Why Is No One Using Our Patient Portal?

By Christina Thielst via Multibriefs

Patient portals and the functionality they offer have the potential to increase access to service, improve convenience and more effectively engage patients and consumers. They can also increase efficiencies for both patients and their providers.

It is for these reasons that most providers, payers and technology vendors have at least considered offering patients and consumers access to these online tools. Unfortunately, some of those who have adopted patient portals complain that they have made the investment, only to realize low adoption and utilization rates.

So, why might patients not be using your patient portal?

Many patients — especially those with low health or tech literacy rates — may have heard of your portal, but don't understand the benefits to them individually. Or perhaps, there are barriers to them acting to gain access; such as believing they aren't tech savvy enough or simply not having the motivation to change old habits.

Aside from providing access to a platform, the provider/payor/vendor also needs to invest in strategies that facilitate user education, training and adoption. In some cases, this requires turning to family caregivers who need access themselves in support of the patient, or who can help them learn and navigate the most relevant areas to them personally.

In other cases, the provider/payor/vendor needs to reflect upon the targeted population and the usability of the portal, its functions and offerings. A few examples of user complaints include:

• It is difficult to register and gain access to the portal
• Not enough relevant info — such as a list of imaging studies completed, but no access to the report or results
• Staff and/or providers don't respond to messages in a timely manner — if at all
• Appeals and grievances can be submitted through the portal, but the decision is mailed through the U.S. Postal Service, resulting in delays

A recent Black Book Research poll found that 96 percent of patients report leaving their doctor's office with limited knowledge of how to use the patient portal. Of the 40 percent who attempted to use the software in 2016, 83 percent said it was too complicated. For benchmarking purposes, this means only 7 percent of patients found the portal simple enough to use.

An excellent way to identify opportunities to improve your patient portal is to assess the portal design, functionality and alignment with your patient needs and interests. Some questions to reflect upon include:

• Is there statement that reassures patients of the portal's security measures and privacy safeguards?
  
  If there is a delay in when test results or reports are released to patients, is that clearly communicated?
• Can patients complete routine questionnaires online and make periodic updates to their information?
• Would an online appointment summary of key findings and/or follow-up add value for patients who don't remember everything the physician tells them during the encounter?
• Is it easy for patients to see summaries, reports and results and forward them to other providers on their care team?
• Are engaging tools and resources available to guide patients on self-management activities, such as suggested apps, medical device options/recommendations or multimedia educational content?
• Can patients message both administrative and clinical staff to avoid frustrating call trees and phone tag?
• Can users securely upload documents to attach to their messages or add to their medical record?

Another technique is to gain insight to the patient perspective by obtaining feedback from your population by asking a pool of patients to assist you with user testing. This would include feedback on the ease of gaining access, navigating the site, their assessment of resources and information, and completing transactions, such as requesting an appointment, messaging, bill pay, etc. User testing by patients and their family caregivers can also help you determine whether:

• the site easy to navigate at home for all segments of the population
• the portal accommodates the patient's, or family caregiver's, learning needs
• the resources, information, functionality are relevant to the patient population(s) served and provide value to users
• patients want to see other online tasks accommodated by the portal, such as requesting medication refills, bill payment
• your patient want to upload data, such as glucose levels, daily weights or information from wearable sensors for trending and alerts to both the provider and patient when some intervention is needed.

As consumers take on more responsibility for their healthcare costs and self-care activities, they will continue to demand access to easy-to-use technology that facilitates more efficient and effective completion of health tasks.

Patients have become accustomed to this technology in other areas of their lives, such as retail, banking, travel and general communications. They expect it from their entire healthcare network, starting with their providers and payors of care.

Christina Thielst, FACHE, is a skilled and innovative hospital and healthcare administrator and entrepreneur with a deep desire for continually improving the health of the community being served. Christina is also the author of "Applying Social Media Technologies in Healthcare Environments."