- Although the US healthcare industry has nearly ubiquitously transitioned to EHRs and other electronic documentation, challenges remain for patient data access, according to the 2018 ONC Annual Report to Congress.
The report, presented to Congress at the end of last year, outlined some of the progress made since EHRs became a mainstay in healthcare.
Since 2015, EHR use and patient portal access has been near universal. In 2015, Certified EHR Technology (CEHRT) adoption reached 96 percent in non-federal acute care hospitals. For office-based physicians, that number reached 78 percent.
Patient portal access also grew between 2009 and present day. Per a July 2018 MGMA report, patient portal adoption rates reached over 90 percent.
Despite those promising figures, these technologies are not exactly living up to their potential. Specifically, data exchange and patient data access lag, the report authors noted.
“Despite the individual right to access health information about themselves established by the HIPAA Privacy Rule, patients often lack access to their own health information, which hinders their ability to manage their health and shop for medical care at lower prices,” ONC reported.
Only 61 percent of hospitals can electronically find patient data from an outside organization, and only 53 and 51 percent of hospitals can integrate multiple health IT sources and access patient data from disparate locations, respectively.
Patient data access also falls behind, the ONC report pointed out. Although patients can access their EHR data using the corresponding patient portal, data integration has yet to be realized.
“Patients should be able to easily and securely access their medical data through their smartphones. Currently, patients electronically access their health information through patient portals that prevent them from easily pulling from multiple sources or health care providers,” the report noted. “Patient access to their electronic health information also requires repeated use of logins and manual data updates.”
The industry currently faces numerous barriers to more meaningful health IT use. For example, technology simply cannot support the level of data exchange that is needed to drive meaningful patient engagement. More efforts are needed to make EHRs and other technologies more amenable to meaningful data exchange.
The cost of developing such technology also poses an issue.
“Specific barriers include the lack of sufficient incentives for sharing information between health care providers, the need for enhanced business models for secondary uses of data, and the current business models for health systems or health care providers that do not adequately focus on improving data quality,” the ONC report stated.
Finally, healthcare organizations have difficulty trusting other competing businesses or providers with patient data.
“Electronic collaboration with a diverse team across the continuum of care, even when the team member is Annual Update on the Adoption of a Nationwide System for the Electronic Use and Exchange of Health Information a business competitor, is critical to effective care of patients,” the ONC said. “Trust barriers inhibit this basic tenet of care.”
Not all is lost, the report pointed out. The healthcare industry has made strides in increasing the use of application programming interfaces, which allow certain technologies to interact with one another. APIs have been a boon for patient data access as more developers adopt common standards that create a plug and play experience.
“[Open APIs] support patients’ ability to have more access to information electronically through, for example, smartphones and mobile applications,” ONC explained. “HHS applauds the emergence of patient-facing applications that allow patients to access, aggregate, and act on their health information.”
Going forward, more of an emphasis on data exchange and patient data access needs to underscore all health IT projects, ONC recommended. Creating a culture of open data access, overcoming challenges of data blocking, and emphasizing the right of the patient to access her own health data will be crucial.
“[The healthcare industry must] focus on improving interoperability and upgrading technical capabilities of health IT, so patients can securely access, aggregate, and move their health information using their smartphones (or other devices) and health care providers can easily send, receive, and analyze patient data,” the ONC report concluded.