Julia Zakhaleva, MD1, Andrea Ferrara, MD2, Joseph Gallagher, MD2, Paul Williamson, MD2, Samuel DeJesus, MD2, Renee Mueller, MD2, Mark Soliman, MD2, Reid Vegeler, MD2, Allen Ghlandian, MD2. 1Orlando Regional Medical Center, 2Colon & Rectal Clinic of Orlando
Patient portals have the potential to improve both quality and access to health care by enabling patients to communicate with their provider, access their medical records, schedule appointments, refill prescriptions, and pay bills. They can increase care efficiency by actively engaging patients and their families. Moreover, the adaption of patient portals fits a number of the meaningful use criteria for Stage 1 established by the Centers for Medicare and Medicaid Services. The goal of this study was to examine the implementation and promotion of a health portal in the multi-partner surgical subspecialty practice.
METHODS AND PROCEDURES
A retrospective review of electronic health records (EHR) was conducted. The patient portal came online in August 2013. Patients were notified about its existence by a sign in the waiting area and a mailed letter until March 2013. From March 2013 to August 2014 patients were also reminded about the portal by the office staff with a written notice at each office visit. Patients created their account from a link on the practice website. An additional verification code needed to be obtained through EHR for the portal to become active. The chi square test, t-test, and Fisher’s exact test were used for statistical analysis.
The total number of patients seen was 4041. The number of patients notified by a sign and a letter was 2067 (51.15%). Only 104 patients (5.03%) used the portal initially, while 223 patients (11.3%) used the portal after a personalized reminder, resulting in a statistically significant difference (p < 0.01). There was equal gender distribution in both groups, with 54.28% women before March 2013 and 53.35% women afterwards. A statistically significant difference in age distribution between female and male patients was identified (p < 0.01). When analyzed in the subgroups divided by gender and age (younger than 21, from 22 to 40, from 41 to 64, older than 65), there was no significant difference between women and men of different age groups in the portal utilization (p = 0.07). Overall, patients averaged 2 visits, while patients with portals averaged 2.8 visits (p = 0.437). There was a statistically significant difference in the diagnoses distribution between all patients and patients with portals (p < 0.01), with limited number of patients with benign anorectal condition (8.0% vs. 20.3%) accessing the portal.
Personalized reminders about the health portal increased the number of patients who started using this resource. Their distribution was equal between the genders and age groups. However, the overall number of patients of utilizing the portal was only 11.3%. Perhaps, a surgical subspecialty practice attracts a relatively low volume of chronic patients who would benefit the most from the portal. Nonetheless, there is a need for more education and recruitment of patients into health portals.