Dr. Burdick Adjusts Clinic Workflow to Increase Patient Portal Use
Dr. Tim Burdick is a family physician at Oregon Health & Science University (OHSU) Rural Health Clinic, the only primary care practice in Scappoose, Oregon. Serving a socioeconomically diverse community of farmers, loggers, and executives, Dr. Burdick sees patients once a week at OHSU and works as the clinic’s unofficial “physician champion” of health IT. In that role, he helped the clinic adjust its workflows and conduct outreach to increase the number of patients enrolled on the patient portal.
Low Participation In Patient Portal
Dr. Burdick knew from his prior clinical experience that patient portals offer a number of benefits to patients, including greater access to health information and faster communication with providers. “Most of the time, patients don’t need to come in when they just have a couple of questions,” Dr. Burdick explained. “Secure messaging on the patient portal can help us avoid phone tag and unnecessary office visits.” Despite the potential for patient portals to improve patient engagement, in the two years since OSHU went live with its patient portal, only 30% of the clinic’s patients had an activated patient portal account.
In July 2013, Dr. Burdick launched a clinic-wide initiative to find out why patients were not enrolled on the patient portal. He first met with each of the clinic’s providers and quickly found that many had concerns about patient portals and did not actively encourage patients to enroll. “There was a lot of fear that the patient portal would be intrusive to providers and that patients would be confused.” Dr. Burdick explained. “These myths had been swirling around the office for a while.”
Outreach and Workflow Redesign Bring Patients and Providers on Board
To address their concerns, Dr. Burdick collected peer-reviewed journal articles and return-on-investment studies that demonstrated the benefits of patient portals for providers and patients. He held a staff meeting to present the information and share experience from his former practice, offering his own anecdotes about the patient portal’s benefits. “By the end of the meeting the conversation had changed,” Dr. Burdick said. Providers began to think about how the patient portal could really help them improve patient engagement.
The clinic began to conduct outreach and adjust workflows to increase the number of patients enrolled on the patient portal. When patients first enter the office, for example, the receptionist gives the patient a handout introducing the patient to the patient portal and explaining the portal’s benefits. Then when the patient goes back to the exam room, a medical assistant enters and helps them enroll on the spot during their visit. “If the patient still says they aren’t interested, when our providers enter the exam room they reiterate the benefits of the patient portal,” Dr. Burdick explained. “By having everyone in the office bring up the patient portal at different touch points, patients begin to realize the value of the tool.”
Increased Patient Engagement and Quality Improvement
The clinic’s workflow adjustments and outreach campaign helped increase the percentage of patients enrolled on the patient portal from 30% to 45%. The clinic staff also saw that patients were taking greater ownership of their health and health care. Providers noticed, for example, that their patients were frequently logging on to the portal to view their lab results. Because OSHU’s patient portal automatically uploads lab results when they come in, patients were proactively scheduling follow-up appointments to discuss abnormal results before their doctors had even seen them!
The clinic’s progress with patient portals has triggered success with other quality improvement initiatives, such as the patient-centered medical home (PCMH). “The patient portal has definitely been an instrumental part of gaining National Committee on Quality Assurance recognition as a PCMH,” Dr. Burdick remarked. The patient portal is also inspiring pilot projects. For instance, Dr. Burdick is working on a live note-sharing program that allows patients to see their providers’ clinical notes electronically. The clinic continues to refine its patient portal experience and promote patient engagement.