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How a Patient Portal May Have Saved a Patient's Life


On this Thanksgiving Day, Missouri family man Tom Smith expresses gratitude for his physician's patient portal.

On Thanksgiving Day, doctors and patients give thanks for so many things - from family and great colleagues to delicious meals.

And this holiday, Smithville, Mo., patient Tom Smith can add one more item to that list. The 48-year-old father is thankful for his doctor's patient portal - which he credits for saving his life.

Like many patients with busy lifestyles, the manufacturing engineer for a car battery company hated calling the doctor and leaving messages. Even more, he hated taking the time off work to get a checkup, though he very much liked David Voran, his family medicine physician employed with Heartland Health of Platte City, Mo.

So when Voran's staff told Smith about its patient portal, which it purchased from Cerner in 2007, Smit was intrigued he could send a secure message directly to a doctor, who would respond in a timely fashion.

"I'm one of those people who hates calling the doctor's office," Smith told Physicians Practice. "First you reach the receptionist, then they transfer you to the nurse, who takes a quick message and you can't put a whole lot of detail in that, and then the office calls you back and it's the nurse relaying the information through the doctor."

The portal offered a quicker, easier, less-hassling alternative, so Smith started to use it regularly. His growing comfort with the technology, as it turned out, came not a moment too soon. Smith started having dizzy spells, unusual stools, and stomach pains in the fall of 2012.

At first, he brushed it off. Smith didn't have time for a visit to his physician, and, he figured, the pain would likely subside. But instead, it started getting worse.

"Finally, I end up getting on the portal one morning," said Smith, recalling the message he sent Voran about having odd pains, stomach issues, and dark stools. "Within a couple of hours I get an e-mail message that there was a reply on the portal. He sent me a reply that he was concerned about gastrointestinal bleeding and he told me to come into the office right away."

Blood tests quickly revealed his red-blood-cell count was low - in fact, he had lost one-fourth of his red blood cells. Voran immediately made Smith an appointment with a gastroenterologist for six days later. In the meantime, Smith started feeling better over the weekend and dismissing the symptoms that were troubling him. But on Thursday, six days after the initial visit, the gastroenterologist did an EGD and discovered that the blood vessels in Smith's stomach were standing out, and some were bleeding.

"They discovered a mass during the endoscopic procedure, admitted him and discovered the tumor that was eroding into his stomach," recalled Voran.

What followed is something Smith will unlikely ever forget.

"The doctor told me the results are kind of significant and said 'I can't let you leave,'" said Smith. "I laughed and said, 'what's the worst that could happen?' The doctor said, 'if you start bleeding from your stomach again, there's a 20 to 60 percent chance you could die."

That was enough for Smith, busy as he was with work and family, to stay put.

"If I hadn't contacted Dr. Voran that Friday and gotten a reply, since I had felt better on Monday, I probably wouldn't have gotten any further with that. I would have just kept on working," said Smith.

Long story short, Smith ended up having a pancreatic neuroendocrine tumor, which was soon removed. Then in April of 2013 a routine PET & CT scan showed recurrence of the tumor and his physicians recommended chemo right away, Voran recalled. Just about a month ago Smith finished his last round of chemotherapy and is now cancer-free.

Meanwhile, his physician is thankful that patients like Smith, who can't stand making phone calls, have taken to his practice's Cerner portal so quickly. "When the patient sends a message, those on the average take a minute to respond to," said Voran. "It's not unusual for a patient to message me…and ask the question 'should I come in?' We've been able to tailor the quality of the visit by eliminating unnecessary visits. The portal reduces one more barrier to communication."

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