Difference between revisions of "Patient portal"

Revision as of 14:00, 22 November 2010

Patient Portals: Pros and Cons

Patient Portals are a becoming a more common component or add-on to clinical information systems. The ability for a patient to view and potentially affect the input of information into their electronic medical record may enhance the accuracy of the record itself and potentially improve the quality of care for that patient. In a study by Hassol et, al.(1),the majority of patients were satisfied with the accuracy and completeness of their records as well as the ease of use and ability to communicate with their clinician. Similar results were found in a study by Ralston et, al. (2), Patients were most satisfied with their ability to request medication refills, communicate electronically with their provider and view test results.

Another study by Schnipper et, al.(3), showed that the accuracy of medication lists was improved by use of a patient portal. However in a similar study by Staroselsky and colleagues(4), there was no improvement in accuracy of medication lists between patients using a portal vs. those who did not. Both of these studies relied on the clinicians to accept the information provided by the patient and update the medication lists.

This brings us to the cons of patient portals. Although they seem to be good for the patient, most clinicians feel they would increase their workload significantly(5). In the study by Staroselsky, the patient’s emailed information about medication discrepancies to the clinicians but the majority of clinicians did not act upon them.

There was also patient dissatisfaction with the ability to view their lab results. In the studies by Hassol and Ralston, there was less satisfaction with lab review than other components of the portal. Many patients were concerned about what they perceived as abnormal results that were not adequately explained by their clinician.

There were also some concerns expressed by patients about privacy and security of information.

In summary, patient portals appear to be embraced and accepted by patients, but clinicians view portals less favorably due to the perception that their workload will be increased. There are also issues with the viewing of medical information by persons with no medical training and a limited ability to interpret that information.

References:

1) Hassol A, Walker JM, Patient Experiences and Attitudes about Access to a Patient Electronic Health Record and Linked Web Messaging J Am Med Inform Assoc, 2004 Nov-Dec; 11(6):505-13

2) Ralston JD, Carrell D, Patient Web Services Integrated with a Shared Medical Record: patient use and satisfaction J Am Med Inform Assoc. 2008 Mar-Apr; 15(2): 265

3) Schnipper JL, Gandhi TK, Design and Implementation of a Web-based Patient Portal Linked to an Electronic Health Record Designed to Improve Medication Safety: the Patient Gateway Medications Module Inform Prim Care.2008; 16(2);147-55

4) Staroselsky M, Volk LA, An Effort to Improve Electronic Health Record Medication List Accuracy Between Visits: patients’ and physicians’ responses Int J Med Inform.2008 Mar;77(3):153-60

5) Siteman E, Businger A, Clinicians Recognize Value of Patient Review of Their Electronic Health Data AMIA Annu Symp. Proc. 2006; 2006: 1101

Submitted by Melody Schniepp M.D.