Q&A: UW Prof on Whether Patient Portals Are Working as Designed

The percentage of U.S. hospitals that rely entirely on paper records to document information on their patients now stands at 1 percent, down from 69 percent in 2003, according to a study published recently in the American Journal of Health-System Pharmacy.

For more than two decades, hospitals and clinics have been working to digitize their medical records in tandem with companies that develop electronic health records (EHR) software. These records systems allow users at healthcare organizations to do everything from scheduling appointments to documenting information on patients in clinical settings to tracking the charges that end up on hospital bills. Several of the firms that develop medical records software have even introduced products designed to be used by patients and improve their healthcare experience.

As Xconomy reported last week, many in the healthcare industry believe that tools in the latter category, often referred to as “patient portals,” can improve patient-physician communication, and help both parties save time.

For example, some patient portals allow patients to securely exchange messages with their primary care providers and other clinicians. On one hand, many doctors view the ability to send electronic messages to patients as an improvement over communicating by telephone. However, it’s not clear whether this form of written communication—either via patient portals or e-mail—makes it more likely that patients will be able to get the information and advice they need without having to come in for a doctor’s visit.

A study published in the journal Management Science in July looked at some of the effects of allowing patients to exchange messages with providers at a large U.S. health system (the name of the organization wasn’t disclosed). The study, co-authored by researchers at the University of Wisconsin-Madison and University of Pennsylvania, found that allowing these exchanges, or “e-visits,” did not reduce the volume of office visits at the health system or allow doctors to see more new patients.

One of the study’s authors is Hessam Bavafa, an assistant professor of operations and information management at the Wisconsin School of Business. Bavafa recently spoke with Xconomy about some of the findings in the study, and what implications it might have for patient-physician communication. This transcript of our conversation has been lightly edited for clarity.

Xconomy: What made you and your co-authors decide to do this study?

Hessam Bavafa: One of the motivations of this study is that it’s always interesting to see, as we introduce new channels of service or product delivery, what happens to the customer experience.

I think about myself as a teacher at the university. Students e-mail me questions and I can respond to their emails. I think about an e-mail sent to me as an e-visit, basically an e-consultation. Many of the problems that [lead] students to send e-mails to me, they don’t have to come to my office hours. I can just send them a two-line answer and it’s over.

What about healthcare? Does this trend—this substitute-ability of e-visits and office visits that I see in my teaching—translate to healthcare?

X: Tell me about the study design. The dataset you all built comprises more than 140,000 patients and 90 doctors, correct?

HB: Yes. This is one health system, which runs multiple primary care practices, [studied] over five years and two months. We have data from nine primary care practices.

X: Were the “e-visits” you all examined as a part of this study limited to text-based communication, or did some of them also take place using videoconference tools?

HB: In this study, we focused particularly on text and telephone interactions. In our … Next Page »

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