U.S. trails behind in use of electronic records, prescribing

Relatively small numbers of American physicians are using electronic records or prescribing, and the United States lags behind other English-speaking countries in this regard, according to a survey of physicians conducted by Rochester, NY-based Harris Interactive for the Harvard School of Public Health and the Commonwealth Fund's International Health Care Symposium in 2000. The survey found that the use of electronic systems is much more advanced in Britain, New Zealand and Australia than in the United States. The numbers for Canadian usage were low, however, similar to those in the United States.

Primary care vs. specialty

The biggest differences between countries, by far, were in the use of electronic systems by primary care physicians compared with specialists.

For example, the proportions of primary care physicians who were using electronic medical records (sometimes) were 17% in the United States, 14% in Canada, 25% in Australia, 52% in New Zealand and 59% in the United Kingdom. And the proportions of primary care physicians who were using electronic prescribing "often" were 9% in the United States, 8% in Canada, 44% in Australia, 52% in New Zealand and 87% in the U.K.

The use of electronic medical records and electronic prescribing was lower among specialists than among primary care physicians. Here again, however, the United States lagged behind, with the lowest proportions of specialists using either electronic medical records or prescribing.

Why the discrepancy?

According to Harris Interactive, there is a simple explanation for these differences. In countries with national health services, or universal government-funded health insurance, there is a single payer. If the single payer says physicians must use electronic systems, they will do so.

In the United States, there are thousands of employer-provided health plans, hundreds of insurers and managed care plans, and 50 state Medicaid systems. This makes it much more difficult and expensive to introduce new electronic systems.

Harris Interactive concluded that the United States will almost certainly continue to trail behind many other countries in the uses of information technology, despite the consensus that they would substantially reduce medical errors, improve the quality of care and possibly save money. PR