What’s wrong with today’s Portal?

John Moore from Chilmark Research , a leading industry analyst firm focusing solely on health IT, wrote an insightful article on what is wrong with today’s healthcare portals.

Reading John’s article got me thinking about why I started MDCapsule http://www.mdcapsule.comin the first place with my cofounder, Celina. Celina had been a patient of mine for over 10 years and during her health visits with me she would often ask my advice about medical issues pertaining to her elderly Aunts. Celina, being the caring and compassionate person that she is, is also the primary caregiver for her  3 elderly Aunts who all happen to be over 80 years old and limited in their spoken English(their primary language is Portuguese). She is part of the growing “sandwich generation”, millions of Americans, typically women between the ages of 40-50 years old, who are responsible  for bringing up their own children while at the same time caring for their aging family members. Check out CNBC’s Sarah O’Brien’s article “Being Stuck in Sandwich Generation is no Baloney” if you want to learn more.

Celina works in the software industry and was used to the ease of communication among departments, companies, and even international clients. But when it came to accessing information about her Aunts’ medical visits, it was like Fort Knox. Celina would make it a point to be present at the visits, bringing along with her folders of medical information from other physicians. But going to your Aunts’ multiple medical visits is often too difficult when you are working full time and can’t take the time off.  She would spend countless hours on the phone requesting the medical information and the physician’s notes on the visits, with limited success. The portals were no help either, with only labs or X-rays that she couldn’t interpret or understand. And not to mention the multitude of portals! Each Aunt had multiple physicians, with different portals…a Rolodex was just needed to keep track of the passwords for each!

And so we come to Celina’s medical visits with me. Instead of spending time with me going over her medical issues, Celina would take out her Aunts’ medical tests and ask me to interpret them. Of course I would interpret them for her but since I was not one of the physicians taking care of her Aunts, I always felt like I was shortchanging Celina, not really providing her with the adequate information she is entitled to and deserves as the primary caregiver. I would be left telling her to contact the physician responsible for the test, a cop-out that made both of us feel like helpless bystanders in the care process.

So what about portals? For Celina,  portals act as a repository of medical information that are often incomplete and impossible for her to interpret. In addition, the multitude of portals that she needs to access add yet another layer of complexity. Portals, instead of being a starting point to greater communication and collaboration between caregivers, patients and their physicians, serve instead as a barrier to that process. How often would I hear a patient ask me, “Doc, is my mammogram normal? there is stuff about calcifications and cysts…what does that mean?” As a physician, I am responsible for the care of my patient but within that is the responsibility of educating the patient and involving him/her in the care process. So do I think we should “Kill the Portal”…No. But we can make it a heck of lot better !

Dr. Nathalie