Transcript THE COMMONWEALTH FUND Commonwealth Fund - Alliance for Health Reform Capitol Hill Briefing Investing in Health IT: What the U.S.

THE
COMMONWEALTH
FUND
Commonwealth Fund - Alliance for Health Reform
Capitol Hill Briefing
Investing in Health IT: What the U.S. and Other
Countries are Learning
October 29, 2010
Robin Osborn
Vice President and Director
International Program in Health Policy and Practice
Primary Care Doctors Use of Electronic Patient
Medical Records*
2
Percent
100
99
97
97
96
95
94
72
75
68
46
50
37
25
0
NET
NZ
NOR
UK
AUS
SWE
GER
FR
* Not including billing systems
Source: 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.
US
CAN
THE
COMMONWEALTH
FUND
Adoption of Electronic Medical Records in General Practice:
Incentives and Influencing Forces
3
Year
Technology
Use Became
Common
Govt
Billing
Mandate
Govt
Funding
Support
College/
Association
Leadership
Peer
Influence
Accreditation
of Vendor
Systems
Degree of
Support
Received
AUS
2001
No
Yes
Yes
No
No
No
DEN
1994
No
No
No
Yes
Yes
Yes
ENG
1992
No
Yes
Yes
No
Yes
No
GER
1997
Yes
No
No
No
Yes
No
NET
1993
No
Yes
Yes
Yes
Yes
No
N.Z.
1993
Yes
No
No
No
Yes
Yes
NOR
1995
No
No
Yes
Yes
No
No
SWE
1995
No
Yes
Yes
Yes
No
Yes
Source: D. Protti, “Comparison of Information Technology in General Practice in Ten Countries,” Electronic
Healthcare, Vol. 5, No. 4, 2007
THE
COMMONWEALTH
FUND
4
Benefits of Automation in General Practice
Note: Rated by doctors on a scale of 1 to 8, 1 being the most important.
Saving
Time
Simplified
Repeat
Prescription
Quicker
Receipt
of
Results
Improved
Patient
Mgmt
Legibility
of Records
and Forms
More Timely
Communication
with Other
Clinicians
Availability
of Clinical
Data
Online
Data for
Clinical
Research
AUS
1
2
5
3
4
7
6
8
DEN
4
2
3
5
6
1
8
7
ENG
1
2
3
4
5
6
7
8
GER
1
2
4
5
3
7
6
8
NET
1
2
5
4
3
6
8
7
N.Z.
1
4
3
5
6
2
7
8
NOR
4
3
2
1
7
5
8
6
SWE
4
1
3
2
7
8
6
5
Source: D. Protti, “Comparison of Information Technology in General Practice in Ten Countries,” Electronic
Healthcare, Vol. 5, No. 4, 2007
THE
COMMONWEALTH
FUND
Use of IT On a Routine Basis for Core Tasks
in Primary Care Practices
5
Percent reporting
ROUTINE:
AUS
CAN
FR
GER
NET
NZ
NOR
SWE
UK
US
Electronic ordering of
laboratory tests
86
18
40
62
6
64
45
81
35
38
Electronic access to
patients’ test results
93
41
36
80
76
92
94
91
89
59
Electronic prescribing
of medication
93
27
57
60
98
94
41
93
89
40
Electronic alerts/
prompts about a
potential problem with
drug dose/interaction
92
20
43
24
95
90
10
58
93
37
Electronic entry of
clinical notes
92
30
60
59
96
96
81
89
97
42
THE
COMMONWEALTH
FUND
Source: 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.
Computerized Capacity to Generate
Patient Information in Primary Care Practices
6
Percent report the
COMPUTERIZED capacity
to generate:
AUS
CAN
FR
GER
NET
NZ
NOR
SWE
UK
US
List of patients by
diagnosis
93
37
20
82
73
97
57
74
90
42
List of patients by lab
result
88
23
15
56
62
84
49
67
85
29
List of patients who are
due or overdue for
tests/preventive care
95
22
19
65
69
96
32
41
89
29
List of all medications
taken by an individual
patient *
94
25
24
65
61
96
45
49
86
30
* Including those that may be prescribed by other doctors
Source: 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.
THE
COMMONWEALTH
FUND
Primary Care Practice Routinely Sends Patients Reminders for7
Preventive or Follow-up Care Using Computerized System
Percent
100
92
82
76
75
48
50
26
24
25
18
17
10
3
0
NZ
AUS
UK
NET
SWE
FR
US
GER
CAN
NOR
THE
COMMONWEALTH
FUND
Source: 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.
Primary Care Practice Routinely Tracks Laboratory Tests Until 8
Results Reach Clinician Using Computerized System
Percent
100
75
69
60
56
50
50
40
28
28
28
25
25
13
0
AUS
UK
NZ
SWE
GER
US
NOR
NET
FR
CAN
THE
COMMONWEALTH
FUND
Source: 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.
Primary Care Doctor Routinely Receives Alerts or Prompts to 9
Provide Patients with Test Results Using Computerized System
Percent
100
75
68
49
50
41
26
25
22
15
12
11
11
CAN
FR
GER
8
0
AUS
UK
NZ
NOR
US
SWE
NET
THE
COMMONWEALTH
FUND
Source: 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.
Primary Care Practice Has a Process for Identifying10
Adverse Events and Taking Follow-Up Action
Percent of primary care physicians reporting their practice
has a process that works well
100
75
56
50
41
32
32
20
25
18
18
12
10
5
0
UK
SWE
AUS
NZ
US
FR
GER
NOR
CAN
NET
THE
COMMONWEALTH
FUND
Source: 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.
Chronically Ill Patients’ Reports of Online
Capabilities
Percent report they can
currently:
11
AUS
CAN
FR
GER
NET
NZ
UK
US
Make a doctor’s
appointment via the
Internet
4
4
8
12
8
4
10
11
Access own medical
record online
1
1
4
3
2
1
2
9
Base: Has Internet access
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COMMONWEALTH
FUND
Source: 2008 Commonwealth Fund International Health Policy Survey of Patients with Chronic Conditions
Primary Care Practices with Advanced Electronic
Health Information Capacity
12
Percent reporting at least 9 of 14 clinical IT functions*
100
92
91
89
75
54
50
49
36
26
19
25
15
14
FR
CAN
0
NZ
AUS
UK
NET
SWE
GER
US
NOR
* Count of 14 functions includes: electronic medical record; electronic prescribing and ordering of tests; electronic
access test results, Rx alerts, clinical notes; computerized system for tracking lab tests, guidelines, alerts to provide
patients with test results, preventive/follow-up care reminders; and computerized list of patients by diagnosis,
medications, due for tests or preventive care.
Source: 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.
THE
COMMONWEALTH
FUND
Primary Care Practice Uses IT On a Routine Basis for
Core Tasks in the U.S., 2006 & 2009
13
Percent reporting ROUTINE:
2006
Electronic ordering
of laboratory tests
2009
23
38
Electronic access to
your patients' test
results
50
59
21
Electronic
prescribing of
medication
Percent
40
0
25
50
Source: 2009 Commonwealth Fund International Health Policy Survey of Primary Care Physicians.
75
THE
COMMONWEALTH
FUND
100
14
Thank You!
THE
COMMONWEALTH
FUND