Wednesday, November 28, 2012

The Commonwealth Funds Provides A Primary Care And Health IT Report. Useful Stuff.

This report has had a lot of coverage in the last week. For example:

UK GPs top for use of EMRs

15 November 2012   Rebecca Todd
More than two thirds of UK GPs use electronic medical records and can also order tests or prescriptions online, manage patients lists or generate patient information electronically, a new survey reveals.
The 2012 Commonwealth Fund International Health Policy Survey of 8,500 primary care doctors in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, the United Kingdom and the United States, places the UK at the top of the table in their use of electronic records.
The report, published today, shows that more than two thirds (68%) of GPs in the UK said they have ‘multi-functional HIT capacity.’
Lots more here:
and here:

Aussie GPs lag behind on e-record use

21st Nov 2012
AUSTRALIA’S high rate of GPs keeping electronic patient records has declined since 2009 and Australia lags behind other countries in terms of electronic exchange of patient summaries with doctors in other practices, new research shows.
A survey by the Commonwealth Fund of 10 countries – Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Switzerland, the UK and the US – found progress in the use of health information technology in healthcare practices, particularly in the US.
Yet a high percentage of primary care physicians in all 10 countries reported they did not routinely receive timely information from specialists or hospitals.
Of the 500 Australian GPs surveyed, the use of electronic medical records was high but fell from 95% to 92% from 2009 to 2012 while the other nations mainly recorded increases.
Australia also had one of the lowest rates of GPs reporting they could electronically exchange patient summaries and test results with doctors outside their practice, at 27% – third last when compared to the other nine countries, with only Canada and Germany trailing.
More here:
Here is the link to the original report:
The key part worth quoting is the summary of findings:

Key Findings

  • Two-thirds (69%) of U.S. primary care physicians 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), though the two countries lag the U.K., New Zealand, and Australia in EMRs and use of HIT to perform a range of functions, like generating patient information or ordering diagnostic tests.
  • In the U.S.—the only country in the survey without universal health coverage—59 percent 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 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 primary care doctors 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 percent saying the system needs only minor change.
The full article and associated downloads are well worth a download and read. The report clearly identifies some gaps that Australian GPdom could do well to work on - as well as some areas that are going pretty well.
A part of the report I found interesting regarding GPs was the apparent drop in use of EMRs by a few per cent since the last survey in 2009 and the ongoing low level of connectivity and patient focussed services offered in Australia for patients electronically. There is a market opportunity for someone there I believe.
It is also of interest how few Australian GPs presently use secure messaging exclusively to transmit prescriptions rather than transmit the prescription and also print out a copy for the patient to present to pharmacist - to scan the barcode to download the prescription. Just a system difference I guess.


Terry Hannan said...

David, I have found this information somewhat fascinating. Australia is often reported as having >98% computerisation of their practices but what are they actually computerising? has the technology changed the care processes? Some indicators would suggest no. Consultant physicians use of e-technologies is even lower. Osborn, M., R. Day, et al. (2009). "Are specialist physicians missing out on the e-Health boat?" Intern Med J 39(10): 655-661.
I am also of the understanding that UK-based GPs have been able to transmit prescriptions -at least to the NHS repositories-for years. Again what has this done for patient care, adverse events and the quality of care? Just soem thoughts on the topic.Terry

Anonymous said...

For an Australian perspective
see chapter 4.2 "Computer use at GP practices" in the latest BEACH report General practice activity in Australia 2011-12.

Also, ask why the Bindman et. al. study published in 2007 didn't use UK data.

Computer data is vulnerable to GIGO (Garbage In = Garbage Out).

--Tim C