First, we need to define the terminology. Patient Portals are software or web services accessible in real time by both physicians and patients. Patient Portals come in two flavors: tethered to an EHR and untethered.
Tethered Patient Portals are just a different view of the doctor’s EHR. This is a restricted view of a patient chart and it includes the ability to communicate with the clinic in a secure fashion. Some EHR vendors provide their own Patient Portals, while others offer full integration with third party Portal vendors. In both cases, physicians use their EHR to communicate with patients.
Untethered Patient Portals are standalone Portals used for secure communications only. Patients can send and receive messages to/from their physician, but they do not have a complete view of their chart. Physicians cannot initiate communications directly from their EHR. Instead they need to log into a separate Portal application.
There is a third type of software/service usually mentioned in this context, and that is the Personal Health Record (PHR). The best known providers of this type of service are Microsoft Health Vault and Google Health. PHRs, however, are directed to aggregation of patient data from multiple sources and less concerned with real time communication between patient and doctor. PHRs are outside the scope of this discussion.
What is Health 2.0? The term derives from the better known Web 2.0 terminology. There are many definitions for Web 2.0, but generally speaking it is the new generation of web applications that are interactive (as opposed to static), collaborative, user centered and very social in nature. The most ubiquitous examples of Web 2.0 and its power are social networks liked Facebook, Twitter, You Tube and even Google Apps. Health 2.0 means pretty much the same thing for health care oriented applications. The newer EHR technologies that are delivered over the web, the various online patient communities, telemedicine, and remote monitoring devices are all examples of Health 2.0 applications.
A Patient Portal has all the makings of Health 2.0, but it lacks a social aspect. If a Patient Portal could allow the creation of patient communities and facilitate social interaction of patients with similar conditions or interests, it would be the ultimate Health 2.0 application, and much more powerful than larger internet communities of patients. The reason for this is that a Patient Portal community is also a physical community – people who have the same doctor, usually reside within a commutable distance. A Patient Portal Community could create relationships and support systems not just in cyberspace, but in the real world as well. For example, a Diabetes community could bring together folks that may decide to go for walks together every Saturday; dialysis or cancer patients can arrange for carpools; young moms can get together for play-dates or outings at the mall….. The possibilities are endless.
How does a doctor or vendor facilitate such benefits? The answer is very simple: by adding Forum capabilities to your Patient Portal. Forums are websites where one can go and ask questions, receive answers, start a conversation and get to know other people with similar interests. There are multiple options for free Forum software you can download or have hosted for pennies a day (see below). For privacy and security reasons, Forums should not be integrated with your EHR, but should be accessible from your Patient Portal. Even if you don’t have a Patient Portal, you probably have a website for your practice. You can add a link to the Forums right there. The hard part for the doctor is to configure Forums for the conditions you see most often, to encourage your patients to sign up, and actively participate in the conversations, at least initially. Your patients will more than likely take it from there. If you feel up to it, you may even add a blog to your Forums where you can provide guidance and advice, promote health and wellness and empower patients and families to participate in their own care.
While global Internet communities have obvious advantages in their sheer size and diversity, small local communities have the ultimate power of transcending the Internet and affecting real change on the ground, and isn’t that what Family Practice is all about?
Sample Free Forum Software:
PHPBB - http://www.phpbb.com/
SMF - http://www.simplemachines.org/
Forum Software Reviews
http://www.forummatrix.org/
http://www.forum-software.org/forum-reviews
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