Report says ONC needs measures to assess patient access to records

While the Department of Health and Human Services has multiple efforts to enhance patients’ ability to access their electronic health information, HHS lacks the ability to assess the effectiveness of these initiatives.

That’s the conclusion of a new Government Accountability Office report that specifically calls out the Office of the National Coordinator for Health IT for its shortcomings in this area.

Despite the fact that ONC is required by the HITECH Act and the Medicare Access and Children’s Health Insurance Program Reauthorization Act to develop performance measures for the adoption of EHRs and related efforts to facilitate the electronic use and exchange of health information, ONC has not developed a specific means for measuring outcomes associated with its efforts aimed at furthering patients’ ability to electronically access their health information, according to the GAO.

“Without such measures, HHS lacks critical information necessary to determine whether each of its efforts are contributing to the department’s overall goals, or if these efforts need to be modified in any way,” states the GAO report.

For instance, auditors charge that ONC cannot determine if patient electronic access is higher for participants in the Blue Button Initiative, compared with access rates for non-participants, or if providers who use the Patient Engagement Playbook—a tool developed by the agency to assist providers in using patient portals to engage patients—achieve more patient electronic access than non-users.

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To address this shortfall, the GAO recommended that the HHS Secretary direct ONC to develop performance measures to assess outcomes of key efforts related to patients’ electronic access to longitudinal health information, including determining whether the number of providers that participate in these initiatives have higher rates of patient access to electronic health information.

In addition, auditors recommended that the HHS Secretary direct ONC to use the information these performance measures provide to make program adjustments—where appropriate. “Such actions may include, for example, assessing the status of program operations or identifying areas that need improvement in order to help achieve program goals related to increasing patients’ ability to access their health information electronically.”

ONC and HHS are looking to the comments as opportunities for improvement, officials say.

“HHS and ONC reviewed and concurred with the recommendations,” says Acting National Coordinator Jon White, MD. “The GAO report is a great opportunity to review our efforts.”

In a written response to the GAO report, HHS stated that ONC would “make every effort to develop performance measures for patient education and outreach initiatives but would have to balance these efforts with its efforts to develop measures for the adoption of EHRs, interoperability and patient engagement nationwide.”

Further, HHS indicated that ONC would use the information the performance measures provide to make program adjustments, and that it is committed to using such metrics to guide program improvement.

“We’re looking forward to working on those recommendations,” adds White. “We’ve got great measures on how the technology works and how the certified technology gives people access to information. But we’re looking forward to developing new, better measures on people getting access to their data.”

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