Why GAO Did This Study. HHS's goal is that all Americans will be able to electronically access their longitudinal health information, that is, their health information over time. HHS's efforts to achieve this goal include the Medicare EHR Program and other efforts to encourage providers to make patient health information available and for patients to access such information. GAO was asked to review the state of patients' electronic access to their health information. This report (1) describes the electronic access to health information available to patients, and patients' views of this access, (2) describes the extent to which patients electronically access their health information, and actions providers reported taking to encourage such access, and (3) evaluates HHS's efforts to advance patients' ability to electronically access their health information. GAO analyzed data from HHS and other sources; reviewed applicable strategic planning documents; surveyed a generalizable sample of providers that participated in the Medicare EHR program; and interviewed HHS officials and a nongeneralizable sample of patients, providers, and health information technology product developers. Since 2009, the Department of Health and Human Services (HHS) has invested over $35 billion in health information technology, including efforts to enhance patient access to and use of electronic health information. One of the largest programs is the Centers for Medicare & Medicaid Services' (CMS) Medicare Electronic Health Record Incentive Program (Medicare EHR Program), which, among other things, encourages providers to make electronic health information available to patients. Program data for 2015 show that health care providers that participated in the program (3,218 hospitals and 194,200 health care professionals such as physicians) offered most of their patients the ability to electronically access health information. Patients generally described this access as beneficial, but noted limitations such as the inability to aggregate their longitudinal health information from multiple sources into a single record. Data from the 2015 Medicare EHR Program show that relatively few patients electronically access their health information when offered the ability to do so. Patients GAO interviewed described primarily accessing health information before or after a health care encounter, such as reviewing the results of a laboratory test or sharing information with another provider. While HHS has multiple efforts to enhance patients' ability to access their electronic health information, it lacks information on the effectiveness of these efforts. The Office of the National Coordinator for Health Information Technology (ONC) within HHS collaborates with CMS to assess CMS's Medicare EHR Program as well as its own efforts to enhance patient access to and use of electronic health information. However, ONC has not developed outcome measures for these efforts consistent with leading principles for measuring performance. 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. What GAO Recommends. GAO recommends that HHS 1) develop performance measures to assess outcomes of key efforts related to patients' electronic access to longitudinal health information, and 2) use the information from these measures to help achieve program goals. HHS concurred with the recommendations.
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