Electronic medical record conceptGrowth in EHR usage depends to some degree on the brand of platformused, and on whether a hospital has participated in qualityprograms from The Center for Medicare and Medicaid Innovation.(Image: Shutterstock)

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The use of electronic health records (EHRs) by hospitals in theU.S. has grown considerably in recent years, but though manyhospitals provide patients access to their EHR data, smallerhospitals are lagging behind in their ability to share data withpatients. In addition, patients are not accessing the data in largenumbers.

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The findings come from two studies released in April by theOffice of the National Coordinator for Health InformationTechnology (ONC). The studies looked at separate-but-relatedissues: the use of EHRs by hospitals, and the capabilitiesof patients to access EHR data from hospitals.

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Nearly all hospitals use EHRs, allow patients' access

The ONC said that as of 2017, 94 percent of hospitals in theU.S. have EHRs that are used in clinical practice. Between 2015 and2016, there was a seven percent increase in hospitals using EHRdata in clinical practice. Between 2016 and 2017, the numberremained roughly the same.

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“Since 2015, the majority of hospitals have used electronicclinical data from their EHR for internal hospital processes thatinform clinical practice,” the report said in its summary. “Themost common uses of EHR data in 2017 were supporting a continuousquality improvement process (82 percent), monitoring patient safety(81 percent of hospitals), and creating a dashboard with measuresof organizational performance (77 percent). EHR data is leastcommonly used to develop an approach to query for patient data (51percent), assess adherence to clinical practice guidelines (59percent), and identify care gaps for specific patient populations(60 percent).”

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The study also suggests the growth in EHR usage depends to somedegree on the brand of platform used, and on whether a hospital hasparticipated in quality programs from The Center for Medicare andMedicaid Innovation (CMMI), part of the Centers for Medicare andMedicaid Services (CMS).

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Sharing data increases, but smaller hospitals lag behind

The second study looks at the ability of patients to view,download, and transmit (VDT) their health information from hospitalEHRs. The NC data shows that although nearly all hospitals providepatients with the ability to electronically view and download theirhealth information, significantly fewer critical access hospitals(CAHs) provided patients with the ability to VDT compared tonon-CAHs.

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CAH facilities are traditionally smaller hospitals (25 beds orfewer) and located in areas with relatively few health care options(at least 25 miles away from the next-nearest hospital.) Thefindings point to a gap in patient access to health care data inrural areas and small communities.

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The study found that 96 percent of acute care hospitals allowedpatients VDT capabilities in 2017. “Although nearly all hospitalsprovided patients with the ability to view their healthinformation, small, rural and CAHs lagged behind their counterpartsby at least 2 percentage points” the study sad.

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And patients have not been accessing EHR information in largenumbers, the study showed. The 2017 data showed that relatively fewhospitals (8 percent or less) reported that 50 percent or more ofpatients activated access to their patient portal. Two-thirds ofhospitals reported that 25 percent or fewer patents accessed thehospital's data portal; and four in 10 hospitals reported that 0 to9 percent of patients activated their patient portal.

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“Programs that encourage hospitals to provide these capabilitiesto patients are important to ensure that patients have their healthinformation when and where they need it,” the study's authorswrote, adding that federal programs such as MyHealthEData have been launched to encourageconsumers to access hospital EHR data.

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