Michelle M. Doty, Katherine Shea, Karen Davis, Kristof Stremikis
K. Davis, M. M. Doty, K. Shea, and K. Stremikis, "Health Information Technology and Physician Perceptions of Quality of Care and Satisfaction," Health Policy, published online Nov. 25, 2008.
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A survey of 6,536 physicians in seven countries finds that adoption of health information technology (IT) is highly variable, with the United States lagging well behind other countries. Physicians with greater IT capacity were more likely to report feeling well prepared to manage patients with chronic diseases, among other benefits.
Advances in health IT are making it easier for physicians to provide coordinated, high-quality care by streamlining many tasks: sending patient reminders, creating disease registries, prescribing and refilling medications, and viewing lab results, among others. Unfortunately, adoption of health IT by physician practices has been slow across countries.
Federal leadership in the U.S. may be required to accelerate IT adoption among physician practices. In England, for example, the federal government has established standards, and has financed and implemented IT tools; as a result, nearly all physicians there have EMR systems and a great majority report high IT capacity. The U.S., which has been slow to adopt standards and has not made a financial commitment to IT, lags behind all of the study countries, except Canada. Additional IT system development is needed in nearly all countries, particularly to enable the linking of patient information across sites of care. When physicians cannot access hospital records, transitional care can be undermined, sometimes resulting in costly re-hospitalizations.
Data was obtained from the 2006 Commonwealth Fund International Health Policy Survey of Primary Care Physicians, which involved 6,536 physicians in seven countries: Australia, Canada, Germany, the Netherlands, New Zealand, the U.K., and the U.S. The researchers created an IT measure of 14 capabilities, including use of EMRs, routine electronic ordering of tests, and computerized systems for patient reminders. Physicians were considered to have "low" IT capacity if they reported two of the 14 items, "middle" capacity if they reported three to six items, and "high" if they reported seven to 14 items.
Despite evidence that IT can improve the quality and safety of care, adoption of health IT systems by physician practices has been slow and variable across countries.