Communication with patients is vital to delivering quality care, but the telephone can be an inefficient and frustrating communication tool. Busy signals, voicemails, incomplete messages, poor translation and extra documentation time are but a few examples of the drawbacks. As a result, Desert Ridge Family Physicians sought to improve its service by giving patients the ability to exchange e-mails with their doctors through a secure patient portal.
Desert Ridge, a six-doctor practice in Phoenix, began enrolling patients in a portal program in January 2010. There is no charge for the service, and to date more than 5,800 of our 9,000 active adult patients have enrolled. Since the launch, we have experienced numerous benefits, including decreased call volume, better communication, increased patient satisfaction — and most importantly, enhanced patient care.
Our primary motivation for launching the patient portal was an acknowledgement that phone calls were inefficient for us and frustrating for our patients. We studied our phone call patterns and found that our “best-case” patient question involved three staff members, including a physician, and consumed an average of seven minutes of staff time and one minute of physician time. A “worst-case” patient question consumed 11 minutes of staff time and two minutes of physician time. Sadly, the “worst case” scenario was more common than the “best case.” Our outgoing calls did not fare much better, commonly resulting in repeated voicemails and return calls with additional questions.
Multiplying those minutes by dozens of phone calls and messages per day, we envisioned the benefits of using portal technology. An e-mail message sent to us through a portal arrives directly in the physician’s inbox, and requires only about a minute for a physician to read and answer. What’s more, we feel that a portal allows physicians to provide better care because they communicate directly with our patients — rather than through voicemails or messages left with an assistant.
As we began enrolling patients in the portal program, we made sure it became part of the rooming process for everyone. We gave patients a reason to enroll by explaining that they would be able to correspond directly with their physicians, view their physician’s instructions, see their lab results and request medication refills. Not surprisingly, they have been very receptive to the idea.
In the first month, we enrolled 63 patients; then 250 in the second month and 443 in the third month. Now more than 5,800 patients have signed up, and we have calculated that we make/receive 60 fewer phone calls per day — saving 95 minutes of medical assistants’ time daily. That translates to nearly eight hours per week once spent on the phone that is now used to better serve patients.
Despite some initial concern, we’ve found that patients use the portal service appropriately. Each physician receives an average of four new e-mails a day, and is able to respond quickly, while saving each conversation to the patient’s chart. Our patients report greater satisfaction from writing messages directly to their physicians and receiving direct responses back. Since launching the NextGen Patient Portal, we have experienced other benefits in addition to decreased call volume and increased patient satisfaction, including:
- Better communication. We have discovered that patients are more likely to provide necessary details in a written message than on a voicemail. Because they can be more thorough on the first interaction, patients now often have all of their concerns addressed in one exchange. Our physicians appreciate this increased level of detail because it allows them to construct better responses without excessive back-and-forth messages.
- Greater efficiency. For prescription refills, patients provide necessary information on the portal’s medication refill page. In the past, patients often would forget information during a voicemail, requiring a call back. With the portal, the refill request is processed on the first e-mail message. If it is rejected, we can provide a complete explanation without having to rely on the pharmacist to relay the message.
- Improved care. While efficiency was the primary motivation to begin using a patient portal, it is the improvement in care that has made it a success. Our physicians have found that the portal allows them to be more engaged with their patients, so it is easy to check up on them, receive updates on any new changes, and conduct proactive outreach.
The demands on practices to provide better care coordination and chronic disease management have never been greater. Our experience at Desert Ridge Family Physicians shows how a simple, Web-based patient portal can eliminate hours of non-productive time per week — ultimately helping us improve communication and provide better patient care.
Dan Nelson is the practice administrator at Desert Ridge Family Physicians in Phoenix.