Interoperability is no longer the missing link in electronic health information technology, but the chains binding hospitals, physicians and patients are still incomplete, according to three surveys released this month by federal researchers.
All three studies, based on data collected by independent surveys, were written by researchers from the Office of the National Coordinator for Health Information Technology at HHS.
In a study of the electronic means and methods used for patient engagement, the number of hospitals that allow patients to view, download or transmit their own medical records has vastly increased, according to data from the American Hospital Association survey.
By far the most widespread function is the ability to electronically view patient records, chiefly through portals.
In 2014, 91% of hospitals offered that capability, up from 24% in 2012.
Transmitting a record from a hospital's EHR to another provider's EHR or a patient's device was the least available function, with two out of three hospitals having that technology
A VDT requirement in the federal EHR incentive payment program's Stage 2 meaningful-use criteria was one of its most controversial. It was reduced from 5% of a providers' patients to one single patient in the recently released final rule.
But hospitals also have adopted a plethora of other computer-assisted patient engagement technologies, including allowing patients to amend their records, request prescription refills, schedule appointments and submit patient-generated data. All of these functions increased by nearly 100% or greater since 2012.
Office-based physicians (PDF) are increasingly embracing interoperability as well, according to a separate study based on data for 2013 and 2014 from the Center for Disease Control and Prevention's National Electronic Health Record Survey. For example, more than half of physicians exchanged secure messages with patients in 2014, up from 40% the prior year, while 42% exchanged patient information with another healthcare provider in 2014, compared with 39% the prior year.
Types of information exchanged in 2014 were fairly uniform, with 34% sharing lab results and medication lists, 33% exchanging medication allergy lists and problem lists, and 32% exchanging imaging reports. But fewer than one in 10 physicians exchanged all five types of information, the study reports.
Finally, patients (PDF) are slightly less engaged in information sharing, but they are warming up to interoperability too, according to the third report, based on data from consumer surveys by the NORC, a research arm of the University of Chicago, and the MITRE Corp., a research and think tank.
In 2014, 38% of survey respondents indicated they had been offered access to their online medical records, but that was up from 28% the year before. And of those offered access, more than half viewed their records at least once in 2014, up from 46% in 2013. In both 2013 and 2014, about 7 in 10 individuals who accessed their online medical record, used it to monitor their health.
Lab test results were the most commonly viewed record, by 92% of patients, followed by a list of their medical problems and current medications. Eighty-one percent of consumers reported in 2014 that they found the information useful, down slightly from 81% the prior year.
“Access to individual health information online is only a starting point,” ONC chief Dr. Karen DeSalvo said in a blog post preceding the release of the surveys. “As a community, we have more work to do to ensure that individuals and their families can fully digest and understand their health information.”
