In the USA, digital patient portals have been in use for many years. And numerous studies prove it: Their benefits and cost-effectiveness are great. Which findings are now important for the implementation of funding stock 2 of the KHZG – an analysis.
“Patient portals can provide benefits to patients and healthcare providers alike. Especially when interacting with an electronic health record, these technologies have the potential to improve both quality and access to care by enabling patients to communicate electronically and securely with their providers through features.”
That’s a quote from a California HealthCare Foundation study titled “Measuring the Impact of Patient Portals: What the Literature Tells Us.” Against the backdrop of the KHZG and the growing importance of digital patient portals in Germany, the quote and study sound highly topical – but they are not. In fact, the study is already ten years old. It was published in May 2010.
At the moment, this makes us aware of two things in particular. First, it underscores the fact that with many digitization topics that are “red-hot” in our country and in Europe right now, we are merely trying to catch up with leading nations that are already much further ahead in digitizing their healthcare systems. However, the lead of other nations also has an advantage, which brings me to my second point. Because we can learn a lot from this experience about the benefits and cost-effectiveness of digital patient portals. And that’s exactly what I’d like to focus on at the moment – firstly, because I’ve hardly ever missed an opportunity to emphasize how important it is that we don’t lose touch. I think this message has now been received. On the other hand, we in Europe no longer have to go through the same learning curve as the “early adopters” – and that in turn gives us an advantage.
Studies in the USA and Canada are clear
But back to the studies. Also older, published in 2014, is a meta-study by Erasmus University Rotterdam and the University of California Berkeley that examined how clinical outcomes can be achieved using a patient portal. Again, the study makers concluded that integrated solutions, in particular, can improve clinical outcomes and patient experience, thereby increasing their cooperation. Most importantly, the study makers identified four relevant mechanisms that pay into these improvements:
Insights into patients’ personal health information, harnessing that information, interpersonal continuation of care, and purposeful services. Again, the evaluation is based primarily on data from integrated, connected ghealth services in the United States.
A recent study from Canada surveyed users of a patient portal between January 2016 and July 2018 about the portal’s added value. First, 93 percent of study participants said the patient portal was easy to use. 51 percent also found that it was time-saving to book appointments via the portal. 40 percent even had to repeat themselves less frequently during their appointments. In addition, respondents perceived changes in the healthcare system that they attributed to the portal. For example, 48 percent of respondents no longer had to physically visit the clinic at all, and 2.7 percent were even able to avoid visiting the emergency room. And of the nearly 20,000 clinic visits, the rate of missed appointments was 9.5 percent without using the patient portal and only 4.5 percent with it. Or in other words, the “no-show rate” was reduced by 53 percent thanks to the patient portal.
European studies show: Education is everything
In the meantime, there are also initial studies and analyses in Europe on the use and cost-effectiveness of digital patient portals. One example is a study conducted last year by Erasmus University Rotterdam. One particularly interesting aspect of this analysis is that whenever patients or healthcare professionals make only limited use of a patient portal, the reasons are non-technical. For example, patients are concerned about the confidential handling of their data. Or they were not even aware that a digital patient portal was available. Elsewhere, they lacked digital access or believed it offered no added value – without having used it at all. Lack of knowledge or relative complexity of use were also among the barriers for patients.
Similarly, staff feared additional workload from the patient portal or were unable to interact with patients via the portal due to a lack of digital skills. Concerns about not being able to respond quickly enough also prevented staff from integrating digital solutions into everyday hospital life. Furthermore, concerns about liability risks were high.
Bottom line for future projects
In my view, the older U.S. studies in combination with the more recent European findings point primarily in one direction: digital patient portals can make a significant economic contribution in clinics and at the same time improve the quality of care for patients, IF the change process that is automatically associated with the introduction of a portal is well communicated to patients and staff.
However, it also means that the solution that is introduced must be easy and transparent to use – for patients and staff alike. For example, important functions of the hospital information system, such as the calendar stored there, must be integrated into the patient portal. When a patient books a treatment via the portal, this must be immediately visible in the HIS in real time. This is the only way to avoid additional work for the staff. The overriding keywords here are interfaces and interoperability.
Access to the portal must be barrier-free for patients. This means that, regardless of whether the services stored there are used via the patient’s own device brought to the clinic or from the hospital’s bedside terminal, usability must be high and use must be simple and straightforward, so that not only the digital natives can access the services easily We now have the opportunity, with well-designed solutions, to reduce concerns and worries among users of digital patient portals, so that we can directly tap into the added value of benefits and cost-effectiveness that is demonstrated in the U.S. studies. Technically, suitable solutions are available. And with the KHZG, the financial resources are now also available to significantly reduce the lead of other nations. So let’s get to work.