转发博客文章：国际EHR实施情况

wholx

Orginal link:
http://geekdoctor.blogspot.com/2009/07/international-ehr-adoption.html



International EHR Adoption从 Life as a Healthcare CIO 作者：John Halamka
Iwas recently asked to compare EHR adoption in the US to othercountries. Based on my own experience and the comments I received fromcolleagues, there are three aspects to consider:

* Use of Ambulatory EHR
* Use of Inpatient EHR
* Interoperability

Ambulatory
Themost widely implemented are England, Denmark, Netherlands, and certainregions of Spain which are close to 100%. Sweden, Norway are at 80% andbehind and Germany/France are at 50%. The US is somewhere between 2 and20%, depending on how you classify a comprehensive EHR. Based on mydefinition - codified problem lists, e-prescribing, and decisionsupport, the US is below 10% adoption.

Inpatient
Teachinginstitutions are generally well equipped, although less sophisticatedon average than the US. Coverage in mid-low tier hospitals is high inEngland, Sweden, Norway, Denmark, and Finland, followed by Germany andSpain. In the US, CPOE adoption nationally is less than 25%

Interoperability
Denmarkhas the most signification implementation of production HIE with over90% of encounters shared electronically. Certain regions in Spain,English, and Sweden have significant HIE. Canada Health Infoways hasdone excellent work with standards harmonization and incentivizing dataexchange at the Province level. In the US, e-Prescribing is high issome states such as Massachusetts, Rhode Island and Nevada, but quitelow in others. Clinical Summary exchange is done in some regions(Indiana, New York, Massachusetts, Tennessee, Minnesota, Arizona,Virginia) but most regions are just beginning implementation.

I've visited several sites in Sweden over the past 5 years, and the most innovative County is Jönköping

Qulturumis the organization in Jönköping that organizes the most innovativeaspects of healthcare quality improvement including IT implementation.

As we think of lessons learned to guide US EHR installations, Scandinavia is definitely a region that has done IT right.

I welcome comments based on your own international experiences.