Patient Portal: The thread that connects patient and provider to enable deeper mutual engagement for managing healthcare

2017 Alliance feature article provided courtesy of TriMed Technologies

What do patient engagement, Electronic Health Records, appointment scheduling, bill payment and reconciliation, prescription refill requests, retail experience, Value Based Payments, HIPAA, and physician office best practices all have in common?

While they seems to be a varied cornucopia placed in a single basket, they all can be connected with technology called Patient Portal.

Like three major highways merging together into a single expressway, and moving at higher and higher speeds, healthcare is experiencing the convergence of government mandates, disruptive payor models, and the general population’s changing expectations and seeming culture shift to consumer driven, retail experiences.

Healthcare providers, from hospital systems to primary and specialty care providers, are increasingly connecting with their patients through their respective Patient Portals. At least they are attempting to do so. In a report published by the American Hospital Association in July 20161 between 2013 and 2015 online medical views more than doubled, download of medical records nearly tripled, and requests to change medical records more than doubled in that period. While this news sounds promising, the reality is that on a broad scale, patients/consumers reported very low use of the tools that patient portals primarily provide.

A survey in 2015 prepared by Nielsen’s Strategic Health Perspectives2 and presented by The Council of Accountable Physician Practices points to the gap between government mandates and payor and provider desires over against the unmet needs of consumers when it comes to not only basic online access, but to deeper interaction with their healthcare provider. This is broken down to HAVE vs. WANT in the following chart:


Moreover low-income consumers, those with a combined household annual income of less than $35,000 and Medicaid consumers said that they WANTED Text Appointment Reminders at a rate of 22% and 32%, respectively. That’s nearly one in three Medicaid recipients, for just one potential online engagement service. When it comes to Text Reminders about taking medications or other health reminders, nearly one in four respondents receiving Medicaid benefits said that they WANTED this engagement.

But there are additional health care related tasks that are available to consumers that the Patient Portal can provide. According to general population benchmark data published by ACI Worldwide and Aite Group in January 20173, more than 56% of bills are paid online by way of a biller, bank or third party web site. Of note for the revenue cycle management side of physician practices, nearly three out of four of online bill payments are made on the biller’s (ie, practice) websites. Healthcare providers who fail to implement this ‘low hanging fruit’ of patient engagement do so at the cost of efficiency and best practice workflow.

Portals provide the ability for patients to schedule, cancel and reschedule appointments online. This technology is analogously utilized by the airline industry across carriers and has been in use for some time – whereby a consumer can prepay their flight and choose a seat at the same time. The healthcare industry, such as it is, lags behind in the implementation of this kind of service to it’s own consumers, due to either practice financial or cultural barriers – maybe both.

Other value drivers of a Portal include the ability for patients and guarantors to request prescription refills, view and respond to lab results, and view and print immunization schedules for parents and guardians. Online demographic registration and the completing of online forms, including consent forms, are additional workflow efficiencies that effective practices are beginning to utilize to minimize cost and enhance the patient experience.

One dictionary has the definition of a portal as: a door, gate, or entrance, especially one of imposing appearance, as to a palace. And technically, that’s what an online Patient Portal should provide – a doorway that connects a patient or family to his or her healthcare provider – a doorway that opens both ways. The foundation of the Portal, if all of these good things are derived, is the Electronic Health Record. The EHR provides the infrastructure that connects the patient and provider and allows them to intelligently manage health care efficiently and securely.

Aside from the fact that government mandates require the use of a Portal (among many other things) in order to maximize reimbursement and avoid future penalties under new MACRA value payments, a Portal – or doorway- between patient and provider only makes sense. Of course any technology that provides online access to the patient must meet the stringent demands of HIPAA privacy and security. This requires both technological and practical standards within a practice in order to comply.

In summary, the big picture is that the Patient Portal connects a lot of dots in the constellation of patient-provider healthcare. It opens the door of opportunity to engage more deeply with their healthcare provider and it balances the power between provider and patient whereby the patient has online access to their Protected Health Information 24/7. But not all patients are engaged, and a significant percentage of the population wants to engage in more ways than physicians, due to either financial or cultural reasons, are able and willing to provide. Over time however, it seems inevitable that physicians and patients will come closer together in the management of individual care. It’s just a question of how much time that will take.


  1. Data from the 2015 AHA Annual Survey Information Technology Supplement
  2. Prepared by Nielsen’s Strategic Health Perspectives for CAPP & Bipartisan Policy Center 2015
  3. © Copyright ACI Worldwide, Inc. 2017

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