Care Orchestration Should Start in the Patient Portal

By Anne Baskakova, MBA · Originally published on KevinMD · August 29, 2026

After years of working with numerous health systems and my own experiences as a patient and caregiver, I have come to realize how challenging it can be to manage one's own care. Care doesn't stop when patients leave a health care facility. It is often just the beginning of a long journey for them. Most often, after a doctor visit or surgical procedure, a patient has an extensive to-do list: products to purchase, medication regimens to follow, follow-up appointments to schedule, and more.

Follow-through takes time, emotional effort, and organization. People have busy lives, and health care diagnoses can be complicated, so it's not surprising that some of these details fall through the cracks. The challenge can be especially daunting for patients who have just been diagnosed with a serious illness. They have to process the news and how it will impact their life and their loved ones. Then comes the overwhelming part: figuring out how to address all the steps that are required to treat the condition.

It can also be difficult for caregivers who have to carry the load of serving as the central coordinator for the loved one in their care, especially after the loved one has undergone a surgical or a medical procedure. The caregiver ends up juggling multiple duties: They are the personal care assistant, the source of emotional support, the cook, the chef, the cleaner. The list goes on.

A Systems Problem

It's evident that the health care system has fallen short when it comes to the care patients receive after they leave a medical facility. The providers who prescribe the to-do lists have no reliable way of knowing whether the tasks they recommend are completed and if the patient even has the resources (the finances, transportation, health literacy, and confidence) to accomplish them.

This blind spot is understandable, given the realities the health systems face today. With staffing and funding shortages, providers are stretched thin and patients' electronic health care record (EHR) portals currently have limited after-visit visibility. So what can one do?

The health care system is presented with a host of what-ifs. What if it could offer patients more support beyond a curated to-do list and a recurring nudge? What if patients could navigate all their care to-dos from their EHR portal? And what if all their care supplies could be automatically delivered to their door, shortly after their after-visit notes were finalized?

The Patient Portal Becomes the Care Orchestrator

The EHR portal seems like the logical medium for overall care coordination. Patients are already there: According to the University of Michigan National Poll on Healthy Aging, the share of adults aged 50 to 80 who have used at least one patient portal grew from 51 percent in 2018 to 78 percent in 2023, as patients become more accustomed to using digital tools to manage their health care.

A new class of care-orchestration platforms is emerging that connects provider recommendations to fulfillment partners directly inside the portal. Done well, this creates a complete engagement loop for both patients and providers without making anyone learn new behavioral patterns. Personalized recommendations from the care team connect directly to existing fulfillment partners via the patient portal. Patients gain the ability to complete items on their to-do list and obtain the products and services recommended to them from the comfort of their home. Clinicians gain a source of information they never had, visibility into whether recommendations are acted on.

A well-designed platform in this category would work like this:

• A care team recommends the use of a particular wellness product for an ongoing treatment, which is recorded in the patient's EHR portal.
• The platform engine reviews the after-visit summary and identifies relevant wellness products that are applicable to this recommendation.
• Personalized, brand-agnostic options for the product appear alongside the patient's after-visit summary.
• The patient or their caregiver selects one of the recommended product options and, with a one-click checkout, purchases the product right from the portal.
• A third party delivers the product to the patient, with fulfillment partners handling coordination end-to-end.
• The care team receives purchase confirmation and the added assurance that the patient is following up on recommendations. This increases the likelihood of a favorable care outcome.

The same paradigm would apply to ordering services like physical or occupational therapy, connecting with community-based channels for social determinants of health (SDOH) support, or requesting follow-up appointments with specialists. Access to this data also poses opportunities for research. How much can a solution like this improve portal utilization? What impact could it have on health outcomes? How could this positively impact hospitals' finances? The role of suppliers and ancillary service providers in the care continuum needs to be reassessed as well, particularly the importance of staying clinically appropriate, transparent, and free of clinician sales incentives that can impact care delivery.

A Continuing Quest for Better Care Coordination

Those of us working on the post-care adherence gap know that no single platform is a panacea. But connecting the recommendation to the first action is an important step toward a system that benefits both patients and providers.

Health care is not a hero game; it's an ecosystem. So, I welcome the thoughts of health system operators and researchers on the work others are doing to address the challenges discussed in this article. If you would like to offer your opinion, I am here for it.

Anne Baskakova, MBA

Anne Baskakova is a digital health leader with more than fifteen years of experience scaling patient and provider engagement solutions for organizations including Teladoc Health, NYU Langone, Memorial Sloan Kettering, and Mass General Brigham. Through her consultancy, Verdana Health Advisory, she partners with health systems and startups to scale their product vision and operations.

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