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Patient Access and Engagement

Galen M. Metz, FLMI, AIAA, AIM, ACS

Posted by Galen M. Metz, FLMI, AIAA, AIM, ACS
January 3, 2018

The next phase of the Electronic Health Record (EHR) continuum is patient access, enabling patients to interact with the capability and data the EHR brings. First let us look at ideas for the capability to provide. Then, once the capability and data is provided, let’s examine ways to encourage and motivate patients to actually use it.

If you build it, will they come?

 Why is Patient Access important?

  •  Relationship to outcomes and cost
    • A February 2013 Health Affairs study found a relationship between patient engagement and costs. Low engagement "had predicted average costs that were 8% higher in the base year and 21% higher in the first half of the next year than the costs of patients with the highest activation levels." As Judith H. Hibbard, University of Oregon, and her colleagues wrote, "As healthcare delivery systems move toward assuming greater accountability for costs and outcomes for defined patient populations, knowing patients’ ability and willingness to manage their health will be a relevant piece of information integral to healthcare providers’ ability to improve outcomes and lower costs.”
  •  The experience
    • Patients may measure healthcare against their last drive-through experience. This is increasingly a consumer-oriented environment, so the patient experience is rising in importance as a measure of the overall healthcare organization. 
  • Top of mind for physicians
    • According to CDW Healthcare’s 2017 Patient Engagement Perspectives Study, 71% of providers list improving patient engagement as a top priority.


What are the key elements of patient access?

How can you provide better access to patients?


  1.  Transactional capability

Here are examples of communication and navigation potentially provided by a patient portal.

  • Schedule (or request) appointments with your physician
  • Securely email questions and feedback to your care team
  • Receive copies of “after-visit summaries,” a documented reminder to what was discussed and physician instructions during your visit
  • Lab results, for timely access and a record of your test results
  • Reorder prescriptions via the portal, rather than a pharmacy visit or phone call
  • Access to medical history: immunizations, medications, etc.
  • The ability to pay your bills via the portal

Such portal transactions provide convenience for the patient and efficiencies for the healthcare organization. 

  1. Education

For patient access to reliable medical information on conditions, causes, and treatment options, the portal may link to a third-party source (e.g., WebMD). This provides a guided link to a reliable source, rather than having patients roam the internet on their own accessing medical information from dubious sources. 

  1. Outreach

The portal provides a vehicle for outreach interactions, like the following:

  • The healthcare organization has the capability, via the portal, to present the patient with wellness surveys to better access health conditions and opportunities.
  • The patient can be reminded of tests or immunizations due.
  •  Data analytics. Though an analysis of the data, patients may be identified for specific outreach, like nutritional training opportunities for diabetics.

 How to encourage use

According to Chilmark Research in mid-2016, patient portal adoption is generally around 25-35%. What drives adoption, in my experience, to a best-in-class engagement of over 40%?

  • Make it easy. Provide an easy and painless way to sign up for the portal. If possible, enable signup on the spot – at the registration desk rather than later via email or snail mail. Strike while the iron is hot.
  • Reminders at every opportunity. For example, when the patient has lab work, remind him/her that the results would be posted and available via the portal. Wherever the portal could facilitate the process – at registration, inquiries about results, phone calls to the call center, etc. – remind the patient of the portal and its capabilities to help.
    Connect, contact, and make reach-out simple.
  • Communications. Send out reminders in newsletters and mailings. Post reminders on electronic message boards or posters in the waiting room. Consider a reminder message on your billing notice. 
  • Smartphone. Like with retail, provide convenience via smartphone and tablet access, not just with PCs and laptops.
  • With your existing patients, as well as new patients, conduct a portal signup contest. “Sign up and If you build robust tools for parient access, people will use them, unlocking the potential of entered in a drawing for several valuable prizes.” You may find that for the modest cost of several prizes, the patient portal adoption rate may rise significantly.


Build a patient portal with these extensive capabilities, encourage engagement with the ideas provided, and discover that “when you build it, they will come.”





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Galen M. Metz, FLMI, AIAA, AIM, ACS

Galen M. Metz, FLMI, AIAA, AIM, ACS

Galen is author of • Secrets of Healthcare IT Revealed ( • If You Give a Mouse an EHR – A Parody ( • The Holistic CIO ( He retired after 30 years of healthcare IT management. Previously Galen served as CIO of Group Health Cooperative in Madison, Wisconsin, with responsibilities for the electronic medical record system, health insurance system, self-service web and mobile solutions, business intelligence, and technology infrastructure. Galen is also a professional magician, specializing in close-up magic. The relationship between technology and magic was observed by Arthur C. Clarke, who wrote, “Any sufficiently advanced technology is indistinguishable from magic“.

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