Pros and cons of patient portals in electronic health record

A patient portal is an online platform that allows patients to access their medical information and interact with healthcare providers.

Traditionally, patients would have to wait to hear from their nurse practitioner/provider about test results. They would be notified via telephone or receive a letter in the mail. If the patient had a question or needed to contact the nurse practitioner, they would have to call the clinic. 

Technology has provided ways patients can access information and connect with their nurse practitioner. Patient portals are a way for patients to login and see personal health information. Many of the patient portals are hosted within the electronic medical record. While patient portals offer several advantages, they also have some drawbacks.

Here are the pros and cons of a patient portal in a medical chart:

Pros of patient portals:

Enhanced access to medical information.

Patient portals provide patients with convenient access to their medical records, test results, appointment schedules, and medication lists. This access allows patients to stay informed about their health status and make more educated decisions regarding their care.

Improved communication.

Patient portals facilitate communication between patients and healthcare providers. Patients can securely message their nurse practitioners, ask questions, and seek clarifications without the need for an in-person visit or phone call. This streamlines the communication process and can lead to quicker responses and reduced waiting times. 

Convenience and time savings.

Patient portals eliminate the need for patients to physically visit the healthcare provider’s office for routine tasks such as scheduling appointments, requesting prescription refills, or viewing lab results. This eliminates the need for patients or providers to call the patient, play phone tag, or leave a message and never get a call back. This convenience saves time and effort for both patients and healthcare staff. 

Proof of communication.

The patient portal shows a proof of interaction between the patient and the nurse practitioner. Many information shared across the patient messages feature is saved and can be recalled. If the nurse practitioner is ever involved in a medical malpractice case, the written information is part of the patients chart and will be presented during the case.

This may be beneficial to the nurse practitioner, i.e. written instructions of when to follow-up in the clinic were provided. Or it may be detrimental to the nurse practitioner, i.e. the patient had a complained (via patient messages) of shortness of breath and the proper evaluation and treatment was not provided by the nurse practitioner. 

Empowerment and engagement.

By having access to their medical information, patients become more engaged in their healthcare. They can actively participate in their treatment plans, monitor their progress, and take preventive measures. This increased patient engagement often leads to better health outcomes.

Privacy and security.

Patient portals typically have robust security measures in place to protect patient data. Secure authentication methods, encryption, and privacy policies ensure that sensitive information remains confidential and is only accessible by authorized individuals.

Nurse practitioner able to view medical information. 

I have had multiple instances that the patient was hospitalized or had lab work/radiology tests at a different facility. Instead of waiting to access medical records (can take several days) the patient is able to log in to their patient portal and pull up information. This makes it much easier for me to review the test results without having to repeat the lab or wait for medical records. 

Patient portals provide many benefits for both the patient and the nurse practitioner. With the advancements in technology, patient portals will always be a part of our practice. Nurse practitioners must embrace the use of patient portals but also be aware of the negative aspects. 

Cons of patient portals:

Technical barriers.

Not all patients may be comfortable or have access to the necessary technology to use a patient portal effectively. Elderly patients or those from disadvantaged backgrounds may face challenges in navigating online platforms or lack internet connectivity, limiting their ability to benefit from a patient portal.

Information overload.

Access to extensive medical information can be overwhelming for some patients. Complex terminology, test results, and treatment options may confuse patients who lack medical knowledge. Healthcare providers must ensure that patient portal information is presented in a clear and understandable manner to avoid confusion.

Access to serious medical information. 

I have had several patients that have logged on to their patient portal to view their test results. Unfortunately the test results were not good (for example biopsy results that showed cancer). These patients found out they had a life altering diagnosis via the patient portal instead of me informing them.

I was not able to provide the personal interaction and compassion when telling them the results. I was not there to provide support or answer questions. This access to serious medical information has created a lot of anxious emotions.

Limited personal interaction.

While patient portals facilitate communication, they cannot fully replace the value of face-to-face interactions with healthcare providers. Some patients may miss the personal connection and reassurance that comes from direct human interaction. Additionally, certain medical conditions may require physical examination or visual cues that cannot be conveyed through an online platform.

Technical issues and reliability.

Patient portals rely on technology, and like any digital system, they can experience technical glitches or downtime. This can disrupt patient access to their medical information and communication with healthcare providers. Reliability and system maintenance are crucial to ensure uninterrupted service.

Unequal adoption and access.

Not all healthcare providers offer patient portals, and even among those who do, adoption rates can vary. This leads to unequal access to the benefits of patient portals, with some patients being left out. Additionally, language barriers or disabilities may pose additional challenges for certain patient populations.

Time management difficulties. 

Nurse practitioners already struggle having to stay late at the office and bring charts home. Not only do nurse practitioners have to assess, diagnose, and treat patients. But they also have to document their findings and plan of care.

Not to mention addressing medical refills, reviewing past medical records, and analyzing diagnostic data. Then add on the patient messages within the patient portal. Nurse practitioners have to spend a lot of extra time addressing these patient messages.

Check out The Time Management and Charting Tips Course for additional tips.

Addressing patient complaints via patient portals. 

The increased access to the nurse practitioner allows patients to ask questions easily. However this can cause an issue for the nurse practitioner. Historically, patients had to schedule an appointment to be evaluated and treated by their healthcare provider.

Now it seems like many patients try to get their issues addressed via patient messages instead of in an appointment. Not only does this take more time for the nurse practitioner to address but it additionally the nurse practitioner is not able to bill for their time. If the patient scheduled an in person or virtual appointment, it would help address these issues. 

Here are six tips for addressing patient messages.

Legal issues with patient portals. 

As mentioned above, many patients will notify their nurse practitioner via patient messages about acute or worsening symptoms they are experiencing. This can create legal issues because the nurse practitioner may not have the opportunity to check patient messages on a regular basis.

Suppose the patient notified their nurse practitioner that they were complaining of chest pain. However the nurse practitioner did not see the message until two days later. If the patient suffered a serious medical complication the nurse practitioner could potentially be held liable. There may also be issues with missed typed or misinterpreted instructions through the patient messages. 

Check out Legal Issues with Charting for other tips and ways to avoid a medical malpractice case. 

It’s important to note that the pros and cons of a patient portal can vary depending on the specific implementation, functionality, and user experience provided by the platform. Patient portals are growing in convenience and popularity. So nurse practitioners need to be aware of the negatives of patient portals and develop ways to manage.