Low-resource hospitals behind the curve on app-based data access for patients, ONC says

Smartphone apps
More hospitals are allowing patients to view health data through an app with each passing year, but change was slower across certain settings as of 2019, the Office of the National Coordinator for Health Information Technology warned. (Getty/marchmeena29)

A greater proportion of hospitals are allowing patients to view their health information through apps with each passing year, but small, rural, independent and critical access hospitals have consistently been behind the electronic access curve, according to a new government data brief.

The Office of the National Coordinator for Health Information Technology (ONC) said this week that 7 in 10 hospitals allowed inpatients to access their health information through API-enabled apps as of 2019—a significant jump from the 46% of hospitals that reported the same in 2018.

The proportion of hospitals allowing inpatients to view their clinical notes through a patient portal also increased during that window from 57% to 75%.

Data access through a patient portal has generally remained high since 2016, according to the brief. In 2019, 97% of acute care hospitals allowed patients to view their data through a portal, with 91% enabling downloads, 75% permitting data transfers and 73% allowing all three of these functions via a patient portal.

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The findings are part of a June data brief from the ONC (PDF) estimating nationwide enablement of electronic data access among hospitals. The office compiled these data via a supplement to the 2019 American Hospital Association Annual Survey, which asked each U.S. hospital’s health IT leader to respond on these topics between the beginning of January 2020 and the end of June 2020.

While the overall trend was upward, the ONC noted that certain settings lagged behind the nationwide average.

The proportion of hospitals that enabled app-based health information access in 2019 was significantly different when directly comparing small hospitals to medium and large hospitals (66% versus 75%), critical access hospitals to noncritical access hospitals (62% versus 74%), rural hospitals to suburban and urban hospitals (68% versus 72%) and independent hospitals to those with system affiliations (61% versus 75%).

“This indicates that gaps in access may be due to hospital resources, technical knowledge and other technology issues unrelated to the capabilities of certified EHRs,” the ONC wrote.

Electronic access to health information was roughly similar across inpatient and outpatient care settings in 2019 but decreased among hospitals that used different EHRs across their outpatient sites.

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“This may reflect a lack of connectivity or technological capability to enable patients to access capabilities between the different EHRs,” the ONC wrote. “Implementation of standards-based APIs could reduce variation in the enablement of patient access capabilities across disparate EHR systems.”

By 2019, the Department of Health and Human Services had proposed rules requiring hospitals to provide patients access to their health information through a third-party app, among other interoperability and data blocking requirements.

The government’s rules were finalized in early 2020, although the deadlines for compliance were bumped buck multiple times due to the pandemic. Portions of the regulations finally went into effect in April.

“As the new ONC Cures Act Final Rule requirements are implemented, it will be important to continue to monitor these trends to ensure hospitals enable patients with technology and health information access to better manage their health care,” the ONC wrote.