Recently, I was researching the topic of patient portals for this blog post and figured that for me to truly get a real-world patient perspective, I should actually check out my own primary care provider’s portal. I was almost positive that I had already created a portal account previously when I completed an in-office digital intake form. So, I attempted to login several times but wasn’t sure if I remembered the correct username and password. Not once but twice, I filled out the form to email username and password reset instructions but I nothing landed in my inbox.
As a last resort, I contacted my primary care provider only to learn that, no, in fact I had never set up a patient portal account—talk about frustrating. I returned to the portal, created a new account, and finally got access to the portal. Once inside, I found I could access some lab and test results and past appointment information but neither seemed complete. There was also a direct messaging feature but it seemed outdated and I felt like a patient had to jump through a lot of hoops to communicate back and forth with the provider.
However, patient portals do serve a purpose and like any healthcare provider tool they have their strengths and weaknesses. This article will look at patient portals and compare and contrast the capabilities of patient portals against the alternative of text messaging, particularly when it comes to tools’ ability to help providers connect more successfully with their patients.
Initially, patient portals were mandated under meaningful use legislation and again later under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), which changed the pay for service model to a value-based system. One of the stipulations of the law was that in order for providers to be reimbursed for Medicare patients, they needed to provide a minimum percentage of patients with access to their electronic health records (EHR) so that patients could be more involved in their own care.
In response, providers set up web-based patient portal sites that patients could login to and access their medical records, renew prescription medications, receive lab results, and access a slew of other features. Many patient portals also possess communication capabilities so patients can securely message their providers. An impetus of the legislation was that if patients had more of a stake in their own care, including that they could access their own records and communicate more effectively with their providers, it would lead to better patient-provider relationships and therefore improved outcomes.
However, getting patients to buy-in to the concept of patient portals and begin using them in any significant numbers has proved to be an ongoing challenge. According to a 2017 Government Accountability Office report, 90 percent of providers offered access to a patient portals but less than one-third of patients had ever used theirs. And of those patients who had signed up for patient portal access, only 20 percent used theirs on a regular basis. Another study found that only 9 percent of patients actually use their provider's patient portal.
Inherent to patient portals are a series of limitations that continue to prevent wide scale adoption. Because of portals’ login requirements many patients experience frustration in gaining access to their portal. Others find the portals poorly designed, clunky to use, difficult to navigate, and suffering inadequate functionality. Another drawback is that patient portals are siloed according to each provider so that the data and information a given portal provides may be fragmented or incomplete. Many patients have simply never been offered access to a patient portal by their provider or don’t see the benefit of using one.
“If you ask an otherwise healthy individual, ‘Why would you use the portal?’ they would just look at you with a blank stare and say, ‘There's nothing there,’” said Dr. Thomas Selva, a pediatrician and chief medical information officer at the University of Missouri Health Care, in a previous interview.
Yet patients that actively use the patient portals find them a worthwhile resource for:
- accessing medical records,
- refilling prescriptions,
- checking lab results,
- and online billing.
Similarly, in a 2020 patient survey, 58 percent said patient portals were the most impactful technology affecting them and 38 percent wanted to see more consolidated patient portals in the future.
However, while patient portals may serve patients well for certain services, fast and effective patient communication is not one of them. If we’ve learning anything in recent years about patient-provider communication preferences it’s that patients-as-consumers want to connect quickly and easily with providers in the most user-friendly way possible.
In 2021, that mean’s text messaging. Most Americans own smartphones and they expect to be able to text back and forth between their family, friends, businesses, and, yes, their healthcare practices. One survey found that 79 percent of patients want to receive texts from their providers and nearly an equal amount—73 percent—want to be able to send text messages to their providers.
Texting is a much more accessible and responsive tool for direct communications between patients and providers, including the following.
- automated appointment reminders
- group messaging
- automated patient recall
- digital patient intake
- automated patient education and surveys
- pre-visit instructions
In a modern environment, a provider’s ability to text message individual or groups of patients is critical to helping the organization ensure patients arrive for appointments and get the care they need. Via texting, providers can reach out effectively and efficiently to patients. With real-time, two-way texting, patients can text providers questions or to ask for clarifications on care instructions without ever needing to login to a patient portal.
With the COVID-19 pandemic, text messaging has taken on even more urgent role. Group text messaging is a crucial means for providers to quickly and efficiently alert large numbers of patients about the vaccine rollout and schedule them to receive the vaccine.
Clearly, texting and patient portals are important tools for providers to accomplish very different goals and objectives. For communication, nothing can touch texting in its speed and efficiency for providers to connect directly with patients. At the same time, patients portals are more suited to giving patients access to medical records, lab results, billing information, and refilling medications.
To learn more about patients’ latest communication preferences, download the guide “Patient Communication Preferences: The COVID-19 Impact.”