HJNO Sep/Oct 2022

50 SEP / OCT 2022 I  HEALTHCARE JOURNAL OF NEW ORLEANS COLUMN COMMUNITY HEALTH The COVID-19 pandemic was dubbed by some as “healthcare’s use case for the patient portal.” It’s no secret that the worldwide COVID-19 pandemic prompt- ed healthcare organizations to adopt an array of patient engagement technologies such as telehealth, remote monitoring, and wellness apps to name a few. But the success and adoption of these new, elab- orate, expensive tools depended upon something that Federally Qualified Health Centers (FQHCs) already do really well — “connecting” with their patients. Communication is key to helping em- power patients to take an active role in their healthcare today. In fact, “patient en- gagement has been identified as an essen- tial dimension of the multifaceted solution to the cost/quality crisis in U.S. health- care,” according to a study published in the Journal of Medical Internet Research. 1 Pa- tient portal accounts were created by the healthcare industry as a means of increas- ing patient-provider communication. However, since the first portal account was created in the late 1990s, utilization remained low for many healthcare organi- zations, particularly FQHCs serving lower income and/or medically disadvantaged patients. The COVID-19 pandemic saw rates of patient portal adoption jump, of- ten in line with the proportion or volume of patients turning to telehealth visits; however, a study in JAMA Network Open further teases out gaps in the digital divide, citing that patients who are white and/or higher income typically have higher asso- ciations of portal usage and wired internet connectivity compared to lower income and/or Black or Hispanic patients who rely solely on smartphone internet con- nectivity, which is negatively associated with portal adoption. 2 Countless studies have well documented factors beyond socio-economic status contributing to low portal adoption rates, such as: lack of patient portal education, lack of standard instructions and hands-on training for patients, lack of provider and clinical staff education, and no portal promotion with- in the work environment. 3 Lack of portal registration and use is a content issue, due to a lack of information given to patients and providers about the portal. Portal use is also a context issue due to a lack of com- munication and promotion from staff. 4 But while some practices are struggling to bridge those digital barriers for their most vulnerable patient populations, others are raising the bar for creating this type of en- gagement. Electronic health record giant, athen- ahealth, reports that Access Health Loui- siana (AHL) has the highest patient portal adoption rate among all its FQHCs nation- wide. AHL cares for nearly 50,000 patients over a 12-parish range in the southeast and central parts of the state. While the major- ity of AHL’s patients are Medicaid recip- ients, portal adoption remains a priority among its patient population. “Access Health Louisiana continues to be the leader in Patient Portal adoption on the athenahealth platform. For the last two years they have been leading the FQHC’s on athenaclinicals with this metric,” states Heather Murch, Manager, FQHC Customer Success, athenahealth. Access Health Louisiana, like many oth- er healthcare organizations, incorporates a firm focus on patient engagement with its strategic operating plan. In fact, the organization ranked in the top 10% of all community health centers nationwide re- ceiving a National Quality Leader Award from the Health Resources and Services Administration (HRSA) in 2020. It’s Pop- ulation Health team uses a patient-cen- tric approach to evaluating outcomes and achieving the quality goals using a team- based care approach. By May 2020, just shy of 60 days after the city-wide lockdown in New Orleans, Access Health Louisiana converted all of its 400 providers and clinical staff span- ning 12 different Louisiana parishes to a virtual visit platform in order to maintain access to all of our critical primary care and behavioral health services during the THE POWER OF Patient Portal Use