Despite federal push to offer EHR access, patient engagement is low

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A new GAO report says HHS needs to improve the way it measures patient access to EHRs.

Although the vast majority of hospitals and physicians provided access to EHRs in 2015, very few patients took advantage, calling into question the effectiveness of efforts led by the Department of Health and Human Services.

Just 15% of hospital patients electronically accessed their medical records despite 88% of hospitals offering access, according to a report released by the Government Accountability Office (GAO). Nearly one-third of patients accessed EHRs offered by physician practices.

The GAO indicated that HHS has invested more than $35 billion in health IT, part of which included funding to enhance patient access to EHRs. Those efforts were largely overseen by the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health IT (ONC). The ONC has prioritized patient access to medical records through several initiatives, including the Patient Engagement Playbook and EHR certification requirements.

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But the GAO said neither agency has an effective measurement process in place to determine if those engagement initiatives are working. ONC and CMS officials told the GAO the agencies monitor a range of outcomes, but don’t specifically look at whether individual efforts to increase access to EHRs lead to higher usage rates among patients.

"While HHS’s investment in health information technology is significant, HHS lacks the ability to determine whether, or to what extent, CMS’s and ONC’s efforts are helping HHS achieve its goals," the report concluded. 

The GAO issued two recommendations calling on HHS to direct the ONC to develop performance measures to assess outcomes tied to EHR access and use that information to make necessary adjustments to the program.

The ONC has previously said there has been a significant increase in the percentage of hospitals that provide patient access to EHRs, echoing a report from the American Hospital Association. Experts have said patient access to medical records is key to identifying inaccuracies.