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EMR Implementation & HITECH Act Blog

A blog for doctors and medical office staff seeking assistance with EMR and the HITECH Act.


Another Country’s Experience: Health Information Technology (HIT) Can Work and Work Well

As the American health care system takes its first steps toward implementing a comprehensive national system of electronic medical records, can we learn anything from other countries?† Is there anywhere else in the world that’s been there and done that?

According to a new Commonwealth Fund report the answer is yes.
There is a country where 98% of all primary care physicians use EMRs with advanced clinical functionality; where they can manage medications lists, problem lists, progress notes, generate reminders, send and generate prescriptions and more ñ all electronically. †All lab results, medications and referrals are completed electronically, and physicians are automatically notified when a patient uses an ER or other after-hours provider.

Where is this utopia, you ask? †Denmark.

Yes, Denmark.

From this report, it would appear that the Danish have done in the past twenty years what we are hoping to do over the next ten †ñ implement an accurate, efficient, interoperable system of electronic medical records. †So how did they do it? †What can we learn from them?

Yes, they did it with mandates and incentives, but they also did it with something that we don’t necessarily have here in the U.S. ñ an informed, engaged patient base that pressured its physicians into adopting the technology.† According to the report: †ìPeer pressure has been competitive and supportive.† Public monitoring of participation coupled with patientsí views that physicians not using EMRs are ìsecond-rate,î compelled primary care physicians (PCPs) to install IT in their practices.† But the pressure has also been collegial and collaborative, with early adopters shar≠ing with colleagues how computer systems affected their practice.î

How did EMRs get started in Denmark? †Their roots stretch back to the 1980s, when two Danish physicians started electronically communicating on an ad hoc basis. †It worked well for them and began to spread within their hospital to other functions. †Over the next few years it grew and became more formalized, and ultimately, when the Danish government determined how beneficial it was for both physicians and patients, nationalized it.

How well does it work now, in a country with 5.5 million potential patients?† Of all the countries in the European Union, the Danish rank #1 in satisfaction with their health care delivery system.† There are ten certified suppliers supporting thirteen basic systems. †Three control 57% of the market and all but two systems are windows based.

MedCom, the national integrator which grew out of the efforts of those first two physicians, now handles all certification, training and interoperability issues with 14 people and a budget equivalent to US $2.9 million.

Rich Silverman
PCHS Blogging Team

Image by Per Palmkvist Knudsen courtesy of Wikimedia Commons under a Creative Commons Share Alike Attribution License