The concept of the patient portal makes sense in theory: Give people a means of accessing their health information electronically, enabling them to stay on top of things like medications and appointments, health history and chart information.
In practice, however, patient portals can be problematic, with some of the peskier issues revolving around privacy and usability.
WHY IT MATTERS
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Patient portals have evolved over time, transitioning from simple logins to a health system's data to mobile apps that provide access to those systems.
Several companies have tried to make a run at creating a portal that establishes an industry standard, a model for all others to follow. But those efforts, from giants like Google and Apple, have met with only varying levels of success.
According to Stephen Dart, senior director of product management at AdvancedMD, one of the issues is that there isn't a universal privacy standard. In some states, the default is that a patient's data is shareable and the patient has to actively opt out; in other states, that dynamic is reversed.
When it comes to certain online activities, like paying bills, there are standard ways of doing things. Not so in healthcare.
"Since there's no standard paradigm people are familiar with, every device, every technology handles this process very differently," said Dart.
One possible way to address this? Look to social media.
"If you think about social media, a Facebook or an Instagram, there are paradigms they use that are ubiquitous in society," said Dart. "Just because there's adoption of these platforms, they have become standards by their very nature. Those paradigms are something people are familiar with.
"So one of the things I think could really help is to almost take a social media platform type of approach to the user experience. You would manage your data in a way similar to those platforms."
That can't truly be achieved, though, without changes to the regulator picture. Due in part to Meaningful Use, vendors often spend inordinate amounts of money chasing and reporting data in the interest of value-based care.
Because of that, when a firm has fixed budgetary resources, and a significant portion of it goes to something that has specious value, it causes what Dart calls a "brain drain" on the opportunities to improve care.
THE BIGGER TREND
By empowering patients to become involved in their own care, it creates an untapped window into the nation's healthcare system that doesn't exist today. If 10,000 people are using a platform to talk about what works for them and what doesn't work for them, it creates a knowledge base that a family physician would never be able to tap into. And it wouldn't cost the healthcare system a nickel, said Dart.
The promise of the social media approach is that it leverages insight into the psychology of human behavior. Dart offered the following example: Let's say Sally picks up her smartphone in the morning and checks out her weather and news feed. At the bottom of the feed, integrated along with all of the other information, are three journal articles about diabetes in the aging population. Sally reads these items and says to herself, "Oh, if I work out 20 minutes a day I can better deal with these diabetes symptoms."
Because that information is streamlined into the data she tracks daily, that diabetes management strategy becomes a part of her daily routine. The technology has used information in a way that improves health and cuts down on unnecessary utilization, and does so in a way that harnesses the power of community.
That's something that's largely lacking among today's patient portals, said Dart. Portals today are often cumbersome and rife with friction.
"That friction that exists today is part of the problem," said Dart. "Say a patient goes to a portal, but they don't have an account yet. So they have to go through the registration process, log in, look at their lab results, then they don't go back in for six months or a year, or until something happens.
"Then they go in again, and they forgot their password, or the password has expired, so now you've got to answer the security question. They eventually give up and don't even look at their lab results."
It's a scenario that needs to change, he said, and a universal, social media modeled approach to patient portals has the potential to move the needle. What's more, Dart expects it's going to happen within the next 5 to 10 years -- but not within healthcare. He expects a company like Amazon or Apple, or perhaps even a startup, to figure out how to bring all of the pieces together.
"Ultimately it still always boils down to money in healthcare," said Dart, "but the revenue opportunities to engage hundreds of millions of people is going to be too rich to be ignored."