The novel coronavirus pandemic has radically changed our personal and professional lives, perhaps forever. The lessons learned in these last few months have made us stop, think, and change how we move forward and communicate with one another and our patients. One of these changes has been the opportunity to implement telemedicine and telehealth. These services are clearly defined within the CMS Interim Final Rule updated on April 30, 2020.
Based on the new and updated regulations, healthcare providers are given the opportunity to manage patients remotely and deliver care at a distance when appropriate. The communication may be synchronous, using a videoconferencing feature, or asynchronous, allowing both the patient and provider to interact on their own timeline perhaps through an online portal.
A patient portal is defined as a secure website that gives patients convenient, 24-hour access to their personal health information from anywhere with an internet connection. This tool provides patient engagement through videoconferencing; secure online messaging; and the ability to receive test results, request prescriptions, review documentation, and so on. Information shared within the secure portal in this collaborative approach can mitigate and triage the patient’s health concerns (review the June Practice Points column, Triaging Telehealth in Wound Care: Embracing the Regulations within Your Workflows).
Providing continuity of care through patient engagement strategies such as a patient portal is the basis of an e-visit. Although a patient may use his/her portal along the continuum of any visit type, patient adoption of this technology may not be easy. Research has demonstrated that patients’ interest and ability to use patient portals is strongly influenced by personal factors such age, ethnicity, education level, health literacy, health status, and role as a caregiver. In addition, even if patients have an interest, they may not have access to the internet or a computer or smartphone. These barriers are real and need to be discussed when speaking with the patient while assisting him/her with portal adoption.
Five Steps to Optimize Your Patient Portal
This list, although not exhaustive, will assist you to set up your patient portal. It is important that you work through your department’s portal adoption process to ensure compliance is met at every step along the way. Consider these five steps to optimize and streamline your workflow:
Set up your department’s patient portal and create time to respond to messages
Setting up your patient portal involves several steps, including the creation of a portal message. Although setup is generally guided by your department’s or hospital’s process, the portal message may be unique to your department and needs to be created by you for the specific patient population you serve. The message is important because it greets patients when they sign into the portal and provides them with the next steps to contact your department or office. It can be as simple or detailed as desired. You may want to provide office hours, phone numbers to reach the department, information about when to call the department, and/or directions in case of an emergency. The message can also set patient expectations around receiving a response from a clinical staff member or provider after logging a question or concern. Having this information in writing and setting clear expectations for the patient are the start of your communication and patient engagement.
From a clinical workflow perspective, understanding who is responsible for reviewing the online portal questions as well as where and when this work will be completed is important. Clinicians typically build in a few designated times to reply to secure messages during the day. Answering patients’ questions takes time, empathy, and a focused understanding that an online tool cannot take the place of in-person conversations. Sometimes, the question may be best answered with a phone call or in-person visit. Clinical staff should be educated about when these options are more appropriate than a written reply.