As a network we have approximately 11 per cent coverage, with ProCare in Auckland currently 'leading' the way at about 20 per cent of their population on portals.
This was probably my biggest fear, but actually it doesn't happen at all. For some patients they may flick me a few more emails when their anxiety flairs - but this lets me know where they are at and is easy to manage compared to them coming in to see me without having that bit of warning and background. A lot of the time a quick message back via the portal gives the reassurance they need, without doing a whole consult.
I've actually found having the portal has been really good for reviewing my mental health patients. It lets me check in with them, ask quick questions and it is all recorded in the notes where it wouldn't be with a phone call.
It's also been helpful with keeping in touch with a few certain people in their times of need, particularly around times such as Christmas where normal clinic hours aren't in place and patients are travelling.
I figured I was already attempting to manage my inbox and ringing patients, using a portal was going to be one more thing to check every day and really and how much more could I take? But I can hand on heart say it hasn't added any workload. I was already dealing with all these things, but now I'm doing it better.
There used to be a lot of phone tag, with numerous people at the practice having involvement. Now it is more direct, it is between me and my patient and I know exactly what is said - and many times there is a written record of what was said too. If I'm honest I used to get a bit of contact via my email previously anyway, then I had to copy and paste it into patient notes, so this saves that step. Also since it is already an online exchange it's so easy to point the patient to further information also found online.
Using the portal has also given us a chance to really think about who should be involved in what. We improved our practice around the ordering of repeat scripts, streamlining the process as nurses can't do the whole process anyway, so we've freed their time for their nursing workload and we do our own repeat scripts.
Where I work we have some 'protected time' for when we hit a certain volume of patient portal usage. This is the business acknowledging that working on the portal is in fact a good use of time, it is work that would be done one way or another. Doing it by portal is different but better.
I was so worried that people would email about things that I would want to see them for, and then be annoyed if I pushed back and asked them to come into the practice - after all we'd gone and signed them up on the portal! But actually if I ask someone to come in on the basis of an email exchange it means I'm ahead of the game as I already know what is on their mind and I'm ready for it.
Having contact via email has been really good in getting some simple stuff done, such as doing a script for reoccurring conditions with no consult needed. Or getting people off to do tests prior to coming in so I've got the results in front of me when I see them.
The services we provide our patients aren't all for free. Income is generated via the portal with things like work certificates or repeat prescriptions still attracting a fee.
I knew logically that portals meant anytime, anywhere access but the technology really proved its worth when I had a family away on an island with no medical staff and their little one started to show symptoms of croup. They were able to contact me and I gave general medical advice around the 'red flags' to watch for so they could be wary of when they might need to make a decision to leave for the mainland where they could get medical help. They also knew what to expect overnight and it gave them a lot of reassurance.
I think it really does strengthen the bond. Patients can be on the move, anywhere in the world, but still be in contact with the doctor they know, and who knows them and their history.