Your health care records are entering the digital age with the increasing use of ‘patient portals.’ A patient portal is an online health database with individual accounts that each patient can access directly. Each patient account contains the patient’s full medical history, a list of the patient’s diagnoses with links to their descriptions, a list of prescriptions and links to their descriptions, and all medical and radiology results. Through the portal, a patient can also request medication refills, ask non-urgent questions to doctors and nurses, make an appointment, and download all medical records efficiently. The advantages of using patient portals is useful beyond just what the patient can see, the portals can help vulnerable communities with the information they make accessible. Having a portal also gives patients access to their medical record while traveling. Not only does that help the patient, but by pulling up a comprehensive medical record, it makes the healthcare provider’s job easier as well. Because patient portals are so new, there is very little evidence on their impact on patients and their health care providers. The main short-term objective of the patient portals is to increase patient engagement in their own health care. Early studies of the portals show that patients who access the portals are more likely to adhere to their medications.
Dr. Alejandra Casillas, an Assistant Professor in the Geffen School of Medicine at the University of California Los Angeles is studying the risks and benefits of patient portals. She is working with colleagues in the Los Angeles County Department of Health Services (LAC DHS) to learn more about patient perspectives on the use of these portals. In the first stage of her research, she has found that patients are enthusiastic and positive about portals. As one patient told Dr. Casillas, “you go online every month to do your bills and banking… this could just become one of those things.” Many patients agree that using the portal and having everything they need online saves them time and money. A prime example of patients benefiting from the portal is when it comes to acquiring medical records. In many cases, before patient portals, when medical records were needed the patient would have to pay to get them printed, often taking hours out of a day; using the portal a patient’s medical records can be downloaded and emailed to a healthcare provider with an hour. With medical information easily accessible online, healthcare providers are also benefitting. Patient portals can allow clinic and hospital staff to track patient’s progress, contact patients easily, and evaluate how well they are doing their jobs.
Given these positive short-term outcomes for patient portals, healthcare providers and researchers are starting to examine longer-term effects of the portals on health, well-being, and satisfaction with care. Using data already gathered on the portals, researchers can develop interventions tailored to different groups of patients and pilot test evaluations to gain more knowledge on how to improve care and patient engagement. Healthcare providers such as Dr. Casillas are hoping that these portals can advance the health of individuals, but also advance health on a population level.
Although portals show great promise, there are some challenges to their implementation and us. Although a recent study shows that over 80% of the patients who access the portal found that it was beneficial, many patients are not yet using the portals. African American, Latino, and some Asian patients have had lower rates of adoption of the patient portal, which may be because they do not have access to home computers or have limited experience with the technology. A contributing factor may be that many portals are tailored to English speakers and have no options for other languages. In the U.S., there are very few bilingual portals, which makes utilizing them hard for non-native English speakers. Additionally, only about 20% of patients use portals to engage in shared decision-making with their doctors, nurses, and other health care providers. Finally, patients who receive care from different health systems may run into problems because not all hospitals use the same network. For example, Kaiser Permanente uses a network called “Epic” which UCLA uses that allows healthcare providers at UCLA to access medical records if they see a patient from Kaiser Permanente or vice versa. In contrast, the Department of Health Services (DHS) uses a network called “Orchid” which doesn’t allow UCLA healthcare providers to access and view medical records from a LAC DHS patient.
Patient portals have the potential to have a large impact on how people understand and manage their health care, enhance their communication with health care providers, and improve health overall. Unfortunately, this project is lacking the recognition that it deserves and after almost two years, there is still a lack of use.