Using Patient Portals to Promote Patient Communication
In this age of growing technology patients want and have begun to expect the convenience of communicating with their providers electronically. There are several ways to communicate with patients, some safer and more secure than others. Patient portals are one of the most secure methods for communicating but should not be confused with unsecured email (see our tip Unsecured Email and Patient Communication.) Communicating with patients through a portal is more secure because users must be authenticated before they can access/use the portal. If enabled, a patient portal may give access to view or download health information, request prescription refills, schedule appointments, communicate with healthcare providers, and many other functions.
Patient-specific Considerations
- Establish a process to prepare patients for portal use that includes authentication, informed consent, and education.
- Establish clear guidelines for appropriate use such as prescription refills, non-urgent medical advice, simple lab results and appointment management, and inappropriate use such as emergencies, complicated, or sensitive questions.
- Instruct patients to specify the purpose of the request in the subject line. For example, "refill request", "reschedule appointment", "medication question".
- Provide a phone number on your website that patients can call if they need technical assistance with setting up their portal account.
- Consider providing patients with written material such as a brochure to introduce the patient portal and to provide instructions on setting up their account.
Operational Risks to Consider
Available information
What information will you make available to patients on the portal—not all information is useful, such as miscellaneous notes for internal communication; too much information may confuse patients and could reduce the effectiveness of this tool.
Sensitive information
A provider should deliver sensitive information before it is posted to the portal, for example, cancer diagnosis, HIV/AIDS information, genetic testing.
Minors
Depending on state guidelines, minors may consent to specific procedures and treatments, such as abortion, pregnancy counseling, outpatient behavioral health, or HIV testing, without the consent of a parent or guardian, and may control how information is released.
Turnaround Time
Establish expected turnaround time for responding to messages. Include responsibility for coverage when the provider is off.
Set aside specific times each day to respond to portal messages.
Responses
Develop standardized responses for situations such as requests from non-authorized patients, failure to follow system guidelines, and inappropriate use.
Ensure that your responses are professional and appropriate. Use plain language and avoid overfamiliarity.
When patients are initiating an email through the portal—ensure there is a warning “not for emergency use,” instructing them to call 911 if it is an emergency.
These guidelines are intended to reduce your risk. They do not reflect all operational considerations when implementing a patient portal.
If your organization has not implemented a patient portal, there are toolkits and resources to help you.
Resources
HealthIT.gov: Patient Engagement Playbook https://www.healthit.gov/playbook/pe/
American Health Information Management Association: Patient Portal Toolkit (membership required) https://library.ahima.org/doc?oid=301419#.Xyq7ZG5FymQ
Medical Mutual Insurance Company of Maine's "Practice Tips" are offered as reference information only and are not intended to establish practice standards or serve as legal advice. MMIC recommends you obtain a legal opinion from a qualified attorney for any specific application to your practice.