EMR Implementation & HITECH Act Blog

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 – 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  – 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. – an informed, engaged patient base that pressured its physicians into adopting the technology.  According to the report:  “Peer pressure has been competitive and supportive.  Public monitoring of participation coupled with patients’ views that physicians not using EMRs are “second-rate,” compelled primary care physicians (PCPs) to install IT in their practices.  But the pressure has also been collegial and collaborative, with early adopters shar­ing with colleagues how computer systems affected their practice.”

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.