Patient Portal Disadvantages

Included in this paper will be my attempt to discuss the advantages and disadvantages with patients and providers communicating via patient portals. First, What is a Patient Portal? 
Patient Portals are healthcare related online applications that allow patients to interact and communicate with healthcare providers, such as physicians and hospitals. (Wilkipedia) The portal allows you to see, recent doctors visit, discharge summaries, Medications, Immunizations, allergies, and Lab results. Through a patient portal, 
Providers can also send patients post visit instructions, post clinical summaries and lab results via an attachment. This works well if you only go to one set of physicians in a group, such as a hospital portal. Many of us have probably

had some chance to 
benefit from a Patient Portal. (Terry, 2011)
The advantages of patients and providers communication through patient portals are as follows. As a provider, patients will send questions or request through email for which the provider needs to respond. The provider can then respond to these emails in between taking care of others patients. The results allow the physician to be more efficient and also please the patient because the physician was able to respond in a timely manner. As mentioned earlier workflow increase is a great advantage received as a provider. “The cost of running a practice can be reduced by using a portal," says Rosemarie Nelson, an MGMA consultant based in Syracuse, N.Y. "If we get patients off the phone, we get staff off the phone. If staff isn’t on the phone, they're doing something else or we need less staff”. (Terry, 2011; Wilkipedia)
Communicating through portals can even save nurses and receptionists time, too, since the messages pop up real time on their computer screens. The patient to doctor direct communication also cuts out other staff members’ interpretation of medical issues and patient needs that can occur with phone calls, Legan adds. (Crane, 2014)
Many portals allow you to see recent doctors visits, and discharge summary. (Health IT government) Just as workflow is a benefit for the provider, it is also a benefit for the patient. Before, as a patient you would call your doctors office and have to wait to hear from a doctor because at the time you called the physician was with a patient. It could become frustrating as a patient feeling as if you are playing phone tag with your Doctor. Well now that you can email your physician you can be confident that he has received your email and will respond within 24 hours. This is one of the many benefits that get quicker responses from the physicians. The next benefit for patients is that the patient portals allow patients to schedule appointments and also request prescription refills. These are again many of the duties that staff member had to perform on a continuous and daily routine. Now that the patient can schedule their own appointment it frees up a staff member to perform other needed duties. The benefit for the provider, the patient portal allows the physicians to send patients summaries of their recent visits by way of electronic mail such as an attachment. Several offices have felt that using the portal can reduce the cost of running a practice. (Terry, 2011) Rosemarie Nelson of MGM consultants based in Syracuse New York “if we get patients off the phone if staff aren't on the phone they are doing something else or we need less staff ". James Legan a family practice physician noted in an article from healthcare health news says communication through portals can save nurses and receptions time since the messages pop up real time. (Crane, 2014) Meeting the meaningful use objective that is required by government is another benefit for Providers. Meaningful use is using certified electronic health record (EHR) technology to: Improve quality, safety, efficiency, and reduce health disparities; Engage patients and family; Improve care coordination, and population and public health and maintain privacy and security of patient health information. (Meaniful Use Case studies, 2011)

The Disadvantages are as follows.

Most patient portals are linked to one physician’s office, which means that most patients will have to log on to numerous medical providers portals. Lets take a family of three in consideration. They would have to log on the Pediatrician, the Gynecologist and the Family doctor patient portals to obtain their medical information. 
Although one of the benefits of Patient Portal is that patients can send questions by way of email. It may become a challenge deciphering what a patient is asking. There is also the risk of giving incorrect information in response to a patient’s question. Systems have to be set up using a delivery system that guarantees emails have been received, viewed and responded to. Another set of challenges is related to clinicians and staff who have concerns about managing online communication. Providers are concerned that e-mail and web would add to their workload rather than substitute for other tasks, and that many messages might not be clinically relevant. (Slabodkin, 2015) In addition, there is currently little consensus about the rules of patient-provider online interactions and the important role that can be played by staff in responding to certain types of messages. In general, patients are unaccustomed to online communication in clinic settings. Another important challenge is the growing digital gap in the community. Not everyone has a computer or even access to a computer. It’s hard to believe, but there is a

large amount of lower income individuals, lower educated and even older patients that don’t have the knowledge or access to take advantage of the patient portals. Thus, the most vulnerable patient populations may have the least experience with these new tools. 

Nonetheless, according to the results of the study, African-Americans, older patients, those with lower neighborhood median household incomes, and patients with Medicare/Medicaid were all less likely to use the patient portal. (Slabodkin, 2015)
Early on in the development of patient portals the assumption was that information would misguide patients and cause them to rely less on the provider.

Many providers now agree that the use of the Internet such as patient portals results in a more inquisitive and informed patient. (Gwen Van Servellen)One disadvantage as mentioned by Yonette Leacock, an employee of a local hospital, when patients received results prior to speaking to their physicians, patients would read the results and call the radiology department to ask for certain things meant. “One patient actually called and argued with the radiologist about why he describe her as obese in his report”. But as a patient, Yonette agrees that she receives her results in a timely manner and is able to conduct business in efficient manner, instead of calling in and being on hold at her doctors office. Portals are usually linked to a single hospital or office therefore if you had several physicians you frequented you needed to log on to each but an advantage would be if all your physicians belong to one physician group. This would allow for all your doctors to see what each has prescribed or made not of in your charts. Keeping everyone the same page when it comes to your healthcare. One other disadvantage as noted in health news is that small clinics small usually have to absorb all of the start up and training cost involved in using a portal plus the annual usage fee. Smaller clinics couldn’t handle the influx of messages

from patients, which means possibly having to add another staff person to handle them. (Crane, 2014) Security could definitely be a disadvantage of the Patient Portal. Because patients information is now easily available to any hackers who choose to access this system. But most Portals are on secure connections. Most information systems have an audit trail to make sure or catch information going to undesirables. But at the end of day patients must keep their personal information such as passwords secure. Therefore making easy access to medical information a disadvantage of the patient portal.

In summary patient portals empower patients and helps physicians meet Meaningful use requirements. Along with allowing physicians to become more efficient and creating quality relationships with patients. As described and detailed, the advantages outweigh the disadvantages as shown in this paper. In the begging the assumption was that information from the Internet would misguide patients and cause them to rely less on the provider. (Gwen Van Servellen) But now, many providers agree that the use of the Internet results in a more inquisitive and informed partner in managing care. (Gwen Van Servellen)The fact that the information is saved and available electronically allows both patients and their doctors to review old information that could be clinically relevant.