More than two thirds of primary care physicians in the United States use electronic medical records, a substantial increase from 2009, says a survey in the December Health Affairs. “Although the United States and Canada still lag behind countries with near-universal adoption, the spread has been rapid in both countries, with a 50 percent increase in the rates of use of electronic medical records since 2009.”
“A Survey of Primary Care Doctors in Ten Countries Shows Progress in Use of Health Information Technology, Less in Other Areas” looks at PCPs in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Switzerland, the United Kingdom, and the United States.
Harris Interactive, using contractors in the individual countries, conducted mail and telephone surveys from March to July.
Despite the increased use of EHRs by PCPs in the United States, the researchers found a lot of doctor dissatisfaction. PCPs in the United States feel more burdened than PCPs in other countries.
“The United States spends far more than the other study countries on health care services,” says the report. “Yet U.S. primary care physicians were the least likely to be satisfied with the practice of medicine or the health system overall. U.S. studies indicate that primary care physicians’ satisfaction increases and stress decreases when care is redesigned to improve access and support the use of teams, giving physicians time to focus on sicker patients.”
Help may be on the way. “An array of policies in the Affordable Care Act envision primary care as central to efforts to achieve the Triple Aim of better health, better care, and lower costs. With major insurance expansion scheduled for 2014, there is the potential to lower access barriers for primary care and streamline insurance practices to free up physician and practice staff time to provide care.”
Responders say that they put a lot of emphasis on teamwork, and wish they’d get more feedback from specialists.
“When asked if they were always advised of changes that specialists made to their patients’ medications or care plans, fewer than half of the doctors in any country said yes. Germany, the Netherlands, and the United States were at the low end of the country range of results. It is striking that at most, about 1 in 4 doctors in any country said that information from specialists was always timely and available when needed.”
PCPs in the United States and Germany are the most negative about their health care systems, only 15 and 22 percent saying the system needs minimal, not fundamental, change.
“Insurance design also matters,” the study says. “U.S. physicians stand out, as they have in past surveys, for saying that their patients often have difficulty paying for care and that insurance restrictions on care decisions consume substantial doctor and staff time.
“The other countries in the study all provide universal coverage and, with the exception of Switzerland, have little or no cost sharing for primary care and essential medications. All of the other countries limit out-of-pocket expenses to levels well below those typical in U.S. insurance.”