Eleven-Country Survey, Conducted by The Commonwealth Fund, Finds Doctors in U.S. and Abroad Have Problems Coordinating Care with Social Service Providers
Primary care doctors in the U.S. struggle to coordinate care and communicate with other health and social service providers, according to results from the 2019 Commonwealth Fund International Health Policy Survey, published today by the journal Health Affairs. The survey of more than 13,000 primary care physicians in 11 high-income countries (Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom, and the United States) revealed that although the U.S. leads in several aspects of health information technology, its physicians still face challenges with coordinating care and exchanging information electronically outside their practice. Among the main findings:
1. Primary care doctors in the U.S. trail their counterparts in provider-to-provider communications.
While doctors in each of the nations surveyed reported that their practices struggle to coordinate care, the U.S. primary care system falls short in these key areas:
- Communicating with specialists: At least seven in 10 physicians in Norway, France, and New Zealand receive information from specialists about changes to their patients’ medications or care plans. Only 49 percent do in the U.S.
- Emergency department visits: In the U.S., about half of primary care doctors said they are usually notified when a patient is seen in the emergency department (ED). In New Zealand and the Netherlands, more than 80 percent of doctors reported usually being notified about a patient’s ED visit.
- Communication with home care: Communication with home-based nursing care is a problem across countries. Only one-third (33%) of U.S. primary care doctors said their practice routinely communicates with patients’ home care providers about patient needs and services. And just 42 percent of U.S. doctors said they are notified by home care providers of changes in their patients’ condition or health status.
2. U.S. physicians are more likely to offer health information technology to patients but struggle with interoperability.
- Patient portals and web-based tools: Overall, U.S. physicians were more likely to report offering their patients these technologies to improve communication and engagement. More than three-quarters (77%) of physicians give patients the option of communicating with them via email or a secure website. The use of other technologies — such as video consultations and remote monitoring of patients with chronic conditions — is rare in most countries, but U.S. physicians are among the most likely to use them. Physicians from Sweden and the U.S. lead in their use of patient portals to provide appointment scheduling, prescription refills, test results, and visit summaries...