With 478 clinics and 15 medical centers across four states, Winston-Salem, N.C.-based Novant Health has an impressive physical and geographic footprint. But for the 700,000 patients who use its MyNovant system, the major point of contact with the system is often online.

A health system’s online presence isn’t just a marketing tool or a reaction to the latest trend. It’s a new venue of care that needs to be seen as having equal importance to acute and ambulatory care sites, Lauren Miller, operational engagement project manager for Novant in Charlotte, N.C., said in an e-mail.

“The virtual venue of care allows health care providers to stay connected and engaged with their patients outside of their four walls,” Miller explained. She added that the key is “to view patients as consumers,” which requires focusing on their specific needs and preferences.

Their approach is attracting interest from others, and Miller and her colleague Aram Alexanian, M.D., ambulatory optimization physician champion for Novant in Charlotte, outlined their strategy at the recent Collaborate in Practice Conference in Chicago, which was sponsored by the Medical Group Management Association and the American Medical Association.

A virtual venue needs to be innovative, convenient and affordable because “if it’s not convenient, it’s not going to get used,” Alexanian said at the conference. He added that “patients want it,” and — in a competitive market like Charlotte — if they don’t offer it, “someone else will.”

The Novant virtual venue includes its MyChart secure online portal from which, Alexanian said, “we can do a lot of pretty cool stuff.” These services include: e-visits, video visits, online bill paying and scheduling (now required for family medicine, internists and pediatricians accepting new patients), Fitbit integration, a “symptom checker” questionnaire that triggers recommended next steps, personal health tracking (such as glucose reading for patientrs with diabetes), prescription-refill requests, test results viewing, ability for patients to download their own health records, and contacts for customer service either via email or live chat.

Fingerprint login was made available after a study found that the main reason patients called customer service was because they had forgotten their passwords.

Novant has conducted 16,500 e-visits since they were first offered in 2013 and has contracts with three payers that cover them. If a patient's insurance doesn’t cover the cost, he or she is charged $30.

About one-half of MyNovant patients log in to the system each quarter, and use continues to grow. But not all systems have had the same experience.

For some, it’s a challenge to make portal use a priority because there are so many other competing interests and some view the portal as creating more work rather that increasing efficiencies, Miller said.

The keys are to keep the portal’s related work processes as simple as possible, give ample notice before launching new features, make the portal the preferred method of follow-up communication with patients, and focus on how the technology can strengthen patient relationships — not on the technology itself.

“It boiled down to making the portal part of our DNA,” Miller said.