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Are Patients Electronically Accessing Their Medical Records? Evidence From National Hospital Data

机译：患者是否以电子方式访问其医疗记录？ 来自国家医院数据的证据

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摘要

Substantial policy effort has been directed at improving patients' ability to access and use electronic health records. Using nationwide data from 2,410 hospitals for the period 2014-16, we examined associations between patient- and hospital-level characteristics and access to and use of electronic health record data among discharged patients. On average, hospitals gave 95 percent of discharged patients access to view, download, and transmit their information, but only about 10 percent of those with access used it-levels that were stagnant during the study period. Access rates were highest among system-member, teaching, and for-profit hospitals. In contrast, access rates were lower for hospitals in the highest quartile for disproportionate share hospital status and for hospitals located in counties with high proportions of residents who were dually eligible for Medicare and Medicaid; use rates were lower for hospitals in counties with a high proportion of residents who were dually eligible, lacked computer or internet access, or were Hispanic. Overall, our findings suggest that policy efforts have failed to engage a large proportion of patients in the electronic use of their data or to bridge the "digital divide" that accompanies health care disparities. Additional-possibly targeted-policy incentives, as well as higher thresholds for meeting the requirements of the Promoting Interoperability Program, merit policy makers' consideration.
机译：旨在提高患者获得和使用电子健康记录的患者的实质性政策努力。我们在2014-16期间使用了来自2,410家医院的全国数据，我们在排放患者中审查了患者和医院级别特征和电子健康记录数据之间的协会。平均而言，医院给出了95％的排放患者访问，下载和传输他们的信息，但只有约10％的人在研究期间停滞的IT级别。在系统成员，教学和营业额度医院中获得的访问率是最高的。相比之下，对于不成比例的股东医院现状最高四分位数的医院获得较低的访问率，以及位于县的县的医院，居民的高比例为医疗保险和医疗补助;对于县的县中的医院使用率降低了较低的居民，他们符合双重符合条件，缺乏计算机或互联网访问，或者是西班牙裔。总体而言，我们的调查结果表明，政策努力未能在电子使用数据使用或桥接伴随医疗保健差异的“数字鸿沟”中进行大部分患者。额外可能的目标政策激励措施，以及满足促进互操作性计划的要求，优异的政策制定者的考虑更高的门槛。

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