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Portals and the evolution of digital health

VP Strategy

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The Universe is big—really, really BIG. Up from “quantum foam” to whatever lies out and beyond observable space and time, the sheer magnitude of reality has not only limited our scientific understanding, but has posed logistical challenges for science fiction heroes and villains alike. From the writing of Jules Verne to the advanced computer-generated F/X of today’s films, simply getting from here-to-there across the Void has demanded imagination, credulity, and the seemingly inevitable wormhole or multidimensional “portal.”

Webster defines portal as... This is Google, actually

Webster defines portal as… This is Google, actually

Seems the original definition of the word meant “doorway” or “gate,” sci-fi and digital extrapolating the concept of an entrance to that of a bridge between worlds and websites. Makes sense, since the Internet has made information access as instantaneous and global as we’ve been fantasizing star travel could be. Along the way the “portal” has figured prominently not only on STAR TREK, but as a significant milestone in the evolution of how we use digital technology, and our expectations for an increasingly connected future.

As we provide value to our digital health clients, portals have been vital conduits of access and information between physicians, patients, caregivers, and institutional players. The continuous evolution of portals and how they are utilized reflects pervasive changes in technology, design, and user experience. To stay on top of digital health we need to take a close look at portals, understand their development in tandem with other communication streams, and apply best practices to improve our investment and patient health outcomes.

 

User-Experience Full-Circle: Portals and Back Again

Back in the Jurassic Age of the Interwebs, when Bill Clinton was in the White House and people generally had no idea what was possible, people needed all the help they could get simply finding what they were looking for. That assistance came in the form of “portals”—singular experiences much like railway hubs that provided access to every practical destination. Pages crowded with bright blue hyperlinks instantly took folks to mail, news, sports, their email, a phenomenon that made Yahoo! the most visited site on the planet.

Yahoo! home page from sometime around 1998

Yahoo! home page from sometime around 1998

The interface looks laughable after nearly two decades, especially considering how our increasing familiarity and confidence with the Web drove the tiny search box to absorb the entire page, portals passing the baton to search, Google ascending to digital dominion. That reciprocal relationship between user-behavior and user-experience is what makes digital so dynamic and unpredictable, so it should come as no surprise that the portal has resurfaced again and with a vengeance: Take a look at your mobile device for some digital déjà vu:

Mobile devices

Mobile devices

What do you see? A portal structure, of course! Those annoying bright blue hyperlinks swapped for multicolored icons. The infrastructure might be different—mobile apps replacing websites—but the experience and rationale are identical: Exactly like the UX in 1998, devices in 2015 provide a cluttered, illogical, and inefficient way to access data from a single (albeit mobile and touch screen) page. Why? Because mobile is analogously in its infancy, designers and users returning to portals as the simplest way to build and navigate.

 

Healthcare Portals: Falling Behind and Racing Ahead

Enter digital health, and what Eric Topol has described as the “creative destruction of medicine.” The inexorable convergence of technology, user experience, mobility, social connectivity, genomics, biometrics, and big data drive toward the end-goal of the quantified self, a perfect storm where disease becomes predicted and prevented, and interventionist “treatment” transforms into ongoing health and wellness. But a light year begins with a single step, and that crawl before we walk is centered around (drum roll…): Portals.

Who knew? Well, everybody actually. Portals evolved alongside the Web in the 90s, spearheaded by financial services companies that understood the benefit of sharing personal information directly with their constituents, and fostering, wherever possible, a two-way communication stream. The key to success was ensuring portals were practical, private, and secure. Still clunky and somewhat vulnerable, financial portals are nonetheless common—but healthcare lags behind for numerous reasons, some obvious, some less so.

The good news is funding and governmental incentives. The American Recovery and Reinvestment Act of 2009 (ARRA) pumped over $25B into health information technology, while most recently Meaningful Use Stage 2 requirements encourage electronic health record usage and integration. The bad news, however, is fragmentation and poor communication. Physicians already have a tough time with EHR, while the Xerox annual survey reveals patients are eager to participate, but 35% don’t even know when a portal is available to them.

Not surprisingly, enthusiasm for healthcare portals is inversely proportionate to age, Millennials more interested than Boomers. But both segments demonstrate significant increases in mobile device access, and heightened expectations for personalization, value-added services such as appointment scheduling, referrals, test results, physician Q&A, and even mobile health integration through “prescription apps” and eventually wearable tech.

 

The Road to Integration and Adoption

All these factors have led to astonishing growth in the utilization of EHRs among US physicians, up from less than 1-in-5 in 2001 to more than 78% in 2013.  Both HCPs and patients see a powerful correlation between heightened digital engagement and improved outcomes, the healthcare portal as a natural and inevitable conduit between physician’s office, hospital, managed care provider, patients, and their caregivers. But challenges abound, from HIPAA and data security, to the hundreds of active vendors and partners.

Opportunities nonetheless abound, again finding an optimal balance between user experience, and user expectations. The inevitable consolidation of hundreds of viable EHR/PHR candidates into a bifurcated “Coke vs. Pepsi” market could hinge as much on design decisions as competitive strategies: Make the interface simple, visual, and intuitive, and the UX customized, responsive, and easy-to-use. In 2015 all users want personalized dashboards instead of data dumps, TurboTax and Uber instead of Excel and .gov.

All the worthwhile effort from institutional players such as government and managed care aside, the end-user will be the final motivator and determinant of success. As patients and their caregivers become increasingly accustomed to the spontaneity, immediacy, and responsiveness of digital communications and technology in their everyday lives, so too will they come to expect nothing less from their healthcare. And what will take us where we need to go? Yes, that old standby of digital tech and UX, the humble but ubiquitous portal!

Beam us up, Scotty…

 

Key Takeaways

How might you and your client take advantage of these seismic changes in healthcare portals? Are you ready to enter the next phase of the mobile health revolution? Klick is eager to continue the conversation, and partner with the industry’s top digital health leaders. Follow @SpitzStrategy @bdkais, and the Klick blog for the very latest mHealth news.

More About the Author

Michael Spitz

A digital health expert since before digital health was cool, Spitz has since developed omnichannel campaigns for top pharma and device brands, and helps drive agency innovation, digital transformation, and emerging channels. See him present at conferences, read his blogs, and follow him for the latest trends and opinions on Twitter @SpitzStrategy.

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