Understanding the Importance of Developing Performance Measures to Enhance Patient Access to Electronic Health Information

In the evolving field of healthcare, a key focus has emerged: improving patient access to electronic health information (EHI). This change is essential for enhancing healthcare delivery and patient involvement. The Department of Health and Human Services (HHS) has invested over $35 billion in health information technology since 2009 to provide better access to health records for both patients and providers. However, despite this significant investment, many patients find it difficult to fully utilize the electronic systems available.

The Need for Effective Performance Measures

One main issue identified in various studies is the lack of effective performance measures to evaluate how well initiatives are improving patient access to EHI. Although nearly 90% of patients in hospitals participating in the Medicare Electronic Health Record (EHR) Incentive Program were given online access to their health records, many did not take advantage of this option. This gap reveals a disconnect between providing access and ensuring that patients know how to use it.

Carolyn L. Yocom, the Director of Health Care at the U.S. Government Accountability Office (GAO), highlighted the need for HHS to create performance measures that assess outcomes related to electronic access. Without these measures, evaluating the success of these initiatives is challenging.

The Office of the National Coordinator for Health Information Technology (ONC) within HHS is working on tracking national surveys and assessing patient access metrics. The main difficulty is establishing consistent principles for performance measurement that accurately reflect patient experiences and outcomes. Developing these measures is about more than just compliance; it is crucial for enhancing patient care quality.

Patient Access to Electronic Health Records (EHRs)

EHRs have changed healthcare documentation by enabling quick access to accurate patient histories. EHR systems contribute to better patient care and safety while enhancing organizational efficiency. Some advantages of EHRs related to the need for performance measures include:

• Coordinated Care: Providing real-time access to patient information helps clinicians coordinate care, reducing medical errors and unnecessary duplicate tests.
• Communication Enhancement: Secure sharing of information between providers and patients leads to better interactions and transparency in healthcare discussions.
• Improved Documentation: EHRs enhance documentation quality and coding accuracy, which are important for payment processes.

Despite these benefits, studies indicate that patients see electronic access to their health records as useful, yet they often face limitations when trying to gather data from multiple sources into a comprehensive record. Effective performance measures can help identify obstacles to access and guide necessary improvements.

The Role of Interoperability

Interoperability, or the ability of different systems to exchange and effectively use health information, is vital for enhancing patient access to EHI. The Centers for Medicare & Medicaid Services (CMS) has proposed regulations to improve interoperability across healthcare entities. One key provision includes introducing Patient Access APIs, which enable consumers to easily access their health information, including prior authorization statuses.

The CMS Interoperability and Prior Authorization final rule calls for robust data-sharing mechanisms. It requires that payers and providers use Health Level 7® Fast Healthcare Interoperability Resources® (FHIR®) APIs. These requirements aim to make prior authorization processes more straightforward, ultimately benefiting patients and providers.

By measuring essential metrics related to interoperability, healthcare stakeholders, including medical practice administrators and IT managers, can assess the success of these implementations and address challenges faced by patients.

Enhancing Patient Understanding Through API Utilization

As part of the efforts to improve patient access to health information, implementing Patient Access APIs aims to increase clarity about how healthcare processes affect patients. Beginning January 1, 2026, CMS expects payers to include prior authorization decision information in the Patient Access API, aiding patients in understanding their care experiences.

To help patients navigate and utilize these APIs effectively, organizations must offer clear educational resources that explain how to use these APIs, what information they can access, and how this can support their healthcare needs.

Furthermore, developing a Prior Authorization Requirements, Documentation, and Decision (PARDD) API is an important move to reduce administrative burdens on providers while improving patient access to information. Transparency about prior authorization decisions, along with required response times of 72 hours for urgent requests, is vital for facilitating a smoother patient experience.

AI and Workflow Automation in Healthcare

As healthcare looks to the future, integrating artificial intelligence (AI) and automation into workflows presents an opportunity to enhance patient access to electronic health information. Companies like Simbo AI are leading the way in front-office phone automation and answering services, showing the potential for improved interactions in healthcare.

AI-driven solutions can enhance scheduling appointments, managing billing inquiries, and verifying insurance, which saves time for both staff and patients. Through automating repetitive tasks, healthcare organizations allow their personnel to focus on more complex responsibilities, enhancing overall efficiency.

Integrating AI into EHR systems can boost data analytics, helping administrators understand patient behavior, access trends, and coordination challenges better. These insights help identify areas needing improvement in electronic health records access.

Additionally, AI chatbots can offer immediate assistance to patients needing help accessing their health information, reducing frustration and enhancing satisfaction. This automation enables a seamless experience for patients, supporting the goal of effective healthcare delivery.

By aligning AI capabilities with performance measures aimed at improving patient access, healthcare organizations can progress toward a future that prioritizes both efficiency and the needs of patients.

Addressing the Challenge of Patient Education

While technology is essential for increasing access to electronic health information, education is crucial to bridging the gap between availability and utilization. Many patients are unfamiliar with how to access and interpret their electronic health records. The lack of easily accessible educational resources often leaves patients feeling overwhelmed.

Medical practice administrators and IT managers should take proactive measures to address this issue by creating comprehensive patient education programs. These initiatives could include user-friendly tutorials, Q&A sessions, and community outreach to help patients understand their rights and how to access their data.

Healthcare organizations also need to engage patients for feedback on their experiences with electronic access. This feedback is valuable for adjusting access protocols and strategies, which can lead to improved patient engagement and satisfaction.

Collaborating with Stakeholders for Real Change

Enhancing patient access to electronic health information requires collaboration among various stakeholders in the healthcare system. Medical practice administrators, healthcare organizations, technology providers, and regulatory bodies must work together to create an environment where patients can easily access their health data.

By pooling resources and experiences, stakeholders can drive advancements in healthcare technology that meet the needs of both patients and providers. This collaboration will also help tackle barriers to effective data access, such as privacy and data security concerns.

As the healthcare industry faces ongoing challenges, promoting a culture of teamwork and innovation is essential for achieving significant improvements in patient access to electronic health information. Establishing a shared measurement framework will enhance accountability and assist stakeholders in evaluating the success of their initiatives.

Establishing a Foundation for Future Improvements

In summary, developing performance measures to improve patient access to electronic health information is very important. As U.S. healthcare evolves, efforts to enhance patient engagement and care coordination will be crucial in building a responsive and efficient system.

Organizations must commit to implementing performance measures that assess patient access and engagement, simplify interoperability and data sharing, and utilize technology to improve the patient experience. Concentrating on these areas allows healthcare providers to create a system more centered on patients, equipping individuals with the necessary knowledge and resources to manage their healthcare effectively.

Through collaboration, ongoing feedback, and a focus on innovation, the future of patient access to electronic health information can be transformed. As healthcare administrators, owners, and IT managers work toward these goals, the quality of care and patient satisfaction in the United States will improve.