The U.S., which has low rates of adoption of health information technology compared with other industrialized nations, is starting from a disadvantage in most areas that researchers measure to predict health IT adoption, according to a new report.
One example is population. The countries with the most widely adopted health IT systems are the Norse countries of Denmark, Finland and Sweden, which have a combined population of 19.7 million people. The state of New York alone has a population of 19.5 million.
“Large countries with a diverse group of stakeholders appear to be at a disadvantage when deploying health IT,” according to the Information Technology and Innovation Foundation’s report, “
Health IT: Explaining International IT Application Leadership.” “A significant challenge with health IT is the difficulty of coordinating and bringing together various stakeholders to work toward a shared vision and overcome obstacles such as interoperability.”
In the U.S., 28% of primary-care physicians use electronic health records, compared with 89% in the U.K., 79% in Australia, and 100% in Sweden. Low-scoring outliers joining the U.S. were Canada (23%) and Japan (10%). But adoption of EHRs by hospitals was far lower than in physicians’ offices in virtually all countries measured. Except for high-performers like Sweden (88% adoption) and Finland (100%), the U.S.’s 8% adoption rate for EHRs in hospitals was comparable with other nations studied, like the U.K. (3%) and Japan (10%).
The report identified several factors that appeared to encourage adoption of health IT. Government-run health systems like those in Finland and Denmark and single-payer systems like Sweden’s tended to be more likely to adopt HIT, the report said. Also countries that used government mandates got better results, such as when Denmark and Norwary required doctors to use electronic-prescribing technology.
Countries in which doctors belonged to large physician practices, had few health IT vendors, and few competing pharmacies all had higher rates of adoption. “Consolidation to achieve economies of scale generally facilitates deployment of health IT. For example, Sweden was able to more easily introduce a national e-prescribing system because of the existing state monopoly on pharmacies,” the report says. Also countries that instituted reasonable privacy restrictions and that assigned healthcare consumers a unique identifier had higher adoption rates.
The U.S. does have at least two factors going in its favor with President Barack Obama in the White House, the report’s authors noted. Two leading factors in adoption of HIT were strong endorsement from national leaders, and financial incentives to overcome the high initial cost of adoption—both of which were addressed by the American Recovery and Reinvestment Act of 2009 passed in February.
Although the 63-page report concludes with a litany of recommendations, the authors wrote the next important step is for the HHS to force providers to use HIT systems that are interoperable and have “reasonable” privacy standards through the much-debated definition of the term “meaningful use” in the stimulus act. Only those systems that are put to meaningful use will be eligible for government grants under the stimulus act.
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