The use of electronic health records (EHRs) by hospitals in the U.S. has grown considerably in recent years, but though many hospitals provide patients access to their EHR data, smaller hospitals are lagging behind in their ability to share data with patients. In addition, patients are not accessing the data in large numbers.

The findings come from two studies released in April by the Office of the National Coordinator for Health Information Technology (ONC). The studies looked at separate-but-related issues: the use of EHRs by hospitals, and the capabilities of patients to access EHR data from hospitals.

Nearly all hospitals use EHRs, allow patients' access

The ONC said that as of 2017, 94 percent of hospitals in the U.S. have EHRs that are used in clinical practice. Between 2015 and 2016, there was a seven percent increase in hospitals using EHR data in clinical practice. Between 2016 and 2017, the number remained roughly the same.

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

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

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 hospital EHRs. The NC data shows that although nearly all hospitals provide patients with the ability to electronically view and download their health information, significantly fewer critical access hospitals (CAHs) provided patients with the ability to VDT compared to non-CAHs.

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

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

And patients have not been accessing EHR information in large numbers, the study showed. The 2017 data showed that relatively few hospitals (8 percent or less) reported that 50 percent or more of patients activated access to their patient portal. Two-thirds of hospitals reported that 25 percent or fewer patents accessed the hospital's data portal; and four in 10 hospitals reported that 0 to 9 percent of patients activated their patient portal.

“Programs that encourage hospitals to provide these capabilities to patients are important to ensure that patients have their health information when and where they need it,” the study's authors wrote, adding that federal programs such as MyHealthEData have been launched to encourage consumers to access hospital EHR data.

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EHR use growing among hospitals, but patient use lags

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