In the last year, 86 percent of patients with access to their health records used their online records at least once, and 55 percent used them three or more times per year. The findings were released this month in a report entitled “Engaging Patients and Families: How Consumers Value and Use Health IT.” The report is a follow-up to the partnership’s 2011 national survey that examined consumer views toward EHRs and health information technology (health IT).

Since 2011, there has been a considerable shift toward EHRs, according to the report. Eighty percent of adults said their doctor uses an EHR system, up from 64 percent in 2011. Online access to EHRs has also increased, with half of patients having access versus only 26 percent in 2011.

The report was released five years after the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 was enacted and the Medicare and Medicaid EHR Meaningful Use incentive program began. The program encourages the adoption of EHRs through financial incentives to providers. The report comes on the heels of the Office of the National Coordinator for Health Information Technology (ONC) releasing its 2015 Strategic Plan this month. The plan calls for financial and regulatory incentives to encourage the use of health information technology.

“As the National Partnership’s new data show, more consumers are accessing, sharing and using their health information, underlining the importance of interoperability of health data and systems. We are focusing our efforts in these areas to empower individuals to address not only gaps in information exchange and interoperability, but also enable them to take steps to improve their health and better manage their health needs,” said National Coordinator for Health IT Karen DeSalvo, in a statement.

In addition to a rise in EHR use among patients and providers, the study also found that consumers want more functionality and features when they access their records online. More than half want to see the ability to email their provider and to review treatment plans and doctor notes. More than 60 percent want to be able to schedule appointments; 59 percent want to be able to submit medication refill requests; and 75 percent want to see test results online.

Patients are able to trust in the privacy and security of EHRs more now than in 2011, and 77 percent of patients with online access to their health information have a higher level of trust in their doctor and medical staff versus 67 percent of those that don’t have online access.

The partnership surveyed more than 2,000 U.S. adults this year for its study.

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The Meaningful Use program is an electronic health record (EHR) incentive program initiated following the American Recovery and Reinvestment Act of 2009 that authorizes the Centers for Medicare and Medicaid Services (CMS) to award incentive payments to eligible professionals who demonstrate meaningful use of a certified EHR. The program has three stages, but incentives were only provided in Stage 1, which began in 2011. Stage 2 of Meaningful Use began this year and by 2015, eligible providers that have not adopted an EHR will face a financial penalty.

The AMA, headquartered in Chicago, is pressing for changes to the program after new analysis from CMS showed only 2 percent of physicians and less than 17 percent of hospitals have demonstrated Stage 2 Meaningful Use as of Sept. 30, the required reporting date for the 2014 fiscal year.

In response to the data, the AMA is urging policymakers to fix the program by adding more flexibility and shortening the reporting period to help physicians avoid penalties. Physicians representing the AMA also say that full interoperability is necessary to achieve the goals of EHRs — which are to facilitate coordination, increase efficiency and help improve the quality of care — but that is not widely available today.

"The AMA has been calling for policymakers to refocus the Meaningful Use program on interoperability for quite some time," said Dr. Steven J. Stack, AMA president-elect, in a statement. “The whole point of the Meaningful Use incentive program was to allow for the secure exchange of information across settings and providers and right now that type of sharing and coordination is not happening on a wide scale for reasons outside physicians’ control. Physicians want to improve the quality of care and usable, interoperable electronic health records are a pathway to achieving that goal.”

Although there are some systems on the market capable of interoperability, when data is transferred it is not always incorporated into the receiver’s EHR in a digestible way, making it difficult to act on and defeating the purpose of sharing, the AMA argues. Additionally, interoperability often comes at a price, which further hinders its use.

In addition to calling for EHRs to be more interoperable, physicians are also recommending that policymakers ease regulations to allow for EHRs to become more usable. To back its position, the AMA has been citing a 2013 report from AMA-RAND — a collaboration between the AMA and research firm RAND Corporation — that stated EHRs are a major source of dissatisfaction for physicians. The report found that physicians want to embrace technology, but they’re frustrated that regulatory requirements are forcing them to do clerical work and distracting them from paying close attention to their patients.

Physicians also raised concerns about interoperability in the study, saying that the inability of EHRs to "talk" to each other prevents the transmission of patient medical information when it is needed.

The AMA has provided the Office of the National Coordinator for Health IT (ONC) and CMS with a blueprint for improving the Meaningful Use program as well as a framework that outlines eight priorities for more usable EHRs.
 

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