Bipartisan Congressional Health Policy Conference Lessons from Abroad THE COMMONWEALTH FUND Bipartisan Congressional Health Policy Conference Lessons from Abroad International Efforts to Improve Quality, Reduce Costs and Increase Transparency Evidence from the 2006 International Health Policy Survey of Primary Care Physicians in Seven Countries January 12-14, 2007 John E. Craig, Jr.

Primary Care Doctors Use of Electronic Patient Medical Records, 2006 Percent Source: 2006 Commonwealth Fund International Health Policy Survey of Primary Care Physicians

Primary Care Practices with Advanced Information Capacity Percent reporting 7 or more out of 14 functions* *Count of 14: EMR, EMR access other doctors, outside office, patient; routine use electronic ordering tests, prescriptions, access test results, access hospital records; computer for reminders, Rx alerts, prompt tests results; easy to list diagnosis, medications, patients due for care. Source: 2006 Commonwealth Fund International Health Policy Survey of Primary Care Physicians

Providing a Medical Home: Doctor’s Practice Has Arrangement for Patients’ After-Hours Care to See Nurse/Doctor Percent Source: 2006 Commonwealth Fund International Health Policy Survey of Primary Care Physicians

Providing a Medical Home: Doctors’ Reports of Care Coordination Problems Percent saying their patients “often/ sometimes” experienced: AUS CAN GER NET NZ UK US Records or clinical information not available at time of appointment 28 42 11 16 36 40 Tests/procedures repeated because findings unavailable 10 20 5 7 14 27 Problems because care was not well coordinated across sites/providers 39 46 22 47 49 65 37 Source: 2006 Commonwealth Fund International Health Policy Survey of Primary Care Physicians

Percent of Doctors Reporting Practice Is Well Prepared to Care for Chronic Diseases Percent reporting “well prepared”: AUS CAN GER NET NZ UK US Patients with multiple chronic diseases 69 55 93 75 67 76 68 Patients with mental health problems 50 40 70 65 48 37 Source: 2006 Commonwealth Fund International Health Policy Survey of Primary Care Physicians

Primary Care Doctors’ Reports of Any Financial Incentives Targeted on Quality of Care Percent reporting any financial incentive* *Receive of have potential to receive payment for: clinical care targets, high patient ratings, managing chronic disease/complex needs, preventive care, or QI activities Source: 2006 Commonwealth Fund International Health Policy Survey of Primary Care Physicians

Learning from the International Experience Physicians in Australia, the Netherlands, New Zealand and the UK most likely to report multi-task IT systems; U.S. and Canada lag behind Integration and coordination of care are a shared challenge, although countries like Germany are doing better than the U.S. Widespread primary care doctor participation in a range of quality improvement activities although safety tracking systems are rare except in the U.K. Our Panel Christof Veit, M.D., Director, Regional Office, EQS Hamburg, Germany Helan Bevan, Director of Service Transformation, U.K. NHS Institute for Innovation and Improvement Robert Galvin, M.D., Director for Global Health, General Electric