Are portals pushing away patients? A conversation with Michael S. Wolf Ph.D
Written by: Jason Free, Executive Editor
Michael S. Wolf Ph.D. is a health services researcher and a Professor of Medicine at the Feinberg School of Medicine at Northwestern University. Most of his research focuses on health system complexity and the methods patients have available to access and use healthcare systems to support their personal health. He and his team spend a great deal of time focused upon patients who have more chronic care needs and how the healthcare system is helping, or not helping, these patients stay engaged in their self-care.
In terms of healthcare IT, Wolf's work focuses upon how patients today are gaining the opportunity to utilize a variety of consumer health technologies to stay engaged with their healthcare system whether it be a portal or using mobile apps. His work has found that a lot of these tools have not been well designed in terms of patient engagement and that they are even pushing away the patients who are in the most need of assistance.
(Editor's note: To hear audio excerpts of this interview, click on the media player buttons that run throughout this article.)
Free: Let's talk about the research you've conducted relative to patient engagement and portals. Your findings outline how certain patient populations are not only not getting the information that is available to help them engage in their care, but portals may actually be pushing them away from their healthcare information. Is that correct?
Wolf: Yes, that's correct.
To be clear, most of our research is focused on what we are calling lower health-literate patients. These patients, whether it be through a lack of health knowledge or access to good health information, show a concerning disparity in terms of the efficacy of patient portals. People who may have more limited health literacy skills, or limited capacity to properly engage health information, and use it to their advantage and make informed decisions, that tends to be a group that often times represents a number of disparities. Those who are older. Those who are more social economically disadvantaged. Those who belong to more racial-ethnic minority groups.
When we went into the study, we were asking the question: How would this specific population access information through a patient portal? To do so, you have to have computer literacy. You have to engage and remember your password. Then you have to have the knowledge necessary to find some functionality in the portal. We found that these issues are creating disparities within patient populations who may not have such technical capabilities.
As we went deeper into the study, we looked at two things. One, who has really enrolled in their patient portal? Two, if they were enrolled, among those who were enrolled, how are they using it? Was it a text or email to their provider to get information, did they look at lab values, etc.?