ONC Report: Survey Finds Increasing Patient Portal, App Usage

Oct. 19, 2023
The number of people who reported they were offered and accessed their online medical record or patient portal in 2022 jumped 50 percent from 2020, according to a data brief from the Office of the National Coordinator for Health IT

In 2022, about 3 in 5 individuals were offered and accessed their online medical records or patient portals, and the frequency of access has increased consistently over time, according to a data brief from the Office of the National Coordinator for Health IT (ONC). In addition, individuals increased their use of apps to access their online medical records between 2020 and 2022, while web-only access to portals decreased.

In 2020, ONC published the Cures Act Final Rule to increase patient and provider access to health-related data, specifically through health IT developer adoption of secure standardized application programming interfaces (APIs) that make this information more widely available across smartphone apps. The API requirements, which as of 2023 have been rolled out to healthcare providers, enable patients to electronically access their electronic health information using apps. This brief analyzes recent data from the 2022 Health Information National Trends Survey (HINTS), a nationally representative survey of U.S. adults, to assess progress in patient access amidst implementation of Cures Rule provisions during the COVID-19 pandemic, which likely increased demand for access to online medical records.

Here are some highlights from the survey:

The share of individuals nationwide who were offered and accessed their online medical record or patient portal more than doubled between 2014 and 2022. About 3 in 4 individuals nationwide reported being offered online access to their medical records by their healthcare provider or insurer in 2022, which represents a 24 percent increase since 2020.

About 3 in 5 individuals nationwide reported they were offered and accessed their online medical record or patient portal in 2022, which represents a 50 percent increase since 2020.

More than half of individuals who were offered online access to their medical records reported accessing them at least 3 times in 2022, with nearly 1 in 3 accessing it 6 or more times. In 2022, only 1 in 5 individuals reported not accessing their online medical records in the past year, a more than 50 percent reduction since 2017, when nearly half of patients offered online access to their medical records did not access them.

In 2022, nearly half of individuals who accessed their online medical records (48 percent) did so using a website only, whereas 19 percent used an app only and about one third (32 percent) used both an app and website. Half of individuals who accessed their online medical records used an app (only or in addition to a website) to access their records in 2022, representing a 13 percentage-point increase from 2020. Individuals who used an app to access their online medical records accessed them more frequently than those who did not use an app (web-only access).

In 2022, most individuals who accessed their online medical records or patient portal viewed test results (90 percent) or clinical notes (70 percent). About 1 in 3 patient individuals who accessed their online medical records or patient portal downloaded their health information, and 1 in 5 electronically transmitted medical information to a 3rd party.  But the vast majority of individuals (98 percent) did not use an electronic personal health record or portal organizing app (such as Apple Health Records or CommonHealth) to combine medical information from different patient portals or online medical records. ONC stated that this may reflect patient preferences for using the online medical records or patient portals offered by their providers or a lack of awareness of these types of apps and their utility.

While individuals most commonly had an online medical record or patient portal through their primary care provider’s office (63 percent), nearly 1 in 3 individuals also reported having an online medical record or patient portal with another health care provider (32 percent) or insurer (29 percent).  Clinical laboratory and pharmacy online medical records or portals were the least common (reported by 26 percent and 23 percent of individuals, respectively).

Despite the advances in patient access and use of their online medical records, particularly through apps, there are also opportunities for improvement, according to the ONC summary. “Just under half of all individuals were either not offered or did not access their online medical records or a patient portal in 2022, and several studies have identified disparities in the share of patients who report being offered and subsequently accessing their portal). Relatively low rates of downloading and transmitting health information by individuals who access their online medical records suggests a need for further education of both individuals and providers on these features.”

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