Making Sense of the Maze of Online Patient Portals
These days, with the widespread use of electronic medical records, nurses are accustomed to Epic, Cerner, and other major EMR/EHR players. For a patient, the portals to access one’s medical records make up a bewildering maze.
Since nurses are natural patient advocates, they may find their friends, families, and patients complaining about these new ways to access care and communicate with providers. Since nurses are often patients, understanding the maze of online patient portals is as important as using an EMR at work.
Where Did These Portals Come From?
You’ve probably noticed that almost every provider now has an online portal where patients access medical records, communicate with their providers, and perform other tasks relevant to their care. These portals didn’t spring up out of nowhere, and understanding how to use them is a significant aspect of being a patient.
Jean Ross, MHA, BSN, RN, is the founder and CEO of Primary Record, an app that patients and their families can use to organize and share health information from the multiple patient portals they must use to maximize their care.
According to Ross, the 21st Century Cures Act, enacted by Congress in 2016, impacts many aspects of American healthcare, including mandating that patients access electronic health information (EHI). Non-compliance results in hefty fines of up to $1 million per violation, as enforced by the Office of the Inspector General (OIG) (Centers for Medicare & Medicaid Services). Consequently, we’ve seen widespread adoption of these patient portals that most of us now regularly use.
Ross states, “The HITECH Act of 2009 encouraged the adoption of EHRs through financial incentives and regulatory frameworks, ultimately improving healthcare quality, safety, and efficiency. These laws empower consumers by ensuring they can access and control their health data, facilitating better-informed decisions and coordinated care.”
“In 2022, about three in five individuals reported being offered and accessing their online medical records, a 50% increase from 2020,” Ross adds. “The frequency of access has increased consistently, with more people using these apps. This has enhanced patient involvement and control over their healthcare decisions, promoting greater transparency and engagement.”
Navigating the Maze
Mandating that patients have access to their health records has many consequences, and nurses are in a strong position to advise patients, not to mention their own loved ones and friends. But how can we most help ourselves and the people we care about?
Ms. Ross shares, “Consumers face significant challenges due to the lack of interoperability among different patient portals. They often struggle to consolidate their health information, leading to fragmented care, potential medical errors, and increased administrative burden.”
“This fragmentation can hinder the timely sharing of critical health information among providers, negatively impacting patient outcomes,” Ross adds. “Families today are overwhelmed by the complexity of managing health information, particularly medication management and the sheer volume of data.”
She continues, “With multiple family members — including pets — seeing various providers who use different platforms, keeping track of medications, health histories, and care plans is a monumental task. Every time a family engages a new provider, they face the stress of accurately filling out forms and recalling detailed care plans from other providers. This burden is exacerbated by the need to communicate these details accurately during often brief interactions with healthcare professionals who rely on families to relay what is being done and what has changed.”
Meanwhile, some specialist providers aren’t required to provide patient portal access, making things even more confusing.
For older adults, this can be impossible to manage. Ross states, “Older adults who are not tech-savvy or lack access to digital devices are at a significant disadvantage. They may struggle to access their EHI, coordinate care, and communicate with providers. This digital divide can lead to poorer health outcomes and increased reliance on others to manage their care, further complicating their healthcare journey.”
“By complying with the 21st Century Cures Act, healthcare providers avoid penalties and foster a more transparent and supportive environment for their patients,” Ross reflects. “This compliance enhances trust and supports better health outcomes by ensuring that critical health information is readily available.”
Obviously, patients who are tech-savvy will have an easier time with this new electronically enhanced medical world, and it’s up to us to make sure our older, disabled, and less tech-savvy patients, family members, loved ones, friends, and community members find ways to navigate the maze.
What Does the Future Hold?
As nurses, we often mediate or translate between patients, providers, and the organizations that employ us. Whether we officially serve as care coordinators or case managers, we still frequently fall into such roles based on how nurses often function in these situations as patient advocates.
Asked about her vision for the future regarding patient access and care coordination through this maze of online portals and apps, Ross shares, “My vision is a more engaged patient and family. While coordinating care in the community, I realized how hard it was to keep track of what was happening when you can’t be present at every medical appointment.”
“Additionally,” Ross continues, “With more care happening in our communities, we need to view patients and families as partners in maintaining their health records. It should not constantly fall on nurses and front office staff to keep information accurate.”
Ross advises, “By involving patients and their families more directly, we can ensure that health information is up-to-date and comprehensive, ultimately improving the quality of care and reducing the administrative burden on healthcare professionals.”
“A prepared and informed patient can better collaborate with their healthcare team, contributing to creating and maintaining their health story. My hope is that by putting essential health information in the hands of patients and families, especially in times of emergency, there is a way to access the most basic health information that could save lives. This is where apps like Primary Record come into play.”
We nurses are natural advocates who walk between the worlds of providers and patients. While we don’t have the power to change the reality that patients now have to juggle multiple patient portals and electronic access points, we can empower, educate, and inform patients about strategies for navigating them.
If we work in a community health center or clinic, we can organize classes where patients can ask questions and be walked through using these portals. We can advocate for positions to be created, such as patient liaisons, so patients have someone to turn to when they’re having trouble navigating these complex systems.
We can also advocate for special attention to be paid to elderly and disabled patients whose capacity to use these new tools is compromised. No one should be left behind, and nurses must ensure that those who fall between the cracks are identified and appropriately supported. Our goals should be improved care coordination, emergency preparedness, effective information management, and enhanced patient engagement.
Ms. Ross states, “By actively maintaining their health records, families become more engaged in their healthcare journey. This engagement fosters better communication with healthcare providers and empowers families to make informed decisions, ultimately leading to improved health outcomes.”
“We need to ensure that critical health information is readily available and actionable, ultimately improving health outcomes and reducing the stress associated with managing healthcare data, supporting a more seamless and integrated healthcare experience.”
