Commonwealth Fund report examines challenges facing doctors internationally
Communication and teamwork across healthcare systems appears to be a nearly universal challenge, according to a survey of nearly 9,800 primary care physicians representing 11 nations. The Commonwealth Fund released findings of the survey in November 2012, and expanded on several drill-down topics during a webinar presented on Feb. 5.
Researchers reported that gaps in communication among sites of care undermine care coordination and integration in all countries, which included Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States.
Results varied by nation in areas such as technology utilization and how easily patients can access their physician.
[See also: Higher physician fees in the U.S. contribute to the country's high healthcare costs.]
U.S. doctors' use of health IT has been sharply increasing, up from 46 percent who used an EMR in their practice in 2009 to 69 percent in 2012, said Cathy Schoen, senior vice president of The Commonwealth Fund, who presented the findings during the webinar.
U.S. doctors continue to lag their professional counterparts in leading countries such as the Netherlands, Norway, New Zealand, the U.K., Australia and Sweden – all of which reported EMR usage rates above 88 percent in 2012. Switzerland trailed all surveyed countries in EMR use with a 41 percent rate in 2012.
Among the high-tech leaders, only the U.K., Australia and the Netherlands reported more than 50 percent of doctors using EMRs with at least two electronic functions such as order entry management, generating patient information, generating panel information or routine clinical decision support.
In regard to patient access, U.S. physicians were most likely to say that their patients have difficulty paying for care and that coverage restrictions pose significant time concerns. More than 50 percent of U.S. physicians said the amount of time they or their staff spend getting patients needed medications or treatment because of coverage restrictions is a major problem. In no other country was the response rate more than 37 percent in regard to insurance restrictions.
Dutch and British doctors offered high rates of after-hours care (over 94 percent, compared to 34 percent in the United States), while Swiss doctors reported their patients having the easiest access to specialized care (with 59 percent saying they always receive a report with all relevant health information after a patient visits a specialist, compared to 19 percent in the United States).
The overall findings point to the importance of reforms to support primary care and teamwork, along with open pathways for information exchange, said Schoen.
