Most hospitals are not yet ready for LLM-based patient portals

Various capabilities have been incorporated into modern patient portals, including chatbots and digital twins, to maximise their potential for improving the patient experience. However, it may take a while for hospitals to apply the newer large language models to their patient portals.

In the session “Patient portal integration for enhanced hospital operations,” Dr Roel Bolt, CMIO, Franciscus Hospital discussed the evolution and innovation of patient portals.

In recent years, IT providers have introduced chatbots into patient portals, whose main purpose is to answer general questions, such as disease-specific questions, hospital visiting hours and billings.

Dr Bolt foresees that in the future, patient portals will provide more personalised health recommendations based on digital twins. Predictive capabilities can soon also be applied to patient portals to predict their usage based on patient data. 

Another potential future innovation in patient portals is the application of LLMs. 

“It might be an easy way to get clarifications on medical terminologies, but these models still [confuse], and I don’t think we want that [for our patients],” Dr Bolt cautioned.  

Aside from being confusing, there are still uncertainties with the way LLMs interact with patients. “As long as we don’t know how we should interact with different kinds of patients, with different backgrounds, cultures, diseases… it’s going to be a hell of a job for LLMs to do that.”

Dr Bolt said if hospitals wish to incorporate LLMs in their patient portals, “then we [must] have those models locally hosted so we contain the information there, keeping all the data [from] spreading around.”

Transparency and verification are also concerns with running LLMs on patient portals.

Advantages

Citing recent surveys, Dr Bolt noted that only 13%-15% of hospitals with patient portals are benefiting from one or more capabilities of the technology.

“There is a tremendous gain to do it the right way,” he said. The use of modern patient portals can improve patient outcomes, engagement, and satisfaction, among noted benefits. 

Patient portals, he claimed, are also “powerful” tools for optimising hospital business operations. 

“They streamline administrative processes, improve communication, and reduce costs. They enhance patient engagement and satisfaction and provide valuable data for decision-making. Implementing and effectively utilising patient portals can result in more efficient and patient-centred health care operations, ultimately benefiting both hospitals and patients.”

Barriers to adoption

While there are promising advantages to using patient portals, some cannot fully realise their potential given several barriers, including limited digital literacy and internet access, usability issues, security and privacy concerns, and patients preferring in-person contact. 

Dr Bolt also identified health illiteracy – particularly the trouble with understanding medical jargon – as one of the reasons for the lower usage of patient portals.

“This issue is not merely a matter of user-friendliness. It has significant implications for patient outcomes. A lack of understanding can lead to reduced compliance, missed appointments, and even medical errors,” he said. 

One solution to this is the use of SNOMED CT. In the Netherlands, Dr Bolt shared, all hospitals have been required to use the diagnostic thesaurus for billing and reimbursement. The health authority there has also developed patient-friendly descriptions on the SNOMED system.

“These barriers [to patient portal usage] can be tackled with technical solutions, but most importantly, also with training [and] creating awareness for patients and doctors.” Dr Bolt added that doctors promoting its use have been effective in increasing its adoption.

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