A Waikato practice is crediting patient portals for increased efficiencies and helping GPs deliver better care to patients. accessing these health services.
Patient portals were introduced in April 2011 by the Midlands Health Network as part of a new model of care in the three NorthCare medical centres, in preparation for a forecast increase in patients and a reduction in GPs because of retirement.
“Portal use was a key element in the change to our model of care,” says NorthCare Pukete Rd GP Dr John Morgan. “Currently we have just over 8000 adult patients in two of our practices - around 1800 per GP. We needed better ways to connect with and care for them, and portals have allowed us to do that.”
He says improvements over the last four years have made portals more user-friendly, with some offering app versions to make health care information even more portable.
Turning issues into opportunities
When NorthCare implemented its patient portal, they were aware of the perceived issues associated with opening their doors online.
Registering patients for portal use was a challenge in the early days, says John.
“We initially had to deal with the administrative burden of registering patients – it was time and resource intensive. We managed this through our medical centre assistants whose main task was to register patients and activate their accounts.”
Now, around 75 percent of adult patients are registered to use a portal with 65 percent fully activated portal users. Most new patients sign up to portals after being briefed by staff about their benefits.
The practice was initially concerned the portal might lead to an unmanageable influx of patient emails – which research has found is still a concern of some GPs yet to introduce them. But John says this hasn’t been the case.
“We had a gradual increase in portal registrations which allowed us to control the amount of work coming in. Patients are respectful of GP’s time and their emails are usually short, simple and take no time to sort out. I can answer simple patient queries wherever I am. If we do get longer emails, we just invite the patient to come in so we can discuss.”
The portal also provides a way of working in partnership with patients who are high users of practice time such as those with anxiety disorders. “We have talked with some of these patients about the best way to meet their needs. Some now send us a weekly summary email of their concerns instead of having daily contact.”
He says answering patient queries isn’t new work; it’s just coming in a different way via email which is more manageable. “GPs used to respond to patient messages and tasks on their tea breaks or at lunch time. Now, answering queries via the portal has been built into their work time as part of the new model of care.”
Opening up their clinical notes to patients from the start – an area of concern for some GPs – was also a watershed moment.
“Patients really welcome seeing their clinical notes. They feel more involved, better connected and have better access to the practice and their care. Patients have a legal right to access their notes, so we should always record these in a style that is professional and palatable to them.
“Giving full access to clinical notes didn’t create more work for us. In most cases the only queries I get from patients is to correct their notes, so we end up with a more accurate record.”
With patient portals, both patients and clinicians have readily accessible health information which ensures continuous and consistent care anytime, anywhere. “One of our patients took his INR monitoring machine with him while holidaying in the US and consulted with his GP here via email.
“We also had a patient who had an incident while on holiday and needed to see a different doctor. He showed the doctor his medical history via the portal and was given appropriate treatment.”
NorthCare’s nurses now spend far less time on phone calls for blood results, booking appointments and playing ‘phone tag’ with patients asking for their notes as these are all available through the portal.
“The portal freed up our nurses to do what they’re good at – hands-on patient care – and enabled them to work at the top of their scope,” says John.
“We get more high value work from nurses’ time, and this helps us recover costs associated with offering the portal in our practice.”
He says portals also provide speed and certainty in contacting patients.
“For example, I email a patient directly if they have an abnormal blood result. The time it takes me to email a patient about results would’ve been the same amount of time I’d take to type the same task for the nurse to contact the patient.
“Again, this frees up the nurse to spend more time with patients.”
Tips on setting up a portal
John Morgan’s practice advises GPs introducing portals to use one with an app version so they can keep up with current trends and the expectations of new generations of patients.
“We must not forget this is about choice on how people interact with their practice – and apps make us even more accessible to patients.
“Everyone in the practice needs to know the benefits of portals so they can promote them to patients. Invest some extra minutes to activate the portal account while the patient is still in the practice so they can use it from the get-go.
Once a practice offers the portal and realises the efficiencies it can deliver, John urges GPs to “be brave in opening up your clinical notes.”
“Patients nowadays should be fully informed of their treatment choices, and I personally don’t see the logic in not sharing their clinical information with them.”
The patient portal has become an indispensable part of NorthCare and the wider Midlands Health Network.
“I feel more connected with my patients and they agree the portal is fantastic. There would be an uproar if we took it away now!”