“I was resistant at first,” says New York neurologist Heidi Schwarz, M.D., when her clinic introduced a patient portal to the practice workflow. “I have my phone and my emails, and I didn’t want another system to have to interact with. But I have found that the patient portal is a lifeline. I can continue to build patient treatments and listen to patients between visits and my patients love it. There is great patient satisfaction and I provide better care.”
In 2010, the OpenNotes initiative began a campaign to increase patients’ access (often through patient portals) to their medical notes. The initiative’s argument, now born out by research, is that this transparency “can help you improve communication with your patients, build stronger, more trusting relationships, and enhance patient safety, without adding to your workload.”
Like many providers, neurologists have been skeptical about that last part–”without adding to your workload.” Decreased reimbursements and a growing shortage of providers have increased the daily workload of neurologists, leading to unprecedented levels of burnout. One thing that all neurologists seem to agree on, though, is that despite all these changes to their profession, patient care remains their first priority.
David Evans, MBA, the CEO of a large neurology private practice, along with Calli Leighann Cook, FNP-C, a neurology nurse practitioner, say that using patient portals is a way to improve patient care and work efficiency at the same time. In a talk they gave together at the 2018 annual meeting of the American Association of Neurology, they also spoke about ways that patient portals can actually save a practice money.
Patient portals not only give patients’ access to their electronic health records (EHR), they also allow patients to take a larger role in scheduling, confirming appointments, clarifying medical information, and requesting medication refills. This patient engagement improves patient satisfaction and takes a lot of the workload off the practice.
Evans says, “It reduces cost and labor to have patients use the portal.” His practice cut incoming and outgoing phone calls by 50% by using his portal’s messaging system. “As soon as we submit a prescription refill, it sends the patient a notice saying that we’ve refilled their prescription and to contact their pharmacy.” Cook agrees that asking about prescriptions is one of the main reasons patients call the office. Through the patient portal they get their answer faster and that increases patient satisfaction.
Most patient portals also support the use of pre-visit questionnaires. This saves time in the office and gives the provider the patient’s information well in advance. Also, “Patients are more likely to provide complete information if they provide the info at home,” says Evans.
Of course, just as many neurologists have been reluctant to adopt patient portals, so have their patients. Cook and Evans say that it is key to get patients into the portal early–before their very first visit, if possible. A link to access the portal can be easily sent in an email or via text.
“In neurology, people say many patients, like those who have dementia, can’t do it,” says Evans. “At our practice we use a proxy. Identify a proxy right away; someone in the family who can help the patient get online. Just make sure you are following proxy laws in your state.”
Many patient portal systems are compatible with easy-to-use patient kiosks. This is software installed on a secure iPad in your waiting room that patients can use to check in. It can take photos, scan cards, and employ questionnaires. “We allow patients to use our kiosks only if they are on our portal system,” says Evans. “That is a motivator.” Evans says he was able to significantly cut down on front desk staff because of the kiosk.
Digital tools like this are increasingly used in medical offices around the country and patients are savvier than ever. They are also more informed and used to getting what they want when they want it. Since you probably can’t spread yourself any thinner, patient portals offer a solution well worth exploring. They might even add to the enjoyment of practice.
“I am very passionate about the value of a patient portal,” says Cook. “It greatly improves patient-centered care because it really allows the patient to have a big share of that care. They are able to see their notes and interact with their healthcare team. All of those factors are so valuable to the patient and really motivate them to get on board with their plan of care. I think they’re excellent.”