Joslin Patient Portal Launches | A Q&A with Bill Kuklinski
Friday, August 16, 2013
Bill Kuklinski, Joslin’s Director of Software Development is overseeing the design of the patient portal as part of the Joslin Everywhere project at Joslin Diabetes Center. Mr. Kuklinski has over 30 years’ experience in software development and systems consulting.
The goal of Joslin Everywhere is to provide a virtual experience for the patient that is as effective and timely as the physical face-to face encounters the patients have when they come to the Joslin.
The general definition of a portal is a gateway or entrance: Wikipedia defines a web based portal as a website that brings information together from diverse sources in a uniform way. Joslin’s portal is a gateway to not only your medical history but to better participation in your medical care.
As a software project manager working with software engineers and clinical staff, Mr. Kuklinski brings a unique viewpoint to the design of a working portal.
Do you think Joslin Everywhere and the portal can replace face-to-face communication?
Obviously, it is easier to communicate some things live, but having access to your lab values and participating in your care by messaging back and forth with your doctors and educators allows patients to participate in the process of their care. For example, if you take the time to look over your labs before you come, you can ask your provider more focused questions.
Joslin has been working on this portal for a while—why has it taken so long to get started?
It is an ongoing challenge to provide a smooth experience not just for the patient but also for the Joslin providers and to integrate the portal with the medical record. For example the portal can stand on its own but we didn’t want the medical providers and educators to have to become familiar with a separate system. That meant having the portal talk with our electronic medical record system, Nextgen. The portal is open source software— it came free to us and we are paying a company to adapt it for our use--but when the portal was designed there never was any intent that it would interface with Nextgen, so that engendered a whole separate design and development effort.
So, I understand that the portal went live in late April and now there are about 19 patients who are communicating regularly with their providers. What do they see when they use the portal?
There is a lot available already. Patients can check their labs, write messages to and receive them from their health care providers, take health care surveys and open educational content about diabetes. Going forward they will also be able to upload data from their glucose meters, and the portal will eventually link to the patient discussion boards and integrate with our plans for virtual, web-based patient visits.
That sounds exciting. If I am a patient, how to I sign up?
Right now we are still working out bugs in the technology, creating support processes and training our internal users, so we are carefully limiting the number of people using the portal so patients can’t sign up by themselves. Currently providers come to me with a list of patients they think would benefit and I enroll them. We are also enrolling patients through participation in on-site classes such as our Do It program. If you as a patient would like access contact your healthcare provider or educator about being added to the list.
What are some of the issues that have the portal has brought to light?
That’s an interesting question. Previously when medical records were only hardcopy it was easier to determine ownership but the question of ownership of electronic data is more complex. For example let’s say a self-insurer entity has its employees complete a diabetes program through the Joslin. As part of the program the patient uploads their glucose readings and their labs and then wants to download them to another of their providers who isn’t at the Joslin. Who owns those records and controls them?
For the patients who are using the portal how are things working out?
We have received positive feedback from patients; it adds to the frequency of interaction with their providers and they seem happy. When people are talking about diabetes content and not talking about the mechanics of the portal, I am happy. It means that the portal is working the way it should, in the background, out of the way.
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