From the U.S. Government Accountability Office, www.gao.gov Transcript for: Patient Access to and Use of Electronic Health Records Description: Audio interview by GAO staff with Carolyn Yocom, Director, Health Care Related GAO Work: GAO-17-305 Health Information Technology: HHS Should Assess the Effectiveness of Its Efforts to Enhance Patient Access to and Use of Electronic Health Information Released: March 2017 [ Background Music ] [ Narrator: ] Welcome to GAO's Watchdog Report, your source for news and information from the U.S. Government Accountability Office. It's March 2017. The Department of Health and Human Services wants all Americans to be able to access their health records electronically. HHS's Medicare Electronic Health Record program is one of its largest efforts to encourage the use of electronic health information. A team led by Carolyn Yocom, a director in GAO's Health Care team, recently reviewed patients' electronic access to their health information. Sarah Kaczmarek sat down with Carolyn to talk about what they found. [ Sarah Kaczmarek: ] So, when people go online to access their electronic health records, what kind of information can they getEUR [ Carolyn Yocom: ] Well, the short answer is, it really depends. It can depend a lot on the individual provider. One patient may have to go to multiple access points, or portals, as they're called, to find out what's in their health information. Generally, however, our work has shown that most providers have some basic information, like laboratory tests, test results, information about allergies, medications that people are on, immunization records; those are pretty commonly available. [ Sarah Kaczmarek: ] So, it sounds like you can get some useful different kinds of information, but if you see different doctors or different practices, you don't have one portal to get that information all in one placeEUR [ Carolyn Yocom: ] That's true. There are instances where there is a single portal available, but more often than not, providers have different portals that people have to access. [ Sarah Kaczmarek: ] Now, your report found that many people who have the option of getting information from their electronic health records choose not to do so. Why is thatEUR [ Carolyn Yocom: ] Well, we don't know all the reasons. We did use social media to reach out to patients, and we found that, in particular, there were specific health encounters are often the reasons why people check their records. So, people want to have that available, but they don't necessarily need to do it every time. I've been trying to think of analogy, and it's a little bit like a credit rating. You really don't need it until you're starting to apply for a house purchase, or you get a bad credit report. Then, you want to know what's going on. [ Sarah Kaczmarek: ] I know I check mine for my kids, to get their height and weight when they have their pediatrician visits with the doctor for the baby book, but that might be about it. [ Carolyn Yocom: ] Right, right. But, that's a good example. After they've had a visit with their provider is when people tended to access their records. [ Sarah Kaczmarek: ] So, what is HHS doing to encourage patients to access their electronic health records, and how much money are they spending to do thisEUR [ Carolyn Yocom: ] Well, there's two parts to this. Starting with the money, the spending has been right around $23 billion, but it is bigger than encouraging people access. It's also about helping providers have the infrastructure they need to provide the portals, and to provide the information electronically. With regard to patients having access, Health and Human Services does have multiple efforts underway, things like information and resources about electronic records, even videos that people can watch about why they might want to view their records. But, the short answer is, they're not really tracking whether these are being used or whether they're helping patients. [ Sarah Kaczmarek: ] It's really interesting, and so what recommendations is your report makingEUR [ Carolyn Yocom: ] Well, exactly that, that for the things that they're trying, they take a look and see how well they're working, and then make adjustments from there. If they're finding, for example, that one avenue they've been working on, no one's accessing it or using it or finding it helpful, then redirect their efforts and associated money to do something that is working. [ Sarah Kaczmarek: ] Well, that certainly sounds like a common-sense approach. What would you say is the bottom line of this reportEUR [ Carolyn Yocom: ] I think the bottom line is that most patients of providers have some access to their health information, but people generally access only the information when they need it, so it's a resource that's there, but it's not necessarily something you would expect people to use all the time. There have been a lot of improvements. We talk in our report about interoperability, which is a big word for systems talking to each other, and some of the interoperability has been improving, but there's still a lot more work to do. [ Sarah Kaczmarek: ] So, getting back to that idea then of, if you do see different providers or different doctors, interoperability would be being able to get your information all in the same placeEUR [ Carolyn Yocom: ] It'd be able to view, download, and transmit their information, so that if one provider needed to see what another provider had found, the patient could be involved in that, or could be aware of what information is getting transmitted. [ Background Music ] [ Narrator: ] To learn more, visit GAO.gov and be sure to tune in to the next episode of GAO's Watchdog Report for more from the congressional watchdog, the U.S. Government Accountability Office.