By guest author and 1M/1M member Luis Montes
There has been much promise and hype by home health (HH) EMR companies around the use of physician portals. In fact, almost all existing EMR systems offer some sort of physician portal application. Physician Portals have been deemed to be the future of inter-provider communication and patient health information (PHI) exchange. Portals are supposed to offer substantial improvements over conventional methods of PHI exchange currently used today among health care providers: fax, snail-mail, personal delivery, etc.
Our team at PatientDox has been studying the use of physician portals for almost two years. Our research has led us to a dirty little secret: Physicians don’t like to use portals. In fact, of the 238 home health agencies we interviewed, less than 2% of them reported that their physician referral sources actually had joined and used their portal.
Despite the technological advancement, why is it that the primary mode of communication and PHI exchange in the industry continues to be fax? Why is it that so many agencies still hand- deliver patient documents to physicians who tend to be late with reviewing and signing time-sensitive documents? Our research indicates three main fundamental flaws associated with physician portals that explain the poor utilization of this technologically capable but ineffective application:
There are well over 20 major EMR offerings for HH in the market and pretty much every one of them has a physician portal component. This creates an over abundance of physician portals and a major headache for physicians trying to review and sign documents through them.
For a second, just put yourself in one of your referring physician’s shoes. You work closely with well over 8 home health agencies in the area. Some of these agencies use different EMR software systems and they all have invited you to join their own physician portal. To make matters worse, you may also have received invitations to join portals from the DME providers, hospice agencies, and out-patient rehab centers you also work with. After all is said and done, you may have signed up for well over 10 different portals.
If you did decide to join each one of these portal systems, chances are that you now have to remember quite a few log in and passwords.This is a major inconvenience for a busy physician.
Moreover, not all software is created equal and it is a fact that every EMR physician portal out there will look and feel differently. Physicians simply just don’t have the time (or interest for that matter) to learn how to effectively use and navigate through various different portal systems in order to review and sign your much-needed documents.
Status Quo Dilemma
Physicians are busy treating patients and meeting productivity requirements. Unfortunately, reviewing and signing documents for home health agencies (or other sub-acute care providers) is not at the top of their list. So whatever system they may have in place now for reviewing and signing documents for agencies (albeit inefficient) might just be ‘good enough’.
Our research indicates that before any home health agency paperwork makes it to the physician’s desk, it has already been vetted out and reviewed by an allied health professional (nurse practitioner, physician assistant, clinical nurse specialist, etc.) or in some cases even a member of the administrative team. The role of the physician in this process therefore is to simply sign documents. Any red flag or issues are brought to the physicians’ attention prior to him signing any documents by his / her professional or administrative team.
Most physicians are used to the status quo and don’t’ embrace change well. Signing documents at the end of the day might be a lesser burden when compared to joining and learning different portal systems. And since for the most part, a member of his or her team is actually reviewing these documents, physicians don’t really care how these documents are being delivered (portal, fax, snail-mail or as in lots of cases hand delivery).
WIFM Factor (What’s in it for me)
Most portals have been designed with one customer in mind – the home health agency (or other sub-acute care provider) with the goal of getting documents reviewed and signed by physicians as fast as possible.
The problem with this approach is that current portals don’t offer much value to physicians. Our research on the process of how physicians sign and review documents for home health agencies indicate that physicians care about two things when dealing with this process: 1) decreasing the overall time spent reviewing and signing documents; and 2) getting paid for their time and work. For the most part, current physicians portals are not addressing these two value propositions effectively for physicians.
We are confident that technology can vastly improve the communications and efficiency of PHI exchange among healthcare providers. However, unless portals don’t address the three main critical areas addressed in this article, an innovation patented by Xerox corporation in 1964– The Fax Machine – will continue to remain King in the healthcare communication and PHI exchange.
PatientDox was founded to streamline the communication and document exchange between physicians and sub-acute care providers such as home health agencies. PatientDox is very different from a physician portal. The software addresses the three main areas of concern described in this article. Our vision is to reduce the ‘communication friction’ between physicians and providers and bridge the gap so that in the end, providers can offer better patient care.
This article was first published at GetPatientDox blog.