What lies just beyond that portal?

We’ve been looking pretty frequently at the issue of “patient engagement”, of late, because, well, the feds have dropped it squarely on the table with meaningful use Stage 2.

Another reason, however, is that there is a fascinating (to our eyes) array of opinions on what constitutes the best way -- if there is a best way -- to get patients more plugged in.

Here, for example, is one doctor who has come around to the idea of patient engagement, but he’s not sold on the concept or use of patient portals.

“The problem with portals is that they are too narrow,” he opines early on. “First, the person must have access to the portal to get what’s behind it. Physicians need to give permission for patients to view the information they send to them. But people often have more than one doctor, and not all doctors are on the same record system, which means that the patient has information available behind multiple portals (with the complications that implies).

The second problem is that what is behind the portal is determined by the clinician (or hospital) and the EMR system itself. Patients have access to what they are 'permitted' to access, not necessarily what they need. Some physicians (like me) send pretty much every test result I get on a patient, while others abide by the 'no news is good news' rule, sending patients only 'bad' results.”

After flipping through the range of reasons used to justify giving patients access to their information in the first place, he suggests, somewhat counter-intuitively given the direction of current discussions, “Why not put this (information) in the hands of the one whose life depends on it: the patient?  Why rely on portals, or health information exchanges? Why not just give all of this information to the patient in a secure patient record? Yes, there could be hacking, and there will be some people who want nothing to do with this responsibility; but there will also be far more informed decisions made by clinicians who have access to the 'official' record.”

There’s an appealing simplicity in this notion, but as commentators note in the thread that follows the piece, it may be a bit too simple.

But it’s definitely worth reading, as are the comments. Then let us know what you think.

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