The Case Against Patient Portals

jordan shlainLet’s stop calling them patient portals, for crying out loud.

It’s a relic of the early internet days; when you could go to this cool technology called the world wide web that let you peer into far away places which were new and candidly, otherworldly. Yahoo was a portal – waaaay back in the day. To me, it’s reminiscent of the old TV shows Land of the Lost dimensional portal and Star Trek machinations about the future. It conjures up quantum physics and a tear in the time-space continuum.

For some reason, the healthcare cognoscenti are as creative as a lizard when it comes to using language that is both welcoming and fresh.

Patient Portals sound sterile and distant. Furthermore, a portal is a gateway; both an entrance and an exit. Patients, or better, people want access. They want information like everyone else…and why are they called patients (separate post – coming soon).

We don’t log into an Apple Portal, a Facebook Portal or a Google Portal.

If the healthcare industry is attempting to create a lexicon that provides a friendly environment, we should look no further than our current world wide web, not the one from 1996. I have not seen any reference to portals on any website in 2014.

Why do have to label this type of access to our medical records or our doctor. Every other web-service has a log-in button and when you log-in, you have immediate access to the products and services. Simple.

Healthcare has a bad habit of using words that suck (hence my screeds). Hopefully we can change that by thinking outside of our stogy, large, healthcare box.

When healthcare treats patients more like people, we have a chance to re-frame the experience and the sad impression of our impenetrable Fortress Medicine

I welcome any ideas for better descriptions…if we need them.

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14 replies »

  1. As a patient and healthcare professional, I only use my “portal” to communicate with my doctor. Which is a great use of technology.

    As a patient though, I have to wonder why my records aren’t as accessible to me (free of charge) as they are to everyone else in the industry…

  2. Well, there’s 4 minutes I can’t get back in my life. I was expecting a well-researched psychological theory as to why some patients ignore technology that is made available to them. Instead, we get an emotional and unsubstantiated tirade about terminology and semantics. In the future, Doc, do a patient survey instead of portraying your own pet peeves. All of us have better things to do with our most precious time. By the way, you seem to have missed the concept that in most cases it IS a portal, wherein you can submit and receive data. Personally, Star Trek (not necessarily Land of the Lost) got it right and we can only hope to live up to their examples some day.

  3. Our industry has become so unfriendly and complicated for our customers ( patients). We talk another language. Look at your business office’s and financial assistance offices and the lines of client that have simple questions. This tells me we have problems!

    Patient portal is scary. Let’s call is “Customer / Patients personal information link”

  4. I like Patient Portal… it gives you fair warning that you are logging into a system that runs on a 486 and a 56k modem… Or if you are lucky the hospital might let you save your records on a floppy disc!

  5. I’ve been criticized many times for referring to “health consumers.” While even that isn’t my favorite, it certainly beats “patients.” “Patient”, as health professionals use the word, implies illness as well as creating a patriarchal relationship. Then, there’s the issue of turning this word into an oxymoron, considering how long people have to wait to meet with the clinician after arriving on time for a scheduled appointment. I am anything but patient when I’m kept waiting! Whatever happened to time management!?

    There are those health professionals who do believe data should be portable and that the best way to enable portability is to make the person whose data it is the hub. To that end, we are building Personal Health Cloud (http://www.personalhealthcloud.com) where one can gather and manage all one’ health data.

    As for those pesky patients who insist on taking their own BP and waiting until their condition is critical before seeing a doctor, there are a lot of extenuating circumstances that lead to that behavior. Maybe they just don’t like going to a doctor who has a superior attitude. Maybe they’re afraid to go to the doctor because they believe it’s going to be bad news. Maybe they feel they can’t afford it. Maybe they think that if they are admitted to the hospital, they’ll never leave.

  6. Great idea to move beyond the archaic Portal concept. But renaming is a challenge: Patient Data Access App? MyChart is good but specific to one product. How about My Health Data?
    I also welcome other ideas.

  7. My patients take their own BP and other data, and think they are the doctor…neglecting disease until critical requiring hospitalization.

    All is not well with the patient wellness and independence movement.

  8. I would like to know why I can’t just call my doctor’s office to find out results of lab work? Why do I have to use a patient portal (which sounds like I’m going to another time)? I should have been able to call my doctor five days ago to get the results of my lab work, but no, I have to use the patient portal. And I still have no results!

  9. “Why do have to label this type of access to our medical records or our doctor. Every other web-service has a log-in button and when you log-in, you have immediate access to the products and services. Simple.”


    I have equal disdain for the word “interoperability” (I call it “interoperababble”). We really just mean iteratively and recursively accurate “data exchange.”

  10. But health care still is living in the past. Patients are given very limited views of their own medical information (which I once compared to a peep-show in that it has a “look but don’t touch” or “look but don’t own” mentality toward patient data). Calling them portals is appropriate in that it basically acknowldges how far behind health care is than the rest of the world. Until we give patients access and allow them to participate in their own records, we might as well continue calling it “portals.” Anything more would be dishonest.

  11. Excellent post. I think a core issue is that the sick care system (it only treats the sick after all!) doesn’t deal with “people.” It deals with patients, from those needing a simple screening or check-up to the most sick. But it does not deal with regular, run-of-the-mill people, so calling it a patient portal never gets challenged or even questioned.

    There is a reason most of the real innovation comes from outside the system. Talk about a hidebound, stodgy, inward looking industry. Yikes……