Supporting high-touch, value-based care with technology

I’ve been a board-certified family physician for 30 years. I spent the first 20 years in a primary care practice, and the last 10 years working for a technology company, helping health systems use technology in ways that help physicians and patients. So I’m pretty knowledgeable about the interaction including patient care, the patient experience, and healthcare technology.

But recently, my knowledge took on a different dimension. I now know what that interaction feels like from the patient’s perspective.

Lucky genetics, a good diet, and regular exercise have given me robust good health. Other than two healthy pregnancies and a few elective surgeries, my experience as a patient has been limited to routine preventive care. But I’ve recently experienced a health condition that requires ongoing care. And I have to tell you, it’s given me a new understanding of the work I do.

I’ve always understood intellectually that patients with a serious health condition feel vulnerable and are, to a certain extent, dependent on their care team. But I now understand what that feels like, and I can tell you that the small things really matter when you are feeling anxious and vulnerable.

High touch, supported by technology, makes a difference

In my new persona as patient, I’ve gained new respect for a fairly simple piece of technology: the patient portal. A robust, fully functioning portal can make life easier for patients. I’m lucky, because my care team has a good patient portal. I never waste time filing out redundant paper forms. Instead, I can go online and update medications, symptoms, insurance, or other data as needed. I can make appointments, view test results and other health data, and ask questions through the secure messaging function and get answers back. I don’t waste time on hold on the phone.

When I do need to talk to someone, I usually can reach the person I need promptly. For example, I wanted to look at some of my test results, and I was surprised that I couldn’t find the results through the patient portal. This was one of those moments when I was feeling vulnerable, and I wanted to see those results immediately. So I called the care coordinator for my care team, and she promptly followed up to get those results online. Less than hour later, I was looking at the data I needed via the portal.

That may seem like a small thing, but the responsiveness of my care team—the high-touch part of care—reduced my feelings of vulnerability and dependency. I felt more in control. As a patient, that matters.

A big part of success for physician practices under value-based care will depend on the care team’s ability to be “always on” for patients. By that I mean that patients are able to get what they need whenever they need it. While a patient portal is not a complete answer to providing that level of care, it reduces the administrative friction of appointments, data entry, and communications for patients and reduces the time that staff spends on the phone dealing with routine matters. That means that staff are more available when the patient really needs to talk to someone.

For me, that meant I had a very responsive human available to help me when I needed it, and I had the technology available to access the data I wanted. Both are critical to good care. In my work with the technology company, we say that successful technology requires the right people, processes, and technology. I believe that even more strongly now, having seen how that combination improves my experience as a patient.

The other side of the technology issue

I related my experience with the patient portal to a colleague, who had a very different tale to tell about communications with one of her physicians. She says phone communication with the office is so poor that she spent nearly a week trying to contact them, playing telephone tag, because her pharmacy needed to fax a form to them to sign and fax to her health plan. The fax number on their website was incorrect, she kept getting transferred to voicemail, and she kept missing calls back from the physician’s office. Finally, in desperation, she drove 45 minutes across town in heavy traffic to talk to them in person.

“I really wish that I had been able to contact them by email because I could easily have explained what was needed and asked them to send me the correct fax number. What made things even worse is that they don’t accept voicemails during lunch or after hours, telling you to call back, and I always managed to think about the need to call just as they were going to lunch or leaving for the day,” my friend told me.

Getting the basics right will be critical success factor

My friend’s experience is not unusual. While many physician practices have made great progress in transforming their systems to be patient centered, many have not. These practices aren’t actively trying to inconvenience patients—they just aren’t thinking about that aspect of care. My friend is resourceful and determined, so she finally got what she needed. But what about patients who have less time and determination? They might give up, foregoing care because it’s just too hard to deal with the system.

With MACRA requirements looming in the near future and private health plans increasing their use of value-based contracts, physicians must either move to a patient-centered practice methodology or face financial consequences. A robust patient portal can be a critical part of a patient-centered practice, making life easier for patients and reducing the daily administrative burden for the care team.

There are many other technology solutions that can support and enhance patient-centered care, but this is one that is readily available and under-used. If you aren’t using your portal to its full capabilities, or if you have a bare-bones portal with little functionality, it’s time to step up your game.