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GAO Calls on HHS to Better Encourage Patient EHR Access

A recent GAO report found general lack of patient EHR access across HHS programs, including the Medicare EHR Incentive Program.

EHR Access

Source: Thinkstock

By Kate Monica

- The Government Accountability Office (GAO) has requested the Department of Health and Human Services (HHS) reevaluate the effectiveness of its attempts to promote patient EHR access and EHR data use after finding few patients regularly access their data when given the chance.

According to the report, most interviewed patients only access their data immediately before or after a physician visit despite reporting numerous benefits of EHR data beyond doctor visits.

Based on a review of data from the 2015 Medicare EHR Incentive Program, GAO found that a vast majority of patients were offered EHR access but few took advantage of the opportunity.

“Our survey found that nearly all providers routinely provided new patients with access to this information (92 percent of health care professionals and 91 percent of hospitals),” the federal agency stated in its report.

Comparatively, GAO found only 15 percent of hospital patients and less than one-third of patients at physician practices accessed their information when offered the opportunity. Patients reported generally only reviewing their health information to view a laboratory test result or share information with a provider directly before or after a visit.

When patients did choose to access their information, many voiced concern over the lack of a single record containing a longitudinal, complete medical history using data from multiple sources.

“Patients we interviewed said that the type of information made available in their portals was incomplete and inconsistent across providers. Though many patients talked about accessing their lab results through their portal, multiple patients said that their results were not always available for them to view,” stated the report.

“Patients also expressed frustration with the amount of time and effort it took to set up electronic access through their providers, managing multiple passwords for their many portals, and understanding each portal’s user interface,” the report continued.

In its investigation, the federal agency found age plays a part in how likely a patient is to access their information, with older patients being less inclined to electronically access their records. Providers attributed this trend to older patients being less likely to go online in general.

While HHS agencies, including the Office of the National Coordinator for Health Information Technology, have implemented efforts to encourage patient EHR access, HHS lack a reliable way to measure whether these programs and initiatives are effective, GAO reported
 
“In the case of ONC, ONC measures a range of outcomes associated with its multiple efforts, but the office does not measure the extent to which its individual efforts are having an effect on patients’ ability to access their health information electronically—by determining, for example, if providers that participate in these initiatives have higher rates of patient access,” the report offered as an example.

GAO advised HHS to develop outcome measures focusing less on how patients access their information and more on how patients utilize their information once they view it.

Given the discrepancies between how often patients access their information in comparison to how often the information is available, as well as the lack of longitudinal health records, GAO issued the following recommendations: 

  • First, develop performance measures to assess outcomes of key efforts related to patients’ electronic access to longitudinal health information. Such actions may include, for example, determining whether the number of providers that participate in these initiatives have higher rates of patient access to electronic health information.
  • Second, use the information these performance measures provide to make program adjustments, as appropriate. Such actions may include, for example, assessing the status of program operations or identifying areas that need improvement in order to help achieve program goals related to increasing patients’ ability to access their health information electronically.

HHS has stated it concurs with the GAO recommendations and will address the effectiveness of the programs in place. 

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