Dive Brief:

  • In recent years, the majority of hospitals have allowed patients to view and download their health information via their own patient portal. However, hospitals allowing patients to use third-party apps to see their data increased sharply from 2018 to 2019, according to a new report from the federal agency that regulates U.S. health IT.
  • The Office of the National Coordinator found that seven in 10 acute care hospitals allowed inpatients to access their health data using a mobile phone or other software applications in 2019, a more than 50% jump from 2018. Similarly, in 2019 three in four hospitals enabled inpatients to view their more detailed clinical notes in their patient portal, an increase of more than 30% from 2018 as federal regulations continued to incentivize data sharing.
  • Small, rural, independent and critical access hospitals were less likely than their wealthier and more urban counterparts to give inpatients access to their health data electronically.

Dive Insight:

Patient medical records are now digitized across virtually all U.S. hospitals, and patient access to their own information is guaranteed by legislation and numerous regulations and programs from the federal government, managed by agencies like ONC and CMS.

But as any patient who’s tried to get a copy of their clinical history knows, actually getting your hands on your own health information — electronically or otherwise — is easier said than done.

A late 2019 study published in Health Affairs found only 10% of patients with access to their medical records online actually used it, though survey data have consistently shown patients want access to their data and would do so if they knew the capability existed and the process to do so wasn’t too onerous.

However, the ONC brief, which includes the latest national estimate on the proportion of U.S. hospitals giving electronic access to patients, indicates — despite perennial worries about patient access — the progress the hospital industry has made to expand data availability in just the past few years.

In 2019, more than nine in 10 hospitals reported they enabled inpatients to download their information from a patient portal. But significantly fewer allowed patients to electronically send data to a third party from that software: only about three-fourths of hospitals, a statistic that’s been largely unchanged since 2016, ONC said.

And that proportion plummets among small, rural, independent and critical access hospitals, which used apps at lower rates than their more deep-pocketed peers, according to the agency.

Only about two in three of that cohort allowed inpatients to access their data using mobile or software applications, compared to three-fourths of large, urban and system-affiliated hospitals.

Access was similar across hospitals’ inpatient and outpatient care settings. However, hospitals that used the same EHR software across all care settings enabled patient access to data at higher rates than hospitals with outpatient sites that used different EHRs.

About a third of hospitals use different EHRs across outpatient sites. Only 75% of those reported all their facilities let patients view their health data in a portal, compared to 95% of hospitals that used the same EHR across outpatient sites. That reflects either a lack of internal connectivity, or technological capability on the part of the software, ONC said.

“Implementation of standards-based [application programming interfaces] could reduce variation in the enablement of patient access capabilities across disparate EHR systems,” ONC said.

Standardizing APIs, the part of the server that receives requests and sends responses between disparate computer systems, is a key strategy of the government’s ongoing plan to increase data sharing in the siloed healthcare industry. The Trump administration early last year finalized two hefty HHS regulations prohibiting information blocking and aimed at giving consumers free electronic access to their medical data, partially by standardizing APIs and updating EHR criteria.​

Compliance dates for the rules were delayed twice last year due to the pandemic, though the Biden administration’s newly minted ONC head Micky Tripathi told Healthcare Dive in May another delay was unlikely.