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Yup, we're way, way, way behind tiny New Zealand

November 13, 2009
by Mark Hagland
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So here’s a really basic question: how is it that a diverse range of advanced, industrialized nations—including Australia, New Zealand, the Netherlands, Italy, Sweden, and the United Kingdom, have all achieved near-universalization of EMR use on the part of primary care and other physicians? And before you jump in to say, “U.S. healthcare is unique,” keep in mind how broad the range of countries just mentioned actually is. Their healthcare systems differ as much from one another as from the U.S. healthcare system. What’s more, they span a range of advancement when it comes to medical technology in areas such as medical devices. They also differ very broadly with regard to overall healthcare spending, with the U.K. and Italy falling considerably below the U.S. not only in raw figures, but in terms of percentage of GDP spent on healthcare overall.

These findings come out of an 11-nation study of physician practice issues published on Nov. 5 in Health Affairs online. And they underscore just how backward we remain in the U.S. in healthcare IT overall, at least when it comes to EMR adoption, a core measure of healthcare IT advancement. Sure, we’ve got some really nifty innovation going on here in the U.S. that in certain niche areas is more advanced than in other countries; but at the same time, some of that niche innovation is addressing issues that are unique to the incredible complexity of our healthcare delivery and payment system, a kind of complexity most other advanced nations don’t share.

So as we push forward on meeting the gradually advancing requirements of ARRA-HITECH funding, let’s not fool ourselves here. So when you read that 99 percent of doctors in the Netherlands, and 97 percent of doctors in New Zealand and Norway, countries that spend roughly half of the percentage of their GDP on healthcare annually that we do, have adopted EMRs, and we’re at 46 percent, it really does mean something. Even the U.K. and Italy, long known (somewhat unjustifiably, I would argue) for “under-spending” on healthcare, are at 96 and 94 percent of physician EMR adoption, respectfully. (For balance, there is one country in this survey that actually has a lower percentage of office EMR adoption than we do, and that’s Canada, at an abysmal 37 percent.) I just hope everyone hearing those figures gets some fire in the belly about where we’re at on our automation journey, because excuses about the differentness of our healthcare system just aren’t going to cut it any longer.

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