Despite efforts by the U.S. Department of Health and Human Services (HHS) to enhance patients' access to their electronic health information, data from 2015 show that relatively few patients take advantage of the access, according to a March 2017 report from the U.S. Government Accountability Office (GAO). In reviewing the state of patients' electronic access to their health information, GAO found that 88% of 3,218 hospitals and 87% of 194,200 healthcare professionals participating in the Medicare Electronic Health Record (EHR) Incentive Program offered patients access to their electronically available health information in 2015. However, only 15% of hospital patients and 30% of patients of healthcare practitioners went online to access their health information. GAO found that, when patients do access information, they usually do so before or after a healthcare visit (e.g., to check test results). In addition, while many patients described access to their electronic health information as beneficial, they also noted the technology has limitations; for instance, it is impossible to aggregate information from multiple sources into a single record. GAO states, "While HHS has multiple efforts to enhance patients' ability to access their electronic health information, it lacks information on the effectiveness of these efforts." As a result, GAO recommends that HHS develop performance measures to assess outcomes related to patient access to longitudinal electronic health information, and that they use the information gained from these measures to help achieve program goals. In addition to the full report, GAO has released a GAO Highlights document and a podcast on the subject.

HRC Recommends: Many hospitals and physician practices have implemented patient access to EHRs as one method to promote patient engagement, communication, and continuity of care. Organizations interested in implementing patient access should consider taking steps to address patients' potential concerns, such as those related to privacy, substance use and mental health issues, and other conditions that may call for more sensitivity (e.g., terminal illness, obesity). Evaluating various aspects of the open note (e.g., navigation, layout, terminology) in order to reduce confusion may also help.