Patient portal access led to more judicious healthcare utilization, cutting ED visits by 4 visits per 1,000 patients.
Patient portal access may be tied to more efficient healthcare utilization, with patient use leading to fewer emergency department visits and more outpatient clinic visits, according to new data published in PLOS One.
Specifically, patient portals proved to help patients managing chronic conditions more judiciously visit the doctor. Instead of visiting costly emergency departments (EDs) or incurring expensive but preventable hospitalizations, patients accessing their patient portals were better able to manage their own health or, when necessary, access their doctors in a less costly outpatient setting.
Patients managing chronic illnesses often struggle to experience quality healthcare, the researchers explained. Because patients visit a complex web of primary care and specialty providers, have several different data points, and multiple sites of care, they often receive care that is fragmented or repetitious.
“Patient portal tools that improve patient access to their own health information, support self-management, and help patients communicate asynchronously with providers offer an additional mechanism for delivering high-quality guideline-recommended care that can improve patient health,” the researchers said.
Specifically, patient portals allow patients to access their own medical data, secure message with providers, and digitally request prescription refills.
And it’s each of those functions that may lead to lower healthcare utilization, the research group hypothesized.
“We found that access to a patient portal was associated with engaging in significantly more outpatient office visits,” the researchers reported. “When patients with multiple conditions had access to the portal, however, they were also less likely to have ED visits or preventable hospitalizations, suggesting a reduction in downstream clinical events associated with portal use.”
The investigators looked at differences in care utilization in the outpatient, ED, and hospital setting, specifically looking at preventable hospital admissions. Researchers grouped patients by chronic illness – either diabetes only, or diabetes plus a combination of asthma, congestive artery disease, congestive heart failure, or hypertension.
Overall, patients with complex chronic conditions and who had accessed the patient portal visited the ED or were admitted into the hospital less frequently than those who had not accessed the patient portal.
There were 3.9 fewer ED visits per 1,000 patients per month, and 0.8 fewer preventable hospital admissions per 1,000 patients per month, the team found.
Additionally, patients with only diabetes and with complex conditions saw an increase in outpatient visits.
These results suggest more judicious patient healthcare access and utilization, the researchers said. It is certainly a good thing that patients are less frequently accessing costly healthcare services, such as those rendered in the ED or inpatient setting.
And although patients may be visiting outpatient settings more often, the researchers concluded that this was also a positive step forward.
“Patient partners related personal situations of directly avoiding an office visit by asking their doctor a question through the portal,” the investigators wrote. “In other instances, patient partners reported situations where using the portal to check a lab result led directly to follow-up engagement with their physician through an in-person visit.”
In other words, patients visited outpatient settings more frequently because the patient portal prompted more prudent self-management.
“Similarly, patient partners linked the statistical findings of reductions in emergency visits to personal experiences, for example, in using the portal after regular medical hours to obtain a medication that helped to avoid an ED visit,” the researchers added.
Patients used the patient portal to obtain medical care that they otherwise would have accessed in the ED.
What’s more, increased access in the outpatient setting may have prevented ED or hospital admissions. Because patients were more engaged in their care and could easily visit with their provider in an outpatient clinic, they may not have experienced an adverse health event that would have otherwise landed them in the ED or the hospital.
“We interpret these findings as a signal that the portal may be helping to increase engagement in outpatient office visits, a preferable setting to potentially address otherwise unmet clinical needs, and thereby reducing downstream health events that lead to emergency and hospital care,” the researchers concluded.
Date: June 28, 2019
Source: Patient Engagement HIT