- More U.S. patients are using online portals to access their medical information, according to an analysis the Office of the National Coordinator for Health IT presented at its annual conference Monday.
- Nearly 60% of patients report their provider or insurer offered them online access to their medical record in 2019, and nearly 40% viewed their record electronically at least once in the past year. Both are significantly up from 2018, analysts said.
- More patients gave third-party apps access to their health data in 2019, too, re-upping privacy concerns as industry waits for HHS to finalize rules setting standards around interoperability.
The findings come during a tumultuous period in the sector as the agency treads a tightrope between expanding patient access to medical records and privacy and security concerns. The Trump administration has made unfettered sharing of health data a health IT priority, cheering patient advocates and spurring an onslaught of lobbying from major EHR vendors and providers worried about administrative burden.
Verona, Wisconsin-based EHR powerhouse Epic sent a letter to major health system clients last week urging them to speak out against HHS' two rules promoting interoperability, expected in final form any day now, CNBC reported. The rules, one from CMS and one from ONC, passed the 90-day window for review in the Office of Management and Budget earlier this month.
HHS Secretary Alex Azar said in a morning keynote that "scare tactics are not going to stop the reforms we need."
According to ONC's new study, three-fourths of people who declined access to viewing their record online said it was because they preferred speaking to a doctor directly, while a little under two-thirds said they didn't think they needed to see their record online, highlighting the need to educate patients about controlling their own data and providers about using the EHR as a supplemental tool to help patients manage their health.
Of the population that accessed their record electronically, 60% used a computer and 40% used a smartphone health app.
"This is a fairly substantial portion of the population, which tells us a lot about the time we live in," Christian Johnson, a public health analyst with ONC, said Monday at a panel presenting the information. "People do use their smartphones to manage a significant portion of their lives."
Those who used an app to engage accessed it more frequently and said it was more useful and understandable than those who used a computer.
The most popular portal apps are distributed by major EHR developers, large health systems and big lab testing companies, though researchers clarified health system apps are usually branded versions of portals created and maintained by their EHR vendor.
ONC looked at adoption of patient portals by pulling data from the Apple and Google app stores. Epic MyChart, followed by eClinicalMobile from eClinicalWorks, then Allscripts' FollowMyHealth were the three most popular portals on the Apple app marketplace, while on Google's, MyChart again snagged the top spot, followed by FollowMyHealth, then eClinicalWorks.
Though it's unclear to what extent providers understand the technology, overall usage of application programming interfaces is "increasing, albeit slowly," William Gordon, medical director of health innovation at Boston-based Partners Healthcare, said Monday.
In 2019, roughly one in five patients who accessed their record online transferred their personal health information to a third party, compared to 14% in 2017 and 15% in 2018, according to ONC.
ONC analysts found 25 third party apps that use APIs to connect to EHR systems to provide patients access to their medical information. But data pulled from the electronic stores shows patient access apps are barely being used. Of the 25, only eight apps were discoverable through the EHR developer app marketplaces and the SMART app gallery. Thirteen were discoverable through the CMS Blue Button 2.0 program and six were in neither.
Nine third party apps aren't available on the Apple smartphone and 12 aren't available on Google. Nine third party apps are browser-only and aren't available on Apple or Google devices, showing how recent this app development is, Barker said.
On Google's app store, the most popular third party apps were Medicare record platform iBlueButton, with more than 16,000 downloads, and health data aggregator CarePassport, with about 2,600. On Apple's app store, the most popular were interoperability platform Health Gorilla, family health manager Journi, and Human API, which allows users to share their health data with app developers. Apple does not disclose installation numbers, so researchers used number of reviews as a stand-in.