September 24, 2019

Apple bet big on mobile EHRs. Is anyone actually using them?

Daily Briefing

    Less than 1% of patients who use their health system's patient portal also view their medical records on their smartphones, despite a growing push from policymakers to use the technology, according to research published recently in JAMA Network Open.

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    In recent years, more health systems are allowing their patients to download their health information on their smartphones, according to EHR Intelligence.

    Technology giant Apple, for instance, in January 2018 updated its Health app to allow users to view their health records on their smartphones. Today, more than 200 health systems have joined the project, according to FierceHealthcare.

    However, given that the technology is relatively new, little is known about how many patients are actually using their smartphones to access their records. So researchers from the University of California (UC), San Francisco School of Medicine, and UC San Diego Health sought to determine how many patients are using mobile apps to access their EHR data.

    Study details

    For the study, the researchers between March 2018 and December 2018 examined 12 geographically diverse health systems that had been allowing patients to download their health records on their smartphones for at least nine months. The researchers focused on health systems that used Epic EHR systems that interacted with smartphones via FHIR-enabled application programming interfaces (APIs).

    The researchers noted that focusing on a single EHR vendor may limit the generalizability of their findings. However, they pointed out that over half the U.S. population is served by Epic.

    Key findings

    Overall, the researchers found a mean of 0.7% of patients who logged into their health system's patient portal on a given month also used the API. However, over time, the measure saw an increase of 0.14% per month per health system, which the researchers said was statistically significant.

    The rate of unique new users each month was more or less flat, the researchers said. However, when new users were added to the pool of existing users, the researchers observed a statistically significant increasing trend of 156 unique new users per month per health system.


    Overall, the researchers found low patient uptake, but study co-author Julia Adler-Milstein, an associate professor of medicine at the UC San Francisco School of Medicine, noted that the technology is still in its early stages. "[T]here are only a handful of apps that are available and the functionality isn't much beyond what patients have access to on a patient portal," Adler-Milstein said.

    The researchers noted, "There are substantial federal policy efforts under the 21st Century Cures Act and private sector initiatives to advance solutions that allow patients to interact with their health data by first downloading their health record data to their smartphones."

    However, they said policymakers and industry stakeholders need to do more to raise awareness about API functionality. "It will also be helpful as a broader range of data is available through this functionality; right now it is not the full medical record," Adler-Milstein said (Landi, Fierce Healthcare, 8/17; Kent, EHR Intelligence, 8/20; Adler-Milstein/Longhurst, JAMA Network Open, 8/14).

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