to the portal information, how the patients confirm their identity to log in, what is released, and the duration of the availability of the information. We have an interdisciplinary team that contributes to the patient portal process but having the point person reside in the HIM department makes the most sense for governing the entire concept.

One thing to remember is that patient portals do not eliminate the need for traditional release of information processes because we release information to many different requestors for different purposes. The portal does not include every patient document due to the sensitive nature of some results therefore requests for entire charts and abstracts are still necessary in some cases. Patients should participate in the portal for the personal benefit of being proactive in their own healthcare but they should not expect it to replace release of information. I encourage HIM professionals to be involved in the patient portal process in an administrative capacity. The strides made with patient portal optimization are key in optimizing the transition to health information exchange (HIE) concepts which also require heavy HIM involvement.

If you’d like to receive future HIM posts by Erin in your inbox, you can subscribe to future HIM Scene posts here.

Do You Hate Portals?

Posted on June 6, 2014 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I was really interested in this summary of today’s #HITsm Twitter chat. Do people hate portals?

I think if we look at the portals as they stand today, it’s fair to say that people hate portals. They can’t remember their login. They’re complicated. They don’t solve the problems they want them to solve. There are too many of them. It’s just a mess.

I think we all agree that the idealized patient portal would be something we all value. Here are the characteristics of an idealized patient portal:

  • One Login
  • All Health Data from Every Provider (Yes, that includes labs, x-rays, etc)
  • Messaging with Clinic Staff
  • Messaging with Provider
  • Refill Requests
  • Appointment Request
  • Bill Payment
  • One Standard Health History (Intake) Form Accepted by All
  • Data from Personal Health Sensors and Trackers
  • Smart Notifications and Processing of Data

I’m probably missing something, but this list does a pretty good job covering what the ideal patient portal would look like. If someone could execute this patient portal, then we would all love to use it and there would be near universal adoption of it (minus a few people who don’t get on a computer). Sure, we’d still complain about the user interface or some other thing because we love to complain, but we’d all use it just the same.

There are actually some providers who have completed this list for everything that they control (ie. they don’t include data from other providers, don’t handle the intake forms for other providers and don’t do the sensor data). These providers have seen some pretty good traction with their portals, but they wane in use since just having one provider on it isn’t as compelling as a portal that has our entire health history. For many providers you might only see them every 3-5 years (or less). After 3 years, it’s just easier to pickup the phone than to figure out the portal.

This is the reason why Kaiser’s portal has been quite successful. They control the whole spectrum and so they can get pretty close to the above portal nirvana. Until we’re able to do something like that across the spectrum of healthcare in one place, many people will hate their portal (or maybe I should have said “their dozens of portals”).

I personally wonder if we’ll ever get there. If we do, I think it will be some company which goes in and solves one element in a way that provides immediate value to everyone involved. Then, they’ll layer the other features on top of it until they create the portal that everyone loves.

Which Health IT Is Poised For Hospital Growth?

Posted on January 21, 2014 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

Wondering which hospital applications are likely to be popular in the near future?  According to HIMSS Analytics, contenders include patient portals, clinical data warehousing/mining, and radiology barcoding software are poised for faster uptake in hospitals.

To gather this information, HIMSS Analytics did an analysis of the current market penetration and projected five-year sales trajectory each application considered in its Electronic Medical Record Adoption Model (EMRAM) report.  Researchers found that first-time purchases of these advanced EMR applications should grow dramatically in hospitals across the U.S.

According to Healthcare Informatics, there are good reasons why each of these three technology should be on the upswing in hospitals.  For example, the patient portal market is growing because it’s tied to Meaningful Use Stage 2 requirements.  Expected growth in sales of clinical data warehousing/mining technology is tied to the need to leverage data held in EMRs, and it’s that that sales increases in and radiology barcoding are probably associated with patient safety initiatives.

Meanwhile, the report also noted that several basic applications which have already saturated the hospital market will be responsible for a high-volume IT replacement sales, including laboratory barcoding, pharmacy management systems and information systems for radiology and laboratorydepartments.

The report from HIMSS seemingly doesn’t take mobile applications and systems into account — I’d argue because they are not yet seen as enterprise-level tools — but I think hospitals will be spending more on mobile technology than anticipate over the next few years, as tablets and smartphones become a permanent part of their infrastructure.  Just how fast that will happen remains to be seen, but it will happen.

The PHR Concept Is Dead

Posted on June 11, 2013 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

For several years, the healthcare community has struggled with elusive beast known as a personal health record.  The PHR was designed to fill a hole in the sharing of electronic health data by getting patients involved with filling in gaps in their own health information via a Web browser.

The idea is not new.  In fact, according to WIkipedia, the idea of a “personal health log” goes all the way back to the 1950s, though scientific literature didn’t begin to take it on until after 2000, the Web encyclopedia says.  So for decades, healthcare professionals have looked at ways in which private individuals could do more to document changes in their own health.

Fast forward to today, and what have we got?  A bunch of approaches which involve the consumer in their medical data, including:

Patient portals:  Typically, these portals offer access not only to various forms of basic clinical data — such as test results — but also a means of setting appointments with doctors’ offices and a means of communicating with physicians via secure e-mail.

Direct access to EMRs:  In some cases, the portal established by a healthcare organization offers some limited direct acccess to EMR data, offering patients a look at a broader cross-section of data.

Giving patients access to doctors’ notes:  Of late, some organizations have been experimenting with giving patients direct access to their doctors’ notes, experiments which have largely been satisfying to parties on both sides of the equasion.

Certainly, these approaches involve patients more in their health information, but at the same time, in no way make him or her responsible for maintaining their own health records electronically.

If you’ll notice, the core notion of a PHR  — that patients should keep their doctors informed of med changes, allergies, procedures and the like — appears to have dropped out of the picture completely. It seems that after struggling with getting patients involved in being data entry clerks, it works much better to give patients access to data and encouraging them to learn from what they see.

In other words, despite much earnest effort, it appears that the core PHR concept is dead. Long live its better-adapted successors.

Health IT Can Change Delivery Models From The Outside In

Posted on July 2, 2012 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

As we all mull over the implications of the recent Supreme Court decision affirming the key pillar of the health reform law, transformation is definitely in the air.  Hey, if nothing else, we’ve got a presidential election on the way, and it’s likely there will be big changes — either yanking back parts of PPACA or expanding it significantly — when the new POTUS steps in.

This is a great time for the health IT world to assert its place in the system and change the way care is delivered. Of course, I don’t have anything like the space to cover this topic in full  but a few ideas that I think have high potential include:

* Hospital At Home:  This Johns Hopkins model delivers care at home to patients who could use hospital-level care but aren’t likely to deteriorate. It can lower costs by almost one-third and reduce complications, researchers say. Let’s step up and bring sophisticated mhealth apps and remote monitoring to power this further.

*Medical Body Area Networks: With the approval of specifically-dedicated spectrum for MBANs, the FCC has kicked off what should be a revolution in health monitoring, both for consumers interested in self-care and for clinicians. Where can we take it this year?  For example, will consumers wear their network, connected to a receiver in their car, and transmit their own data as they come into an ED for care?  The mind boggles.

* Prescribe An App: This is an area which is juuust getting a foothold in American medicine — though as the linked article notes, the Department of Health in England has created a list of 500 apps for primary care docs to prescribe to patients. The practice can only grow here as evidence helps us sift out the best apps.

*Patient Portals:  Yeah, so what, they’re required under Meaningful Use anyway. So why am I listing them here? Because a nice interspersing of the above technologies with a robust,  user-friendly portal has nearly unlimited potential for medical collaboration:  video visits, telemedicine, mobile visits and check-ins and so on. Although, John also wrote about some of the challenges of patient portals recently on EMR and EHR.

Of course, I’ve said nothing about EMRs themselves, which obviously lie at the center of this Web.  But for a reason. I’m taking the position that in most cases, given the incredible mhealth explosion, care delivery change is going to push in from outside the hospital rather from within. Am I wrong there?