Canada's doctors score low on computer
NEW YORK – A survey of 6,536
physicians in seven countries finds that adoption of health information
technology (IT) is highly variable, with Canada and the United States
lagging well behind other countries. Physicians with greater IT capacity
were more likely to report feeling well-prepared to manage patients with
chronic diseases, among other benefits.
Advances in healthcare IT are making it easier for physicians to provide
coordinated, high-quality care by streamlining many tasks: sending
patient reminders, creating disease registries, prescribing and
refilling medications, and viewing lab results, among others.
Unfortunately, adoption of health IT by physician practices has been
slow across countries.
Physicians’ Use of Electronic Medical Records
(Percent of physicians using EMRs in 2006)
1. Netherlands – 98%
2. New Zealand – 92%
3. United Kingdom – 89%
4. Australia – 79%
5. Germany – 42%
6. U.S.A. – 28%
7. Canada – 23%
The study, “Health Information Technology and Physician Perceptions of
Quality of Care and Satisfaction,” by K. Davis, M. M. Doty, K. Shea, and
K. Stremikis, was published online in November 2008 in Health Policy.
About the Study
Data was obtained from the 2006 Commonwealth Fund International Health
Policy Survey of Primary Care Physicians, which involved 6,536
physicians in seven countries: Australia, Canada, Germany, the
Netherlands, New Zealand, the U.K., and the U.S.
The researchers created an IT measure of 14 capabilities, including use
of EMRs, routine electronic ordering of tests, and computerized systems
for patient reminders. Physicians were considered to have “low” IT
capacity if they reported two of the 14 items, “middle” capacity if they
reported three to six items, and “high” if they reported seven to 14
The Bottom Line
Despite evidence that IT can improve the quality and safety of care,
adoption of health IT systems by physician practices has been slow and
variable across countries.
Electronic medical record (EMR) usage ranges from nearly all physicians
in the Netherlands to only 23 percent in Canada and 28 percent in the
Physicians in the U.S. and Canada, the two countries where EMR use is
lowest, reported predictably low use of associated computerized systems.
For instance, only 15 percent of physicians in the U.S. and 6 percent in
Canada used computerized systems to receive alerts to provide patients
with test results.
In the United Kingdom, 88 percent of primary care physicians can easily
generate lists of medications that patients take, including
prescriptions from other doctors, compared with only 37 percent of
doctors in the U.S.
The ability to generate medication lists promotes coordination of care
among doctors and can help prevent medication errors.
Over three-quarters (78%) of primary care physicians with high IT
capacity felt well prepared to care for patients with multiple chronic
diseases, compared with only 66 percent of physicians with low IT
There is a strong relationship between IT capacity and patient safety:
the greater the capacity, the more likely a practice has a
patient-safety system in place. More than two of five (43%) physicians
with high IT capacity had a process for dealing with adverse events,
compared with 27 percent of practices with low IT capacity.
Thirty-one percent of primary care physicians with high IT capacity and
28 percent of those with medium IT capacity reported their ability to
provide quality medical care had improved over the past five years. By
contrast, just 22 percent of those with low IT capacity reported similar
Addressing the Problem
Federal leadership in the U.S. may be required to accelerate IT adoption
among physician practices. In England, for example, the federal
government has established standards, and has financed and implemented
IT tools; as a result, nearly all physicians there have EMR systems and
a great majority report high IT capacity.
The U.S., which has been slow to adopt standards and has not made a
financial commitment to IT, lags behind all of the study countries,
Additional IT system development is needed in nearly all countries,
particularly to enable the linking of patient information across sites
of care. When physicians cannot access hospital records, transitional
care can be undermined, sometimes resulting in costly
The full study can be accessed at: