The use of health information technology in seven nations
Received 11 March 2008; received in revised form 20 May 2008; accepted 2 June 2008. published online 30 January 2009.
Abstract
Objective
To assess the state of health information technology (HIT) adoption and use in seven industrialized nations.
Design
We used a combination of literature review, as well as interviews with experts in individual nations, to determine use of key information technologies.
Main outcome measures
We examined rates of electronic health record (EHR) use in ambulatory care and hospital settings, along with current activities in health information exchange (HIE) in seven countries: the United States (U.S.), Canada, United Kingdom (UK), Germany, Netherlands, Australia, and New Zealand (NZ).
Results
Four nations (the UK, Netherlands, Australia, and NZ) had nearly universal use of EHRs among general practitioners (each >90%) and Germany was far along (40–80%). The U.S. and Canada had a minority of ambulatory care physicians who used EHRs consistently (10–30%). While there are no high quality data for the hospital setting from any of the nations we examined, evidence suggests that only a small fraction of hospitals (<10%) in any single country had the key components of an EHR. HIE efforts were a high priority in all seven nations but the early efforts have had varying degrees of active clinical data exchange.
Conclusion
We examined HIT adoption in seven industrialized nations and found that many have achieved high levels of ambulatory EHR adoption but lagged with respect to inpatient EHR and HIE. These data suggest that increased efforts will be needed if interoperable EHRs are soon to become ubiquitous in these seven nations.
ABSTRACT