eHealth Articles & White Papers

Patient Portals: Facilitating Change that Matters in Healthcare

Ben Dillon - Vice President & eHealth Evangelist

With all of the talk on Capitol Hill, the nation's awareness of the challenges facing the healthcare system is growing.

Payment reform and universal coverage initiatives are beginning to address significant issues within the system, but these initiatives are rather like putting a cover over a bad piece of furniture. It looks better and it's easier to sit on, but the wood is still rotting and will collapse without a more structural change.

At the same time, other industry pressures are increasing the demand for meaningful change. The current methods for delivering and paying for care are unsustainable. An aging U.S. population increases the need for lower costs and more medical professionals in the future, which are not available under the current care delivery model.

And chronic - not acute - conditions are growing the healthcare burden in terms of services consumed and cost to the industry. These conditions typically require regular management and are not well suited to the periodic encounter model of healthcare.

In addition to changing the way healthcare is paid for, we need to fundamentally shift the way care is delivered.

The Internet's role in shifting business models

When we look outside healthcare, the Internet has proven to be an enabling technology in creating new business models:

• Travel: A wave of self service travel buying started with sites like Expedia and Travelocity, which has made travel agents a dying breed, and Priceline introduced a new model for selling excess airline and hotel inventory through bidding.
• Financial services: The online financial service revolution centered around self service. Direct consumer trading cut staff costs, which enabled small batch trading with low transaction fees and made equity ownership and trading more available to the consumer. And online banking built greater loyalty from consumers by increasing the difficulty of moving to a new bank (do you want to create your account again?).
• Retail: Retail outlets enable shopping from home and make product research and comparison shopping far easier and faster than ever before. In addition, eBay has created a thriving consumer-to-consumer auction marketplace allowing buyers and sellers to find each other no matter where they're located.

So far healthcare has failed to adapt in the same ways.

The Internet's role in shifting healthcare

To be fair, we're beginning to see how the Internet can shift healthcare delivery, but such change is coming from outside the healthcare provider base rather than from within.

Sites like Carol.com and Hospitalcompare.gov attempt to provide health consumers with information from which to make useful comparisons, and online communities like PatientsLikeMe.com allow patients to compare notes on a scale never before possible. However, working from the outside, these efforts will be hard pressed to fundamentally change healthcare delivery.

eHealth technologies, however, provide a platform that can begin to shift the current healthcare delivery model. We'll start to see providers applying these technologies to:

• Make "face time" with patients more effective and efficient by:
  • Automating pre-consultation communications
  • Providing assistance with decisions and education tools to health consumers
  • Managing informed consent for procedures
  • Delivering interactive discharge instructions
  • Streamlining data capture and documentation
• Share information with other providers, which will provide a central point of care coordination for patients.
• Track the healthcare usage of individual consumers using patient portals and personal health records and then, through the use of PRM (patient relationship management) tools, change that lifetime value through proactive communication while improving the patient's overall health.
• Supplement in-person care delivery through interactive disease tracking and management, with the care team utilizing Web-based tools.

While a good website with some transactional capabilities is a start, it's impossible to go far down this path without secure one-to-one communication tools that connect providers to health consumers to share information, track progress and provide guidance. Patient portals can be an effective tool to achieve this.

The move to patient portals

The transition to implementing patient portals is truly about making changes that matter and striving for bigger goals:

• Saving costs: Controlling healthcare costs is going to require more preventative care, added promotion of healthy habits and lifestyles, and better management of chronic conditions. This equates to a large increase in the education and services provided to health consumers without much growth in additional staff or financial reimbursement. Accomplishing this will require technology that allows providers to do more with the time they can commit to patients and enables greater self-care opportunities.
• Improving competitiveness: Changes in the healthcare system will further the process of health consumerism that's been underway for several years. Health consumers value organizations that are easy to work with - in fact, this can differentiate your organization from others. In addition, once consumers are plugged into your portal, you can expect increased loyalty. They've formed a relationship with your care team, they're able to manage all family member information in one place, and it takes much effort to re-establish their information at a new provider.
• Improving care delivery by improving access and facilitating better outcomes: While in-person patient-physician encounters will continue to be a central part of the care delivery experience, greater attention will be paid to the time spent replacing in-person encounters with online encounters to provide care for underserved populations. Whether through medical home-style care management, information therapy, health coaching, or self management health diaries and trackers, consumers will be tracking and watching health issues far more often than they do today with a bank account.

The possibilities are endless, but the direction is clear. The U.S. healthcare system will be unsustainable in the future without the ability to scale efficiently. Scaling without sacrificing quality and effectiveness can occur using technology that engages the health consumer directly and makes them an active party in managing their health.

This is where eHealth is headed. The evolution is beginning. eHealth is transforming from being a marketing channel for healthcare providers to being a significant part of their care delivery infrastructure.

It's an exciting shift and I'm excited to be a part of it.