Ninety-five percent of organizations offer patient data access, but only 10 percent of patients actually use their data.
Despite most hospitals offering widespread patient data access, few patients are taking advantage of those capabilities in any meaningful way, pointing to a need to revamp patient engagement and data access policy requirements, according to a new study published in Health Affairs.
The medical industry has been on a long journey going digital, complete with a big regulatory push to promote patient data access over the past eight years. Working off the evidence that patient data access improves engagement and outcomes, programs like meaningful use have required providers to grant patients access to their medical information.
Specifically, Stage 1 and Stage 2 Meaningful Use have called on hospitals to promote view, download, and transmit capabilities hosted on the patient portal.
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And those programs have been largely successful, the researchers found. In an analysis of 2,410 hospitals participating in Stage 2 Meaningful Use between 2012 and 2016, the researchers found that 95 percent granted patients view, download, and transmit capabilities.
But patient use of health data was left wanting, the researchers added. Only between 10 and 12 percent of patients actually obtained their own medical information, bringing to the forefront questions about how much hospitals can actually control how many patients access their own health data.
Healthcare organizations have long maintained that they have limited ability to influence patient data access outside of hosting the patient portal, the researchers pointed out. Meaningful use regulations, especially those in Stage 2 Meaningful Use, went through several iterations following feedback from participating hospitals.
In the end, the Centers for Medicare & Medicaid Services (CMS), which administered meaningful use, required attesting hospitals to allow patient data access for at least 50 percent of patients and to show that at least one patient had viewed, downloaded, or transmitted her own health data.
This was a move set to appease hospital groups protesting that view-download-transmit measures were outside the control of hospitals, the researchers said.
But other findings from the study call that notion into question. For one, patient use of medical information stayed stagnant over time, suggesting there was space for hospitals to promote patient data use.
“Our results imply that hospitals are in a position to influence levels of access and use,” the researchers said. “Specifically, when we held patient demographics constant, we found that hospital structural characteristics were associated with levels of access and use.”
For example, organizations serving a large proportion of low-income patients were less likely to have robust patient data access offerings.
Patient data access was lower in disproportionate share hospitals (DSHs), or hospitals that receive federal dollars to support treatment of low-income, safety-net patients. Data access was also lacking in hospitals located in regions with high populations of individuals who are low-income, dual-eligible, lack internet access, or were Hispanic.
On the other hand, patient data access was higher in hospitals that were a part of a health system, categorized as a teaching hospital, or were for-profit, likely because they had the funds to address patient data access and engagement efforts.
The implications for this study are twofold. For one, trends in patient data access at certain organizations suggest that healthcare organizations have some influence over their patients accessing their own medical data.
“Provider organizations can engage in system-level efforts that allay patients’ concerns about the confidentiality and privacy of patient portals, and that the patient-provider relationship is an important predictor of portal use,” the research team wrote. “Organizations can also use their market power to influence vendors to improve portal design to facilitate use for patients with low health literacy, technological literacy, or both.”
And since organizations do have the power to encourage more patients to use their medical data, the researchers asserted that federal policies such as meaningful use should have more stringent regulations. In doing so, CMS and other governing bodies can drive greater patient engagement.
“Our study points to the need for additional policy efforts that incentivize providers to improve patients’ access to and use of information,” the team said.
Specifically, requirements for the Promoting Interoperability Program, which has largely replaced meaningful use, should incent stronger patient data access and use.
“Our study suggests that a higher threshold for both measures might be more achievable than providers claim and that CMS may wish to reconsider this decision moving forward,” the researchers asserted.
Federal policies must do their work to address these disparities, as well. Current requirements do not encourage these providers to facilitate patient data use, the team pointed out, which can be limiting when organizations need to tap into financial or personnel resources to drive patient buy-in.
Regulatory programs can make population-specific regulations that set different data use thresholds based on population characteristics.
Additionally, it would be helpful if programs created more specific measures of patient engagement. Providers can fulfill current requirements when one patient simply logs into the patient portal.
“Examples of more meaningful measures may include the percentage of patients who, after discharge, exchange secure messages with their hospital team, transmit lab results to a third party, or assist in medication reconciliation by confirming their discharge medication list,” the team offered.
These examples may demonstrate a more meaningful interaction between the patient and her health data.
Programs may also consider addressing social barriers that limit patient data access, the study authors noted in conclusion.
“Policy approaches that attenuate patient-facing barriers in the community may be effective in improving levels of access and use, such as increasing broadband availability, providing community-based digital literacy training and support, and improving the usability of patient portals,” the researchers said.
Source: Patient Engagement Hit