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Patient Portals Do They Help or Just Amuse?

Started By: carypresant, MD, Oncology, Hematology/Oncology, 12:24AM May 28, 2014

Electronic patient portals have been promoted by CMS in implementing the Healthcare Reform Act.  Additional physician payments can be received if they are compliant under stage 1 and stage 2 meaningful use criteria.  Stage 2 criteria include enabling patients to view online, download and transmit information about hospital admissions as well as other healthcare interventions. 

However, do they help?  C. Goldzweig and co-authors (Annals Internal Medicine 2013; 159:677) reviewed 14 randomized controlled trials in medicine (not specifically oncology) and looked at improvement in outcomes of common diseases.  In looking at diabetes, use of patient portals showed no improvement in hemoglobin A1c levels, blood pressure or low-density lipoprotein cholesterol levels compared to patients who did not use portals.  Only when use of patient portals was combined with intensive case management were outcomes improved for hemoglobin A1c levels and for low-density lipoprotein cholesterol levels.  These beneficial effects appeared to be transitory for hemoglobin A1c. 

In looking at patients with congestive heart failure, the use of patient portals was found to be ineffective in reducing hypertension.  Only when use of the patient portal was combined with access to pharmacist initiated case management were blood pressures favorably impacted. 

In examining access to preventive services, use of a patient portal was found to be helpful.  Use of prevention recommendations, important in oncology, was increased by 3.8% in patients using a patient portal with individualized prevention advice compared to control patients who showed only a 1.5% increased use.  Although these were statistically significant, the absolute improvement was not very high. 

In my practice, our patients enthusiastically use our patient portal. But I now can tell them that if they have not been using the patient portal, they shouldn’t worry about adverse health effects.  Use of the patient portals gives them increased access to information that otherwise requires more time consuming and less efficient methods to obtain.  Nonetheless, trying to comply with recommendations for patient portal use is an important quality measure when we are being evaluated by hospitals, HMOs and ACOs. Even without good evidence for most patient benefits, documentation of compliance with patient portal guidelines is still important to us in our practices. 




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