The U.S. is not alone among high-income nations in its efforts to push health information technology use to primary-care providers, according to results of a recent survey by the Commonwealth Fund.
Nor is the U.S. alone in its struggle to achieve interoperability of systems and the free exchange of healthcare information, the surveyors found.
A "high percentage" of the nearly 8,500 physicians surveyed across the 10 nations covered by the survey "reported that they did not routinely receive timely information from specialists or hospitals," while feedback loops providing physicians with data about their own performance "varied notably" between countries, according to a report
, "A Survey of Primary Care Doctors in Ten Countries Shows Progress in Use of Health Information Technology, Less in Other Areas," appearing online in the policy journal Health Affairs.
In addition to physicians in the U.S., the surveyors plied their primary-care counterparts in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Switzerland and the U.K., asking them about their concerns regarding the use of health IT and communications across care sites and feedback on practice performance, as well as patient access to care, healthcare system capacity and their overall satisfaction with practicing medicine in that system. U.S. physicians were the most likely to complain about the time spent "grappling with insurance restrictions” and noted that "their patients often went without care because of costs," the report said.
The report authors note that eight of the 10 countries surveyed provide financial incentives for patients to seek out primary-care providers, ranging from full coverage with no cost sharing in Canada, the Netherlands and the U.K. to "modest" cost-sharing in the five other countries.
But Switzerland and the U.S. are cost outliers; there, "patients often face substantial deductibles as well as cost-sharing," although income assistance and out-of-pocket limits in Switzerland reduce financial liability for Swiss patients "to levels well below those in the United States."
Fifteen of the survey questions were explicitly about health IT systems use. The U.S. ranked fifth in "multifunctional electronic health- information capacity," with 27% of its physicians surveyed reporting their organization has that capacity—a substantial improvement over a similar survey taken in 2009, when U.S. physicians were among the least likely to have higher-level EHS. The U.K. headed that top five list at 67%, followed by Australia, 60%; New Zealand, 59% and the Netherlands, 33%. The U.S. ranked third in physicians reporting that their patients could electronically access appointments or referrals online (30% said their patients could do so); fifth in physicians saying their patients can submit prescription refill requests online (36%); and seventh in physicians indicating they're able to access patients' e-mailed questions or concerns (34%).