A recent study by the University of Michigan found that 41 percent of those offered access to patient portal did not use it. Non-users tended to be male, 65 or older, on Medicaid or have less than a college education.
The reasons for non-portal use varied depending upon the demographic. Medicaid and Medicare beneficiaries expressed a preference for speaking directly to a provider. Patients aged 40 and older as well as those of some racial and ethnic minority groups expressed concerns about privacy and security.
Research on patient use of portals is relevant to lawyers — particularly at a time when the legal profession is turning to technology to improve efficiency and client service and expand access to justice to lower income clients. Although portals are undeniably useful, lawyers cannot assume that if we build them, clients will come. Instead, lawyers need to understand potential reasons that clients might resist portals and come up with ways to address the obstacles to adoption. Here are some suggestions:
Eat your own dogfood Many lawyers use practice management tools that offer client portals – but some of the systems that I’ve demo’d are confusing and clunky for clients to use. Before allowing your clients to set up a portal, create an account and test whether portal creation is user friendly. Be sure to test the portal both online and on a mobile device which is how most clients are likely to access your portal.
Adequate support If possible, you should set up a client portal for clients while they’re at your office. If that’s not possible and clients will need to set up a portal on their own, be sure to offer dedicated email or phone support to assist clients who have difficulty.
Educate clients about the value of portals In an era of online banking, it’s natural to assume that most of today’s clients are familiar with the concept of online portals and how to use them. But just because clients have used online banking to deposit money or pay bills doesn’t necessarily mean they will understand how a portal relates to legal representation. So take the time to explain how your firm uses a portal to serve clients. For example, you might explain that the portal is like an online filing cabinet that will allow them to view all of the documents in their case at any time. You can also show clients the billing features in the portal so that they can check their balance and pay your bills online.
Be consistent with your use of the portal During my husband’s illness, I relied on the portal for most of his doctors except one who never bothered to upload test results and reports into the portal. If you fail to update the client portal each time an event occurs in a case, clients may assume that the information in the portal is incomplete or not up-to-date and will stop using the portal and start calling your office instead.
Security Engage your clients in a conversation regarding the security of the client portal – in fact, you might point out that communication through the portal is generally safer than email. In most instances, educating clients on portal security should be enough to help them overcome their concerns. If not, you’ll have to make your own strategic decision on whether you want to work with a client who won’t use the portal.
Incentivize clients to use the portal If all else fails, you can always offer clients financial incentives for using the client portal -perhaps a $50 reduction if they successfully set up their portal and log in at least once. Of course, you can also impose a surcharge on clients who call your office to ask for documents that are already in the portal but that’s not likely to be popular. Positive reinforcement through gifts or a discount is the better approach.
Meanwhile, resolving the question of whether client portals can be effective for elderly, lower income or uneducated clients is more difficult. Education may help some clients, but others may not have the time or desire to learn how to use a portal. If that’s the case, it may be that portals are not the right product-market fit (that’s the terminology that all the cool kids in legal are using) and other types of tools like texting or chatbots (or maybe voice or bot-enabled portals) are a better approach. As legal aid groups and courts begin building systems to expand access, they should keep these considerations in mind or they may waste money on platforms that users won’t engage.