Even though the Department of Health and Human Services (HHS) has spent more than $35 billion since 2009 on driving use of electronic health records (EHRs), the government does not have a plan to measure the effectiveness or outcomes of this massive effort, according to a Government Accountability Office (GAO) report. Furthermore, GAO found several signs of trouble, including low patient participation and problems with electronic portals.
In an analysis of HHS data, GAO found that while 88% of hospitals and 87% of physician practices in 2015 offered patients access to EHRs, only 15% and 30% of patients, respectively, accessed their information. GAO interviewed patients who did access their EHRs and found that some reported distinct benefits, specifically accessing and tracking lab results over time. For example, one patient reported that she noticed a trend in her lab results and detected a problem that her provider had failed to inform her about.
But many patients encountered frustrating inconsistencies and complained that EHR portals were hard to use, confusing, and even had inaccurate information that was difficult to correct. GAO interviewed one patient who said that another person’s information was included in her record, and it took multiple requests to her provider to remove it.
In its report, GAO recommended that HHS develop outcome measures to directly measure the effectiveness of its individual efforts surrounding EHRs, identify areas that need improvement, and ensure accountability for achieving results. In reply to the GAO report, HHS noted that the agency has asked the National Quality Forum to develop ways to measure the impact of EHR interoperability on the quality of patient care. HHS also noted that the agency is required by statute to measure the adoption of EHRs by providers rather than the effect on patients, and must direct its limited resources to fulfill that obligation.