Take the experience of Andrew McGlone, M.D., a family practitioner with Annapolis Primary Care. Early adopters of EHRs, they switched from an earlier EHR system to Epic in May of 2009. In 2010, they added Epic’s patient portal, called MyChart, which can be branded to the health system. “At first,” confesses Dr. McGlone, “I was leery of yet another responsibility that I wouldn’t be reimbursed for. Now, my biggest complaint is that not enough of my patients are using the portal.” Noting that about 20-30% of his patients have signed on, he adds, “I was amazed by the amount of time the entire office could save while also providing more immediate and better patient care.
“Before the portal,” Dr. McGlone continues, “if a lab result showed a patient’s thyroid needed adjustment, I’d compare a piece of paper with the chart, then call the patient, often having to leave a message, then eventually having a conversation to confirm the dose and the pharmacy. In the patient portal, everything is right there. In a few keystrokes, I can relay the result and new dose adjustment, electronically prescribe the new medication, and order follow-up lab testing.” Dr. McGlone enthuses, “You can respond on your time and patients can reply back at their convenience. There is no need for additional documentation, as the correspondence takes place in the medical record. If a patient’s lab or imaging results are normal, you provide them reassurance in seconds. Another aspect that made me a convert is that patients can send a message directly to me in their own words, not translated through the staff. The patient portal removes a lot of barriers to care. It allows us to engage in a productive dialogue with our patients, and we have the system set up to protect us from irrelevant or emergency requests.”
Types of Patient Portals and Costs
Essentially, patient portals come in three “flavors.” Some are integrated with the vendor’s EHR, including portals provided by Epic, NextGen, and eClinicalWorks. In a second model, vendors such as GE and Allscripts have interfaced third-party portals (Kryptiq and Intuit Health, respectively) with their EHRs. A third model involves a relationship between the EHR vendor and an independent portal vendor, which could entail additional work for staff if they have to re-enter information.
Costs for patient portals vary. With the Epic and GE Centricity systems, the flat fee paid for the EHR also covers the patient portal module, but some vendors charge an additional monthly fee. Mark Lamos, M.D., president of Greater Baltimore Medical Associates (GBMA), believes that portals have value, but is somewhat reserved about their cost-to-benefit ratio. GBMA, a practice that encompasses 69 primary care providers and other providers, uses the fully integrated portal from eClinicalWorks. Only a few months after the portal launched in January 2012, more than 9000 patients had signed up. “The biggest advantage is that the portal is an alternative to another phone call,” states Dr. Lamos. “The portal works well if the question is succinct, and providers can select from recorded messages to save time. At worst, it’s a breakeven and it probably saves time.”