The following long article appeared a few days ago.
Posted: March 17, 2010 - 11:00 am ET
The European Organization for Economic Cooperation and Development, in its most recent, 2009 report on healthcare spending, pegs Denmark's total healthcare expenditures at 9.8% of its gross domestic product with spending on a per capita basis equivalent to $3,512 per year, compared with U.S. expenditures at 16% of GDP and $7,290 per capita per year.
Of course, Denmark's numbers are for a country of 5.5 million people with a universal healthcare system that is largely—but not entirely—paid for by government-raised taxes—or socialized medicine.
Danes pay slightly more out-of-pocket for their healthcare, on a percentage basis, at 13.8% of total household per capita healthcare spending, than do Americans, at 12.2%. But Danes are guaranteed health insurance from one of just two taxpayer-funded, government-run plans, while we Americans don’t allow bureaucrats to come between us and, well, you know the rest.
So, how is Denmark faring compared to the magic-of-the-market U.S. in the race to implement healthcare information technology?
As the U.S. is only just now embarking on its great experiment of socializing up to 85% of the cost of purchasing and installing electronic health-record systems in hospitals and physicians offices, the not-for-profit Commonwealth Fund reports that Denmark has—figuratively speaking—blown the doors off the U.S. in electronic health-record adoption, at least among office-based, primary-care physicians.
How did Denmark do it?
They did a lot of things right, things we should emulate, according to the Commonwealth report, “Widespread Adoption of Information Technology in Primary Care Physician Offices In Denmark: A Case Study, including using a combination of peer pressure, public awareness and, since 2004, a government mandate for physicians to adopt and use EHRs.
Today, according to the report’s authors, Denis Protti and Ib Johansen, virtually all primary-care doctors in Denmark use highly functional EHRs to order prescriptions, draft clinical notes about patient visits, send appointment reminders and communicate with hospitals and other physicians, including specialists.
Danish patients also have the ability to electronically access all of their medical information including medical records, tests results and hospital discharge instructions. They can also electronically schedule appointments and renew prescriptions, and have access to electronically enhanced, after-hours care when they need it.
In comparison to universal EHR adoption in Denmark, in the U.S., just 28% of U.S. primary-care physicians use an EHR, according to a Commonwealth Fund report last year. Meanwhile, an HHS-funded survey found that only 4% of U.S. office-based physicians used a “fully functional” EHR.
Commonwealth Fund President Karen Davis said she’s had an interest in the Danish approach to IT since being invited by the Danish parliament in 1999 to join a team of outside healthcare industry experts in critiquing the Danish healthcare delivery system.
“I was very impressed by their primary-care system, the fact that they rated highest of any country in Europe for satisfaction,” Davis said. She said she was particularly impressed with the Danes use of technology in its off-hours primary-care health service, which operates between 4 p.m. and 8 a.m. Patient information for the off-hours service is accessed through a national health portal run by the Danish healthcare IT firm MedCom, and available since 2005.
Vastly more here (Free registration required):
The two paragraphs in italics say it all – and both the documents linked in the text are well worth a download and careful review.
Of course besides the obvious payoffs there are the less obvious ones.
Here is an example.
19 Mar 2010
CSC has signed a major contract with the Danish National Board of Health to provide a national adverse incident system to allow patients and professionals to report adverse events encountered across the entire health service.
The contract, which was signed following an EU tender, will replace the current patient safety reporting system which only covers patient safety reporting across secondary care.
The web based system, will allow citizens, patients and healthcare professionals across primary and secondary care to enter information into the system in order to report problems they experience within the Danish health service.
Freddy Lykke, managing director of CSC Scandinavia, told E-Health Europe: “Everyone that is providing care and receiving care is providing this information, which enables it to be entered by one and then checked and cross checked by a number of others.
“So, if a patient received the wrong medicine and reported this, then the pharmacist who gave them their medication would also provide input to the system.”
The system called Risk Monitor Pro, has been developed by CSC’s partners rL solutions, who already provide the system to more than 600 clients worldwide.
However, Denmark’s National Board of Health will be the first European customer to go-live with the system in the summer.
The software also supports the examination of reported information that is reported within the system, which is then monitored and reviewed at locally, regional and at a national level.
It includes simple statistical reporting and automatic generation of different types of reports, such as types, locations and time periods when specific events occurred.
Only when you have the basics in place can you start doing the really high impact, high value stuff!
Do note that this has all taken years and has been incrementally and carefully planned. There is a lot we can learn from all this I think.