Electronic Health Reporter

Guest post by Simon Wieczner, president and CEO, Snowbound Software.

One of the quite enlightened (though likely also overwhelming) healthcare initiatives directed at making healthcare more transparent and understandable is the Medicare and Medicaid electronic health record (EHR) incentive program. This is an act that forces all healthcare providers servicing Medicare and Medicaid patients, and by extension pretty much every patient, to use or expand their EHR systems for a large set of requirements, including making their notes, prescriptions, test results, diagnostic images and additional information all available to their patients on a web-based portal. And, unlike many other regulations that have no enforcement, this act not only requires that providers make these services available to their patients, it also measures and compensates providers on what percentage of their patients actually use said services.

As we all know, however, leading a horse to water is not enough. One of the most important and critical factors that all providers are facing is how to make their patients actually use these portals. Studies already indicate that a large percentage of the public wants more complete access to their medical records and doctor’s instructions electronically, via the web. It also makes sense that access to more complete information regarding your health status increases the odds that you’ll do what is necessary to do to get better.

The good news: We have technology to make that available. Unfortunately, it’s not working as well as it should.

Confronting the Challenges

Providers don’t deliver complete information on their patient portals for various reasons: time constraints, technological issues and even perhaps as a preventive measure against losing their patients by making records too portable. The Medicare and Medicaid EHR incentive program forces the issue by mandating that a certain percentage of patients access their records online and a certain percentage even transfer important medication information to other providers from their patient portal. If these criteria aren’t met, there is a financial cost to the provider.

Since this act is directed toward Medicare and Medicaid patients, a significant percentage of that population will be older, sicker and less able to navigate the web or software applications that allow them to access their records. Yet, providers are required to make it possible and preferable for these patients to use computer methods to view their records.

The proven way to make something like this happen is to:

• Attract and incentivize your target population  — marketing and “salesmanship”
• Make the system they use aesthetically pleasing and fun
• Make the entire process attractive and easy
• Make sure it is useful
• Make it efficient

As a result, providers are going to have to deal with marketing more, as well as making access easier for their patients. I don’t think they teach either one in medical school. Here are some obvious and not so obvious techniques that I foresee becoming common practice:

• Make patients want to use their patient portal. Put interesting medical and health information on the site and give them easy access to it. We’re already seeing more and more providers sending out newsletters that are aesthetically interesting as well as informative. Those will need to be put online.
• Utilize email or text to direct patients to the portal for appointment reminders or updating their calendars
• Send email or text reminders alerting patients that there is information about their visit or tests in the patient portal
• Provide colorful brochures on the portal for issues that are relevant to the specific patient
• Use the opportunity to promote the provider’s services and staff in order to build loyalty and referrals

 Tech Trials

While effective marketing and accessibility are key, let’s not forget the technology side of the issue. Providers can vary widely in computer literacy and in their enthusiasm to employ these modern, computerized and web-enabled operations. They also have to be incentivized, provided easy-to-use methods, educated on new processes and shown ways to become more efficient so there is quick payback for them.

Key factors are often overlooked in the development of these systems. With the presentation of so much varied information on patient portals, the challenge is to make that information easily accessible and viewable. The information variety is extensive, including letters, emails, faxes, diagnostic images, charts, photos, videos and brochures. One approach to making this varied information accessible is to find one common method of storing all documents – perhaps convert everything to PDF files so access will only require a free Adobe Acrobat account. Of course, if you’re dealing with a diverse population, many of whom are older, can you be certain that they all have up to date PDF readers that will reliably view all this information? It’s unlikely.

For this requirement, one can take a lesson from the corporate world. To address the issues of aesthetics, simplicity and ease of use while minimizing support and efficiency, many companies are moving toward using browser-based viewing technology to provide information access to their clientele. From documents and faxes to images, audio and video, browsers that are enabled with HTML5 viewers are the all-around cure-all.

Of course, they need a sophisticated back-end, server-based solution, but that requires no effort on the part of the client. The patient can simply go to their computer or tablet, and perhaps also their smartphone, open up their familiar browser and quickly, simply and effectively access the information they need from the patient portal. Pretty much any computer and browser combination will work. Like the duck that serenely glides across the pond, no one (except the computer engineers hidden away on the server side) can see the frenzied activity underneath.