Patient engagement is seen as a key way to improve patient and population health, but HIPAA often prevents providers from properly engaging patients, according to a recent New England Journal of Medicine report.
The authors said that, despite its potential, patient engagement remains suboptimal, which is affecting healthcare quality and spending.
One possible solution is for providers to let patients opt into a system that allows sharing of protected health information. That might require amending existing HIPAA regulations, but could meaningfully "improve patient engagement with the healthcare system — and therefore health outcomes — while restricting patient autonomy," according to the report.
The authors said healthcare is developing interventions to improve care and reduce healthcare spending. Patient portals, Bluetooth-enabled biometric devices, smartphone applications and text messages can all help improve patient engagement. For these tools to be effective, they must “be accessible, allow for personalized communication and facilitate instantaneous sharing of information,” said the report.
However, covered entities are leery of getting whacked with penalties for noncompliance, so they “have understandably interpreted HIPAA conservatively." That has limited protected health information in patient outreach.
Concerns about HIPAA affecting patient engagement are not new. Some healthcare experts have said HIPAA, which is now more than 20 years old, may be outdated. One reason is that the law creates barriers to better patient engagement.
Patient engagement does work when implemented properly, and patients do like communicating with their physicians. A recent West survey found 75% of patients with chronic conditions want their doctor to contact them regularly to keep tabs on their health. However, patients don't feel that they have proper access to their records. A CDW Healthcare survey found that 89% of patients say they want easier access to their health records.
One way is to integrate patient portals into care, but providers and patients haven’t exactly embraced patient portals. Brian Eastwood, consumer engagement and consumer-directed healthcare analyst at Chilmark Research, recently told Healthcare Dive that patient portal technology adoption is only at between 25% and 35%.
In addition to HIPAA barriers, portals are usually not mobile-friendly, which makes it harder for patients to access them. However, health systems view improved patient portals as an important tool for patients and a system's long-range success. Tami Minnier, chief quality officer at UPMC, recently told Healthcare Dive that a "feature-rich, easy-to-use patient portal will ultimately pay off in increased patient and member loyalty, more engaged patients and families who make better decisions about their health, and potentially lower costs for patients and payors alike.”