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International Survey: 69% of U.S. Primary Care Physicians Now Have Electronic Medical Records

U.S. docs still lag behind European counterparts (Nov. 15)

An international survey of primary care physicians (PCPs) in 10 countries has found progress in the use of electronic medical records (EMRs) — particularly in the U.S., although this country still lags behind several countries where EMR adoption is nearly universal. U.S. physicians report that their patients continue to have problems paying for health care, with well over half saying patients often cannot afford care. In each nation, physicians contend with communication and care-coordination challenges.

In high-income countries, policymakers have pursued reforms in primary care to meet the needs of aging populations and to better manage chronic conditions, such as diabetes and heart disease. To learn about physicians’ experiences in the midst of health reform efforts, a team of researchers surveyed PCPs in 10 countries on such issues as patient access, health information technology, communication, overall views of the health system, and job satisfaction.

PCPs in the U.S., the U.K., Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, and Switzerland were interviewed by a combination of mail and telephone between March and July 2012.

The survey’s key findings include:

  • Two-thirds (69%) of U.S. PCPs reported using EMRs in 2012 — up from less than half (46%) in 2009. Both U.S. and Canadian doctors expanded their use of health information technology (HIT), although the two countries lag behind the U.K., New Zealand, and Australia in the use of EMRs and HIT to perform a range of functions, such as generating patient information or ordering diagnostic tests.
  • In the U.S. — the only country in the survey without universal health coverage — 59% of physicians said their patients often have trouble paying for care. Far fewer physicians in Norway (4%), the U.K. (13%), Switzerland (16%), Germany (21%), and Australia (25%) reported that affordability was a concern for their patients.
  • More than half (52%) of U.S. doctors said they or their staff spend too much time dealing with insurers’ restrictions on covered treatments or medications — by far the highest rate in the survey.
  • In each country, only a minority of PCPs reported always receiving timely information from specialists to whom they have referred patients, while less than half said they always know about changes to their patients’ medications or care plans.
  • U.S. physicians were the most negative about their country’s health system, with only 15% saying the system needs only minor changes.

National policies — including those related to insurance design, support for primary care practices, and HIT — make a difference, the authors write. For instance, all of the study countries, except the U.S. and Canada, have policies for ensuring patient access to primary care outside of regular office hours; these policies range from the establishment of walk-in centers and national help lines in the U.K., to physician payment incentives in Australia. The Affordable Care Act, whose major insurance expansions occur in 2014, is designed to lower barriers to access in the U.S.

The survey results were published on November 15 in the online edition of Health Affairs.

Source: The Commonwealth Fund; November 15, 2012.

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