Portals | MD's - Part 3 - The Physician and the Portal

written by Dr Johann Schreve

Circulating Knowledge


Patient portals are now part of the digital patient management era and I thought that it would be a good idea to do a 5 part series around this controversial topic. 

Introduction to the Patient Portal

I go over some of the elements captured within the patient portal.

The Patient Centred Approach


I discuss the core reason behind the patient portal.

The Physician and the Portal


I discuss the physician’s role in making the portal successfull.

The Portal: Flow and emotions

I explore the core of the portal and how information flows through the specific levels of care. I also explain some of the emotions that drives certain patient behaviors and how you as physician, can direct these emotions.

Future Integrations


I go over some of the more futuristic ideas around the patient portal.

The Physician and the Portal

The medical record was always owned and operated by physicians. With the enhancement in web security, corporations that host these programs, were able to develop an extension of the record, that enables the patient to view the documentation by logging in to a secure network. This extension allows the patient to see the information that is only relevant to them and yields, The Patient Portal

The main reason for developing these portals is to enhance patient autonomy and embrace a patient centered approach. Some will argue that documentation within the portal is written in medical terminology that often creates unnecessary anxiety and confusion. I agree, but patients are quick to admit their limitations and will often discuss this with their primary care provider, which in return opens the door for collaboration regarding their health.

Portals are set up to send out a text message or email to the patient when new reports or results are available within the portal. I personally find this notification system extremely beneficial as the portal becomes a live ecosystem that wants to be explored. 

The idea that patients have total access to their records might be scary for most physicians, but patient focus groups showed that patient portals creates trust amongst users, regarding their health providers. With access to information all around them, patients are keen to look up abnormal results and although it can create that anxiety that I referred too earlier in this article, it does provide them with choice to consult a physician or nurse practitioner.

Using the portal to your advantage

Portals provides patients with 24/7 access to their medical record.

The portal can effectively be used as a communication tool and adds an additional safety net for patients that requires in-hospital care or emergency care. How can this be done?

  • Medical terminology is a language that takes approximately 7 years to learn in most cases. It allows physicians to effectively communicate with each other through documentation or telephone communication.  Patients don’t have the ability to understand our language and by adding a clear follow-up instructions section within their note, physicians are able to effective communicate the following in plain English:
    • Red flags that should prompt the patient to return.
    • When and how to follow-up outstanding results
    • When and how to follow-up with primary care providers
    • Explanation regarding abnormal tests and what was done to manage them
    • Side-effects that may be encountered when a medication was prescribed.
    • Specific abnormal findings on examination that requires follow-up
    • Seeing the plan of care and next steps documented can help reduce patients’ anxiety and make them see that proactive steps are being taken to manage their condition.
  • Keep Language Professional
    • Keep language within the report professional at all time. Focus on the diagnosis and plan of care.
    • Remember that the information is accessed by people outside the clinical setting.
  • As the document is digital, links to relevant resources can be added to allow the patient to navigate reliable resources directly from their portal.
    • Emergency Physicians can add links to the  Information Sheets section developed by the BC Emergency Network These are available in 6 languages

What should physicians avoid?

The note or summary is a legal document that should always be handled with care. Careful consideration should be given regarding the following:

  • 3rd party information and how it is captured within the document
  • medical jargon
  • inaccurate and untruthful facts

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