Slow but steady progress in uptake of patient portals

Over 180 general practices are now offering patient portals in what has been slow but steady growth in the uptake of the technology.

The National Health IT Board had hoped that all New Zealanders would have access to a patient portal by the end of last year, but as of this month, 181 practices are now offering a portal, up from 132 in April.

Health Minister Jonathan Coleman said 75,000 patients are now using a portal, up from 40,000 in April, with the number expected to exceed 100,000 by the end of the year.

Last month, not-for-profit health IT organisation Patients First released financial modelling it commissioned from consulting firm Sapere Research Group on behalf of the National Health IT Board looking at how the introduction of patient portals would affect general practice costs and revenues.

Patients First and Sapere have also developed an interactive tool that allows practices to add their patient population data to help model what effect a portal would have on their particular practice.

Patients First CEO Jayden MacRae said the modelling and the tool were part of a package of resources developed to help overcome practices' uncertainty about patient portals.

“Like any initiative, it can take a while to permeate but I think it's building up a head of steam,” Mr MacRae said. “Patient portals are quite new and there are quite a few things that are unknown about them.

”Before we embarked on [the financial modelling], we knew that clinically it was a good thing to have patient portals, [but] what we were a little bit less certain about was what impact it was going to have on general practice time and their bottom line. We had no idea of the order of magnitude about that.”

The modelling includes four different scenarios, including a baseline level, different levels of substitution in GP workload between online clinical queries and in-person consults, different volumes of online clinical queries per patient, and different cost-recovery fees charged by practices to subscribed patients.

“There's different levels of information,” Mr MacRae said. “General practice is quite diverse and everyone is at a different stage of thinking, and the interactive tool is the most detailed output of that.

“It means practices can put in their whole patient population profile and have it match their practice quite explicitly, but we also realised that that is not going to be for every practice. Some practices are not at that stage. So along with the reports that Sapere have done, they've worked with the Ministry to develop some short single-page case studies, just to get practices thinking."

The modelling includes the potential effects of introducing an annual subscription fee or a fee-per-service charged to patients. While there are no firm figures on how many practices have instituted a fee, Mr MacRae said the modelling was based on real-world experience.

Overall, the Sapere research found that patient portals have the potential to provide a net gain to general practice by releasing staff resources for more productive use.

Clinical queries resulting from a patient portal do not swamp GP time. The modelling shows that while some additional GP time may be needed to deal with clinical queries coming through a portal, the size of this is not large.

It also found that substitution of online clinical queries for some face to face consultations with co-payments can still result in a net gain in resource to a general practice.

“Copayment options for portal use, such as subscription models or fee for service payments for clinical queries, can result in significant new revenue for a practice, but have to be traded off against potential adverse effects on patient use of the portal, and consequently loss of some of the advantages of having it in the first place,” it found.

The New Zealand government has allocated $3 million to the patient portal initiative, including $500,000 for an awareness campaign with the remaining funding to be spent on tools and support for general practices signing up to use patient portals.

Posted in New Zealand eHealth

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