Most hospitals provide electronic access to records, but patients slow to engage, ONC says
- Most patients can now view and download their hospital records electronically, with more than 90% of U.S. nonfederal acute care hospitals reporting those capabilities in 2017, a new briefing paper from the Office of the National Coordinator for Health IT shows.
- Nearly three-fourths (74%) of hospitals also allow patients to transmit health information, and 72% support all three functions: view, download and transmit — up from just 10% in 2013.
- Patients' ability to view and access their information is not equal across all hospital types, however. Critical access hospitals lagged significantly behind other facilities at just 60%.
CMS and providers generally are looking to increase patient engagement in their own health and wellness, in part by providing ready access to their medical records and other related information.
The agency doubled down on that effort in February with a proposed rule that would require Medicaid, the Children's Health Insurance Program, Medicare Advantage plans and health plans in the federal Affordable Care Act exchanges to give their combined 125 million patients free electronic access to their personal health data, including medical claims, by 2020.
The ONC report shows the strides hospitals are making in providing patients the means to access PHI, but whether they are actually accessing that information or getting the details they need to know how to access it is another story.
Among all hospital types, only 8% said half or more of their patients activated access to the patient portal, while four in 10 hospitals said 0 to 9% did so. Roughly two-thirds of hospitals said fewer than 25% of patients activated their access to the portal. The share of rural hospitals reporting 25% to 49% of patients activating portal access was substantially lower than at urban hospitals — 14% versus 21%.
In 2017, nearly four in 10 hospitals said patients were able to access their health information via an API. The capabilities most often available to patients were family member or caregiver access on behalf of the patient (86%), paying bills online (82%), requesting amendments to their health record (79%) and sending or receiving secure messages (72%).
More than half (54%) of hospitals enable patients to request prescription refills electronically, up from just 27% in 2013 and 42% in 2015. The share of hospitals where patients can submit patient-generated data, while still modest, also grew — to 46% in 2017 from 13% in 2014 and 37% in 2015.
Contrasting desire for access, however, is the need for robust cybersecurity — with recent reports from data monitoring companies Bitglass and Protenus showing more records have been subject to breaches.
And patients are aware of this risk. About 60% of adults aged 50 to 64 said they were "very" or "somewhat" concerned about unauthorized access to their records, according to a recent Kaiser Family Foundation survey. Younger adults were less worried, with 42% of people aged 18 to 29 giving those responses.
The ONC findings are based on the IT supplement to the American Hospital Association's annual survey. ONC, which has partnered with AHA to measure health IT adoption at U.S. hospitals since 2008, funded the 2018 AHA IT supplement to gauge adoption and use of EHRs and data exchange