How the Patient Portal Improves Health Outcomes in Chronic Illness

How the Patient Portal Improves Health Outcomes in Chronic Illness

Getting more patients on board to actively use the patient portal could drive better patient engagement in care and boost healthcare outcomes, according to new research out of the University of Texas Austin.


The study, published in MIS Quarterly, found that meaningful patient portal use results in fewer hospitalizations, a decrease in emergency department visits, and lower readmission rates. When frequent patient portal users do get admitted into the hospital, it’s often for a shorter period than patients who do not use the patient portal.


All of these outcomes could result in considerable cuts in healthcare costs, the researchers said.


“The study is good news for hospitals and patients alike,” Indranil Bardhan, the study’s lead research and a professor of information, risk and operations management in UT Austin’s McCombs School of Business, said in a statement. “Effective use of patient health information systems is a good predictor of future patient behaviors and health outcomes.”


In partnership with UT Southwestern Medical Center in Dallas, the researchers looked at 12 years of patient portal use data for 3.266 patients with congestive heart failure.


The team defined patient portal use as using the tool in such a way that it helped improve patient health. To that end, the researchers tracked which key patient portal functions — secure direct message, data access, prescription refill requests, and appointment scheduling — the patients used and how often.


Data showed that patients who regularly used the patient portal were between 2 and 4 percent less likely to be hospitalized, which can amount to thousands of patients for the typical mid-sized hospital, the researchers said. When a hospitalization can cost up to $30,000 per patient, this can result in astronomical cost savings.


Patients who often used the patient portal were also 3.2 percent less likely to visit the emergency room, a notoriously expensive place to receive care. And when frequent patient portal users were admitted to the hospital, their stays were 11 percent shorter than those who did not typically use the technology.


What’s more, strong patient portal use was tied to lower readmission rates. Hospital readmission is measured as having more than one hospital admission within a 30-day period, and is a key clinical quality measure for Centers for Medicare & Medicaid Services (CMS) alternative payment programs.


When patients were frequent patient portal users, they yielded 2 percent fewer hospital readmissions, the researchers reported.


And there is room to improve here, they furthered. The mean patient portal interaction rate was nine encounters per patient, the researcher said, but the standard deviation was 52 interactions.


“According to the Centers for Disease Control and Prevention, $315.4 billion was spent in the United States alone in 2015, to treat patients with CHF and stroke, with a large portion attributed to hospitalization,” the research team pointed out. “Our calculations show that improving patient–provider engagement by increasing the intensity of portal use by one standard deviation from the sample mean is associated with a 9.58% reduction in readmission risk.”


And by cutting that readmission risk, the healthcare industry can chip away at that $315.4 billion in spending.


Of course, there is the argument that it was the patient, not the patient portal, that sparked improvements in quality measures. Patients who are more engaged in their care are innately more likely to use the patient portal, meaning those patients are more likely to adhere to their care plans, medications, and other actions that are necessary to take care of themselves and stay well.


But that may be the entire point, the researchers suggested. More engaged patients may be apt to use the patient portal, but the inverse is likely also true. Using the patient portal gives patients the means to be more involved in their care, and providers should consider promoting stronger patient use.


“Our results highlight the importance of patient–provider engagement by showing that active patient participation in decision making, care management, and self-care is associated with better health outcomes,” the researchers said in the discussion section of their article.


“They indicate that actively engaged patients are likely to have fewer emergency visits and incur lower hospital charges, even though they may exhibit a higher number of outpatient visits.”


And as a result, the patient portal works to cut healthcare costs, promising a positive return on investment for healthcare organizations. When patients are healthier, they require fewer healthcare interventions, and in turn spark less healthcare spending.


“It’s clear that when patients are able to engage more effectively with their providers about their health status, it helps to create the lifestyle improvements that lead to better health outcomes,” Bardhan said.


And to that end, healthcare organizations should consider a renewed push to drive patient engagement and access to the patient portal, the researchers concluded.





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