Survey: EHR use in U.S., Canada lags other countries

Doctors in the United States and Canada lag behind several other countries in the use of electronic health records (EHRs), according to responses of 10,000 physicians in 11 countries queried for the 2009 Commonwealth Fund International Health Policy Survey, the results of which recently were published online in the journal Health Affairs.

Forty-six percent of doctors in the United States and 37 percent of physicians in Canada use EHRs, compared with 99 percent in the Netherlands, 97 percent in New Zealand and Norway, 96 percent in the United Kingdom, 95 percent in Australia, and 94 percent in Italy and Sweden. The rate of EHR use was 72 percent in Germany and 68 percent in France.

Twenty-eight percent of doctors in the United States reported using EHRs in the 2006 survey.

In addition to basic EHRs, the 2009 survey asked about a range of 14 possible computer functions, including electronic medication prescribing and alerts for medication errors, ordering lab tests and viewing test results, and support and prompts for preventive care and follow-up care with patients. Countries with one half or more of participating physicians reporting the use of at least nine of the 14 functions included New Zealand (92 percent), Australia (91 percent), the United Kingdom (89 percent), Italy (66 percent), and the Netherlands (54 percent). The rate was 36 percent in Germany. Countries with about one-fourth or less of participating doctors using at least nine of the 14 functions were the United States (26 percent), Norway (19 percent), France (15 percent), and Canada (14 percent).

In the United States, advanced information capacity was concentrated in larger group practices and those affiliated with integrated care systems. In contrast, in the seven countries with near universal use of EHRs, there was little or no difference in advanced health information technology use by practice size. The authors noted that in these countries, national policies and standards have supported wide adoption of information technology in primary care practices.