A woman in the workshop (I’ll call her Sally) shared how she had been recently told she had high cholesterol by her GP. Sally said she found it hard to believe because she thought ‘skinny’ people didn’t have high cholesterol. She told her GP she was surprised but he didn’t give her much information other than to cut out high-cholesterol foods. Knowing she already had a healthy diet, she was quite confused about how she could have high cholesterol and spoke to a friend about it – who also had high cholesterol but had been put on medication by her GP and “didn’t worry about it anymore”. Sally wondered why her GP hadn’t discussed medication with her. She also went online to search out more information on cholesterol but thought the information was a bit varied and not specific enough for her needs. In the end she stopped thinking about it as it wasn’t helping her answer her questions and it was all a bit stressful.

She realised during the workshop that there wasn’t much in her schema about cholesterol – and what she did have contradicted the message from her GP so might not be accurate. She realised she’d never paid attention to messages about cholesterol because she didn’t anticipate it being an issue for her. She decided to renew her efforts and seek out some explanations from health professionals she knew so she could better understand her situation and what her options were.

I thought this is a great example of how we all have episodes of low health literacy when we encounter a new health issue. It can be challenging to work out where to get good, reliable health information – even when we’re motivated – process it, and then decide how to apply it. It’s also great that Sally feels re-energised to go and find out more. Her GP didn’t provide much help initially but she’s determined to ask more questions next time she sees him. Excellent!

Carla White

http://www.kevinmd.com/blog/2013/04/build-patient-portal.html 

I have always been interested in patient portals because I think they can be a real asset for patients to access their health information. However, the portals I have seen seem to be afterthoughts or add-ons to the main event which is a clinical portal enabling the sharing of health information between different parts of the health system and health professionals. As such, these portals are very useful, providing timely access to data about patients no matter where they are in the health system – Accident and Emergency, at their GP, in a hospital clinic or even in a pharmacy.

The primary focus of most electronic record systems is to share data among health professionals. So the purpose of the system is established early on and the system’s architecture is based on that primary purpose. That is why it is so hard to “bolt on” a patient portal. There are two very different audiences and two very different purposes for the system. It is inevitable that the primary purpose will have precedence.

The blog post relates the story of the Mayo Clinic who are having a problem getting more than 50% of the 240,000 patients who have signed up for their patient portal to actually use the portal.

Mayo Clinic has pinpointed the fact that their portal doesn’t engage their patients. It is an interesting concept. We often think more of face to face interactions or resources needing to be engaging. As a result, Mayo Clinic has adapted social media and social networking models and developed an app so patients can access their health information.

Most people engage frequently with online shopping, social networking and social media sites and the attributes of these systems needs to form the architecture of great patient portals.

Developing a patient portal shouldn’t be an add-on but a separate and equally important development alongside a portal for health professionals. Each portal has a different purpose, a different audience and needs different architecture and features.