Part 2: Understanding the intended benefits of patient portals

Ministry of Health: Supporting the implementation of patient portals.

2.1
In this Part, we examine whether the Ministry had a clear understanding of what it wanted to achieve from supporting the implementation of patient portals, including:

Summary of our findings

2.2
Patient portals were an important part of the Ministry's strategic outcome to encourage and empower people to be more involved in managing their health and making decisions about their treatment.

2.3
The Ministry and other health sector organisations clearly understood the intended benefits from using patient portals, which included improving people's access to, and the efficiency of, health services.

The Ministry of Health's strategic outcomes

2.4
The Ministry was clear about how patient portals could support its strategic outcomes.

2.5
Patient portals were part of the Ministry's eHealth work programme. The eHealth work programme aimed to contribute to achieving the strategic outcomes described in the New Zealand Health Strategy 2016.1

2.6
The Ministry saw initiatives from the eHealth work programme, such as patient portals, as making the best use of innovation, research, and emerging technology to deliver better health outcomes for the public.

2.7
The New Zealand Health Strategy 2016 had five strategic themes:

  • people-powered;
  • closer to home;
  • value and high performance;
  • one team; and
  • smart system.

2.8
Patient portals primarily supported the "people-powered" theme. This theme is about making people "health smart" – that is, people can get and understand the information they need to manage their care – and enabling them to make choices about the care or support they receive.

2.9
The Government's vision for people-powered health by 2026 included that:

People are able to take greater control of their own health by making informed choices and accessing relevant information when they need it; for example, through electronic patient portals.

The intended benefits of patient portals

2.10
The intended benefits from using patient portals were widely reported. They were detailed on the Ministry's website and in its strategic documents, in most of the guidelines and reports produced by the Ministry and other health sector organisations, and in some presentations to the heath sector.

2.11
We describe the main intended benefits below.

Intended benefits for people who use patient portals

2.12
Patient portals could support new ways for people to interact with their doctor. For example, people could log into the patient portal website and access services when and wherever it was convenient for them to do so. People no longer needed to wait for their general practice to open to book an appointment.

2.13
Patient portals could also make it easier for people in remote areas and those with limited mobility, such as older people or people with disabilities, to access care. For example, people could consult their doctor online through the patient portals, which would help reduce travel costs.

2.14
More importantly, patient portals could improve the quality and safety of health services by providing people with better access to information about their health. This could help people to:

  • understand their health condition better;
  • be better prepared for consultations;
  • understand and take their medication better by having the instructions available;
  • remember and follow their care plan; and
  • be more involved in their own healthcare, including detecting and resolving health problems earlier.

2.15
Patient portals are expected to help people improve the quality of their relationship with their doctor, based on people having a more informed view of their own healthcare needs.

Intended benefits for general practices

2.16
As well as improving the quality of the relationship between people and their doctors and people's engagement in their own health information, the intended benefits for general practices mainly centred on improving the efficiency of administrative tasks. For example, patient portals could reduce:

  • the time staff spend on booking appointments;
  • paperwork; and
  • the number of phone calls staff need to make (by having automated patient recalls and appointment reminders).

2.17
Patient portals were expected to reduce information and activities going through or involving multiple people. For example, through the patient portal, people could order a repeat prescription directly from the doctor instead of having to go through the administration and nursing staff first. General practices could also tell people, through the patient portal messaging system, when their prescription was ready.

2.18
Patient portals could also be a useful quality control measure because people were able to spot errors in their health record and request corrections.

Intended benefits for the health system

2.19
The Ministry had reported that people who were more involved in their healthcare through the use of patient portals could improve the quality and timeliness of health services, reducing demand on health organisations.

2.20
The Ministry also reported that there was increasing evidence that people who felt able to make decisions about their healthcare often chose lower-intervention and lower-cost options. This was in contrast to decisions made by doctors in traditional healthcare settings. To make better decisions about their own healthcare, people need reliable access to information about their health and to understand the various healthcare options available to them.

2.21
The intended benefits of patient portals included improving people's access to their personal health information, improving the efficiency of health services, and contributing to the quality and safety of health information.

2.22
In our view, the Ministry had a clear understanding of how patient portals could support the strategic outcomes in the New Zealand Health Strategy 2016, including the intended benefits for people, general practices, and the health system.

1: Ministry of Health (2016), New Zealand Health Strategy: Future direction, Wellington.