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5 Lessons from a Patient Portal Hiatus


It took a two-year, frustration-induced hiatus from pushing a portal to his patients, but this admin finally understands their use.

This article is for those who don’t “get” patient portals.  I feel you.

Coming off a two-year, frustration-induced hiatus from pushing our portal to patients, I feel enlightened.  I still dislike our portal, but at last I understand how a patient portal should fit within our practice.  It took me this long to figure it out.  It took me this long to accept patient portals aren’t going away. Here are the lessons I derived from this experience.

This is the most important lesson of all: portals aren’t for every patient.  I had to change my thinking and stop trying to sign up every patient just to meet a government mandate.  Our focus now is only on those patients who want to use the portal, and those patients tend to ask to sign up for the portal.  We don’t waste time or money trying to sign up patients who don’t want to use a portal.  And we do not make anti-portal patients use a portal; you shouldn’t either.

Just like patients, portals aren’t for every provider.  Portals are about efficient communications between patient and provider, and some providers find them a disruption to their days.  While some practices require providers to communicate via the patient portal, we do not.  Only those providers that find the portal makes them more efficient use it. Ask your peers about their portal use, and glean what you can.  You may find you’ve been working for your portal rather than the opposite.   

All portals are not created equal.  The ideal portal is one that is 1) intuitive, 2) easy for patients to use, 3) reliable, 4) interfaced seamlessly with your EHR and 5) efficient for you and your practice.  It should not add extra work or extra angst, yet ours has failed on the first three checkpoints. 

Here’s my advice.  Ask your portal patients about it.  Ask what they like and dislike, and share this information with your portal vendor -in writing - and ask for a timeline of when patient pain points will be addressed.  Offer to share your concerns on several of MGMA’s listservs (or another organization you belong to) if the vendor fails to address your concerns in a timely manner.  Also ask your portal patients if they like someone else’s portal better.  If your portal doesn’t hit the five checkpoints I shared above, consider a switch.  Your portal and EHR vendors may resist, particularly if they are chummy, but be selfish.  These patients are your patients. 

Most millennials, my daughter being an exception, want patient portals.  They want to communicate, see their results, and set up appointments via a portal.  To them, calling an office is so 20th century.  Failing to offer a robust patient portal puts your practice at a competitive disadvantage for millennials. It also may put you at a disadvantage recruiting younger providers.

Patient portals can improve service and efficiency, and yes, I am an idiot for finally understanding such.  We spent too much time ‘selling’ the portal to every patient.  We spent too much time fielding patient complaints about the portal.  Fortunately, the portal has gotten better; we may yet end up sticking with it, though the jury is still out.

We are now scrutinizing our patient portal as a tool to optimize.  How can we cut down on phone tag and on-hold waits?  How can we share results quickly and cost effectively?  How can our portal help communicate with referring physicians?  How can the portal help us get bonuses under MIPS?  Only now are we embracing the portal for what it can do rather than damning it for its shortcomings. 

I am finally accepting that patient portals are here to stay.  Rather than bend your practice to fit your patient portal, bend your patient portal to fit your practice.  Don’t waste time pushing it on every patient.  Don’t fight it like I did for what it couldn’t do.  Learn from your patients and peers how to make the portal experience better.  You’ll be much happier, just as I hope I will be. 

Lucien W. Roberts, III, MHA, FACMPE is administrator of Gastrointestinal Specialists, Inc., a 28-provider practice in Central Virginia. Though not a Luddite, he does not get the appeal of patient portals.  For the past twenty-five years, he has worked in and consulted with physician practices in areas such as compliance, physician compensation, negotiations, strategic planning, and billing/collections. He may be reached at muletick@gmail.com.

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