While hospital adoption of key patient engagement functionalities is increasing, small and critical access hospitals are lagging behind
Seven out of 10 hospitals in the U.S. (69 percent) now provide their patients with the ability to view, download and transmit their health information electronically, an almost seven-fold increase since 2013, according to a data brief from the Office of the National Coordinator for Health IT (ONC).
The data brief takes a look at trends in hospitals’ adoption of key patient engagement functionalities between 2012 through 2015. The data, which is based on the 2015 American Hospital Association Health IT Supplement Survey, reflects trends among U.S. non-federal acute care hospitals. Vaishali Patel, Ph.D., senior advisor at ONC, also discussed the data findings during a joint meeting of the ONC Health IT Policy and Standards Committees on Tuesday.
According to ONC, the Shared Nationwide Interoperability Roadmap calls on health care providers to enable patients to electronically view, download, and transmit (VDT) their health information to a destination of the patient’s choice. The Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs required participating hospitals and health care professionals to enable patients with online access to view, download, and transmit their health information.
In 2013, only 10 percent of hospitals had adopted VDT capabilities. As of 2015, 95 percent of hospitals enable patients to view their health information electronically, up from 40 percent in 2013; 87 percent of hospitals enable patients to download their health information, up from 28 percent in 2013 and 71 percent of hospitals provide patients the capability to electronically transmit their health information, which is up from 12 percent in 2013.
“The tremendous growth in hospitals’ adoption of view, download, and transmit capabilities in a relatively short period of time points to the potential impact of the Medicare and Medicaid EHR Incentive Programs, and specifically to the measures related to view, download, and transmit that were required for Stage 2 of the program,” Patel wrote in the data brief.
The number and variety of patient engagement functionalities offered by hospitals continued to increase significantly in 2015, according to the data brief. Almost two-thirds of hospitals (63 percent) enable patients to send or receive secure messages and 37 percent provide the capability for patients to submit patient-generated data, an almost 3-fold increase since 2013.
In 2015, more than three quarters of hospitals (77 percent) enabled patients to request an amendment to their health data, and offered patients the ability to electronically pay their bills (74 percent).
It is interesting to note that fewer hospitals have, so far, adopted basic convenient electronic capabilities, such as enabling patients to request prescription refills online. Four out of 10 hospitals allowed patients to request prescription refills (42 percent) and schedule appointments online (44 percent).
Patel wrote in the data brief, “Certain ‘convenience’ functions that enable patients to schedule appointments or refill their medications electronically lagged behind in adoption compared to those that relate to the Medicare and Medicaid EHR Incentive Programs, Health Insurance Portability and Accountability Act (HIPAA) regulations, or billing.”
Nine in 10 hospitals possess four or more electronic patient engagement capabilities, while the percent of hospitals adopting seven to nine patient engagement functionalities increased from 38 percent in 2014 to 43 percent in 2015.
At the state level, the percent of hospitals with VDT capability has spread nationwide between 2013 and 2015, according to ONC. In 2013, no states had 40 percent or more of their hospitals with these three electronic capabilities; whereas by 2015, all states had 40 percent or more of their hospitals with these three capabilities.
However, ONC data also indicates that disparities exist in the adoption of view, download, and transmit functionalities between large hospitals and other types of hospitals, specifically medium, small and Critical Access Hospitals.
As an example, almost 8 in 10 large hospitals have all three VDT capabilities while only about 6 in 10 CAHs (61 percent) have all three capabilities. And, for further comparison, only 65 percent of small hospitals have all three capabilities and 71 percent of medium-sized hospitals have all three capabilities. There seems to be equity when it comes to providing the capability for patients to view their health information, as 93 percent of CAHs and small hospitals offer this capability and 97 percent of medium hospitals.
“Rural and smaller hospitals’ lower rates of VDT capabilities reflect lower rates of certified HER technology adoption, and will require continued monitoring,” Patel said when presenting the data at an ONC Health IT Policy and Standards Committee meeting on Tuesday.
Patel also noted that to increase usage of these capabilities, it will be important to make it easy for individuals to access, aggregate, and subsequently use their health information. And, she pointed out various ONC initiatives to foster patient engagement and access to health information, such as the patient engagement playbook, the consumer health data aggregator challenge and the Blue Button connector.
Moving forward, Patel said analysis of patient engagement should shift from gathering data on hospital adoption of patient engagement functionalities to now focus on usage of those functionalities and how it ultimately improves patients’ health.