Today’s Patient Portals CAN NOT Work: Friction ACROSS Portals

by Vince Kuraitis and Jody Ranck

Friction across multiple patient portals dramatically limits their usefulness—there’s no practical way for patients OR providers to reconcile and integrate information and workflow.

This is the third post in our series on patient portals. We’ve used platform terminology and concepts to explain why today’s patient portals are doomed to mediocrity. Let’s recap:

The first post in this series introduced the platform terminology of single-homing vs.multihoming. Patients strongly would prefer to have as few portals as possible — ideally one, i.e., a single “home”.

The second post described the difference between stand-alone value and network value. Today’s patient portals can provide some stand-alone value, but they provide minimal network value.

In this post we’ll discuss the pitfalls of friction across multiple portals. Your mom having seven portals is more than just inconvenient—it’s dangerous.

High Friction ACROSS Portals

Patients who must use multiple portals inevitably encounter friction. Think of friction as a pain point or as a barrier to getting something done. Let’s distinguish between different types of possible friction:

• Friction within an individual portal, e.g., lack of capabilities and functionality, poor UI. These are challenges, but they’re mostly under the control of the individual organization that provides the portal.
• Friction across multiple portals — what this post is about. Think of it as systemic friction. This friction will exist no matter how good the UI and functionality of an individual portal. For example, the hospital portal might have a good UI, but the hospital can’t control the UI and functionality of all the other portals that patients must use.

Examples of Friction ACROSS Portals

Patients experience portal fatigue. The friction and transaction costs of having multiple patient portals is high. Here are some examples of how friction inevitably occurs across patient portals:

Multiple signups: “I have to spend time and effort signing up for multiple portals. I forget passwords.”

Differing UIs for different portals: “Every portal has a different user interface. I get confused.”

Varying functionality across portals: “Every portal has different capabilities. I can’t remember which portal does what. Can I pay my endocrinologist on his portal?”

Clinical terminology is not standardized: “Is hypertension the same as high blood pressure?”

Data is not standardized: “Are test results comparable from different labs?”

Lack of one care plan to follow: “I have diabetes and other chronic conditions. I’d like to have one care plan to follow. Do each of my providers know what the other is doing? How do I know? How do they update one another on my condition?”

Uncertainty. “I’m a diabetic with a question. Should I visit the portal for my internist, my endocrinologist, my health plan coach, my diabetic educator, my podiatrist, my optometrist, my nutritionist, someone else?”

There’s no practical way for patients OR providers to reconcile and integrate information and workflow across multiple portals.

“To achieve hyper-adoption and high usage, bring down friction in usage. Lower barriers of skill, time, resources, money and access.” –Sangeet Paul Choudary, Platform Power

In the next posts in this series, we will:

• Summarize the findings of the first three posts
• Discuss implications — as currently structured, today’s portals can not achieve critical mass and network effects
• Propose some alternative patient portal platform configurations that could work