In November 2019, a study by Health Affairs found that only 10% of patients with online access to their electronic health records accessed their files. This extremely low number is puzzling, as many polls have shown that the majority of patients desire immediate and secure access to their data. A Health Affairs panel convened to analyze the major obstacles facing patient access today. Read on to discover how Exscribe is addressing these challenges.
Obstacles Originated Early
In 2009, the passage of the Health Information Technology for Economic and Clinical Health Act (HITECH) provided incentives for Medicare and Medicaid eligible providers to adopt health information technology, and introduced penalties for non-compliance. Original Meaningful Use policies required just a single patient to access their records for an entire organization to get financial credit in the program. This incentive was not strong enough for individual providers or healthcare organizations to widely promote electronic access to patients.
Furthermore, increasing patient access has been a challenge in part because providers and health IT stakeholders feared that increased data exchange and access could lead to more personal liability before the transition to value-based care. With the implementation of the Quality Payment Program in 2017, the return to fee-for-service is unlikely, and tangible reimbursement incentives are now tied to long-term health outcomes. Providers and healthcare organizations are therefore more invested in promoting ways for patients to maintain their health outside of the office, part of which includes access to their records.
Current barriers to access
The main obstacles to patient access as outlined by the panel include outdated formats for information, inefficient delivery methods, and exorbitant fees. Fees to obtain a patient’s medical record vary widely; some states cap charges at different price points, while some prohibit charging for records at all. The panel suggested making records available to patients by email to combat inefficient delivery methods and outdated formats. Currently, this process is tricky to accomplish in a HIPAA-compliant manner. Attaching a record to an email carries a host of risks with it – a single typo could result in a breach of confidentiality. A patient portal fills the need for immediate access to records. Exscribe’s patient portal includes the ability to have record summaries sent to the patient’s account in a secure fashion.
Secondly, the panel recommended accelerating technical requirements for patient access to data through open application programming interfaces (APIs). Stakeholder comments to CMS and ONC have been pushing for the agencies to include a mandate for certified health IT to adopt open APIs as a top priority, especially as the agencies are finalizing rules for information blocking penalties. Today, Exscribe is working with the FHIR standard on open APIs to ensure information can move as seamlessly as possible between EHR systems and other clinical applications.
Finally, the panel recommends expanding and clarifying privacy protections for patients. Public outcry over the reveal of Project Nightingale, which has been found HIPAA-compliant, shows that patients are growing more concerned over their healthcare data and how it is used and accessed. Exscribe’s offerings of a secure patient portal and current development work demonstrate commitment to both patient privacy and access.