ONC Data Brief ■ No. 40 ■ April 2018
ONC Data Brief No. 40 | Individuals’ use of online medical records and technology for health needs 13
Summary
Online access to medical records serve as a key tool to help individuals and caregivers understand their health and
manage their health care needs. Online access to medical records has grown by 24% since 2014. In 2017, half of
individuals had been offered access to an online medical record by either a health care provider or insurer, of which,
more than half viewed their information. This represents about 3 in 10 individuals nationwide. Almost one in five
individuals cared for or made health care decisions for someone with a medical or behavioral condition or disability in
2017. About one-quarter of these caregivers accessed their care recipients’ online medical record within the past year, a
majority of whom reported having their own log-in credentials.
Consistent with past survey findings, nearly half of individuals did not access their online medical record.
3
Individuals’
preference to speak with health care providers directly was a common reason cited for not using an online medical
record. This suggests that some may perceive online medical records as a replacement for rather than as an additional
means of communicating with health care providers. Similar to past findings, a perceived lack of need was also
frequently cited as a reason for not using an online medical record.
4
Prior ONC research found that individuals may not
realize the value of accessing their online medical record until they have a medical need.
5
Given that the patient record
request process can take time, it is of great benefit to access one’s data prior to an urgent health need. Additionally,
healthy individuals may also benefit from correcting errors in their medical record before a health issue occurs. Among
individuals that accessed their medical record online, almost one in 10 requested a correction to information in their
record. Explaining these benefits to healthy individuals may increase usage of online medical records. Addressing
disparities in Internet access and use of technology may also be an issue given that one-fifth of individuals reported
lacking a way to access their online medical record.
Health care providers play an important role in enabling consumers’ access and subsequent use of online medical
records. The three-quarters of individuals who were offered and encouraged to use an online medical record by their
health care provider were nearly two times more likely to access their medical record compared to those who were not
encouraged to do so (63% vs. 38%). Providing health care providers with suggestions on how to encourage their patients
to use their online medical records may also increase consumers’ usage of online medical records.
Among the 53% of individuals who viewed their online medical record at least once in the past year, over 8 in 10
considered it both easy to understand and useful. The most frequent uses of online medical records related to those
tasks that could be completed with greater convenience (e.g., outside office hours). These tasks include requesting
prescription refills, making appointments and filling out paperwork; and communicating with health care providers via
secure messaging. A significant number of those who accessed their online medical record also used it to monitor their
health and to inform treatment decisions. The widespread inclusion of clinical data such as laboratory test results,
medications, and health problems can make online medical records useful for informing patients’ decisions.
Although many individuals viewed test results, few individuals downloaded or electronically transmitted their health
information from their online medical record. Individuals may not be aware of the benefits of these more advanced
functions, nor of their right, per HIPAA, to request to sending their medical record to a designated third party. These
functionalities may also not work well in online medical records and many providers or apps may not possess the
capabilities to receive and incorporate such information. However, recent market developments suggest that increased
adoption of FHIR (Fast Healthcare Interoperability Resources), a standard for electronically exchanging medical record
data and health IT developers publishing APIs, will enable more individuals to use apps to store, manage, and transmit
their health records across a variety of devices.
6,7
Individuals’ use of devices and apps to address health needs is becoming more common. Among the 8 in 10 tablet and
smartphone owners, 44% reported having a health or wellness app. About one-third of individuals own an electronic
monitoring device such as a Fitbit, blood glucose meter, or blood pressure monitor. These patient-generated data may