Of all the medical specialties, neurologists see some of the most complex patients. This idea bears out anecdotally among the neurologists we have interviewed here at Neurology Insights but also statistically. In this 2018 study published in JAMA, neurologists were ranked #3 among physician types for patient complexity as well as for their number of comorbidities (Nephrologists were ranked #1, if you must know). Not surprisingly, among the comorbidities they listed: diabetes.
In addition to the neurological sequelae associated with diabetes, this complex and chronic condition often requires well-coordinated care involving repeated testing and care by other providers. A new study published last month (June, 2019) in the journal PlosOne, shows that all this can be improved when these complex patients have access to a patient portal.
“A patient portal is a secure online website that gives patients convenient, 24-hour access to personal health information from anywhere with an Internet connection,” according to The Office of the National Coordinator for Health Information Technology. Patient portals also increase patient engagement, allowing them to make and reschedule appointments, ask questions, and request medication refills. All of this can improve communication between patient and provider, while decreasing practitioner workload.
The authors of the study published in PlosOne looked at nearly 170,000 patients seen in the Kaiser Permanente Northern California system, immediately following implementation of an online patient portal. The patients all had a diagnosis of diabetes, and more than 75 percent of them also had comorbidities like hypertension, CHF, and asthma. The researchers analyzed these patients’ electronic health record (EHR) data and portal use for the calendar years 2006 and 2007. EHR data included “counts of all outpatient office visits, emergency department (ED) visits, and preventable hospitalizations defined by admissions for ambulatory care sensitive conditions (ACSCs).”
Of all the patients studied, 22 percent began using the portal system during the study period. And portal use was associated with higher rates of outpatient visits, fewer emergency room visits, and fewer preventable hospital stays. The authors concluded, “Access to a patient portal can increase engagement in outpatient visits, potentially addressing unmet clinical needs, and reduce downstream health events that lead to emergency and hospital care, particularly among patients with multiple complex conditions.”
These study findings are consistent with the views of neurologists we have interviewed like Heidi Schwarz, MD, who says portals have allowed her to provide better care and have also improved patient satisfaction. David Evans, MBA, the CEO of Texas Neurology, also says that patient portals can improve office efficiency and even save your practice money. His practice has a patient portal button prominently displayed on their website. Patients can also access the portal on in-office kiosks as well as through their mobile phones.
If you are interested in setting up a patient portal for your patients, check with your EHR provider. They may already have a plug-and-play system you can tap right into.While the American Academy of Neurology does not provide product-specific recommendations, their Synapse network can be a great way to crowdsource a recommendation. We also recommend you check in with colleagues to find out what systems they are using. When in doubt, do what we do: ask a neurologist—they are a resourceful bunch.