When Pittsburgh-based UPMC launched its patient portal eight years ago, one of the main challenges was overcoming physician resistance to sharing uncensored medical data with patients.
"There's a lot of paternalist physicians out there who say patients don't know how to handle the truth," Daniel Martich, MD, CMIO of UPMC, told attendees at last week's HealthIMPACT conference in Chicago. These are the physicians who do not want patients to see complicated, detailed test results without them in the room to put the data in context and explain what they mean for the patient's health and future.
However, even ahead of meaningful use stage 2 requirements, UPMC recognized online access to their medical information was not only something that would ultimately help engage patients in their care, but a feature that was increasingly expected. "It is something patients have always wanted and now technology has made it a possibility," says Dr. Martich.
Citing the old adage that "culture eats strategy for lunch," the patient portal project proceeded slowly and incrementally. "The only way to approach this is step by step by step," says Dr. Martich.
UPMC's first step was adding patient information in the portal on a limited basis, starting with about 200 common lab tests. Initially, there was a three-day lag between when the physician received the test results and when they were added to the portal, allowing the physician time to review the information before the patient saw it.
Experiencing little physician pushback, more lab tests were slowly added to the portal. The amount of time between when labs are released to physicians and when they are released to patients was also reduced. Now UPMC has 7,000 lab tests that are immediately added to the portal, along with radiology, pathology, urology and other specialist results as well.
However, patient engagement doesn't hinge on having an extensive list of tests and imaging reports available through the portal. For hospitals working to quickly build robust portals that will capture the patient participation necessary for meaningful use stage 2, Dr. Martich recommends focusing on getting basic lab results in the portal to which providers are unlikely to object.
"The biggest win for patients is the lowest-hurdle lab results," says Dr. Martich. "The metabolic panel, cholesterol... you'll engage your patients with something as mundane as triglyceride levels, all you need is just some critical mass of lab data and patients will be engaged."
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