PCPs struggle to coordinate care, communicate with providers

While U.S. primary care physicians are leveraging health IT, they are struggling to coordinate care and communicate with other providers, compared with PCPs in other countries.

That’s among the findings of a survey of more than 13,200 PCPs in 11 high-income countries. Results of the Commonwealth Fund’s International Health Policy Survey were published on Tuesday in Health Affairs.

“Compared to physicians in other countries, substantial proportions of U.S. physicians did not routinely receive timely notification or the information needed for managing ongoing care from specialists, after-hours care centers, emergency departments or hospitals,” according to the authors. “Primary care practices in a handful of countries, including the U.S., are not routinely exchanging information electronically outside the practice.”

The PCP survey, conducted in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States, measured their use of health IT to facilitate patient engagement and communication with providers across settings.

Specifically, the survey’s measures included giving patients the option to electronically communicate with physicians; the use of video consultations or remote monitoring; the presence of patient portals with capacity to make appointments, request refills, and view test results and patient-visit summaries; and the ability to electronically exchange patient information, such as clinical summaries, laboratory or diagnostic test results, and medication lists with doctors outside the respondent’s practice.

Among the survey’s findings:

• Only 49 percent of U.S. PCPs said they communicated with their patients’ specialists, compared with at least seven in 10 physicians in France, New Zealand, Norway and the U.K., who reported receiving information from specialists about changes to their patients’ medications or care plans.

• About four in 10 PCPs in the U.S. (40 percent), Australia (38 percent) and Canada (42 percent) routinely coordinate with patients’ social service and community providers, compared with 74 percent of physicians in Germany and 65 percent of those in the U.K.

• Slightly more than half of U.S. PCPs reported being able to exchange patient clinical summaries, laboratory and diagnostic test results, and patient medication lists with physicians outside their practice. By contrast, the vast majority of physicians (72 to 93 percent) in the Netherlands, New Zealand, Norway and Sweden reported having these abilities.

On the positive side of the ledger, 52 percent of U.S. PCPs reported usually receiving a report from the hospital within 48 hours of discharge, compared with only one-third or fewer in seven other countries. In addition, PCPs from Sweden and the U.S. led in their use of patient portals to provide appointment scheduling, prescription refills, test results and visit summaries.

“Overall, U.S. physicians were among those who more frequently reported offering health IT tools to better communicate with and engage patients,” states the article.

According to the survey, 77 percent of U.S. PCPs offered patients the option to communicate with them about a medical question via email or a secure website. “The use of other technologies—such as video consultations and remote monitoring of patients with chronic conditions—was rare in most countries, but U.S. physicians were among the most likely to use them.”