Healthcare News of Note: Health systems benefit from hike in use of patient portals 

• About 3 in 5 individuals nationwide reported they were offered and accessed their online medical record or a patient portal, which is a 50% increase since 2020.
• Physician time spent working in the EHR during patient scheduled hours (PSHs) increased from 4.53 to 5.46 hours per 8 PSH.
• Some 85% of people with medical or dental debt reported debt of $500 or more, with half of them saying the debt was for expenses associated with treatment of an ongoing health condition.

Over the past few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals.

1.  Greater patient use of online medical records and patient portals could improve patient health and benefit health systems

“Improved patient outcomes” and “significant health system benefits,” are likely results of more patients in the United States having access to and using the information available to them via online medical records and patient portals, according to the latest brief from the Office of the National Coordinator for Health Information Technology (ONC).

According to the authors: “decreased healthcare costs and strengthened patientphysician relationships,” were possible benefits to health system that enabled patients to access and use the information contained in online medical records and patient portals.

Key findings

Results from the brief showed that in 2022:

• About 3 in 5 individuals nationwide reported they were offered access to and accessed their online medical record or a patient portal, which is a 50% increase since 2020.
• More than half of individuals who were offered online access to their medical records reported accessing them at least three times, with nearly one in three accessing them six or more times.
• Of those who accessed their online medical records, 48% used a website only, 19% used an app only and 32% used both.
• Most people who accessed their online medical records or a patient portal did so to view test results (90%) and clinical notes (70%).

Improvement opportunities

Despite more patients having access to and using information available to them via online medical records and patient portals between 2020 and 2022, “there are also opportunities for improvement,” according to the brief. 

For instance, the relatively low rates of downloading and transmitting health information by individuals who accessed their online medical records suggested a need for further education of both individuals and providers on these features.

The brief analyzed data from the 2022 Health Information National Trends Survey (HINTS), with the goal of “assessing progress in patient access amidst implementation of Cures Rule provisions during the COVID-19 pandemic, which likely increased demand for access to online medical records,” the authors wrote.

2. Increased telemedicine use raises the time physicians spend in the electronic health record

Telemedicine use is associated with physicians spending a greater amount of time in the electronic health record (EHR), “mostly documenting visits and not messaging patients,” according to a study of 1,052 physicians published Oct. 30 in JAMA Internal Medicine.

“This study sought to understand the extent of the changes in EHR use at the physician-week level from before to during the COVID-19 pandemic,” wrote the authors.  

Key findings

Comparing weekly EHR metadata of ambulatory physicians at UCSF Health during two time periods — August 2018-September 2019 and August 2020-September 2021 — showed:

• Physician time spent working in the EHR during patient scheduled hours (PSHs) increased from 4.53 to 5.46 hours per 8 PSH.
• Physician time spent working in the EHR outside of PSHs increased from 4.29 to 5.34 hours.
• Time documenting during and outside of PSHs increased from 6.35 to 8.18 hours.

The authors concluded: “Health systems may need to adjust productivity expectations for physicians and develop strategies to address EHR documentation burden for physicians.”

Additional telemedicine news

Previous HFMA content about telemedicine/telehealth includes:

• My Oct. 23 blog “Healthcare News of Note: Telehealth visits are more often coded with a lower billing code than in-office visits.”
• “The evolution of telehealth and the potential for sustainability,” by Elizabeth Barker, published Aug. 30.
• “Telehealth is primed for growth despite post-lockdown fade,” by Eric C. Reese, PhD, published Oct. 14, 2022.

3. New study: Chronic health problems are the source of ‘much debt’

Some 85% of people with medical or dental debt reported debt of $500 or more, with half of them saying the debt “was for expenses associated with treatment of an ongoing health condition,” according to findings from the Commonwealth Fund’s first Health Care Affordability Survey.*

“While media reports frequently highlight unexpected health care events and emergency room visits that leave people with lots of medical bills, our survey findings suggest that the source of much debt is simply care for chronic health problems,” wrote the authors.

Key findings

Results from the report, published Oct. 26, include:

• 48% of people surveyed were paying off $2,000 or more in healthcare debt. The authors noted: Among all working-age adults in the United States, an estimated 27% are currently carrying medical debt of more than $500 and 15% owe $2,000 or more.
• Insurance coverage did not prevent people from incurring medical debt. Three in 10 adults with employer coverage were paying off debt from medical or dental care, as were 33% of those in marketplace or individual-market plans, 21% with Medicaid and 33% with Medicare.

*For the survey, a nationally representative sample of 7,873 adults ages 19 and older was interviewed between April 18 and July 31, 2023, with the analysis focusing on responses of 6,121 respondents ages 19 to 64.

HFMA bonus content

Read the November issue of hfm magazine, including the story “Healthcare labor union activity gains steam: The consequences for hospitals and health systems,” by Nick Hut; the Voice of Experience piece “Theresa Mouton: CFOs need to be able to lead through chaos,” by Steven Berger, FHFMA; and the Expert Reviewed article “How CFOs can bring the rigor of finance to the call center,” by Yuriy Kotlyar and Ronald Spoltore.

Listen to the Nov. 6 Voices in Healthcare Finance podcast episode “November policy roundup with Nick Hut and Shawn Stack,” hosted by Senior Editor Erika Grotto.

Read the Nov. 7 article “Medicare’s hospital outpatient payment rate for 2024 improves marginally from the proposed rule,” by Nick Hut.