EHR Portals: The Patients Who Use, the Patients Who Don't

Patients want online access to their health information. But many patients do not take advantage of electronic health record (EHR) portals — and there is a large disparity between those who do and those who don’t, according to prior research.

Creating national measures of patient uptake for establishing a better baseline for understanding future progress and ecosystem evaluation is the focus of recent research at the University of California, San Francisco and UC San Diego Health.

The rate of unique new users month-over-month was nearly flat. When the researchers added unique new users to the existing users, there was an increase of 165 unique new users per month per health system.

The mean of those who logged into their healthcare organization’s portal in a month and also used an application programming interface (API) was 0.7%. The doubled over time to 0.14% per month per health system.

“Our findings suggest that if health systems want to achieve broad patient use of APIs that they will need to do more than simply make them available,” Julia Adler-Milstein, Ph.D., director of the Center for Clinical Informatics and Improvement Research, wrote in a statement to Inside Digital Health™. “It is too early to know now what specific strategies will be effective, and so it is a period in which experimentation will be valuable.”

Through policy changes, patients have the ability to download health record data directly to their smartphones. Health systems deploy technical and security standards that offer patients access to their electronic health information. Patients then activate the connection between their health system’s records and their phones. Patients transmit data elements like current medications, test results and immunization history to their phones.

The research team identified 12 diverse U.S. health systems that allowed their patients to download their electronic health information to a smartphone via FHIR-enabled APIs for at least nine months. Health systems included had a mean annual net patient revenue of $3.64 billion and a mean of 1,728 staffed beds.

The health systems all used Epic as their EHR vendor. This helped the researchers create a standard data specification that the vendor created for each participating health system.

Data specification included monthly and cumulative counts of unique patient users and the number of unique patients who logged into the patient portal each month.

Access to clinical data via FHIR APIs by smartphone applications could allow patients to better understand and control their health data.

“Our results offer baseline national measures against which to track efforts to create an ecosystem in which patients use their smartphones to manage and engage with their health record data,” the researchers wrote.

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