HIT Struggles Across the Globe

Researchers at the Commonwealth Fund and Harris Interactive conducted a survey of primary care physicians in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Switzerland, the United Kingdom and the United States. The survey found progress in the use of health information technology in health care practices, particularly in the United States. But it also found vast room for improvement in all countries surveyed.

Adoption of Electronic Records By Country Adoption of Electronic Records By Country

The U.S. has made big strides in adoption of electronic records since a similar 2009 survey, which found an adoption rate of 46%. While it's not lowest in adoption rates, it and a few other countries surveyed are way behind leaders like The Netherlands and New Zealand.

Netherlands 98%

Norway 98%

New Zealand 97%

UK 97%

Austria 92%

Germany 82%

US 69%

France 67%

Canada 56%

Switzerland 41%

Patient Electronic Access to Physicians Patient Electronic Access to Physicians

The percentage of physicians that enable patients to e-mail questions or concerns.

Switzerland 68%

The Netherlands 46%

Germany 45%

France 39%

New Zealand 38%

United Kingdom 35%


Norway 26%

Austria 20%

Canada 11%

Requesting Referrals and Appointments Online Requesting Referrals and Appointments Online

The percentage of physicians that enable patients to request referrals and appointments online.

Norway 51%

United Kingdom 40%


Switzerland 30%

Germany 22%

France 17%

The Netherlands 13%

New Zealand 13%

Austria 8%

Canada 7%

Online Rx Refills Online Rx Refills

The percentage of physicians that enable patients to request prescription refills online.

The Netherlands 63%

United Kingdom 56%

Norway 53%

Switzerland 48%


Germany 26%

New Zealand 25%

France 15%

Austria 7%

Canada 6%

Health Information Exchange Disappoints Health Information Exchange Disappoints

One of the most interesting, and disheartening, findings of the survey is that while many practices--and countries--have invested heavily in HIT adoption, and some have extremely high adoption rates, the critical ability to exchange data with other medical professionals is not as widespread as would be expected.

Following are the percentages of practices reporting they can electronically exchange patient summaries and test results with doctors outside their practice.

New Zealand 55%

The Netherlands 49%

Switzerland 49%

Norway 45%

France 39%

United Kingdom 38%


Austria 27%

Germany 22%

Canada 14%

Analytics and Performance Measurements Analytics and Performance Measurements

Another area that has room for improvement across all nations is analytics and performance measurements, which is being pushed hard in the United States by the federal government and other stakeholders. A few snapshots, starting with the percent of physicians reporting they routinely receive and review data on patient satisfaction and user experience.

United Kingdom 84%


Austria 56%

New Zealand 51%

The Netherlands 39%

Germany 35%

Switzerland 15%

Canada 15%

Norway 7%

France 1%

Clinical Outcomes Clinical Outcomes

Percent of physicians reporting they routinely receive and review data on clinical outcomes.

United Kingdom 84%

The Netherlands 81%

New Zealand 64%

Germany 54%

United States 47%

Austria 42%

Norway 24%

Canada 23%

France 14%

Switzerland 12%

Emergency Department, Hospital Usage Emergency Department, Hospital Usage

Percent of physicians reporting they routinely receive and review data on their patients' usage of hospital and emergency department services.

United Kingdom 82%


New Zealand 43%

Austria 39%

Norway 33%

Switzerland 32%

Canada 30%

Germany 24%

The Netherlands 21%

France 9%

Can't Get No Satisfaction Can't Get No Satisfaction

U.S. physicians were the most gloomy about their nation's health system. Only 15% said the system worked well, the lowest rate of any country (though Germany was close, with 22% of physicians saying the system worked).

When asked if they were satisfied practicing medicine, Germany (54%) the U.S. (68%) and France (76%) had the least satisfied physicians.

Part of the dissatisfaction among U.S. physicians might stem from their battles to provide needed care in the face of insurance coverage restrictions. Fifty-two percent of US physicians said a getting that care in face of restrictions was a “major” problem. Germany was second with 37% and The Netherlands third at 26%.

The Report The Report

The report on the survey is titled "A Survey Of Primary Care Doctors In Ten Countries Shows Progress In Use Of Health Information Technology, Less In Other Areas."

The full report can be accessed via the Health Affairs Web site here.

The authors of the report are Cathy Schoen, Robin Osborn, David Squires, Michelle Doty, Petra Rasmussen, Roz Pierson and Sandra Applebaum.

A recent survey of primary care physicians in 10 countries, published in Health Affairs, found that U.S. physicians might be behind the curve with health I.T., but no one's lapping the field.


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