Because I write about health IT all the time, I have been disappointed that my own primary care doctor has so far refused to go electronic. I think she is a great doctor in many ways. She really seems to listen and takes the time to assess what your health problem is. But going to her office does seem like a step back into my childhood of the 1960s and 1970s. Everything is on paper and involves the fax machine. She told me she doesn’t think the meaningful use incentives are worth disrupting her practice to implement. She said she would wait until the EHR and practice management software is more mature before switching. So despite the fact that I like her as a doctor, every once in a while I think about looking for a primary care practice that is more automated and that has a good patient portal.
Yet most health systems seem to be in the early stages of implementing patient portals, so finding primary care practices with experience using them is still a challenge. My first experiences with hospital and specialist patient portals have not been as satisfying as I would have hoped.
The first involved getting an x-ray at a local hospital. The health system encouraged me to create a portal account to see lab results, diagnoses, etc. I was encouraged and signed up. But what I got access to was a radiologist’s four-sentence note about what he saw in the x-ray and no other context. Meanwhile, the first appointment I could get with an orthopedic specialist in their system was six weeks out. That left me trying to interpret the radiologist’s description on my own, looking up terms in Google, which I am sure most specialists would prefer that patients not do, especially with serious diagnoses.
Then the other day I went to my dermatologist and the receptionist handed me a piece of paper about a new patient portal. But the description of the portal seemed written to dampen any enthusiasm about logging in. “Currently our clinical summaries are very basic and do not contain much information. In the future this will change and contain more information…..Please do not request laboratory or biopsy results, request appointments or send any form of urgent message through this portion of this system as it is not set up for this and messages may not be received in a timely manner.” But the description reminds me that by accessing my clinical summary online and then sending them a message that I have read it, “you are helping us achieve two of the required core measures of the federal government’s Meaningful Use program.”
Now I realize they are just getting set up online, and they have to walk before they can run, but isn’t it going at it backwards to tell patients that there is almost nothing of value available yet on the portal but that they should use it anyway because it will help the providers meet some obscure federal regulation?
How about looking at the portal as an exciting opportunity to engage patients – and not offer it up until you have a business use case that is compelling to me as a patient/consumer?
Also, with all these providers not part of an integrated system, I will end up with four or five portal accounts. I guess I will have to try to create a personal health record account of my own to aggregate that data.
Despite my early difficulties with patient portals, I am still a big fan of the concept and look forward to being an online patient for many years to come!
