Patients want more ways to manage their healthcare and health business affairs online, but as a group hospitals and health systems vary widely in how well they’re doing the job.

To put it more directly: U.S. hospitals and health systems still aren’t giving the digital customer what they want most—less red tape, less paper and better and faster ways online to access medical records and deal with doctors.

Based on an analysis of data from Internet Health Management’s 2017 Digital Hospital 500 rankings, there are about three dozen features and functions that hospitals have incorporated so far into their digital and mobile healthcare programs.

They range from enabling patients to access electronic health information, find doctors and pay bills to more sophisticated tools for rating and reviewing providers online or accessing electronic physician notes about them.

All hospitals ranked in the 2017 Digital Hospital 500 offer their consumers and patients at least some digital connectivity, most typically through an information portal that let patients view at least a part of their medical record, and e-mail their doctor or another clinician.

For example, 491 institutions (98.2%) lets patients view and download bills online, while 488 hospitals (97.6%) offer a digital tool for finding a physician and 483 (96.6%) for booking an appointment online. A total of 473 (94.6%) Digital Hospital 500 organizations let patients view test results, while 468 (93.6%) let patients send secure e-mails to their doctor and 458 (91.6%) offer online access to laboratory or test results.

More than three-fourths of all Digital Hospital 500 hospitals —382 or 76.3%— have an electronic records system in place that can serve as the foundation to build or expand a portfolio of digital and mobile health tools. But there remains a wide disparity in terms of the online features offered by Digital Hospital 500 hospitals. Of the 34 features researchers looked for in a hospital’s digital and mobile program, the median number offered by institutions in the Digital Hospital 500 was 17. For the Top 100 hospitals, the median is 21 features, but that number steady drops with each quintile in the ranking: 101-200 (18), 201-300 (17), 301- 400 (15) and 401-500 (12).

The hospitals with the most complete portfolio, each offering 29 of these digital and mobile self-service features, were UPMC and Renown Health (No. 26), a part of one the largest not-for-profit healthcare networks in Northern Nevada. Four other hospitals—Cleveland Clinic (No. 1), Memorial Regional Hospital (No. 10) in Hollywood, Fla., Tampa General Hospital (No. 18), Sentara Norfolk General Hospital (No. 16) in Norfolk, Va., and Montefiore Medical Center (No. 8) in the Bronx—each had 28. Tampa General Hospital’s high feature count in part stems from its March 2016 rollout of an expanded version of its consumer-based digital healthcare program, TGH Virtual Care.

More than a year into the program Tampa General has had about 2,300 patients sign up for digital doctor visits. TGH Virtual Care is set up to treat non-emergencies, including upper respiratory conditions such as bad colds, the flu, bronchitis and sore throats. Doctors will also virtually treat ear aches, eye infections and body aches and pains among other conditions, the hospital says. The service costs $49 a visit. “We wanted to expand ways people can access medical services quickly, conveniently, and at a lower cost than a trip to the hospital,” says Tampa General CEO Jim Burkhart.

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