The Commonwealth Fund in its study, “A Survey of Primary Care Doctors in Ten Countries Shows Progress in Use of Health Information Technology, Less in Other Areas”, analyzed the international status of electronic health records (EHRs), providing a fascinating global look at EHR adoption within primary care.
EHR Multifunctional Capacity Lags
Of the surveyed countries, three countries lag the U.S. in overall electronic medical record adoption: Switzerland (41%), Canada (56%) and France (67%) lagged the U.S. (69%) in 2012. Norway and the Netherlands took the top honors at 98 percent.
Strikingly, the percent of physicians reporting that they have multifunctional electronic health information capacity is much lower.
Practices reporting that they used at least two electronic functions in each of the following domains are characterized as having “multifunctional” capacity: generation of patient information; the generation of patient registry and panel information; order entry management; and decision support.
Using this measure, the highest recorded use falls to 68% (UK) with fewer than 50% of the physicians reporting in seven of the 10 countries and 10 percent or less in four countries (Canada, France, Germany, and Norway). As we think of the opportunities for EHRs in small physician practices, it is important to note that in almost all countries, the rate was lower for physicians in practices of less than 2 FTEs than the mean for all practices.
Patient Engagement Opportunities
Another area for improvement is in patient engagement. Physicians were asked to report on patients’ ability to electronically access their practice via e-mail for questions or concerns; to request appointments or referrals online; and to request prescription refills online. Only in Switzerland did more than half of the participating physicians report that patients could e-mail questions or concerns. And only one country, Norway, had more than half of the physicians surveyed indicate patients could request appointments or referrals online. Online prescription refills fared a little better with three countries having more than 50 percent of physicians reporting electronic patient access.
Specialist Communications Needed
Looking beyond the patient-primary care physician relationship, care coordination with specialists represents a significant opportunity too. The surveyed physicians were asked when a patient is seen by a specialist, do they always receive key information and in a timely manner? In eight of 10 countries, fewer than 50 percent of physicians indicated they always receive a report with all relevant health information. In no country did more than half of the physicians report always receiving information about changes to a patient’s prescription/care plan. This is also the case when asked about always receiving information in a timely manner when needed.
Within different health system models, EHR adoption is growing and even where penetration is near universal, a significant opportunity remains for increasing the depth of these systems, engaging patients further and integrating specialists for stronger closed-loop communications with the primary care physician.
As a cloud-based electronic health record platform that integrates a patient health portal with a comprehensive documentation model that is Meaningful Use compliant and includes the ability to conduct secure, HIPAA-complaint virtual consultations, the Hello Health® solution continues to leverage the power of connected communications to amplify the inherent advantages of digital documentation and to help doctors generate revenue to sustain their mission.
Stephen Armstrong is senior vice president for Hello Health, the revenue generating EHR platform for primary care practices supporting practice vitality through patient engagement.