A growing number of consumers are embracing electronic health records (EHRs), and the significant boost in online access to health information is increasing patient engagement in their care. In the last year, more than four in five patients with online access to their health records (86 percent) used their online records at least once — and more than half (55 percent) used them three or more times a year. Those are among the findings from a study released today by the National Partnership for Women & Families.

Engaging Patients and Families: How Consumers Value and Use Health IT follows up on the organization’s groundbreaking 2011 national survey that assessed consumer views toward EHRs and health information technology (health IT). “To date, the public discourse on health IT has largely focused on the views of doctors, hospitals and vendors,” said National Partnership President Debra L. Ness. “It is crucial to hear what patients have to say about how they experience EHRs and health IT as they receive care and manage their health — and that’s the focus of Engaging Patients and Families.”

The new survey offers an in-depth look at how patients value and use health IT, and which functions are important to them. The National Partnership report provides seven strategies to engage patients and families more effectively in their care. It is being 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 — and on the heels of the Office of the National Coordinator for Health Information Technology (ONC) releasing its 2015 Strategic Plan this week.

“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, MD.

By repeating questions from 2011, the new survey identifies trends in patient attitudes, reflecting progress from the launch of the Meaningful Use and other federal and state programs to substantial adoption and use of EHRs today. Its new questions yield data on major new topics in discussion for health IT policies and programs, including patient-generated health data, patient care plans and mobile access. The survey includes oversamples of three populations that experience disparities: Latino/Hispanic, Black/African American and Asian American adults.

Among key findings in Engaging Patients and Families:

• Eighty percent of adults in the United States who have doctors and know what kind of record systems — electronic or paper — their doctors use said that their doctors use EHR systems. That is up from 64 percent in 2011;
• Eighty-five to 96 percent of all patients found EHRs useful in various aspects of care delivery, while only 57-68 percent saw paper records as useful;
• Patients’ online access to EHRs has nearly doubled, surging from 26 percent in 2011 to 50 percent in 2014;
• Consumers want even more robust functionality and features of online access than are available today, including the ability to email providers (56 percent); review treatment plans (56 percent), doctors’ notes (58 percent) and test results (75 percent); schedule appointments (64 percent); and submit medication refill requests (59 percent);
• Patients’ trust in the privacy and security of EHRs has increased since 2011, and patients with online access to their health information have a much higher level of trust in their doctor and medical staff (77 percent) than those with EHRs that don’t include online access (67 percent); and
• Different populations prefer and use different health IT functionalities. For instance, Hispanic adults were significantly more likely than non-Hispanic Whites (78 vs. 55 percent) to say that having online access to their EHRs increases their desire to do something about their health;ⁱ and African American adults were among the most likely to say that EHRs are helpful in finding and correcting medical errors and keeping up with medications. So specialized strategies may be necessary to improve health outcomes and reduce disparities in underserved populations.

The new study also reports the views of lesbian, gay, bisexual or transgender people, as well as people with disabilities, since these individuals experience significant disparities, too.

“The views of patients must be front and center as we take the next steps in implementing health IT,” said Sandra R. Hernández, President and CEO of the California HealthCare Foundation, which funded the new survey. “As we as a nation become more diverse, the imperative to address disparities grows. We need the kind of robust information EHRs provide and the genuine patient engagement they can facilitate.”

The new report offers guidance for enhancing the effectiveness of EHR adoption in improving the quality and cost effectiveness of care and guiding delivery system reform. It offers recommendations for multiple communities, including providers, policymakers and employers.

Harris Poll conducted the online survey of 2,045 adults who indicated that they have a primary doctor and their doctor keeps medical and health information in electronic or paper format. The survey was conducted between April 22 and May 7, 2014 on behalf of the National Partnership for Women & Families. The report includes a number of recommendations on the use of EHRs, online access, electronic communication and information sharing, privacy and trust, and designing and building for diversity.

“Every step forward in Health IT is one step closer to achieving the ‘Triple Aim’: improving care, improving health and reducing costs,” said Mark Savage, the National Partnership’s director of health information technology policy and programs. “Engaging Patients and Families shows that we have made progress in leaps and bounds in just a few short years. But clearly there are barriers still to overcome, and this report breaks down policy implications for the Meaningful Use program as well as broader delivery system initiatives that must be carried out. And it’s an important reminder that meeting the needs of patients and families must always be at the core of health IT design and implementation.”

ⁱ Hispanics with online access have a low base size in the survey, and this result should be interpreted as directional in nature.