By Lisa Rapaport

(Reuters Health) – Only about one in 10 discharged hospital patients given access to their electronic medical records go online to take a look, a U.S. study suggests.

Widespread efforts to adopt electronic health records at hospitals have been underway for years, in part to improve the quality of care and help patients become more engaged, informed healthcare consumers. But it’s not clear how engaged patients really are with electronic records.

For the current study, researchers examined data collected from 2,410 hospitals nationwide between 2014 and 2016. Overall, hospitals gave 95% of discharged patients access to view, download and transmit their electronic health information, the analysis found.

But only about 10% of patients with access to their electronic medical records actually accessed their data.

“This suggests that there is significant room for improvement in engaging patients with their information electronically,” the study team, led by Sunny Lin of Oregon Health and Science University-Portland State University School of Public Health, writes in Health Affairs.

“Overall, our findings suggest that policy efforts have failed to engage a large proportion of patients in the electronic use of their data or to bridge the ‘digital divide’ that accompanies health care disparities,” the authors write.

Compared to patients at for-profit hospitals, those treated elsewhere were less likely to have access to their records but more likely to take advantage of access when it was available.

People treated at major teaching hospitals were more likely to access records and the probability that they would do so increased over time, the study also found.

Patients without computer or internet availability at home were less likely to be discharged with access to electronic records than people with these amenities, and they were also less likely to access records even when this was possible in theory.

Researchers found a similar pattern for patients seen at hospitals that were part of larger health systems.

At hospitals with high proportions of low-income patients, by contrast, access rates were lower.

Hispanic patients also had low access rates.

In 2011, the Centers for Medicare and Medicaid Services (CMS) launched a national effort to speed the adoption and use of health information technology with financial incentive payments for hospitals to adopt electronic medical records, the study team writes.

Starting in 2014, as part of this effort, hospitals were required to give patients online access to their medical records. This is typically done through a “patient portal.”

The study wasn’t designed to prove whether or how specific hospital or individual characteristics might directly impact patients’ use of the electronic records. Researchers also didn’t look at whether electronic records access or use directly affected health outcomes for patients.

“Under-resourced hospitals and hospitals in counties with a high percentage of underserved populations have lower levels of access and use,” the researchers conclude. “Policy makers seeking to improve patient-centered care should therefore consider efforts to reduce this persistent digital divide by targeting both hospital- and patient-facing determinants of electronic health information access and use.”

SOURCE: Health Affairs, online November 4, 2019.