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HHS Should Do More to Measure EHR Access, GAO Says

The Department of Health and Human Services should re-assess the effectiveness of its efforts to increase patient access to electronic health records, according to a recently released Government Accountability Office report.

Since 2009, HHS has invested more than $35 billion in health IT. One of its largest programs is the Medicare Electronic Health Record Incentive Program, which encourages providers to make EHRs available to patients. In 2015, despite 90 percent of health care providers under the program providing patient access to EHRs online, fewer than 30 percent of patients were actually accessing those records. GAO interviewed the patients, and found that most accessed their health information only directly before or after a health care encounter.

Throughout the course of the interviews, GAO found that many patients don’t access their health records because the portals are not very functional. Patients stated that they could view their health information electronically, but it was unclear whether they could download or transmit the information. They were also frustrated with how much time and effort it took to set up portal access and how frequently the information was incorrect.

The report notes that the most common patient complaint was that “they could not aggregate all of their health information into a single longitudinal health record.”

Although HHS has spent a lot of time focused on increasing patient access to health data–with programs such as the Patient Engagement Playbook, the Blue Button Initiative, and the Consumer Health Data Aggregator Challenge–they don’t have information on the effectiveness of these efforts. Currently, there is no direct measure of the impact on increasing electronic access to health information beyond seeking public comment.

The GAO report gives HHS two recommendations to help ensure its efforts are measured and properly adjusted to be successful:

  • Develop performance measures to assess outcomes of key efforts related to patients’ electronic access to longitudinal health information.
  • Use the information from the performance measures to make program adjustments, as appropriate.
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