Health Information Technology
Health information technology—electronic systems that health care professionals and patients use to store, share, and analyze health information—can help improve health care quality. For example, electronic health records could improve the quality of care and reduce health care costs by improving providers’ and patients’ access to critical information. However, health IT implementation has its own set of challenges.
The Department of Health and Human Services (HHS) is responsible for a variety of efforts that address health information technology, including setting standards for certain health IT products, issuing guidance for providers and patients, and overseeing initiatives that facilitate patient access to electronic health information. However, HHS has faced a number of challenges.
- Addressing interoperability challenges: The interoperability of electronic health information—the ability of systems to exchange information with other systems, and process that information without extra effort on the part of the user—involves a number of challenges. These include insufficient data standards, problems matching patients to their health records, variation in state privacy rules, costs, and the need for governance and trust among participants.
- Consumer access to records: HHS wants all Americans to be able to access their health records electronically. Health care providers that participated in its Medicare Electronic Health Record Incentive Program offered nearly 9 out of 10 patients the ability to access their health information online. However, relatively few of these patients actually accessed their records online, and HHS does not know how effective its efforts to increase online access have been.
- Privacy and security: Electronic health information is vulnerable to cyber-based threats that can result in breaches which can have serious adverse impacts such as identity theft or fraud. HHS has established guidance for providers to ensure that they comply with privacy and security laws, but the guidance does not address all the elements called for by the National Institute of Standards and Technology.
- Patient matching. Health care providers may receive electronic records from another provider that need to be matched to existing patient records (e.g., when treating a new patient, a provider might obtain records from other providers who previously cared for the patient). This matching generally relies on the use of demographic information such as a patient’s name, date of birth, sex, Social Security Number, or address, among other information. However, inaccurate, incomplete, or inconsistently formatted data can make record matching difficult. These data issues can occur because, for example, provider staff makes transcription errors when entering data into electronic records, patients fail to provide correct information when registering, or patient information can change over time. Additionally, different providers may not always collect the same demographic information or format the information the same way in their system.
Figure Title: Examples of how variation in demographic information used for matching medical records can cause patient matching challenge
GAO-19-197: Published: Jan 15, 2019. Publicly Released: Jan 15, 2019.
Health care providers increasingly share records electronically. It can be hard to match records to the right patient, and mistakes can have consequences. For example, a doctor might use information from the wrong record when treating a patient. Inaccurate, incomplete, or inconsistently formatted data can make record-matching difficult. These data problems can happen for many reasons, e.g., a pat...
GAO-17-305: Published: Mar 15, 2017. Publicly Released: Mar 15, 2017.
The Department of Health and Human Services wants all Americans to be able to access their health records electronically. Health care providers that participated in HHS's Medicare Electronic Health Record Incentive Program offered nearly 9 out of 10 patients the ability to access their health information online. We found that relatively few of these patients accessed their records online, and pat...
GAO-17-184: Published: Jan 27, 2017. Publicly Released: Feb 27, 2017.
Many patients who leave hospitals receive continuing care from places like rehab facilities (called post-acute care settings). When patients leave the hospitals and move to post-acute care settings, electronic health records can help providers know what the patient needs and better coordinate care. However, we found that issues like increased costs and a lack of access to technology deter the use...
GAO-16-771: Published: Aug 26, 2016. Publicly Released: Sep 26, 2016.
The use of electronic health information can allow providers to more efficiently share information and give patients easier access to their health information, among other benefits. Nonetheless, systems storing and transmitting health information in electronic form are vulnerable to cyber-based threats. The resulting breaches—involving over 113 million records in 2015—can have serious adverse...
GAO-15-817: Published: Sep 16, 2015. Publicly Released: Sep 29, 2015.
Representatives from the 18 nonfederal initiatives GAO reviewed described a variety of efforts they are undertaking to achieve or facilitate electronic health record (EHR) interoperability, but most of these initiatives remain works in progress. EHR interoperability is the ability of systems to exchange electronic health information with other systems and process the information without special ef...
GAO-14-207: Published: Mar 6, 2014. Publicly Released: Mar 6, 2014.
Based on the number of providers awarded incentive payments, participation in the Department of Health and Human Services' (HHS) Medicare and Medicaid Electronic Health Record (EHR) programs increased substantially from their first year in 2011 to 2012. For hospitals, participation increased from 45 percent of those eligible for 2011 to 64 percent of those eligible for 2012. For professionals, suc...