Covid drives patient interactions online

NEWS - eHealthNews.nz editor Rebecca McBeth

A quarter of all patients enrolled with a GP in New Zealand are registered to use a patient portal.

New figures from the Ministry of Health show that as of September 2020, nearly 1.2 million people are registered to use a patient portal, up from 970,000 in September 2019.

More than 680 general practices are offering portals, which allow patients to interact with them online by booking appointments, ordering repeat prescriptions and viewing lab results, and some primary health organisations now have all practices offering the digital service.

Chair of GPNZ Jeff Lowe says that while having a quarter of eligible patients registered nationally is an improvement, it is still “pretty poor uptake” given that portals have been available for more than a decade.

“I don’t think it’s good enough. I think far more practices and practitioners should be using portals as I’m sure that if patients are given the choice, they will use them,” he tells eHealthNews.nz. 

A Ministry of Health spokesperson says it is keen for as many general practices as possible to offer portals to their patients and it has worked with the sector over the past five years to encourage their effective use, with a focus on improving equity. 

The number of patients registered for portals has risen by more than 20 per cent over the past year, which the spokesperson says is likely driven by lockdowns to prevent the spread of Covid-19.

The pandemic has driven a ten-fold increase in the number of practices offering video consultations, from just 30 in September 2019 to more than 300 in September 2020. 

The number of practices offering patient access to clinical notes has also risen by 45 per cent and laboratory results by nearly a third over the past year.

Lowe is a GP at Karori Medical Centre in Wellington, which was an early adopter of patient portals and has 90 percent of eligible patients (aged 16 and over) registered and 80 percent activated to use one.

He says portals increase the reach of practices, especially to patients who, for various reasons, are not often seen by a doctor.

His practice data shows equal uptake for NZ European and Māori patients, but slightly less for Pacific and Asian, which Lowe suspects may be due to a language issue. He adds that a surprisingly high number of older patient and their families are frequent users of portals.

He believes portals provide better convenience for both patients and doctors and some patients are now choosing to enrol with practices that offer one.

“My experience has been that the portal has improved how my day flows and been a significant component in returning the joy of practising as a GP,” says Lowe.

However, the funding formula for general practice needs to change to support portal use.

“We need a funding model for general practice that is fit for purpose and incentivises the right behaviours, such as more use of patient portals and e-consultations,” Lowe says.

At the country’s largest Primary Health Organisation, 37 per cent of patients use a portal: the same as the number using it before the pandemic hit in January 2020.

Sue Wells, associate clinical director at ProCare Health, says that while the PHO did not see a big increase in portal use due to the pandemic, it did see a 250 percent increase in the use of video consultations virtually overnight when the country went into level 4 lockdown last year.

Wells says the PHO wants to improve its data around portal use to better understand who is registering for and using portal functionality as without this, the PHO does not know if there is inequity of access and where it should target resources to improve uptake.

“We want to know from the portal vendors more about who’s booking appointments and having consultations etc, especially for different groups like Māori and Pasifika. We don’t want to increase disparities so we are very keen to improve the data,” she says.