A provocative headline got my attention recently. It proclaimed that patient portals are “largely unused.” It caught my eye partly because it didn’t sound all that plausible — and because taking such a headline at face value could be unhealthy for your businesses, dear clients and friends of Capko & Morgan.  I decided to dig into the matter.

The article text actually mentioned that 37% of patients have recently used portals. Could the author actually believe that 37% utilization is trivial? That seemed to be what they were saying, yet it’s hard to imagine they believe that. (Would a 37% decrease in salary leave one’s pay “largely” unchanged?)

Perhaps, you may be thinking, this was just a forgivable, inadvertent misuse of “largely.” But I tend to think not. This type of exaggeration is just too common in modern media, even in our world of the business of healthcare. I tend to think the headline intended to sensationalize. Yet even if that wasn’t the intention, it’s still not a benign error, which is why I’m calling it out.

Mischaracterizing portal adoption has a hidden cost

Clients often tell us they’ve held back on technologies that could make their practices more efficient because they’re concerned patients won’t use them. But that thinking usually means practices miss out on significant benefits, since the tools they delay adopting (or forgo altogether) could make interaction easier for patients or make their practices more profitable (or both). This tendency to hesitate has been especially true for patient portals, and it’s often very costly.

Somewhere along the way, the idea took hold that portals aren’t worthwhile unless nearly every patient uses them. But this is not true. It’s not even close to true.

If even a small percentage of patients regularly uses a portal, those patients will benefit — and their physicians will save time, too. (And that’s strictly on the clinical side. Portals have the potential for even more dramatic benefits on the payment and administration side, even when utilization is very low.)

What’s more, relative to other recent technologies, portal adoption is arguably not that slow at all.

The first patient portals were introduced in a very limited way about 20 years ago. The 37% adoption figure quoted by the article suggest a trajectory similar to ATMs, which were introduced in the late 1960s and reached 40% US adoption in the late 1980s.

PCs, the internet, and smartphones have been adopted more universally, and they reached 40% penetration more quickly than patient portals. But here’s the thing: while virtually everyone can benefit from a smartphone, or even an ATM, only patients who need to be seen by their physician regularly will see immediate benefit from a patient portal. If nearly 40% of all patients are using a portal, that likely means a higher percentage of the patients who can benefit the most are actively using one.

The underlying study had a different agenda

The source material for the article, a Health Affairs (HA) study, has a different focus and title altogether: “Who Isn’t Using Patient Portals and Why? Evidence and Implications from a National Sample of US Adults.”

HA’s survey found that 63% of insured adult respondents had not used a patient portal during the prior year. Some of those “nonusers” undoubtedly had no need to communicate with a physician, and that would surely be a factor in whether or not a patient used a portal. If patients who don’t use a portal are also not contacting their physicians by other means, we probably don’t need to be concerned about their portal nonuser status.

HA also found one common reason some patients hadn’t recently used a portal was because they had no primary physician. Which, of course, only makes sense: without a physician, how can you sign up for a portal? Knowing such patients haven’t used a portal reveals nothing at all about whether patients who see a physician regularly appreciate having access to a portal.

Speed kills accuracy?

Since the article drew its conclusions from this study, it seems the author either misunderstood the survey or was looking for a more interesting angle. Publications need to get your attention. They’re competing against each other for eyeballs and clicks. The journalist may also not have had time to digest the study in detail. In the media world, speed often trumps all else ( possibly even accuracy and thoroughness). That means we readers need to dig deeper when an article’s extreme conclusion doesn’t seem to pass the smell test.

Portals don’t need anything close to 100% — or even 37% — utilization to be valuable and ROI-positive. Don’t be dissuaded by negative hype that’s intended to drive clicks. Portals can help your practice and your patients. And if you need help figuring out how to get started with a payment or EHR portal, I hope you’ll contact us.

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