Providence patients preregister in cyberspace

Vocal’ minority use it so far

Since August 1999, patients at Providence Health System in Portland, OR, have been able to preregister for admission or outpatient services via the Internet. The trick, says Barbara Wegner, CHAM, regional director of access services, is getting them to do it.

"Some people are using it, but it hasn’t caught on like wildfire," Wegner explains. Providence is publicizing the new preregistration option through local newspapers and the newsletters it sends to its physician group, she adds. Other plans include placing cards explaining the service in physician offices and posting notices around the hospital and in access interviewing booths, Wegner notes.

Providence also is working to make the process more user-friendly, she adds. "There is a lot of information to be entered, a lot of screens you have to go through."

As people become more familiar with the idea of sending information across cyberspace, usage will increase, predicts David Hardy, information systems coordinator for regional access services. "It’s just like making purchases on the Internet. Initially there is not a lot of volume, but it just takes time to catch on."

Web surfers who do choose to use the Internet option have made it clear that’s the only way they want to communicate, Wegner points out. "We found out at the beginning, when we were calling people back to clarify information, that those patients expected to be contacted via the Internet as opposed to a phone call. They were pretty vocal about it."

One access employee has been designated to handle the Internet preregistrations, which come in to the central access services department, a kind of call center, she says. "They are checked every day. I would say this is a starting point [for other Internet services]. We probably would like to get into doing appointments. The physician offices may be interested in that."

One possibility being discussed, she says, is having patients enter their demographic information directly into the computer system so access personnel wouldn’t have to re-enter the data. Both Wegner and Hardy say that idea presents a number of challenges. "One obstacle would be making sure the data entry was correct," Hardy points out. "Having a person review what is entered is invaluable. If the patient put in the name of a physician that doesn’t exist, for example, that would confuse our system."

Another concern, Wegner notes, is the likelihood that multiple patients will have the same name, in which case such direct access could compromise a person’s privacy. "I could go in and call up my account, but there might be a number of Barbara Wegners in an index of 3 million. I could be looking at another person’s entire medical history."

There is little if any reason, however, to be concerned about the security of the pre-registration information that is sent over the Internet, Hardy emphasizes. "People are still leery about putting personal information on the Internet, but there is the same level of security as with an Internet purchase." The 128-bit encryption that is used to protect the transmission of registration data is by far the most secure of the two basic versions of encryption, the other of which is 40-bit, he says. "There is a huge difference between 40-bit encryption and 128-bit encryption. Some experts have estimated it would take 1,019 years to break a 128-bit encrypted message. This, for practical purposes, should be considered safe."

Although it’s common for people who use the Internet to have that level of encryption on their Web browsers, those who don’t may upgrade on the registration screen, Hardy adds.

(Editor’s note: To check out the Providence Health System preregistration process, go to the health system’s Web site,, and look for the Web registration link.)