Having been forecast for some time now, the hour of the patient portal seems to have arrived for US healthcare. In fact, according to a 2012 survey, 57 percent of providers already have a patient portal in place, although the survey sample size was somewhat small.

A number of market factors have converged to push these applications to the top of providers’ priority lists. Some have been artificially spurred by Meaningful Use, while others appear as natural evolutions of patient expectations.

Although patient engagement could be listed as one of a laundry list of terms making its way to the top of the healthcare lexicon, the concept behind the words isn’t entirely manufactured from the aforementioned federal regulations.

As it relates to patient portals, engagement really means access. Patients are accustomed to quickly and easily accessing personal information in other aspects of their lives without substantial barriers. Now they expect their health information to be available in the same fashion. Studies support this growing expectation: 41 percent of patients confirmed they would consider switching providers , yes, abandon relationships that span years , to gain more complete access to their health information.

It seems fewer and fewer patients are willing to tolerate providers who don’t offer an easy for them to access to their desired information. It’s been happening in other industries for years, and now patients are beginning to expect the same services from their healthcare providers.

Though not specifically tied to the shift in patient’s expectation of access, federal Meaningful Use laws are certainly relevant. To attest for Stage 2, providers must have 5 percent of their patients view, download, or transmit health information as well as implement reminders for follow-up appointments and identify relevant educational material for more than 10 percent of patients with two or more office visits in the preceding two years.

Providers often argue that the goals of Meaningful Use lean too sharply toward completing the checklist than actually improving patient care, but in the instance of patient portals the two seem aligned. Patients want greater access to their health information, and if providers want to receive federal subsidies for implementing new technology, they are required to grant that request.

Loyalty Above All Else?

Now that adopting a patient portal has moved from the realm of innovation and into the reality of necessity, the criteria with which providers are choosing specific products becomes an even more compelling topic to scrutinize.

Given the middling levels of satisfaction it seems most providers feel towards their electronic health record systems, usability, or the intuitiveness of the technology for the user, would have been a good bet as the top consideration for providers when choosing a patient portal.

The reality, however, is far different.

Based on the results of a recent KLAS survey, providers most often choose portals that feature as a model of their current EHR system. The report highlighted that provides were willing to overlook interoperability if they could implement a functioning portal through their current EHR vendor.

These findings underscore a trend in provider’s healthcare IT buying habits: the desire to limit and simplify vendor relationships.

While providers would likely prefer intuitive technology, the task of managing multiple vendor relationships seems to be a great enough deterrent that physicians and hospitals would rather opt for one healthcare system that manages everything.

Having a system that integrates everything from practice management to patient portals seems to be the direction in which healthcare IT is headed.

Popular Integrated Portals

Tethered portals simply refer to EHR portals that are provided by the same vendor as an EHR system, while untethered portals are more likely to be vendor agnostic. With a nod to the aforementioned findings that physicians prefer tethered portals, let’s examine three popular examples of tethered portals.

Epic MyCharts

It would be a huge oversight not to mention the portal for the most popular EHR on the market. Although MyChart only integrates with EPIC EHRs , par for the course at this point , the portal does offer providers, and patients, a wide range of functionality. Patients can install MyChart’s mobile app on their smartphone or tablet and access their records while traveling or on-the-go.

Additional features include the ability to pay medical bills online, and for parent’s to access their children’s records. In a nod to population health management, patients with chronic diseases can get disease summary updates with treatment reminders, and view educational information related to their data stored in the EPIC EHR.


By acquiring Jardogs and its FollowMyHealth system, Allscripts added one of the most robust patient portal applications as a supplement to its electronic health record system. Providers already considered Jardogs’s patient portal a best-of-breed application before it was purchased by Allscripts. The portal’s interoperability allows patients to aggregate data from disparate sources and use the portal as a personal health record.

Though most integrated EHR portals are limited to only gathering data from their respective EHR systems, it’s possible that Allscripts will maintain the versatility of Jardogs’s portal. That would put them ahead of the market in terms of exchanging health information with other EHR systems, which is required for Stage 2 interoperability.


Rated highly in a 2012 KLAS study, NextGen’s portal didn’t feature enough responses to be rated in the 2013 report. However, this probably speaks more to the regional differentiation of healthcare IT products than it does to a decrease in market share.

As you might expect, NextGen’s portal features intuitive native integration with the company’s EHR system, and also includes detailed features for gathering patient data throughout the user experience. This portal also lets patient refill prescriptions, view their health records, and even allows providers to add patient information to a health record from their email inbox.


What does the loss of market share mean for best of breed and EHR agnostic portals? Is interoperability being put on the backburner in favor of seamless integration with one system? Share some insight in the comments.

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