Patient Engagement Goes Online

You've launched your patient portal. Now what?patient engagement goes online

In June, the Bulletin interviewed radiologists about their experiences implementing online patient portals. (Read about it at But to satisfy meaningful use (MU) requirements, radiologists must do more than just launch a patient portal.

For stage 2 of MU, patients must also use that portal to engage with their electronic health records (EHRs). The ACR summary of the guidelines states that in order for an eligible professional (EP) to achieve this objective, "more than 5 percent of all unique patients seen by the EP during the EHR reporting period (or their authorized representatives) [must] view, download, or transmit to a third party their health information."

While many practices already have a patient portal, Mike Peters, ACR director of regulatory and legislative affairs, notes, "The challenge is not so much implementing the patient portal itself, but getting enough patients to utilize its functionality to meet the associated meaningful use measures." As stage 2 MU nears for those who began participating in 2011 or 2012, radiologists are taking a closer look at their portals and implementing strategies to increase patient engagement.

Alberto Goldszal, PhD, MBA, CIO at University Radiology in New Jersey, is overseeing his practice's engagement efforts and encouraging patients to take advantage of the portal. The practice attested successfully for year 1 and 2 of MU stage 1. Like in many practices, large and small, University Radiology physicians have not yet attained usage levels high enough to meet the stage 2 requirements. Curtis P. Langlotz, MD, PhD, vice chair for informatics in the Department of Radiology at Penn Radiology, a part of the University of Pennsylvania Health System in Philadelphia, works on his institution's system-wide patient portal, which includes radiology reports. While University of Pennsylvania Health System physicians successfully attested to stage 1 MU, many are now assessing their eligibility for stage 2. Both Goldszal and Langlotz point to a variety of challenges for radiologists hoping to meet the requirements.

One problem Goldszal sees is portal fatigue. As providers across the spectrum of care work to come on board with MU, patients are given access to portals for a variety of providers. And, says Goldszal, if the system works as intended, the radiology report could show up in both the radiology portal and the referring physician's portal, removing the need for patients to access the radiology portal. While more portals lead to patient familiarity, this also means more passwords, more URLs, and more records for patients to keep track of. And that's assuming all patients have the experience and online access necessary to tap into the portals in the first place. "In our area, there is wide variation in the degree of internet connectivity, smart phone usage, and technological savvy," says Langlotz.

But for Langlotz, the main obstacle is patients' standards when it comes to what they expect to be able to do online. "We need to provide more features that patients really want," he says. "It's nice to view your test results and request prescription refills online. But I think what we really need is scheduling. If you can purchase a plane ticket and select a seat online (saving both the customer and the airline lots of time on the phone), why can't you schedule your medical appointments the same way?"

Another, perhaps more fundamental, challenge is the fact that physicians cannot, and indeed should not, force patients to use a portal, no matter how many benefits it may provide. "All we can do is build the portal, train patients on how to use it, show the portal's value to patients, and be open for business," says Goldszal. "At the end of the day, it's going to depend on the patient."

By Lyndsee Cordes

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