- Although most healthcare organizations offer patients access to their individual health records, less than one-third of patients look at that data on the patient portal, according to a new report from the Government Accountability Office (GAO).
HHS has advocated for better patient data access in recent years, making patient portals and viewing, downloading, and transmitting capabilities key provisions to the agency’s meaningful use requirements.
As of 2015, 88 percent of eligible hospitals and 87 percent of eligible professionals had offered their patients electronic access to their own health data, GAO reported. However, in that same year only 15 percent of hospital patients and 30 percent of patients visiting a non-hospital-based provider had used the patient portal to view, download, or transmit their medical records.
Source: Government Accountability Office
While eligible hospitals and eligible professionals may have successfully met meaningful use requirements, those figures are a far cry from HHS’s goal of every patient engaging with his or her own health data.
There were several patterns among non-hospital-based providers with low patient portal uptake, GAO reported.
Providers in rural areas with high poverty levels saw lower patient portal access rates. Smaller practices with 50 or fewer group practice members also saw lower patient portal access.
Providers in general and specialty practice (i.e. dentistry, podiatry, and dermatology) saw higher patient portal use rates than those in subspecialties.
For both eligible hospitals and eligible professionals, patient portal access was higher for organizations in areas with smaller populations of senior patients.
“Multiple providers who responded to our survey and that we interviewed conveyed that, in their experience, older patients are less likely to electronically access their information,” GAO reported.
“Providers and health IT developers noted that younger patients and those with chronic conditions are most likely to want electronic access to their health information.”
There is conflicting research connecting patient age with patient portal use, GAO pointed out. While some studies claim that older patients are less technology literate or do not have access to computers to access the patient portals, other data shows that age is becoming less of a factor in patient portal use.
Fewer patients are accessing their electronic health data because they do not have a reason to do so, GAO noted. These patients might be young and generally healthy, and therefore have no labs or medical histories with which they must become familiar.
Among patients who do access their own health data, GAO found that most did so before or after a healthcare encounter to review laboratory test results or to send information to their providers.
These low levels of patient portal uptake are not for lack of effort on the providers’ part. GAO found that most providers have strategies in place to spur more patient portal buy-in, including the following:
- Educational and marketing brochures
- Usability and design improvement
- Clinician testimony and encouragement
- Offering in-office computer access
- Reminder emails
- Clinical staff incentives
- Raffles and giveaways for patients
- Discounts on procedures
HHS has also taken many steps to encourage patient data access, including releasing the Patient Engagement Playbook, supporting the Blue Button Initiative, enforcing Health IT Certification Standards and Certification Criteria, and developing the Consumer Health Data Aggregator Challenge.
However, there are not enough success measures in place to determine the effectiveness of these strategies, especially with regard to tracking meaningful use impacts and progress.
“Although ONC measures some progress related to these efforts and the Medicare EHR Program, ONC does not directly measure the impact of these efforts on increasing patients’ electronic access to health information,” GAO said.
The ONC and HHS can track how many organizations offer health data access, but they do not track how many patients actually do access the portal.
GAO offered two suggestions for HHS to mitigate the problem.
First, GAO recommended HHS and the ONC work to develop patient engagement performance measures to assess how these efforts affect patients. For example, the two agencies could develop a strategy to determine how many patients access their own electronic health data versus how many organizations offer patients the ability to do so.
Second, HHS and the ONC should develop methods to use performance measures to make program adjustments. For example, the two agencies could use findings about patient data access to improve their strategies for encouraging patient portal uptake.
HHS concurred with both of GAO’s recommendations. In written comments, HHS explained that it is currently working alongside the ONC to determine patient portal uptake.
Going forward, the agency said that the ONC should work to use performance measures to better guide government initiatives.