Reveleer CEO Jay Ackerman

Patient Engagement

Patients Flock to Online Records and Health Apps

Digital patient experiences are becoming more important than ever, with new figures from the ONC showing a massive jump in demand for ways to access health information online.

The 2022 Health Information National Trends Survey (n=6,252) found that the portion of US adults who accessed their medical records through online tools jumped 50% between 2020 and 2022, from 38% to 57%.

• Over the same period, the share of adults who were offered online access to their medical records by a payor or provider increased 24% to about 3 in 4.

• Patients who were offered digital access to their records also used them more frequently, with 54% accessing them at least three times in 2022 (vs. 38% in 2020).

The ONC attributed the trend in part to the Cures Act Final Rule, which in 2020 introduced new requirements for standardized APIs for smartphone health apps.

• In 2022, almost half of people who accessed their online medical records used only a website, whereas 19% used only an app and 32% used both.

• The combined 51% of people who accessed their online records using an app represents a 13 percentage-point increase from 2020, and those app users also accessed their records more frequently than web-only users. 

Most of the patients accessing their online records or patient portals are using them to view test results (90%) and clinical notes (70%), but only 1 in 3 are sharing that info with a third party.

• A vast majority (98%) also aren’t using a personal health record or portal organizing app to combine info from different sources, which the ONC suggested reflects a patient preference for tools supplied by their providers (it also probably points to a general lack of awareness around these apps and their utility).

The Takeaway

Despite the strides we’re making in patient access and the use of online medical records, the ONC’s report highlights plenty of room for improvement. Nearly half of all patients either weren’t offered or didn’t access their records / portal in 2022, and recent studies have shown significant disparities in those who do. There’s also still a relatively low percentage of patients sharing their health information, which like many of these issues, indicates a need for better education on these features.

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The Wire

• Suki Notches Major Expansion: Suki announced the expansion of its Suki Assistant ambient AI platform to over 20 new independent practices across a wide range of specialties. The Suki Assistant is uniquely positioned with not only ambient note generation capabilities, but also separate dictation and command modes. Additionally, Suki has the widest range of EHR integrations on the market, playing nice with Epic, Cerner, Athena, Elation, and Meditech.

• The Burden of Healthcare Costs: A Commonwealth Fund report gave a grim look at the burden of US healthcare costs, with half of working-age adults struggling to afford care and a third saddled with medical debt. Whether their coverage was through an employer, Medicaid, or Medicare, about 3 in 10 people reported that the cost of care cuts into their food and utility budget. On top of that, almost 40% reported skipping or delaying care in the past year due to the cost, and 57% of this group said their health worsened as a result.

• Waystar Delays IPO: It looks like we might have to wait until 2024 for the next healthcare IPO afterall, with revenue cycle management company Waystar delaying its stock market debut until next year. Waystar appears to have gotten spooked by the Federal Reserve’s comments that rates will stay higher for longer, as well as the poor performance of recent IPOs from Instacart and Birkenstock. Right when you think the market might be finding its footing, you get another reminder of how fragile it really is.

• Olive Calls It Quits: Healthcare automation vendor Olive AI is shutting down after offloading its core business units, marking the end of the startup’s fall from grace despite reaching a peak valuation of $4B just two years ago. Olive’s prior authorization line is now in the hands of Humata Health, while its clearinghouse and patient access branches coincidentally ended up at still-privately-traded rev cycle company Waystar.

• Selfies Create Diagnostic Challenges: Patients are increasingly submitting selfie images to their physicians, but differences between smartphones in how selfies are presented can complicate diagnostic efforts. In JAMA Neurology, researchers describe the case of an 18-year-old woman whose selfies suggested left-sided facial flushing, but whose MRI exams showed right-sided pathology. The discrepancy is because Apple devices show images in mirrored format (left is left) but save images in traditional format (left is right). A surgical scar helped clinicians correct the discrepancy and diagnose her condition as Horner syndrome.

• Biden’s AI Plan: President Biden’s just-issued executive order directs “the most sweeping actions ever taken to protect Americans from the potential risks of AI systems,” while setting up the HHS as the lead policy enforcer within healthcare. The order establishes a range of AI guardrails relevant to all industries, balancing them with new grants related to areas like immune-response treatments and burnout. Although the initial response has been generally positive, critics are holding out to see whether meaningful actions will back up the words.

• LLMs Show Promise in MSK Care: Mount Sinai researchers demonstrated that publicly trained LLMs can accurately identify the pain location and acuity of certain musculoskeletal conditions, according to results published in Lancet Digital Health. After comparing LLaMA-7B’s classifications to MSK indicators that clinicians manually labeled for 1,714 patient notes, the model was highly accurate at classifying shoulder pain (89%), knee pain (90%) and lower back pain (94%). LLaMA-7B also achieved classification accuracies of 83% for acute pain, 83% for chronic pain, and 82% for acute-on-chronic pain.

• IKS Acquires AQuity Solutions: Care enablement platform IKS Health is acquiring AQuity Solutions for $200M. IKS is primarily focused on coding, documentation, and revenue cycle tech for the ambulatory market, while AQuity offers similar solutions for the acute care space. The combined company will have annual revenue of over $330M and more than 14k employees, and also mentioned that it can now scale its AI solutions by integrating Aquity’s data sets.

• 23andMe Health Recommendations: 23andMe debuted a new Health Action Plan service that allows its users to receive personalized recommendations based on results from their genetic reports, self-reported data, and blood / biomarker values. The recommendations include things like “clinician ordered lab tests combined with a personalized clinical analysis from a healthcare provider,” and could make a big splash considering 23andMe has over 14M customers worldwide.

• COVID Clinician Exodus: The number of physicians planning to reduce their clinical hours doubled during the COVID-19 pandemic compared to previous years. In Mayo Clinic Proceedings, 40% of 1.3k physicians surveyed in 2021 said they would “likely” or “definitely” reduce clinical hours in the next 12 months, compared to 16% in 2011 and 20% in 2014. The numbers underscore the pandemic’s impact on physician job satisfaction and point toward continued workforce shortages.

• Cardiac Monitoring Headphones: Your headphones might soon be able to double as cardiac monitors. Google researchers presented what they’re calling Audioplethysmography (APG), a new cardiac monitoring modality that allows consumer-grade noise canceling headphones to send and receive low intensity ultrasound signals and measure changes in heart rate. When used with 153 participants, the APG headphones accurately measured heart rate and heart rate variability (3.21% & 2.70% median error rates) across variations in skin tone and ear canal size.

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