Mosaic Life Care CTO, CMIO Dr. Joe Boyce: Make patient portals 'Facebook simple'

Joe BoycePatient portals are often referenced as an essential link between patients and healthcare providers, but a number of barriers stand between these platforms and their true potential. Joe Boyce, MD, CTO and CMIO of Mosaic Life Care, based in St. Joseph, Mo., shares insight into how patient portals operate today and how they need to evolve to remain relevant.  

Please note responses have been lightly edited for clarity and concision.

Question: How can healthcare leaders maximize engagement with patient portals on both the clinician and patient side?
Dr. Joe Boyce: At the very core, leaders must focus on both sides of the user interface and create a mutually pleasing experience that generates value for the clinician, as well as the patient.

Our early and intense investment into our EMR technology years ago allowed the organization to provide the necessary education and support for clinicians to adopt and grow with the technology early on. Just as patient care at Mosaic Life Care is team-based, we incorporated the same philosophy into the development and expansion of the EMR. If a current product didn't answer a need, leadership, clinicians and technology services worked together to build it ourselves. It wasn't an easy task, but one that is certainly paying off for us now within our ACO space, as well as providing the base to where we wanted to begin with portal development.

On the patient side, it is all about convenience, access and value. We (leadership) knew we had to provide more than just an online appointment scheduling feature to really do what we wanted to do for patients initially. We knew we had to make it easy, we knew we had to make it mobile-friendly and we knew we had to supply what consumers wanted even though, in many respects, they did not know what exactly that was just yet.

So, quite simply, we asked, "If you could have anything you wanted regarding your healthcare all in one online spot, what would that look like?"

We learned patients wanted to ask their provider questions on their time and not be limited by office hours. They wanted to be able to send an email to their provider, know it was secure and answered in a personal way. They did not want to pick up a phone, wait on hold to leave a message with a promise of a return call later. They knew that process was broken for them.

We also discovered patients were dissatisfied with clinicians behind laptops during office visits typing things about them that seemed "secret." If you think about it, it is a bit on the rude side! Consumers indicated they would often forget a concern, question or be too afraid to describe exactly what their symptoms were during face-to-face appointments. They were frustrated in seeking healthcare information through Internet searches only to be met with conflicting, hard to understand and terribly confusing lists of symptoms, which many times looked the same between minor and extremely terrible diseases.

At the end of the day, it is a challenge to engage clinicians and encourage them out of their ruts. Patients are ahead of us and expect everything to be Facebook simple.

Q: What do you think a patient portal needs to be considered robust?

JB: Beyond what I described above, portals must offer transparency with access to their personal health information, as well as transparency of the clinical service they are receiving from their provider. Transparency builds trust, and that builds patient engagement. Continuing the personal relationship between provider and patient and extending it to include the digital space actually improves outcomes.

Q: Do you think patient portals are being used to their full potential in healthcare today?

JB: Not even close. Portal use is just leading to the next generation of online care and eVisits/home care, and potentially "Uberized" care. We have to make sure we don't lose what is best about traditional medicine when you are talking to a caring provider that knows you well. But at the same time, we need to change. The biggest hang-up, as always, is the way we get paid. After that, it is cultural change that can be major, but the market will sort that out. Patients will go to providers that give them what they want, especially when they have huge deductibles and cost considerations.

Q: How can clinicians use patient portals to make communication with patients more transparent?

JB: Patients want to read their own notes. It has made a big difference in identifying errors and correcting misinterpretations, along with helping with overdone cut and paste [techniques] used by clinicians within the EMR. Patients also want to contribute to their own notes, in their own words. However, this level of transparency does require compromises from both sides.

Clinicians' concerns about patients finding out a diagnosis via the portal (a cancer diagnosis, for example) before their provider can reach out to them resulted in a 48-hour portal view delay on [our]  pathology and radiology notes. Some providers think this delay is too short while almost all patients believe it is far too long.  

Q: How do you think patient portals and the role they play in patient-provider communication will change over the next few years?

JB: I've made the remark many times before that over the course of my 25-plus years of being in healthcare, there has been more change over the last five than all of the previous 20. I think at least over the next decade that level of change will exponentially accelerate. Patient portals will have to keep up. To do that, continued investment into the technology necessary to collect and interpret the big data, and then pinpointing that back down to patients in an individual and personal way, will be key.

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