Patient Data Access, Mobile Patient Portals Reach Unprecedented Use

Patient data access is at an all-time high, with new data from the Office of the National Coordinator for Health IT showing three in five patients being offered and accessing their digital health records by way of the patient portal.

These findings following the full rollout of patient data access rules under the 21st Century Cares Act, ONC said, indicating that information blocking provisions under the law may be working to improve patient engagement.

ONC has tracked patient data access and patient portal utilization for nearly a decade. This latest data brief shows that patients are more likely than ever to not just be offered but also to access that information. Overall, 57 percent of patients were offered and accessed medical records and patient portals. Three-quarters (73 percent) were offered access.

Those figures are up considerably from 2020 when only 38 percent of patients were offered and accessed their health data.

The ONC data brief also showed a boom in app-based patient portal use, with 51 percent of patients saying they use this medium for patient data access. That is up from 38 percent of folks who said the same in 2020.

On the flip side, the number of people solely looking at their digital medical records on web-based platforms shrunk from 60 percent in 2020 to 48 percent in 2022. App-based patient portals may be getting more popular because they are more convenient and user-friendly, although the ONC report did not dig into those details.

Most patients are using patient portals to view their test results while downloading and transmitting their records is far less common. New in this year’s data brief, 70 percent of patients are looking at their clinical notes, a new action allowed under the 21st Century Cures Act.

The ONC data also revealed that patients are accessing their medical information somewhat regularly. While only 21 percent of patients said they didn’t access their own medical records at all within the past year, a quarter reported accessing their records once or twice and three to five times each, respectively. A whopping 29 percent of patients accessed their medical records six or more times.

This counters previous notions about patient portal access. In the past, experts contended that patient portals mostly function as a safety net for patient engagement. While patient portals could house patient data and perform other patient access functions, they were mostly utilized by folks who frequently meet with providers, like those with chronic conditions.

Indeed, these figures could indicate that the prevalence of chronic conditions—and the more intensive patient engagement needed for management—is becoming greater, but the data showed that making medical record access more portable has also increased patient access.

As noted above, patients were more likely to look at their patient portals on mobile apps instead of via web-based patient portals. The data further revealed that patients who used a mobile app were more likely to view their medical records multiple times within a year.

For example, 40 percent of patients using web-based data access tools only viewed their medical records once or twice in year; far fewer app users said the same (26 percent). Conversely, 42 percent of app users looked at their patient portals six or more times in a year, compared to just 28 percent of web-based portal users who did the same.

These findings come now that the information blocking rules under the 21st Century Cures Act are in full effect. Per the law, healthcare providers must make patient health data and clinician notes immediately digitally available.

The ONC data brief indicates that the rules are working to increase patient data access, but separate reports have called the law into question, or at least best practices for carrying it out. It is still murky whether immediate data access—which could mean patients receive abnormal test results before they can talk to a doctor—is good for the patient experience.

Two unrelated 2023 reports coming out within days of each other indicated that immediate patient data access does not help the overall healthcare experience. The first, published in JAMA Health Forum, showed that the number of unsolicited patient complaints related to communication, documentation, treatment, and diagnosis at Vanderbilt University Medical Center increased after the Cures Act went into place.

The researchers found that patient complaints were related to seeing a test or lab result that confused them, they felt went unexplained, or that caused them anxiety.

A separate report in the journal Radiation Oncology showed that getting immediate access to test results is okay—but it’s even better to have doctors discuss results with patients.

Overall, patient stress levels went down following a cancer scan when they had access to their test results. However, those stress levels lowered even further when patients could talk to their doctors about the results.

These findings counter previous studies showing that patients are okay with getting their lab results via the patient portal, even if it’s bad news and even if they can’t talk to their doctors right away.

As healthcare industry leaders work to better understand how patients want to interact with their digital medical records, it may be fruitful for providers to explain the process to patients. Outlining that patients may receive test results before clinicians can meet with them and discussing whether the patient wants to open those results immediately could be helpful in ensuring a better patient experience.