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Patient Engagement Reaches New Heights: A Decade of Digital Health “Dividends”
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Patients are increasingly expecting near-instant access too their health details, a shift driven by federal policies, hospital innovation, and the lasting impact of the COVID-19 pandemic. A new analysis reveals significant progress in patient engagement capabilities across U.S. hospitals,mirroring the long-term benefits of strategic investment – as Warren Buffett famously observed,”Someone is sitting in the shade today because someone planted a tree long ago.”
From Foundational Access to Advanced Capabilities
Over the past decade, patient engagement has evolved through three distinct eras – foundational, emerging, and advanced – each shaped by evolving policy priorities and technological advancements. These eras aren’t solely defined by adoption rates, but by the underlying innovations that enabled hospitals to invest in empowering patients.
The Foundational Era, spurred by the HITECH Act and Promoting Interoperability Programs, focused on establishing core capabilities. Prior to 2012,only 24% of hospitals offered patients electronic access to their health information. By 2025, that figure surged to 99%, with 80% of hospitals now supporting the four foundational capabilities: viewing, downloading, transmitting, and securely messaging health data.
The Emerging Era, driven by the 21st Century Cures Act and Information Blocking regulations, expanded transparency and patient choice. This led to increased adoption of capabilities like accessing clinical notes and utilizing smartphone health apps. Currently,over 80% of hospitals support patient access via apps,with 70% enabling access based on HL7® Fast Healthcare Interoperability Resources® (FHIR®) standards.
We are now entering the Advanced Era, where hospitals are increasingly allowing patients to import and upload their own data – a key step toward truly patient-centered care. While currently enabled in less than half of hospitals, this capability is gaining momentum, fueled by a growing recognition of its importance. The Trump governance signaled support for this advancement earlier this year, and the Centers for Medicare & Medicaid Services (CMS) has issued a call to action for stakeholders to embrace this “advanced era.”
Variable Progress and the path Forward
While significant strides have been made, the gains haven’t been uniform. Community hospitals, serving as the primary care source for many Americans, have been instrumental in expanding access to electronic health information.However, advanced capabilities like data import and patient-generated data integration still lag in lower-resourced hospitals. This disparity reflects differences in resources and vendor capabilities, potentially impacting the quality of care for vulnerable populations.
According to a recent data brief, hospitals have widely adopted nine patient engagement capabilities: viewing, downloading, transmitting, and messaging health data; importing records; viewing clinical notes; accessing information via apps; submitting patient-generated data; and secure messaging.
[Placeholder for Figure 1: Non-federal acute care hospitals’ adoption of nine patient engagement capabilities, 2024]
[Placeholder for Figure 2: Non-Federal Acute Care Hospitals’ Adoption of Foundational, Emerging, and Advanced Engagement Capabilities in Any Setting: 2021-2024]
Looking ahead, continued collaboration between the federal government, the health IT community
