U.S. doctors are far less likely to use health information technology that helps reduce errors and improve care than those in other countries, according to the 2009 Commonwealth Fund International Health Policy Survey.

Published online today in the journal Health Affairs, the survey finds that only 46 percent of U.S. doctors use electronic medical records, compared to 99 percent of doctors in the Netherlands and 97 percent of doctors in New Zealand and Norway.

Many of the areas in which the United States lags would be addressed by health reform legislation currently under consideration in Congress, according to Commonwealth Fund officials.

"We spend far more than any of the other countries in the survey, yet a majority of U.S. primary care doctors say their patients often can't afford care, and a wide majority of primary care physicians don't have advanced computer systems to access patient test results, anticipate and avoid medication errors or support care for chronically ill patients," said Commonwealth Fund Senior Vice President Cathy Schoen, lead author of the article.

"The patient-centered chronic care model originated in the U.S., yet other countries are moving forward faster to support care teams including nurses, spending time with patients, and assuring access to after-hours," she added. "The study underscores the pressing need for national reforms to close the performance gap to improve outcomes and reduce costs."

The survey of more than 10,000 primary care physicians in Australia, Canada, France, Germany, Italy, the Netherlands, New Zealand, Norway, Sweden, the United Kingdom and the United States describes a U.S. primary care system that is under stress and highlights areas where the nation can learn from other countries.

Notably, the United States could use financial incentives to improve quality and efficiency, expand access to healthcare and simplify insurance, expand the use of health information technology to prevent medical errors, and use a medical home approach to primary care where patients have options for care at any time of day or night, teams of healthcare providers to manage conditions and continuity of care.

"Access barriers, lack of information and inadequate financial support for preventive and chronic care undermine primary care doctors' efforts to provide timely, high quality care and put the U.S. far behind what many other countries are able to achieve," said Commonwealth Fund President Karen Davis. "Our weak primary care system puts patients at risk and results in poorer health outcomes and higher costs. The survey provides yet another reminder of the urgent need for reforms that make accessible, high-quality primary care a national priority."
 

Survey highlights on next page...