Patient portals have the potential to streamline clinician workflow and improve patient engagement.

But at first, clinicians may be overwhelmed by the number of features that portals offer or fear that using the portal will be cumbersome and ineffective.

You can take small steps to overcome these barriers and get the most out of your patient portal. Although patient portals vary from vendor to vendor, most include a basic set of features that offer value to patients. These features can improve the way clinicians and patients:

• Handle administrative tasks, like booking appointments
• Communicate with each other
• Manage care

Use these features to engage your patients in their care and make care coordination and communication more convenient, efficient, and effective — for them and for you.

Keep in mind that other features may also be available — but make sure you’ve determined their value before adding them. If you clog the portal with unnecessary information and tools, patients may get overwhelmed and find the portal more difficult to navigate and use.

Booking medical appointments and refilling prescriptions over the phone can be time-consuming for both patients and clinicians. On average, it takes a little more than 8 minutes to make an appointment over the phone. ²³

In 2017, over half of non-federal acute care hospitals reported that they allow patients to schedule appointments and refill prescriptions through their portal. ²⁴ Allowing patients to book medical appointments and refill prescriptions online will free up staff to support your practice in more valuable ways. ²⁵ And research shows that patients use these features — in 2017, 39% of people with access to a portal used it to make appointments and 37% requested medication refills. ²⁶

Between 2015 and 2017, the number of non-federal acute care hospitals that offered secure messaging through their patient portal increased by nearly 10%.³⁰ By setting up secure messaging, your practice will take a big step toward achieving a Meaningful Use objective: “Use secure electronic messaging to communicate with patients on relevant health information.” ³¹

There are many scenarios in which patients and clinicians need to communicate between visits. Patients may have follow-up questions about a clinician’s guidance or a medication. ³² Clinicians may need to share test results or explain a recommendation in more detail.

Using the portal, patients and clinicians can:

• Share brief messages and updates
• Clarify issues and advice
• Correct misunderstandings before they become significant problems
• Record details, like a referral name or post-operative instructions
• Link to educational materials and other online resources ³³

Patient portals offer an opportunity to improve and streamline patient-clinician communication and practice workflow. The portal’s secure email can reduce the need for face-to-face visits and phone calls by giving patients and clinicians a quick, convenient way to exchange information.

With secure email through the portal, your practice can:

• Avoid telephone tag, which can lead to both miscommunication and communication delays
• Address routine health issues more efficiently, so you can dedicate more time to patients who need in-person care
• Have support staff to triage messages, so that clinicians only need to weigh in as necessary ³⁴
• Share lab results — a best practice identified by some EHRs, like athenahealth — or other post-visit follow-up with patients

To maximize efficiency, practices must integrate reading and responding to email into their workflow. For example, assign a staff member to acknowledge all patient messages within 1 business day. Clinicians can then respond to the patient’s question or issue at their convenience. ³⁵

Tips for Practice Administrators ³⁶

If your practice uses the portal’s email feature, consider establishing policies that address:

• Turnaround time for responding to patient emails. Don’t use email for urgent issues.
• The types of communication allowed over email. Decide which requests (like prescription refills and appointment scheduling) clinicians will fulfill and which sensitive topics (like HIV and mental health) they’ll discuss.

Tips for Clinicians

Follow these guidelines for communicating with patients by email. ³⁷

Address privacy issues

• Let patients know which other clinicians or practice staff may read and respond to their emails — for example, outside usual business hours or when you’re on vacation. Include this privacy disclaimer in each patient’s medical record.
• Keep a mailing list of patients, but only send group emails using the blind copy feature. Never send group emails where patients can see each other’s names.

Give patients clear guidance

Make sure to explain the policies and procedures for using portal email, like typical response time and types of communication allowed over email (see Tips for Practice Administrators above).

Also, ask patients to:

• Write a subject line that describes the nature of their email, like “Billing question” or “Medical advice”
• Call 911 or your office about urgent issues

For more information and guidance, check out ONC’s Fact Sheet: Using Secure Electronic Messaging to Support Patient and Family Engagement. ³⁸

Patients immediately forget up to 80% of the clinical information they receive during a visit. ⁴² Clinician notes can give patients a snapshot of a visit so they can better remember, understand, and act on their clinician’s advice after the visit has ended. Patients have always had a right to see these notes — but until recently there hasn’t been a simple, straightforward way to access them. ⁴³

By offering patients access to notes through a portal, you can promote transparency and change the way people engage with their health and care. ⁴⁴ Since patients are the best source of information about their health, they can also act as a second pair of eyes on the record. With patients checking for accuracy, clinicians can improve the quality of a medical record and make more informed clinical decisions. ⁴⁵

Tips for Clinicians

When sharing notes with patients, it’s important to:

• Explain to patients what they can expect to see in the notes
• Use plain language instead of medical jargon or abbreviations
• Soften language and add context, when necessary (for example, instead of labeling a patient as “obese,” include their BMI and link to patient education about BMI)
• Keep notes focused on specific issues
• Discuss lab or study results, if applicable
• Reference educational materials, whenever possible ⁴⁶

Research shows that adding educational resources to patient portals can make them more useful and effective ⁵⁰ — and help you increase patient engagement. Portals and electronic health records can also help your staff provide tailored information and community resources to patients who may benefit from them.

When choosing educational resources to add your patient portal, it’s important to select trusted sources. For example, healthfinder.gov offers actionable, evidence-based, plain language health and wellness information, as well as free interactive tools like myhealthfinder, which provides personalized preventive health care services recommendations.

Because healthfinder.gov manages the content, you can add the tool to a portal or website without having to worry about keeping the information relevant and up-to-date.

You can also use your EHR to track social determinants of health: the social, economic, and environmental conditions that can affect health and health outcomes. Including this information in your EHR can help your staff identify and address factors that may contribute to health complications, such as unsafe housing or lack of access to safe opportunities for physical activity.

See the PRAPARE Implementation and Action Toolkit for resources on how to set up your EHR to gather data on social determinants of health, and how to assess and respond to that data once it’s collected.

More and more patient health information is available electronically — but patients and caregivers still face challenges in accessing, using, and sharing their data. Patient portals may not include all the information patients need — and what's there may be inaccurate or incomplete. And often, health data can’t be requested or shared electronically, or transferred to other health care clinicians without a cumbersome, multi-step request process.

To learn more about the challenges patients face in the records request process, check out ONC’s report Improving the Health Records Request Process for Patients: Insights from User Experience Research [PDF - 2.6 MB]. The report includes personas and journey maps illustrating these challenges, as well as tips on creating a better records request process.

We know that patients and caregivers who do have access to their data can better coordinate their health care, prevent repeat or unnecessary tests and procedures, and have greater control over their health and well-being.

That’s why ONC is committed to addressing large-scale access and portability issues — to help in creating a medical records request process that works for everyone.

There’s a lot that health care practices can do today to improve the records request process and reduce the burden on consumers, clinicians, and care teams. Integrating records requests into your patient portal is a win-win — it increases patient satisfaction, saves time, and reduces hassle for clinicians, administrators, and other practice staff.