Patient Health Information Shared Electronically by Office-based Physicians: United States, 2015

August 15, 2018

Questions for Brian Ward, Health Statistician and Lead Author of “Patient Health Information Shared Electronically by Office-based Physicians: United States, 2015

Q: Why did you decide to focus on office-based physicians who electronically share patient health information (PHI) in the United States?

BW: While previous research has looked at the extent to which office-based physicians electronically shared PHI, it has not provided details as to the types of PHI that are electronically sent, received, integrated, and searched for. Therefore, we decided to expand upon this previous research by describing the types of PHI that are shared electronically.


Q: How did you collect data for this report?

BW: Data from this report were from the 2015 National Electronic Health Records Survey (NEHRS). NEHRS is a nationally representative mixed-mode survey of office-based physicians, and asks about their adoption and use of electronic health records (EHRs). The different modes (or manners) NEHRS uses to collect data are via web, mail, and telephone.


Q: What were some of the most observed types of PHI electronically shared in physician offices?

BW: Among office-based physicians who sent PHI electronically, the most commonly observed types of PHI sent were referrals (67.9%), laboratory results (67.2%), and medication lists (65.1%). Among physicians who received PHI electronically, the most commonly observed types of PHI received were laboratory results (78.8%), imaging reports (60.8%), and medication lists (54.4%).

For physicians who integrated PHI electronically, the most commonly observed types of PHI integrated were laboratory results (73.2%), imaging reports (49.8%), and hospital discharge summaries (48.7%).

Finally, a large majority of physicians who searched for PHI electronically did so for medication lists (90.2%), medication allergy lists (88.2%), and hospital discharge summaries (80.4%).


Q: Do you have trend data that is older than 2015 or is this the first this data has been published?

BW: Older NEHRS data are available, dating back to 2008 (when it was a supplement to the National Ambulatory Medical Care Survey); however, these older data are not compatible with the measures examined in this report.


Q: What is the take home message in this report?

BW: These are the first national estimates of PHI type according to the aspects of interoperability among physicians with EHR systems, and these estimates can be used as a benchmark for future studies. Combined with measures of electronic sharing of PHI by physicians, information on the specific type of PHI shared electronically among office-based physicians will assist in tracking progress outlined in the federal plan for achieving interoperability.

Advertisements

High-deductible Health Plan Enrollment Among Adults Aged 18-64 With Employment-based Insurance Coverage

August 9, 2018

Questions for Robin Cohen, Ph.D. and Lead Author of “High-deductible Health Plan Enrollment Among Adults Aged 18-64 With Employment-based Insurance Coverage

Q: What made you decide to put together a report about high and low deductible health plans for adults with employment-based coverage?

RC: We decided to produce an analysis focusing on high-deductible health plans (HDHPs) after observing how enrollment in HDHPs has increased over the past decade. In addition, HDHP enrollment growth has been faster among those with employment-based coverage than among those with directly-purchased coverage, so it also made sense to highlight employment-based insurance plans in this study. This report examines differences in the demographic characteristics for those with employment-based coverage by plan type.    


Q: Was there a finding in your new report that really surprised you?

RC: It was the dramatic increase in high-deductible health plan (HDHP) enrollment in recent years that really surprised us. We hadn’t expected to see such a large jump, which was most notable among those with a health savings account (HSA). The percentage of adults aged 18 to 64 enrolled in an HDHP with an HSA more than quadrupled in the past decade from 4.2% to 18.9%.


Q: What differences or similarities did you see between or among various demographic groups in this analysis?

RC: Both the differences among age groups and the lack of variance by sex in this study’s findings are notable. Among adults aged 18 to 64 with employment-based coverage, there were no differences in the type of health insurance plan by sex. Enrollment in a high-deductible health plan with a health savings account was higher among adults aged 30 to 44 than those aged 18 to 29 and 45 to 64.


Q: What is the significance of having a health savings account and not having one when you have a high-deductible health insurance plan?

RC: A health savings account (HSA) allows pretax income to be saved to help pay for the higher costs associated with a high-deductible health plan (HDHP). However, this report did not examine the association of having an HDHP — coupled with an HSA — on service use and financial burden for medical care.

 

Q: Is it a choice for Americans to have a health savings account? Can anyone have one?

 

RC: A health savings account (HSA) must be coupled with a high-deductible health plan (HDHP), but not everyone enrolled in an HDHP has an HSA. High-deductible health plans with HSAs are offered to individuals both by employers and in the direct-purchase health insurance market.

Q: What would you say is the take-home message of this report?

 

RC: I think the real take-home message in this Data Brief is the role that education and income play in health insurance coverage with these types of high-deductible health plans (HDHPs). More highly educated and affluent adults were more likely to enroll in an HDHP with a health savings account (HSA) and less likely to enroll in a traditional plan or an HDHP without an HSA — than their less educated and less affluent counterparts. The National Health Interview Survey will continue to monitor different types of private health insurance, and the survey can be used to examine further differences according to plan type.

Q: Do you have trend data on high-deductible health plans going back further than 2007?

RC: No, we don’t have earlier than 2007 trend data on high-deductible health plans (HDHPs). The National Health Interview Survey began to collect data on enrollment in HDHPs starting in 2007.


QuickStats: Age-Adjusted Death Rates from Lung Cancer by Race/Ethnicity — National Vital Statistics System, United States, 2001–2016

August 6, 2018

During 2001–2016, the lung cancer death rates for the total population declined from 55.3 to 38.3 as well as for each racial/ethnic group shown.

During 2001–2016, the death rate for the non-Hispanic black population decreased from 63.3 to 41.2, for the non-Hispanic white population from 57.7 to 41.5, and for the Hispanic population from 23.9 to 16.6.

Throughout this period, the Hispanic population had the lowest death rate.

SOURCE: CDC/National Center for Health Statistics, National Vital Statistics System, 2001–2016, Mortality. CDC Wonder online database. https://wonder.cdc.gov/ucd-icd10.html.

https://www.cdc.gov/mmwr/volumes/67/wr/mm6730a8.htm?