The Obama administration's federal incentive programs to spur the adoption and use of digitized medical records has helped the U.S. position itself as a global leader in the adoption and use by physicians of health IT, concludes a new eight-country study from Accenture.

Released Feb. 15, the study, Connected Health: The Drive to Integrated Healthcare Delivery, examined eight countries--Australia, Canada, England, France, Germany, Singapore, Spain, and the United States--and looked at how these nations' health systems are applying systematic approaches to healthcare IT.

According to the Accenture report, the federal government's efforts, including its initiative to set aside up to $27 billion for the adoption of electronic health records, has had a significant impact on the U.S.'s ability to keep up with or even outpace several industrialized countries regarding their use of healthcare IT. In fact, the U.S. was a leader in many capabilities of Health Information Exchanges (HIEs), including e-prescribing, computerized physician order entry (CPOE), e-referrals, and administrative tools.

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Rick Ratliff, who leads Accenture's Connected Health services, said one of the more surprising finding of the research was that the U.S. is one of the few countries in which healthcare IT penetration is nearly equal among primary physicians and specialists.

"Nearly half of U.S. physicians and specialists reported regular use of healthcare IT systems, and more than one third confirmed using health information exchanges to connect with physicians in other organizations," Ratliff told InformationWeek Healthcare. "Only Germany showed similar levels of healthcare IT adoption across both sectors."

Ratliff did note, however, that there is significant variation in healthcare IT adoption levels across different states, networks, and care settings in the United States. The level of health information exchange is generally low and occurs primarily within single organizations or networks rather than across different organizations and settings.

"This means large integrated delivery networks are at an advantage as compared to smaller hospital systems and private physician practices, though the Meaningful Use incentives should stimulate wider progress," Ratliff explained.

Accenture's research was based on interviews with more than 160 health leaders--including government officials, clinicians, health information specialists, academics, and analysts--and a survey of 3,700 physicians across the eight countries, as well as extensive secondary research.

The study also used the Accenture Connected Health Maturity Index, which compares the relative progress of each country's adoption of healthcare IT as well as healthcare information exchanges used between clinicians and organizations. The index is based on physicians' use of different healthcare IT and HIE functionalities, such as electronic entry of patient notes, e-referrals, e-ordering, e-prescribing, and electronic communications with other clinicians.

Other key findings for the U.S. were:

-- Approximately 62% of specialists are using electronic tools such as e-scheduling and e-billing to improve administrative efficiency, compared to a 49% global average.

-- The majority of U.S. physicians (59%) enter patient notes electronically during and after appointments, the same as their international colleagues in the study.

-- More than half of U.S. primary doctors (54%), more than any country surveyed, are using e-prescribing to send prescriptions to pharmacies electronically, compared to just 20% on average for the other countries.

-- Nearly half of physician specialists (48%) send electronic orders (i.e., lab, radiology, or diagnostic tests), compared to roughly one-third (36%) as a global average for the study.

-- Nearly a third (30%) of primary and specialist physicians send and receive e-referrals for recommending care outside their organization. Independent physicians, however, were significantly less likely to make use of HIE capabilities compared to physicians who are employed or aligned with larger health systems.

According to Ratliff, compared to other countries the United States lagged behind other industrialized nations in terms of moving from a private to publically driven model. In addition, the U.S. has faced some obstacles in preparing for a connected health system, such as slow adoption rates for key technologies, lack of information sharing between enterprises, costs, and lack of staffing. However, the study shows the U.S. is turning the corner.

"While U.S. providers may have started from a disadvantage, they are now adopting health IT at a relatively fast pace, and by 2019, the majority of healthcare providers will be using highly functional, interoperable EMR/EHR systems," Ratliff said. "From the point of view of use and level activity, we are seeing that the U.S. healthcare system is making good progress in terms of connected health maturity."

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