Adoption of HIE and Patient Engagement Low in Practices

The August 2014 edition of the Journal “Health Affairs” published the results of a survey conducted by representatives from AHRQ, ONC, Harvard and the University of Michigan.

The article is titled “Despite Substantial Progress In EHR Adoption, Health Information Exchange And Patient Engagement Remain Low In Office Settings.”

Key findings of this 2013 survey:

  1. EHR adoption continued to increase, with 78% of practices reporting the adoption of some type of EHR and 48% had the features needed for the use of a “basic EHR.”  Providers in solo practices and non-primary care specialties has the lower rate of adoption.
  2. Only about 14% of providers share data electronically with other providers outside of their organization.
  3. The survey found that 30% of physicians routinely used secure messaging capabilities with patients.
  4. It also found that 24% routinely provided patients with the ability to view online, download, or transmit their health record.

Editorial Comment*:  This is an excellent and informative article about the state of health information exchange (HIE) and patient engagement in the U.S. in 2013.  HIE is plagued by limitations related to the cost of interfaces, lack of adoption of required technologies, business disincentives, privacy concerns, a lack of implemented standards, and challenges associated with reconciling data from disparate sources.   Patient engagement represents another challenging area of healthcare as patient have not traditionally been taking advantage of patient portals and PHRs.  A lack of interoperability, requiring patients to manually enter data in PHRs, would benefit from greater levels of health information exchange.  As the authors note in the discussion of this article, greater attention needs to be paid to policies that will facilitate the broader adoption of HIE and patient engagement tools.

Link to full article (requires subscription to Health Affairs): “Despite Substantial Progress In EHR Adoption, Health Information Exchange And Patient Engagement Remain Low In Office Settings”

The abstract is available here.

Author Affiliations:

1. Michael F. Furukawa (michael.furukawa@ahrq.hhs.gov) is a senior staff fellow in the Center for Delivery, Organization, and Markets at the Agency for Healthcare Research and Quality, in Rockville, Maryland. He was director of the Office of Economic Analysis, Evaluation, and Modeling at the Office of the National Coordinator for Health Information Technology (ONC) in the Department of Health and Human Services when this article was written.
2. Jennifer King is chief of the Research and Evaluation Branch in the Office of Economic Analysis, Evaluation, and Modeling at the ONC.
3. Vaishali Patel is a senior adviser in the Office of Planning, Evaluation, and Analysis at the ONC.
4. Chun-Ju Hsiao is a health scientist administrator in the Center for Quality Improvement and Patient Safety at the Agency for Healthcare Research and Quality.
5. Julia Adler-Milstein is an assistant professor in the School of Information and the School of Public Health, University of Michigan, in Ann Arbor.
6. Ashish K. Jha is a professor of health policy and management at the Harvard School of Public Health, in Boston, Massachusetts.

Citation: Michael F. Furukawa, Jennifer King, Vaishali Patel, Chun-Ju Hsiao, Julia Adler-Milstein and Ashish K. Jha, Despite Substantial Progress In EHR Adoption, Health Information Exchange And Patient Engagement Remain Low In Office Settings, Health Affairs, no. (2014): doi: 10.1377/hlthaff.2014.0445

* The Editorial Comment represents the opinions of Michael Stearns, MD.