Improve patient portals--but watch for the blame game

I read with interest the recent blog post written by José Pagán, director of the Center for Health Innovation at the New York Academy of Medicine, extolling the virtues of the online medical portal he uses for his pets.

His veterinarian's portal has large readable fonts, is easy to navigate, includes a dashboard, allows him to upload photos, provides for online interaction with the veterinary practice and includes a list of suggested questions for the next visit.

In contrast, the Web portal he uses with his physician is somewhat useful, but also outdated and cluttered. Key definitions are missing, and for some reason he receives reminders for screening tests not needed for years. It also provides nice but somewhat basic information, such as "keep a positive mental outlook" and "floss."

I agree that all online medical portals for people should be well designed, otherwise clinicians and consumers won't reap the most benefits from them. It's ridiculous for pet portals to be better than human portals.

However, Pagán leaves some questions unanswered, creates unnecessary confusion, and perhaps misplaces the blame for the design discrepancy.

For instance, he puts blame on "providers" who aren't pressing enough for improvements because "the likelihood that patients will take their money elsewhere is relatively low." He also says there's too much focus on "technological solutions" for patient portals rather than on what consumers want.

However, Pagán doesn't explain why pet portals are designed better and are more user-friendly. Do the same developers design both kinds of portals, and are veterinarians more vocal about what they want in a portal? Is he insinuating that physicians are accepting inferior ones because they're using them only to meet the Meaningful Use requirements, compared to veterinarians, who are adopting portals to keep and retain business? Do pet owners care more about portals than patients do?

And are all pet portals superior, or just the one his veterinarian uses?

The blog post is also a bit confusing. For instance, it's pretty clear that the term "providers" used above is referring to clinicians, since he also refers to their patients.

But when Pagán says "providers facing little competition will not see the need to improve unless information about the usefulness and quality of web portals is available to potential users" and "some providers have still managed to design useful web portal and features," I can't tell if "provider" means clinician or portal developer.

If he means that clinicians are at fault for poor patient portal design, that seems a bit harsh. They've hardly been invited to the design table, much to their frustration.

But if he means patient portal designers, and that they are more concerned with meeting Meaningful Use requirements the usability, he may be on to something. And that plays right into what a number of people have been saying, that the Meaningful Use program, by requiring certain "certified" technology and measurements, has stifled technological innovation.

While I like the concept of online portals--and use them, where offered by my physicians--I would not join or leave a physician practice solely on the basis of the usability of his or her portal. I'm more concerned about the medical care being provided. A portal, even the best one, only goes so far.  

But it makes sense to make them as good as they can be. The bottom line is not who to blame for inadequate human medical portals, but to improve them. And if pet portals offer the inspiration, let's start there. - Marla (@MarlaHirsch and @FierceHealthIT)

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