US lagging behind in co-ordinating care with social service providers
A new report published by Health Affairs has identified that US doctors struggle to co-ordinate care with social service providers compared with other high-income countries
The survey of 11 high-income countries – Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the UK and the US – examined the operations of 13,200 primary physicians, looking specifically at provider-to-provider communications, the promotion and uptake of health information technology and the co-ordination with social service providers that offer housing, meals or transportation.
The report highlighted that while doctors in each of the nations surveyed reported that their practices struggle to coordinate care, those within the US primary care system found this particularly difficult. For example, only 49 per cent of physicians in the US receive information from specialists about changes to their patients’ medications or care plans, while at least seven in 10 physicians in Norway, France, and New Zealand do. And, in the US, about half of primary care doctors said they are usually notified when a patient is seen in the emergency department (ED), where more than 80 per cent of doctors in New Zealand and the Netherlands reported the same.
The study also threw light upon the uptake of patient portals and web-based tools, citing US physicians as among those most likely to use them (77 per cent gave patients the option of communicating with them via email or a secure website) – although physicians from the UK and Sweden were leading in their use of patient portals to provide appointment scheduling, prescription refills, test results and visit summaries.
However, despite this innovative approach to technology, only around half of US physicians reported being able to exchange patient clinical summaries, laboratory and diagnostic test results, and patient medication lists with outside physicians. Commenting on this, Michelle Doty, lead author of the study, and Commonwealth Fund Vice-President for Survey Research and Evaluation, said: “The US pays more for healthcare than any other country. Despite progress in using health information technologies, our primary care doctors often lack the tools to co-ordinate patient care and referrals with hospitals and specialists, as well as with social service agencies. We must do more to strengthen primary care and improve communication across care settings.”
Indeed, when asked about barriers to coordinating patient care with social services, about one-third or more of US physicians said that the following are major challenges: no referral system (31 per cent in the US; up to 45 per cent in France), inadequate staffing (36 per cent in the US; up to 56 per cent in the UK), and no follow-up from social service providers (37 per cent in the US; up to 61 per cent in the UK).
“While many countries across the globe struggle to deliver all the components of good primary care, many others have developed innovative solutions,” said David Blumenthal, Commonwealth Fund President. “We should learn from one another and take steps here in the US to incentivise well-coordinated primary care. Because if it isn’t working, patients won’t get the best care possible.”
You can read the survey results in full here.