As many good ideas do, it began, with a simple question at a recent membership meeting of the MA Coalition for the Prevention of Medical Errors (MA Coalition). The MA Coalition's members, quality and safety professionals from health care, community organizations and state agencies, were having a thoughtful exchange with Ellen DiPaola, President, Honoring Choices MA, discussing the importance of every patient “owning” their own Health Care Proxy and having the ability to easily review it, update it, and share it with their health care providers.

The question, posed by Annette Roberts, Director of Quality & Patent Safety, Milford Regional Medical Center seemed straightforward enough: “Can I upload my Health Care Proxy into my patient portal?”  The answer, surprisingly, turned out to be anything but simple.

Patient portals are on-line services linking patients to their physician offices, hospitals and health systems. They offer 24/7 access to help doctors and patients manage appointments, medications, test results, and sometimes, to share information with regarding informed decisions about care. Seemingly an ideal and secure way to manage all of that, storing a Health Care Proxy and other care planning documents, at present, isn’t something most patient portals allow.

Annette’s question, therefore, yielded a surprising answer which sparked some interesting suggestions. For example, if you could upload your Health Care Proxy to appoint your Agent, why not also upload your Personal Directive and MOLST (Medical Orders for Life-Sustaining Treatment) as well. In addition to merely uploading copies, could the patient view, update as needed, store and share these documents with family and providers within patient portals?

These questions led us to the next logical one, but one for which we also didn’t have the answer: by uploading the Health Care Proxy to your patient portal, is the document automatically transferred to your Electronic Medical Record (EMR)?  If that were the case, all of your treating health care providers and members of the care team would readily have it when needed, including a hospital’s Emergency Department in a medical emergency.

“Imagine if, as a patient, you could make your Health Care Proxy available to your physician, and keep it updated, through your patient portal,”  said Paula Griswold, Executive Director, MA Coalition. “Think how valuable that could be for patients and for their care providers, to ensure that there is an easily accessible, up-to-date version of their planning documents when needed.”

As a result of these questions, The MA Coalition and Honoring Choices MA began a joint project to look more closely at the utility of patient portals to improve the patient's ability to manage their health information and care decisions, thereby enhancing the care provider's ability to deliver high quality, person-directed care.  We are discovering just how diverse the “patient empowerment features” are on the portals offered by different providers. In some, patients can view and share information with their Agent & family members. Others don’t offer those features. Still others are currently working on innovative features.

Seeking to know more, we’ve designed "The Portal Challenge" a simple one minute survey- just 4 questions and a comment section to share your ideas. What can your Patient Portal do?  What would you like it to do? We welcome your ideas to maximize the effectiveness of this powerful patient-care provider tool.  We will post comments as we receive them to help foster an open dialogue.

Take the Portal Challenge here.