Use of medical patient portals - an online way to manage your health - has grown by 61 per cent in New Zealand over the last six months, increasingly being driven by patients.

Latest Ministry of Health figures show that at the end of June, 173,000 people were registered on portals across 335 medical centres - around a third of the practices in New Zealand. This was up from the 107,034 registrations at 277 practices as recently as last December.

Through portals, patients can book appointments, review blood tests, order repeat prescriptions, ask a simple question of a doctor, review their medicines list and personal immunisation and medical histories. They can more effectively manage their own health and well-being and overcome frustrations like chasing up the results of a blood test; they can put a question to their doctor without having to go to an appointment.

Being able do these things in your own time from the comfort of your own home or at work - even outside local medical centre opening hours - is one of the reasons for the surge in the use of portals.

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The growth mirrors that in more mature markets overseas. In the US, one report anticipates compound annual growth of patient portals by 18 per cent by 2020; a study still under way by the University of Texas is showing early indications of a 20 per cent drop in hospital admissions and re-admissions from congestive heart failure by patients using portals, according to Health Data Management last month.

In New Zealand, one of the most successful operators of a portal is the Medplus Family Medical Centre in Takapuna, Auckland. In two years the number of Medplus patients registered on the portal has grown from virtually none to just under 60 per cent of those eligible - or 5,182 patients.

Co-owner of the practice, Dr Heidi MacRae, says their entire team, from doctors to receptionists, are involved and pro-active: "We constantly remind patients they can access their test results within a couple of days without phoning or coming in and, if they do phone, we will tell them they are available online.

"Patients absolutely love the portal because it empowers them. If they are coming in for an appointment they are able to review their test results before they get here so that they can have a better informed discussion with the doctor.

"It is also very convenient for a patient to be able to book an appointment for themselves."
Her centre recently conducted a survey of registered patients; 86 per cent of respondents said they found the portal useful or very useful and 87 per cent said it was easy to use. Most people use the portal to review laboratory test results (89 per cent of respondents) and to book appointments (62 per cent).

Use of the Medplus portal is free, although there are charges for repeat prescriptions for example - but at $5 it is cheaper to order online than to phone in for one, because of the staff time saved.

Dr MacRae says in certain situations doctors can consult with patients online: "We can do this if they have a simple question but, if not, we recommend they come in and see us. At the end of the day nothing will ever replace face-to-face consultations."

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The experience at Medplus is echoed by another New Zealand GP, Dr Greg White, who runs a sole charge practice in Central Otago. Around 20 per cent of his 1500 patients are registered on his portal which is provided free.

"We promote the portal as much as possible," he says. "We had an email campaign and include information about it in our newsletter. When someone rings up to request something, we remind them they can use the portal."

Dr White is one of a growing number of GPs making the notes he writes during a consultation available through the portal for patients to read.

"I think it is very helpful to patients to be able to read my diagnosis and see my train of thought. People don't usually retain everything you tell them. By opening up their notes patients can log in the next day, remind themselves of the discussion and see what they have to do next.

He can't understand why some GPs are reluctant to open up patient notes: "Patients are entitled to ask for their notes anyway. You always have to be aware that what you write could be read by the patient. I think GPs who have qualms about opening up patient notes may be worried they will be inundated with queries, or judged on what they have done or written."

Dr White says he has had a couple of patients ring to clarify his notes but there have been no issues.

Dr Sadhana Maraj, eHealth Clinical Lead, Health IT Engagement at the Ministry of Health, says all test results must be approved by doctors before they are uploaded. If a doctor has bad news for a patient, he or she will go through normal procedures and arrange a personal consultation.

Public demand for portals is growing and "the more demand there is, the more doctors will respond to this need."

Some practices have set up an iPad at reception so patients can register for the portal there and then. Portals are so convenient to use and make managing your health easier, so why not sign up for one now? To find out if your general practice is offering a patient portal, go to www.patientportals.co.nz and check on the map of New Zealand.