Making Patient Portals a 2-Way Partnership

October 20, 2018

Patient Portals can be powerful tools that offer patients 24/7 secure access to view their medical information and manage their health care decisions from their computer or phones. However we found in a recent survey that not all portals are “created equal”.

Patient Portals, provided by  physician’s offices, hospitals and health systems, offer their patients user-friendly sections or tabs in which to view test results, communicate with clinicians, schedule appointments and even pay your bill. Yet, most Patient Portals do not provide a section/tab to view and share a patient’s most vital health care decisions documented in their Health Care Proxy, Personal Directive or Living Will, and MOLST form (Medical Orders for Life-Sustaining Treatment).

“Think how valuable that could be for patients and for their care providers,” says Paula Griswold, Executive Director, Massachusetts Coalition for the Prevention of Medical Errors (MA Coalition), “to ensure that there is an easily accessible, up-to-date version of a patient’s planning documents when needed.”

We wondered- what would you like your patient portal to be able to do? Working together with the MA Coalition, an Honoring Choices Alliance Partner, we launched the Portal Challenge, a 1-minute online survey to explore two major questions.

First we asked: “If you could upload your planning documents to your Patient Portal to view, update and share with others, would you upload your Health Care Proxy, Personal Directive and MOLST Form?”

Of 100 survey respondents, the results were overwhelming in favor of uploading planning documents as follows:

  • 100 respondents would upload their Health Care Proxy;
  • 94 respondents would upload both their Health Care Proxy and Personal Directive;
  • 69 respondents would upload their MOLST

Second, we asked: “If you could upload your planning documents to your Patient Portal to automatically become part of your Electronic Medical Record (EMR), would you expect your documents to be available to your care team and to your hospital’s Emergency Department?” (Sometimes these are two separate medical record systems.)

The results clearly favored an automatic transfer of a patient’s planning documents into the EMR to share as follows:

  • 100 respondents expect their planning documents to be available to their doctors & care team;
  • 94 respondents expect their planning documents to be available to their hospital’s Emergency Department.

Out of the 100 respondents, 64 identified as patients and 36 identified as care providers and patients. Interestingly their responses and feedback were similarly positive to uploading documents and having the documents be readily available in the EMR.

The survey strongly indicates the need to make the Patient Portals more of a two way partnership, where health systems benefit from easy delivery of information,  and, as one care provider respondent put it ”where my patient’s decisions are just as important as test results.” We have the technology to improve patient portals for all adults 18 years old and older. It’s time to make this powerful tool truly person-centered, giving the patient the control to view, update, and share their care decisions to receive the best possible care that honors their care choices, all through their lives.

Here are some great comments shared by the respondents:

  • “It’s a WIN-WIN!” …  “a great way to keep me and my doctors up to date on my care decisions.”
  • “Just add a ‘Patient Choices Tab’ on my portal page … “where I can upload and see my planning documents, and decide who to share them with.”
  • “I’m my 87 y.o. mother’s Health Care Agent”… “Mom’s portal let’s her share her test results with me. Be great to store & share her Health Care Proxy and MOLST too.”
  • “So I can pay my bills, but can’t see my Health Care Proxy?… “If we have the technology to pay bills and make appointments, it should be easy to make a place to upload my Health Care Proxy and get it in my medical record.”
  • “As a Primary Care Physician, I’d like to upload directly through the portal to the hospital records”… “when I send patient records to the hospital, they often don’t make it into the EMR.”
  • “Genius! …”would give me great piece of mind to know my documents were safety stored in my portal, where I can access by computer or phone.”

Thanks to all for participating in the survey and sharing your useful feedback.  A special thanks to our partner, the Massachusetts Coalition for the Prevention of Medical Errors and their members for inspiring the Portal Challenge!  Several of the Honoring Choices Partners are currently working on improving their Patient Portal systems. We will keep you posted on their progress.

Read more about how it all started- see Portal Challenge here.