It's Time to Kill the Patient Portal

The Patient Portal is often touted as an indication of healthcare’s focus on patient engagement. However, my experience has been something like this:

“Hey look! You can manage your appointment online on this web page that looks like it was developed by high school students in 2002. Just so you know - you can only view it on your desktop running Internet Explorer! Also, it works 20% of the time so just reload the page if it crashes”

This is certainly not true of all Patient Portals; the one my wife uses with her health system in Chicago is amazing. However, with general adoption rates hanging around 15-20% (source), I think it is time to call this a failed experiment. We need a replacement solution that embodies patient-centricity. Enter the Patient Health Hub.

The Patient Health Hub: The Future of Patient Engagement

The Patient Health Hub (PHH) is built to support what should be the primary focus of every health encounter, the patient. With its mobile-first, UX 2.0 design, the PHH will mirror the online experience consumers now expect from digital companies. It will provide multi-language support to expand access to some of the most vulnerable populations. Most importantly, it will not be tied to any single health system or physician. Every EMR and every doctor’s office will integrate with the PHH so that all information about an individual in consolidated.

But what can a patient do with this amazing new innovation? Here are just a few ideas:

Care Communicator

A feature that allows a user to communicate with any member of his or her care team through voice, video, text, etc. Additionally, through integration with the latest telehealth vendors, a patient can receive care for minor illnesses directly through the application.

My Care Plan

The health needs of an individual are varied, and their care plans should be personalized based on those needs. Some people are trying to improve their endurance to run their next marathon while others are just trying to better manage their diabetes and lose a few pounds. The care plan feature of the health hub will allow users to work with their care teams to design and track goals specific to their needs.

Insurance Marketplace

One of the biggest issues in healthcare is the number of people who have the wrong insurance plan, costing them thousands of dollars annually (source). Because the PHH will have clear insight into all aspects of your health and financials, it will be able to use this information to help you select the plan that will best serve you into the future.

Provider Marketplace

Trying to find the right doctor in today’s environment is a near impossibility. You have to access several different websites for reviews, provider quality scores, physician background information, and much more. Instead, the PHH will bring all of this information to you, and it can even recommend doctors if needed. Additionally, this solution will display transparent quality and cost metrics (based on your health plan) relevant to your search. Empowering consumers with this information will pay dividends on patient experience, cost of care, and general opinions about US healthcare.

Appointment Manager

Time to stop calling the doctor’s office every time you need to make or change an appointment. Not only does it require time on your side, it also necessitates additional administrative support in the physician office. Instead, imagine being able to schedule an appointment with any doctor in the country from your phone. OpenTable was founded in 1998, it’s time to bring the experience to healthcare.

Financial Manager

The exorbitant price of treatment in the US is probably here to stay for a long time. However, despite these costs, consumers have little guidance on how to manage their personal finances to handle medical expenses. The Financial Manager will utilize data about consumer health and plan choice to help them better prepare for these unexpected outlays of cash.

My Medical Record

One health record capturing all of your information across physicians is just common sense. Many countries have this (e.g., France - the top rated system in the world), and there is not a reason you shouldn’t here in the US. There is no rational argument in the world for how this would do anything but good for patients.

Device Integrations

Investment in consumer health devices has only just begun, and it is expected to accelerate as big tech jumps in the game (read more here and here). Through a robust API, it is important that these applications integrate directly with the PHH to reduce the lift required to track patient reported information. Updating your care plan has never been so easy.

Why doesn’t this exist already?

This seems so great! What has stopped us from developing this tool already. There are too many reasons, but here are a couple big ones:

  • Legal Challenge: HIPAA is outdated and makes the transmission and use of patient health data more complicated than it needs to be. We need new laws that can help free up this ecosystem while also continuing to support patient privacy.

  • Technical Challenge: Every EMR and device treats patient data differently. Our decentralized approach to the development of technology without a common set of standards has led to this challenge. Unfortunately, unwinding or altering the integrations between thousands of products is going to be an incredibly costly endeavor. We can do it over time, but we need alignment on standards first.

  • Business Model Challenge: No fee for service provider on earth wants the PHH to exist. Why? It is a direct competitive threat to their business model. By freeing up a patient’s health data, this means a consumer can visit any provider office without fear of duplicated and unnecessary paperwork or tests. I wrote a lot more about this here and here.

How do we solve these problems?

Like everything in healthcare, the challenges to building out a high quality patient experience seem insurmountable. This vision of a Patient Health Hub can serve as a guidepost, but its true implementation will likely look much different. Here are some steps we can take today to start moving our industry in this direction:

  • Reform HIPAA: Update HIPAA laws to enable easier flow of patient data while still providing serious privacy protections. A GDPR-like solution would be hard to pass in the US, but I think we are getting to a point where it is necessary.

  • Data Standards: Align nationally around a common standard for health data storage and transfer and ensure all enterprise technology can conform to that standard.

  • Value Based Care: The PHH is an asset in VBC in comparison to the threat it poses to fee for service medicine. The more providers in VBC arrangements (whose success in often predicated on open sharing of healthcare data) the more likely a unified patient experience will be desired.

  • Empower Patients: Navigating the US healthcare system is harder than living with your disease in the US healthcare system. We need to open up transparency on pricing, quality, outcomes, etc. to give patients the power to make the decisions critical to their care. No more guess and check. Let’s empower patients to make decisions for themselves

Healthcare has lagged other industries in consumer-focused digital innovation for too long. The Patient Health Hub is an example of where we can take a lead. Fight on.