Electronic Medical Records: US Doctors 4%, NZ Doctors 60%

A recent NEJM study of US family doctors shows that just 4% are using Electronic Medical Records (EMR) systems fully (13% using a basic system). This compares to 60% of family doctors in New Zealand. (Update: The Commonwealth Fund survey gives a figure of 92% of NZ family doctors using EMR systems – it also gives a figure of 28% of US doctors).

Abstract

Background Electronic health records have the potential to improve the delivery of health care services. However, in the United States, physicians have been slow to adopt such systems. This study assessed physicians’ adoption of outpatient electronic health records, their satisfaction with such systems, the perceived effect of the systems on the quality of care, and the perceived barriers to adoption. Methods In late 2007 and early 2008, we conducted a national survey of 2758 physicians, which represented a response rate of 62%. Using a definition for electronic health records that was based on expert consensus, we determined the proportion of physicians who were using such records in an office setting and the relationship between adoption and the characteristics of individual physicians and their practices.

Results Four percent of physicians reported having an extensive, fully functional electronic-records system, and 13% reported having a basic system. In multivariate analyses, primary care physicians and those practicing in large groups, in hospitals or medical centers, and in the western region of the United States were more likely to use electronic health records. Physicians reported positive effects of these systems on several dimensions of quality of care and high levels of satisfaction. Financial barriers were viewed as having the greatest effect on decisions about the adoption of electronic health records.

Conclusions Physicians who use electronic health records believe such systems improve the quality of care and are generally satisfied with the systems. However, as of early 2008, electronic systems had been adopted by only a small minority of U.S. physicians, who may differ from later adopters of these systems.

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Teens Visit Second Life Doctors for Embarrassing Illnesses

Article in the Guardian:

Spanish health authorities launched a virtual portal through the Second Life website yesterday designed to help young people too embarrassed to speak to a doctor about sexually transmitted disease or a drug problem.

Real doctors will log on and offer advice to their anonymous patients. What both will see is an image of a consulting room with a doctor and a typical patient.

Dr Rosario Jimènez, of the Adolescent Attention Working Group, is one of the doctors who will spend up to four hours a week answering their virtual patients’ questions.

She said: “Teenagers do not often go to see the doctor but this is an efficient and amusing tool to reach them because we can both use the same route. Even though they do not often suffer serious illnesses, they often expose themselves to risks which can develop into problems in the future.

“This is a way to talk about their doubts about taking drugs or sexual relations which they cannot do in a traditional consultation.”

The Second Life health portal was set up by the Spanish Society for Family and Community Medicine (FYC) and the Coalition for Citizens with Chronic Illnesses.

Dr Luis Aguillera, FYC president, said: “This idea started as a way to connect health professionals and adolescents and to give internet users a reliable space to get health advice.”

The Spanish-language isla de salud (health island) on Second Life will also include detailed information on health matters and a meeting room for website users.

The FYC plans to open other Second Life portals for chronic conditions in six months.

Aguillera said: “Even though a virtual consultation can never substitute for a real face-to-face one, we will be able to deal with problems of dermatology and psychology through a webcam.”

Smartphone use by doctors on the increase

My friend Dr Mo Al-Ubaydli has written a great piece for iHealthBeat about the rise of Smartphone use in Doctors’ offices:

More and more doctors are using smartphones — essentially PDAs that can make phone calls — in their daily lives, yet few of them are integrating the devices into their clinical practice. New clinical software designed specifically for smartphones is helping to overcome some barriers, yet there are other roadblocks preventing smartphones from becoming much more common in medicine than they are now.

Read the article

(Mo and I produced The Doctor’s PDA and Smartphone Handbook published by the RSM Press)