Shifting Preferences & the Art of Patient Portals

Even with the convenience of tools such as telehealth, it can be difficult to build long-lasting relationships in 10- and 15-minute increments every few months. Fortunately, it’s not difficult to stay in touch virtually, and patients are making it even easier. Roughly 70 percent of patients preferred to use digital technology for tasks such as ordering prescription refills, checking their health records, and monitoring health metrics.4

You may be overlooking several technologies you probably already have that are extremely powerful when it comes to building relationships with today’s healthcare consumers. According to research published in 2018 by Black Book Market Research, 83 percent of physician practices are making use of secure messaging to communicate with patients and patients’ families, and 94 percent of physicians believe that the use of such technologies improves patient safety and outcomes. Yet even some physicians who use these technologies haven’t truly embraced them.9 That can be a roadblock when it comes to improving patient relations.

“Doctors who use their portals have an edge,” says healthcare consultant Lake. And not just with young patients. “When family members are involved in caring for elderly relatives, the portal can make it easy for caregivers to keep up with appointments, lab results, and so on.” Be sure your patients know how to register for and use your portal. From paying bills to checking lab results to making appointments, portals keep your patients connected with your office. Train staff to introduce patients to portal use and provide printed handouts with step-by-step instructions. Because some patients can be understandably concerned about security, consider providing a handout on good password management.

Re-evaluating & Revising Workflows

Ball uses her portal and secure messaging quite a lot. “I feel like it’s the main way I stay in touch with patients between visits,” she says. And significantly, Dr. Ball gets the messages herself. If it’s a request for an appointment — or a list of symptoms that require a visit — she forwards the message to her staff to schedule a visit. However, if it’s a question she can answer, she responds to the patient directly. This method of triage prevents physicians from spending too much time on tasks staff can deal with, but still makes physicians available to patients. Nguyen takes the same approach, screening the messages first and personally answering the ones that need his attention before passing along others to his staff. He sees the portal as just like email, only more secure.

“I get the message first and decide what to do. I feel that we have more channels of communication this way,” he says.

To old-school doctors this may seem like a little too much patient contact, but it can work well if you take the right approach. You need not feel that you are chained to your patients, or even to your phone. A routine schedule for checking messages — once or twice a day — and sharing the load with the other physicians in your practice can make this kind of connectivity with patients easily manageable.

It also helps to educate patients. Data show more patients understand about their conditions, the less they will need to check in with you.10 Secure messaging through your portal allows you to share infographics, data, and links to reputable health information online. This can be used to provide reliable information that is of interest to patients even when they aren’t ill. Wellness info, such as the best diet for controlling blood pressure or how to incorporate more exercise into the day, can be shared via portals. Secure messaging via your portal also allows you to gauge the level of a patient’s understanding. The kinds of questions and responses you get can help you know what you need to cover at the next visit. In the end, this will save time. “A lot of patients think everything is urgent,” Nguyen says with a chuckle. “I don’t spoil them, but I do educate them about what it critical and what is not.”

Social Media & Patient Surveys

Even patients who do not use your portal likely use social media. According to the Pew Research Center, around 70 percent of Americans are active on some form of social media. 11 If you want to be where your patients are, social media is the first stop. Here are a few things you might consider posting on sites such as Facebook and Twitter: reminders to get flu shots, cold weather safety tips, links to interesting and engaging posts on other doctors’ blogs. You can also weigh in on controversies that pop up from time to time, such as the value of vaccinations or the risks of energy drinks. But the most important thing to understand about social media is that it is a conversation, not a billboard. Notice what issues and concerns interest your patients and respond with posts and tweets about those. Just like social life in the real world, social media online doesn’t work if you always talk and never listen.

Dr. Stout’s team regularly engages with patients online. By immediately responding to any negative feedback — such as posts about long wait times or rude staff — they reassure patients that they are heard, not ignored. It also gives the practice a chance to rectify problems and keep from losing patients over minor issues.

Another way to know what your patients are thinking is to simply ask them. In these days of healthcare consumerism, it’s crucial to have some way to track your patients’ experiences. 12 According to a 2018 study by PwC, 73 percent of people surveyed said that customer experience is a major factor on their purchasing decisions. 13 Patient surveys can help you make sure that your customers are getting the kind of experience they demand.

If your surveys are coming back positive, that’s great. But taking time to look for and address even small concerns can make a huge difference. A note to a patient — for example, “Sorry to hear you had a long wait when you were in to see me last week.” — is simply good customer service. It can also be an opportunity to suggest they try telehealth or audio conferencing.

Apps & Analytics

Modern patients are also eager users of healthcare apps. Ball, an OB-GYN, uses Baby Scripts, an app that helps guide patients through pregnancy. Similar apps, such as those that track fitness, record blood pressure readings, or monitor chronic conditions, such as diabetes, are among the fastest-growing apps on the market. When physicians provide these apps to their patients, it gives patients a connection with the provider and direct involvement in their own healthcare management. It also, says Ball, “allows us to give them the information we want them to have.” Apps like these can also be helpful when the patient comes in for a visit. They can allow you and the patient to review health data the patient might have forgotten had they not been able to track it with an app.

In 2019, physicians will be able to bill for a variety of new virtual services when treating Medicare patients, including virtual check-ins with established patients and remote evaluation of pre-recorded patient information, such as video or images submitted by the patient. In addition, there are three new Current Procedural Terminology(CPT) codes that physicians can use to bill for time spent setting up and analyzing patient generated health data.14

Even when you aren’t directly engaging with your patients, you can still be getting to know them better. Data analytics allows you to identify which patients are most likely to benefit from various therapies and approaches, which ones might benefit from having a case manager, and which ones are likely to respond well to new technologies such as telehealth. For example, using the tools available in your electronic health record (EHR), you can easily identify which patients are at risk for opioid abuse or which ones are likely not taking their medications as prescribed. Analyzing patient data can tip you off to a patient who is missing appointments or foregoing medications because of socioeconomic problems. Then you can direct them to the proper social service agency. “There’s a lot of data sitting on your EHR that you can compare to best practices,” says Stout. This will allow you to locate gaps in care, such as someone being late for a diagnostic test or wellness visit. “You can then get in touch with the patient by their preferred method — usually text — with a link to scheduling,” she says.

“Our organization sends e-surveys to patients post-visit, and for us, virtual visits rate as good as or better than in-person visits.”

– Graham Galka, Vice President of New Product Development, Privia Health

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Key Takeaways

Today’s patients prefer digital technology for requesting prescription refills, checking lab results, and monitoring health metrics.

Wise use of your portal can give you an edge on the competition.

Using a triage system for patient messages can keep you from becoming overwhelmed.

Train staff to introduce patients to portal use and provide printed handouts with step-by-step instructions.

Make patients feel safe by offering introductory-level IT suggestions, such as a handout on password safety.

Chapter Three: Review Quiz



1. Medscape National Physician Burnout & Depression Report 2018

2. Trends In Primary Care Visits

3. Survey: 5 Millennial Trends Altering the Delivery of Healthcare

4. Healthcare consumerism 2018: An update on the journey

5. Analysis of High Deductible Health Plans

6. The Everything Guide to Millennials

7. Is patient empowerment the key to promote adherence?

8. Higher Primary Care Physician Continuity is Associated With Lower Costs and Hospitalizations

9. Lags in Interoperability and Enterprise Mobile Tech Strategy Don’t Impede Secure Messaging Adoption, Black Book Cybersecurity Survey

10. National Institutes of Health

11. Social Media Fact Sheet

12. Patient Satisfaction Survey as a Tool Towards Quality Improvement

13. 35 Customer Experience Statistics You Need to Know for 2019

14. Final Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2019

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