England Among Leaders in Healthcare IT for Primary Care, Accenture Eight-Country Study Reports

London; March 27, 2012 – England’s primary physicians are among the most advanced users of healthcare IT, but a widening gap in secondary or specialty care could undermine the potential for integrated care delivery, according to a new report from Accenture (NYSE: ACN). The eight-country study, which includes Australia, Canada, England, France, Germany, Singapore, Spain and the United States, also showed England had the largest gap among the eight countries between IT maturity in primary and secondary care.

“Although the use of healthcare IT functionality is widespread across England and it’s encouraging that physicians in primary care settings are leading the way in healthcare IT adoption, there is a notable disparity between care settings.” said Jim Burke, who leads Accenture’s healthcare business in the U.K. and Ireland. “Clearly more needs to be done in secondary care in order to develop greater connectivity across the English healthcare system.”

The Accenture study, Connected Health: The Drive to Integrated Healthcare Delivery, analyzed how countries and health systems are applying systematic approaches to healthcare IT. The findings are the result of more than 160 interviews with health leaders – including government officials, clinicians, health information specialists, academics and analysts, a survey of 3,700 physicians across the eight countries and extensive secondary research.

Connected Health Maturity Index

The study noted differences in IT use across a variety of care settings. In primary care, for example, Spain scored the highest overall for connected health “maturity.” In fact, according to the study, 58 percent of Spanish physicians are routine users of healthcare IT functions and 52 percent regularly participate in HIE. While healthcare IT maturity in primary care was higher in England (63 percent) and Australia (62 percent), primary care physicians’ use of HIE was significantly less advanced.

Within secondary or specialist care, healthcare IT and HIE are generally less advanced than among primary care physicians, with some exceptions, notably in Singapore. The study showed, however, that U.S. and German specialists were on equal footing with their primary care colleagues. The prevalence of HIE for secondary-care physicians was the lowest in Canada and Australia.

England Findings Compared to Other Countries
The study showed that England had the largest gap between IT maturity in primary care – where it was a leader – and secondary care, where it lagged behind the other countries studied, according to the England Country Snapshot from the Accenture study.

Among the key findings for England related to care setting disparity:

• More than 90 percent of primary care clinicians report entering patient notes during or after consultations, the most of any country surveyed, but this drops to just 16 percent for secondary care, the lowest for any country surveyed.
  
  
• Eighty-four percent of primary care clinicians claim they receive electronic alerts while seeing their patients, the most of any country surveyed, but this figure falls to just 7% in secondary care, the lowest of any country surveyed.
  
  
• In primary care settings, 47 percent of physicians in England claimed their organization uses electronic tools to ease the administrative burden, which is lower than all but one of the other countries surveyed for primary care. For hospital and specialist care clinicians, this figure drops to 25 percent, which is well below the 49 percent international average.
  
  
• Almost 30 percent of primary care physicians claim using clinical decision support to help make treatment decisions, which drops to just 13 percent in secondary care.
  
  

Other findings yield interesting geographic comparisons:

• Exactly 90 percent of primary care physicians receive clinical results electronically, which compares to 58 percent internationally.
  
  
• Forty-seven percent of secondary care physicians surveyed claimed they communicate electronically with clinicians in other organizations, which was the highest of all countries surveyed.
  
  
• Forty-one percent of primary care physicians surveyed are notified electronically of their patients’ interactions with other health organizations, which was the highest of all countries surveyed.
  
  
• A high proportion of English physicians reported that patients’ clinical data is shared across their organization to improve care protocols and clinical outcomes – 92 percent and 70 percent across primary and secondary care respectively.
  
  
• Thirty-three percent of English physicians indicate that their patients can electronically schedule or change appointments, which compares with an average of 21 percent across all countries surveyed.
  
  
• More than a third of physicians report that their patients can see health-related information during consultations and electronically request prescription refills.
  
  

“This study shows promising results among UK physicians, particularly in primary care settings, which is representative of the significant improvements in England’s healthcare IT and communications infrastructure. There are still barriers to full integration, particularly in secondary care.” said Burke. “However, the Department of Health has led the way in establishing online health architecture, which has begun to reshape the relationship between citizens and their health service providers. There is the potential to drive further progress in this area.”

Medical Data Shared by England Physicians
According to the Accenture study, England is rapidly adopting HIE systems for enabling primary and specialty physicians to share and exchange patient data:

• More than half of primary care doctors (51 percent) have access to clinical data about a patient seen by another organization; this figure drops to less than one-third in secondary care (31 percent)
  
  
• Nearly half of secondary care physicians (47 percent), the most of any country surveyed, are communicating electronically with clinicians in other organizations, which happens slightly less (32 percent) in primary care.
  
  
• Increasingly, English physicians also are sharing patient data outside their organization to improve disease management. In fact, 70 percent of primary doctors and 44 percent of specialists practice this on a regular basis, according to the study.
  
  
• Approximately two in five English primary physicians (41 percent), the most of any other country surveyed, are electronically notified of patient interactions with other health organizations (i.e. hospital admission), and drops to 9 percent in secondary care.
  
  

“Health Information exchange is progressing across some parts of the English health service,” said Burke. “But there is a risk it could be held back by the fragmentation between primary and secondary care settings. The study shows however that many physicians see exciting possibilities.”

Comparison of Country Dynamics
To assess the progress across the eight countries studied, Accenture mapped the innovations and efforts against six dynamics of successful connected health: vision and leadership, strategic change management, technology infrastructure, co-evolutionary approach, clinical change management and integration strategy.

According to the Accenture analysis, Spain led the other countries for the dynamics of its “robust technology infrastructure” and “co-evolution.” Singapore had the best performance for “vision and leadership” and England and Australia for “clinical change management.” Germany and the United States were among the leaders in “integration drives integration.”

England also was among the leaders for “co-evolution”, although fared less well for its “strategic change management” and in “integration drives integration”.

“A common misconception is that the one key to connected health success is having the right technology, when, in fact, there are many factors – the most important being change management and collaboration,” said Burke. “Ultimately, connected health is driven by a clear vision to improve quality, enhance access to care and achieve better control of costs, which is enabled by the right technology.”

Methodology
In 2011, Accenture studied the distinguishing characteristics of healthcare IT in eight countries: Australia, Canada, England, France, Germany, Singapore, Spain and the United States.

The research entailed a literature review and more than 160 interviews with healthcare experts and health system leaders in the eight countries, including government officials, clinicians and clinical organization leaders, healthcare IT executives, and academics and analysts. Accenture also conducted an online survey with 3,727 physicians in the eight countries (approximately 500 each in Australia, Canada, England, France, Germany, Spain and the United States, and approximately 200 in Singapore), which provided comparative data on physicians’ use of different functionalities of connected health. The survey also captured attitudinal data on the perceived benefits of healthcare IT with respect to several dimensions of quality, access and cost, and explored physicians’ views on the barriers and incentives to encourage adoption and use. Finally, Accenture conducted further in-depth secondary research and consulted with academic and subject matters experts to compile a list of health systems and organizations that are widely seen to be leading the way in connected health. From that, it developed 10 case studies of health systems that represent the benchmark for good practices.

Learn more about Accenture’s Insight Driven Health.

About Accenture
Accenture is a global management consulting, technology services and outsourcing company, with more than 246,000 people serving clients in more than 120 countries. Combining unparalleled experience, comprehensive capabilities across all industries and business functions, and extensive research on the world’s most successful companies, Accenture collaborates with clients to help them become high-performance businesses and governments. The company generated net revenues of US$25.5 billion for the fiscal year ended Aug. 31, 2011. Its home page is www.accenture.com.

Contact:

Mark Radvanyi
Accenture
Office: +44 207 844 5406
Cell: +44 7770 704 884
mark.radvanyi@accenture.com