Patient portal

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Patient portals are healthcare-related online applications that allow patients to interact and communicate with their healthcare providers, such as physicians and hospitals. Typically, portal services are available on the Internet at all hours of the day and night. Some patient portal applications exist as standalone websites that sell their services to healthcare providers. Other portal applications are integrated into the existing healthcare provider's website. Still others are modules added onto an existing electronic medical record (EMR) system. What all of these services share is the ability of patients to interact with their medical information via the Internet. At times, the lines between an EMR, a personal health record, and a patient portal can be blurred due to feature overlap. [1]

Contents

Features and benefits

The central feature that makes any system a patient portal is the ability to securely expose individual patient health information through the Internet. In addition, virtually all patient portals allow patients to interact in some way with healthcare providers. Patient portals benefit both patients and providers by increasing efficiency and productivity. In the United States, patient portals are also regarded as a key tool to help physicians meet "meaningful use" requirements to receive federal incentive checks, especially for providing health information to patients. [2] Some patient portal applications enable patients to register and complete forms online, which can streamline visits to clinics and hospitals. Many portal applications also enable patients to request prescription refills online, order eyeglasses and contact lenses, access medical records, pay bills, review lab results, and schedule medical appointments. Patient portals also typically allow patients to communicate directly with healthcare providers by asking questions, leaving comments, or sending email messages.

Disadvantages

The major shortcoming of most patient portals is their linkage to a single health organization. If a patient uses more than one organization for healthcare, the patient typically needs to log on to each organization's portal to access information. This results in a fragmented view of individual patient data. [3]

Practice portals

Portal applications for individual practices typically exist in tandem with patient portals, allowing access to patient information and records, as well as schedules, payments, and messages from patients. [4] Most patient portals require the practice to have some type of electronic medical record or patient management system, as the patient data needs to be stored in a data repository and then retrieved by the patient portal. While lauding practice portals for their ease of use, some physicians note that it is hard to encourage patients to utilize online portals to benefit both themselves and the medical practice staff. [5]

Security

Healthcare providers in the US are bound to comply with HIPAA regulations. These regulations specify what patient information must be held in confidence. Something as seemingly trivial as a name [6] is viewed by HIPAA as protected health information. For this reason, cybersecurity has always been a top concern for the industry when dealing with the adoption of patient portals. While there may be systems that are not HIPAA compliant, most patient and practice portals are secure and compliant with HIPAA regulations. The use of SSL and access control patterns are commonplace in the industry. Patient access is typically validated with a username and password. [7]

History

Internet portal technology has been in common use since the 1990s. The financial industry has been particularly adept at using the Internet to grant individual users access to personal information. Possibly because of the strictness of HIPAA regulations, or the lack of financial incentives for the health care providers, the adoption of patient portals has lagged behind other market segments.

The American Recovery and Reinvestment Act of 2009 (ARRA), in particular the HITECH Act within ARRA, sets aside approximately $19 billion for health information technology. This funding was intended to offset the costs of electronic medical record systems for practicing physicians. Because the conversion to electronic medical records is typically complex, systems often transition to patient portals first and then follow with a complete implementation of electronic medical records.

To attest to Meaningful Use Stage 2, eligible professionals must have 5 percent of their patients view, transmit, or download their health information. Additionally, providers must implement notifications for follow-up appointments and identify clinically relevant health information for more than 10 percent of their patients with two or more appointments in the preceding two years. [8]

Consequently, personal health record systems are becoming more common and available. In 2012, 57 percent of providers already had a patient portal. [9] At present, individual health data are located primarily on paper in physicians' files. Patient portals have been developed to give patients better access to their information. Given patient mobility and the development of clear interoperable standards, the best documentation of patient medical history may involve data stored outside physician offices.

Future

E-visits (remote use of medical services) may soon become one of the most commonly used patient portal features. The most likely demographic for uptake of e-visits are patients who live in remote rural areas, far from clinical services. A telehealth visit would be much cheaper and more convenient than traveling a long distance, especially for simple questions or minor medical complaints.

Providing a route that does not require in-person patient clinic visits may potentially benefit both patients and providers. Many organizations find that overall utilization drops when e-visits are implemented, in some places by as much as 25%. [10] This makes e-visits a very interesting proposition for insurance companies, although few actually reimburse for them currently. With proper functionality, E-visits also allow the patient to update their allergies, vital signs, and history information.

Vendors

Some vendors, such as athenahealth, Epic Systems, and Cerner offer patient portals as one module of a complete electronic health record (EHR) system. Other vendors, such as Allscripts and Medfusion, offer patient portals that can be integrated with any EHR. [11]

Recent market surveys[ specify ] have highlighted best of breed, or applications that excel at one or two functions, are losing ground to portals provided by large vendors. While best of breed portals are better equipped for interoperability, portals supplied by larger vendors may be overall better equipped to handle the patient engagement requirements of Meaningful Use Stage 2. [12]

See also

Related Research Articles

Medical privacy, or health privacy, is the practice of maintaining the security and confidentiality of patient records. It involves both the conversational discretion of health care providers and the security of medical records. The terms can also refer to the physical privacy of patients from other patients and providers while in a medical facility, and to modesty in medical settings. Modern concerns include the degree of disclosure to insurance companies, employers, and other third parties. The advent of electronic medical records (EMR) and patient care management systems (PCMS) have raised new concerns about privacy, balanced with efforts to reduce duplication of services and medical errors.

<span class="mw-page-title-main">Health Insurance Portability and Accountability Act</span> United States federal law concerning health information

The Health Insurance Portability and Accountability Act of 1996 is a United States Act of Congress enacted by the 104th United States Congress and signed into law by President Bill Clinton on August 21, 1996. It aimed to alter the transfer of healthcare information, stipulated the guidelines by which personally identifiable information maintained by the healthcare and healthcare insurance industries should be protected from fraud and theft, and addressed some limitations on healthcare insurance coverage. It generally prohibits healthcare providers and businesses called covered entities from disclosing protected information to anyone other than a patient and the patient's authorized representatives without their consent. The bill does not restrict patients from receiving information about themselves. Furthermore, it does not prohibit patients from voluntarily sharing their health information however they choose, nor does it require confidentiality where a patient discloses medical information to family members, friends or other individuals not employees of a covered entity.

Medical billing, a payment process in the United States healthcare system, is the process of reviewing a patient's medical records and using information about their diagnoses and procedures to determine which services are billable and to whom they are billed.

<span class="mw-page-title-main">Electronic health record</span> Digital collection of patient and population electronically stored health information

An electronic health record (EHR) also known as an electronic medical record (EMR) or personal health record (PHR) is the systematized collection of patient and population electronically stored health information in a digital format. These records can be shared across different health care settings. Records are shared through network-connected, enterprise-wide information systems or other information networks and exchanges. EHRs may include a range of data, including demographics, medical history, medication and allergies, immunization status, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information.

Medical practice management software (PMS) is a category of healthcare software that deals with the day-to-day operations of a medical practice including veterinarians. Such software frequently allows users to capture patient demographics, schedule appointments, maintain lists of insurance payors, perform billing tasks, and generate reports.

eHealth describes healthcare services which are supported by digital processes, communication or technology such as electronic prescribing, Telehealth, or Electronic Health Records (EHRs). The term "eHealth" originated in the 1990s, initially conceived as "Internet medicine," but has since evolved to have a broader range of technologies and innovations aimed at enhancing healthcare delivery and accessibility. According to the World Health Organization (WHO), eHealth encompasses not only internet-based healthcare services but also modern advancements such as artificial intelligence, mHealth, and telehealth, which collectively aim to improve accessibility and efficiency in healthcare delivery. Usage of the term varies widely. A study in 2005 found 51 unique definitions of eHealth, reflecting its diverse applications and interpretations. While some argue that it is interchangeable with health informatics as a broad term covering electronic/digital processes in health, others use it in the narrower sense of healthcare practice specifically facilitated by the Internet. It also includes health applications and links on mobile phones, referred to as mHealth or m-Health. Key components of eHealth include electronic health records (EHRs), telemedicine, health information exchange, mobile health applications, wearable devices, and online health information. For example, diabetes monitoring apps allow patients to track health metrics in real time, bridging the gap between home and clinical care. These technologies enable healthcare providers, patients, and other stakeholders to access, manage, and exchange health information more effectively, leading to improved communication, decision-making, and overall healthcare outcomes.

<span class="mw-page-title-main">Telenursing</span> Nursing care through telecoms

Telenursing refers to the use of information technology in the provision of nursing services whenever physical distance exists between patient and nurse, or between any number of nurses. As a field, it is part of telemedicine, and has many points of contacts with other medical and non-medical applications, such as telediagnosis, teleconsultation, and telemonitoring. The field, however, is still being developed as the information on telenursing isn't comprehensive enough.

A personal health record (PHR) is a health record where health data and other information related to the care of a patient is maintained by the patient. This stands in contrast to the more widely used electronic medical record, which is operated by institutions and contains data entered by clinicians to support insurance claims. The intention of a PHR is to provide a complete and accurate summary of an individual's medical history which is accessible online. The health data on a PHR might include patient-reported outcome data, lab results, and data from devices such as wireless electronic weighing scales or from a smartphone.

Health technology is defined by the World Health Organization as the "application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures, and systems developed to solve a health problem and improve quality of lives". This includes pharmaceuticals, devices, procedures, and organizational systems used in the healthcare industry, as well as computer-supported information systems. In the United States, these technologies involve standardized physical objects, as well as traditional and designed social means and methods to treat or care for patients.

Health Information Exchange (HIE) refers to the electronic mobilization of health care information across organizations within a region, community, or hospital system. The participants in data exchange are collectively called Health Information Networks (HIN). In practice, HIE may also refer to the health information organization (HIO) that facilitates the exchange. The primary goal of HIE is to facilitate access to and retrieval of clinical data to provide to public health authorities in analyses of the health of the population.

Health information management (HIM) is information management applied to health and health care. It is the practice of analyzing and protecting digital and traditional medical information vital to providing quality patient care. With the widespread computerization of health records, traditional (paper-based) records are being replaced with electronic health records (EHRs). The tools of health informatics and health information technology are continually improving to bring greater efficiency to information management in the health care sector.

Protected health information (PHI) under U.S. law is any information about health status, provision of health care, or payment for health care that is created or collected by a Covered Entity, and can be linked to a specific individual. This is interpreted rather broadly and includes any part of a patient's medical record or payment history.

Electronic prescription is the computer-based electronic generation, transmission, and filling of a medical prescription, taking the place of paper and faxed prescriptions. E-prescribing allows a physician, physician assistant, pharmacist, or nurse practitioner to use digital prescription software to electronically transmit a new prescription or renewal authorization to a community or mail-order pharmacy. It outlines the ability to send error-free, accurate, and understandable prescriptions electronically from the healthcare provider to the pharmacy. E-prescribing is meant to reduce the risks associated with traditional prescription script writing. It is also one of the major reasons for the push for electronic medical records. By sharing medical prescription information, e-prescribing seeks to connect the patient's team of healthcare providers to facilitate knowledgeable decision making.

Surgical scheduling software is computer software related to scheduling of tasks for a sequence of surgical cases in one surgery theatre and with one surgery staff using an operational model, a computer and a network. Another vital part of the surgery scheduling process is the communication between the Facility and the Vendor.

The Health Information Technology for Economic and Clinical Health Act, abbreviated the HITECH Act, was enacted under Title XIII of the American Recovery and Reinvestment Act of 2009. Under the HITECH Act, the United States Department of Health and Human Services resolved to spend $25.9 billion to promote and expand the adoption of health information technology. The Washington Post reported the inclusion of "as much as $36.5 billion in spending to create a nationwide network of electronic health records." At the time it was enacted, it was considered "the most important piece of health care legislation to be passed in the last 20 to 30 years" and the "foundation for health care reform."

Healthcare CRM, also known as Healthcare Relationship Management, is a broadly used term for a Customer relationship management system, or CRM, used in healthcare.

<span class="mw-page-title-main">Medical image sharing</span> Electronic exchange of medical images

Medical image sharing is the electronic exchange of medical images between hospitals, physicians and patients. Rather than using traditional media, such as a CD or DVD, and either shipping it out or having patients carry it with them, technology now allows for the sharing of these images using the cloud. The primary format for images is DICOM. Typically, non-image data such as reports may be attached in standard formats like PDF during the sending process. Additionally, there are standards in the industry, such as IHE Cross Enterprise Document Sharing for Imaging (XDS-I), for managing the sharing of documents between healthcare enterprises. A typical architecture involved in setup is a locally installed server, which sits behind the firewall, allowing secure transmissions with outside facilities. In 2009, the Radiological Society of North America launched the "Image Share" project, with the goal of giving patients control of their imaging histories by allowing them to manage these records as they would online banking or shopping.

Health data is any data "related to health conditions, reproductive outcomes, causes of death, and quality of life" for an individual or population. Health data includes clinical metrics along with environmental, socioeconomic, and behavioral information pertinent to health and wellness. A plurality of health data are collected and used when individuals interact with health care systems. This data, collected by health care providers, typically includes a record of services received, conditions of those services, and clinical outcomes or information concerning those services. Historically, most health data has been sourced from this framework. The advent of eHealth and advances in health information technology, however, have expanded the collection and use of health data—but have also engendered new security, privacy, and ethical concerns. The increasing collection and use of health data by patients is a major component of digital health.

Federal and state governments, insurance companies and other large medical institutions are heavily promoting the adoption of electronic health records. The US Congress included a formula of both incentives and penalties for EMR/EHR adoption versus continued use of paper records as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the, American Recovery and Reinvestment Act of 2009.

RXNT is an American privately held healthcare software technology company. The company provides ambulatory practices, hospitals, medical billers, and other healthcare professionals with digital health tools. The company was created in 1999, as a standalone e-prescribing system.

References

  1. ↑ "What physicians need to know about patient portals". American Medical Association. 7 July 2015.
  2. ↑ Terry, Ken (June 27, 2010). "Patient Portals: Beyond Meaningful Use". Physicians Practice. UBM Medica, LLC. Archived from the original on August 6, 2012. Retrieved February 6, 2012.
  3. ↑ Otte-Trojel, Terese; de Bont, Antoinette; Aspria, Marcello; Adams, Samantha; Rundall, Thomas G.; van de Klundert, Joris; de Mul, Marleen (October 2015). "Developing patient portals in a fragmented healthcare system". International Journal of Medical Informatics. 84 (10): 835–846. doi:10.1016/j.ijmedinf.2015.07.001 . Retrieved 31 January 2025. under such a fragmented setup, in order to see all of his or her information and interact with all of his or her providers, the patient must access multiple portals, each with a distinct interface, password, and username
  4. ↑ "AuntMinnie.com Practice Portals". Archived from the original on July 15, 2009.
  5. ↑ Litton, J. Scott Jr. (February 3, 2012). "Encouraging Patients to Use Online Communication". Physicians Practice. UBM Medica, LLC. Archived from the original on February 12, 2012. Retrieved February 6, 2012.
  6. ↑ "HIPAA PHI: Definition of PHI and List of 18 Identifiers". UC Berkeley Human Research Protection Program. Retrieved 31 January 2025. List of 18 Identifiers 1. Names
  7. ↑ "Provider HIPAA Checklist: Moving Toward Compliance" (PDF). Centers for Medicare & Medicaid Services. U.S. Department of Health and Human Services. March 2003. Archived from the original (PDF) on September 12, 2014. Retrieved April 16, 2012.
  8. ↑ "Stage 2". Centers for Medicare & Medicaid. U.S. Department of Health and Human Services. May 12, 2014. Archived from the original on May 25, 2014. Retrieved 25 May 2014.
  9. ↑ Tavares, Jorge; Oliveira, Tiago (2016-03-02). "Electronic Health Record Patient Portal Adoption by Health Care Consumers: An Acceptance Model and Survey". Journal of Medical Internet Research. 18 (3): e49. doi: 10.2196/jmir.5069 . ISSN   1439-4456. PMC   4795321 . PMID   26935646.
  10. ↑ Chang, JI E.; Lai, Alden Yuanhong; Gupta, Avni; Nguyen, Ann M.; Berry, Carolyn A.; Shelley, Donna R. (June 2021). "Rapid Transition to Telehealth and the Digital Divide: Implications for Primary Care Access and Equity in a Post-COVID Era". The Milbank Quarterly. 99 (2): 340–368. doi:10.1111/1468-0009.12509. ISSN   0887-378X. PMC   8209855 . PMID   34075622.
  11. ↑ PatientEngagementHIT (2019-01-31). "Epic MyChart Patient Portal Snags Best in KLAS 2019 Ranking". PatientEngagementHIT. Retrieved 2021-01-26.
  12. ↑ Neuner, Joan; Fedders, Megan; Caravella, Mary; Bradford, Lisa; Schapira, Marilyn (2015). "Meaningful Use and the Patient Portal: Patient Enrollment, Use, and Satisfaction With Patient Portals at a Later-Adopting Center". American Journal of Medical Quality. 30 (2): 105–113. doi:10.1177/1062860614523488. ISSN   1062-8606. PMC   4141030 . PMID   24563085.
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