Making the Most of a Portal

The patient had a mastectomy, then reconstructive surgery. At home recuperating, she felt horrible—lots of pain, a high fever, couldn’t hold food down. Her doctor had said, “If you need anything, e-mail me on the hospital’s portal.”

So that’s what she did. No answer. She figured she must be suffering normal post-op symptoms. Only they weren’t. She ended up in the emergency room. Diagnosis: septicemia, a bacterial infection of the blood. And the reason her doctor hadn’t responded to her e-mail? The doc wasn’t a conscientious e-mail reader.

The moral of the story: Patients need to set up guidelines to make sure a portal doesn’t lead them astray.

1. “I say this over and over and over,” says Saul Weingart, MD, PhD, an internist at Dana-Farber Cancer Institute: “Do not use e-mail to communicate urgent information. Pick up the phone.” Even if you personally respond to e-mails right away, your doctor might not.

2. So how do you know how long a doctor or nurse or social worker takes before reading and responding to e-mails? Ask them.

3. In general, a long, complicated question is best handled on the phone, not via e-mail.

4. If a family member, say a spouse or the English-speaking child of a parent who doesn’t speak English, wants access to the patient’s portal files, discuss it with the doctor. HIPAA privacy regulations may require some sort of written permission.

5. Early on, find out what kind of information is available on the portal (so you don’t waste time looking for what’s not there).

6. Guard your password. Neither you nor the doctor should post it anywhere online.

7. Keep your password with you when traveling. If you get in trouble in another city, it’s nice to be able to pull up your record.

8. Don’t jump to the worst conclusion about test results. Your doctor may be able to provide encouraging context for what looks like dire news.