Web-Based Patient Portals Improve Patient Care
Boston, MA—Across the country, many hospitals have begun to use web-based patient portals in their healthcare delivery, but are these portals improving care? According to Kaiser Permanente representatives who spoke at the 2014 Medical Informatics World Conference, they are, and the numbers show it. Although not specific only to oncology, this new approach can have a beneficial impact on managing patients with cancer, improving medication adherence, and preventive services.
Terhilda Garrido, Vice President, Health Information Technology Transformation and Analytics, Kaiser Permanente, said that roughly 10 years ago, Kaiser made a $4-billion investment in their electronic health record. “Today, out of 9.3 million members, 4.4 million are now KP.org members,” said Ms Garrido. “About 60% of our adult members are members of KP.org. The KP.org functionality is a patient portal that sits on top of the electronic health record. It exposes part of the electronic health record to the patient.”
Kaiser has approximately 611 medical offices and 17,000 physicians. Through Kaiser Permanente’s web portal, patients can communicate with their doctors, view test and laboratory results, schedule appointments, and refill prescriptions, among other tasks. In 2003, Kaiser essentially had no interactions that involved secure e-mails.
Secure e-mail through the web portal now represents 32% of primary care patient encounters. On average, physicians receive roughly 5 e-mails daily from patients, some of which can be answered by other members of the care team.
According to Ms Garrido, patient satisfaction with the portal is high, with approximately 85% of patients rating portal encounters an 8 or a 9 on a 9-point scale, with 9 being highly satisfied. In 2010, the average registration rate was 52%; the registration rate 60% (highest) in patients aged 60 to 69 years, and 46% among patients aged >70 years.
A personal action plan is a KP.org view of a member’s preventive and chronic conditions, screenings, tests, and immunizations. It reminds members of actions that will help maintain their health. Michael Kanter, MD, Regional Medical Director, Quality and Clinical Analysis, Southern California Permanente Medical Group, said the personal action plans have had an impact. People who registered and visited the patient portal were slightly more likely to have preventive care (eg, Pap smear, flu shot) than other patients.
“We think this is helping out our screening rates for cancer and all sorts of cardiovascular diseases immensely. We have people signing up for weight management programs at a higher rate,” said Dr Kanter.
In an evaluation of 35,000 Kaiser patients, portal use at Kaiser was associated with a 2% to 6.5% improvement in health data. Patient adherence to statins, as well as measures of low-density lipoprotein levels, improved by 6% among patients with diabetes who exclusively used the patient portal for prescription refills compared with users of the web-based portal who did not refill their medications online. This indicates that adoption of online refills may improve medication adherence.
Dr Kanter pointed out that the online registration at Kaiser varied by race and ethnicity, with approximately 61% white patients, 55% Asian patients, 43% black patients, and 37% Hispanic patients registering for the site. In an attempt to decrease health disparities, Kaiser has launched a Spanish language version of the web portal, which is rapidly growing in popularity.