Background

The tools in this resource center are presented in these three phases of adoption.

CHCF is interested in helping community health centers understand the unique challenges of adopting a patient portal to connect patients with their electronic health records. This online Patient Portals Resource Center was developed based on the work of the CHCF Patient Portals Initiative (PPI).

WHAT: Giving patients easy access to electronically stored and personalized medical information has the potential to transform health outcomes. By providing a portal, or electronic doorway, through which to access health information and communicate with providers, patients can better monitor their conditions and seek appropriate services.

WHY: A 2010 national survey found that consumers who have electronic access to their personal health records (PHRs) feel like they know more about their health (56%) and the care their doctors give them (52%), feel more connected to their doctors (38%), and led them to do something to improve their health (32%) as a result. (For more information, see Consumers and Health Information Technology: A National Survey.) Early interventions, improved access to their care team, and increased efficiency of care delivery can ultimately lead to reduced costs and improved quality of care.

WHO: While patient portals are becoming widespread in large medical delivery networks, adoption is less pervasive among safety-net providers. To engage California safety-net providers in the implementation of patient portals to improve patient and family engagement, clinical outcomes, and operational efficiency, in 2011 CHCF sponsored the Patient Portal Initiative.

WHERE: Three California health centers with relatively mature electronic health record (EHR) systems, but no patient portal yet in place, participated in the PPI:

Health Center (location) EHR System Patient Portal
Open Door Community Health Centers (Humboldt and Del Norte Counties) Epic MyChart
Shasta Community Health Center (Redding) NextGen NextMD
West County Health Centers (Occidental, Sebastopol, and Guerneville) eClinicalWorks eClinicalWorks

HOW: In the planning phase, grantees explored the benefits and feasibility of deploying a patient portal in their respective organizations. During the implementation phase, PPI grantees planned and executed their portal rollouts and integrated portal use into daily operations. As they progressed, the health centers defined and collected metrics that were aimed at assessing patient input, provider and staff feedback, and use of the portal. Grantees participated in regular meetings to share ideas, solve common challenges, identify best practices, and learn from experts in the field.

RESULTS: The tools presented in this Patient Portals Resource Center were used or created during the PPI and are provided here for use by community health centers across the state and nationally. All resources have been linked to original sources and are available for unlimited reuse and reproduction.

Definitions

The terms “personal health record,” or PHR, and “patient portal” are often used synonymously, particularly in surveys where consumers are asked about electronic connections with their care providers. For our purposes here, PHRs and patient portals are distinguished as follows:

Personal health record:

  • Is owned by the patient (or proxy for the patient)
  • May have information that is not contained in a medical record
  • Is often a standalone application
  • Allows for patient input of information
  • Is used for managing health information, promoting health maintenance, and assisting with chronic disease management
  • Is focused on health information, behavior change/prevention, and self-management

Patient portal:

  • Is a secure website through which patients can access a PHR
  • Often contains information from a patient’s EHR
  • Is usually “tethered”┬áto a health care organization with applications that build on an EHR
  • Enables users to complete forms online, communicate with providers, request prescription refills, review lab results, or schedule medical appointments
  • Can enhance patient access and increase administrative efficiency and productivity

For more information, see Measuring the Impact of Patient Portals: What the Literature Tells Us.

PHRs and patient portals can be viewed as a spectrum of applications that range from a standalone application, in which the patient enters the bulk of information, to one that is connected to a health care organization and builds on an existing EHR. Regardless of the architecture, all PHRs aim to increase patient access to personal health information in a secure fashion to enable greater patient participation in the care process.

All three PPI health centers implemented PHRs/patient portals that are tethered to their organization and offered through their EHR system vendor, which allows for patient-provider communication and display of key information from the EHR. For this reason, the technology is referred to simply as a patient portal, or portal, throughout.

Patient Portals: Benefits to Providers

In this short video, doctors and clinic staff talk about the benefits of using patient portals to engage with patients and to coordinate care.

 

Patient Portals: Patients’ Perspectives

In this short video, patients discuss the advantages of using patient portals to manage their health and to communicate with clinic staff.