The Digital Doctor is “In”Accenture Eight-Country Survey ofDoctors Shows Significant Increasein Healthcare IT UsageAn Accenture survey among 3,700doctors in eight countries reveals thattoday’s doctors are going digital—nowmore than ever before. In fact, the recentAccenture Doctors Survey showed a spikein healthcare IT usage across all countriessurveyed (Australia, Canada, England,France, Germany, Singapore, Spain andthe United States).The Accenture survey compares findingsfrom last year’s survey to reveal prevailingperceptions among doctors today, andshow trends across areas of healthcare IT.Based on this year’s findings that showincreasing levels of adoption of EMR andHIE, the digital doctor is in—and is hereto stay.Going digital globallyGlobally, the number of physicianswho describe themselves as “routinely”accessing clinical data about patientsseen by different health organizationshas increased by 42 percent (rising from33 percent of doctors surveyed in 2011,to 47 percent in 2012).Accessing clinical data about patients isone of the simplest forms of informationexchange in healthcare, so this leap inactivity is promising as it illustrates thatdoctors are embracing the benefits ofsharing and receiving information via HIE.Another key indicator of the overall rise inhealthcare IT is the fact that 91 percent ofphysicians surveyed report that they areactive users of electronic medical recordseither in their own practice or hospital/clinic. More than half of the doctorssurveyed (60 percent) report using anEMR in their own medical practice. Thisindicates that more and more doctors aregoing paperless.While globally, there is virtually no changein the number of physicians reportingthey “routinely” receive clinical resultselectronically that populate patients’EMR, use varies by country. For example,Singapore showed the largest increasebetween 2011 and 2012 (40 percent), andthe US showed the second largest increase(24 percent).Terminology:Healthcare IT is an umbrella term for theexchange of health information in anelectronic environment, including healthinformation exchange, electronic medicalrecord and electronic health record.Health information exchange (HIE) is themobilization of healthcare informationelectronically across organizations within aregion, community or hospital system.An electronic medical record (EMR) isa computerized medical record created inan organization that delivers care, such as ahospital or doctor’s office, usually part of alocal standalone health information systemthat allows storage, retrieval and modificationof records.Electronic health record (EHR) is a systematiccollection of electronic health informationabout individual patients or populations indigital format and capable of being sharedacross different healthcare settings.
2 | Accenture Doctors SurveyFigure 1: Digital doctors across all eight countries are routinely accessing clinical data about patients seen bydifferent health organizations.Source: Accenture Doctors SurveyQuestion: How frequently do you use/perform the following functions/activities?[Function: I have electronic access to clinical data about a patient who has been seen by a different health organization (e.g., hospital, laboratory)]0 100%Use RoutinelyUse SometimesUse RarelyInterested in UsingNot Interested in UsingAustraliaCanadaEnglandFranceGermanyGlobalSingaporeSpainUnited States773101685342826223728242410246665767581717151410151513194244543439474969452012Routinely reaching for themouseToday’s doctors are turning more oftento their PCs for clinical data. Forexample, the global number of physicianselectronically entering patient notes“routinely” has overall increased by 14percent in the past year. The US showedthe largest increase in the number ofdoctors electronically entering patientnotes either during or after consultations,moving from 58 percent to 78 percent, ayear-on-year increase of 34 percent.Globally, the number of digital doctorswho “routinely” e-Prescribe (electronicallysend prescriptions to pharmacies)increased by 17 percent, changing from18 percent in 2011 to 21 percent in2012. Singapore (36 percent), the US (33percent) and Spain (32 percent) showedthe largest increases in e-Prescribing.England and Canada showed no significantchange.Certain countries also showed an increasein sending order requests to laboratories.Singapore had the highest increase at75 percent, with the US following at 21percent.The Singapore SurgeIt’s not surprising that Singapore showedone of the largest increases in accessingclinical data about patients seen bydifferent health organizations, movingfrom 32 percent in 2011 to 49 percentin 2012 (an overall jump of 53 percent),as they are in process of implementing anational electronic health record (NEHR)system. The NEHR enables a single patienthealth record for clinicians to access acrossthe healthcare continuum. As patients visitproviders—including primary care clinics,acute and community hospitals—healthcareprofessionals will be able to access a singlepatient record for medical information.
Accenture Doctors Survey | 3England54%36%45%21%64%29%46%24%64% 60%41% 54%44% 46%France Germany Singapore Spain67%57%27%18%68%36%26%16%74%57%21%17%77%59%32%18%41%38%31%27%52%57%35%26%72%65%37%29%73%47%38%36%52% 37% 48% 50% 35% 49% 64% 63%29% 34% 22% 39% 32% 49% 49% 69%16% 9% 49% 31% 32% 56% 59% 61%2011 2012 2011 2012 2011 2012 2011 2012 2011 2012 2011 2012 2011 2012 2011 2012Healthcare IT functionAustralia Canada United StatesElectronically enters patientnotes either during or afterconsultationsOrganization uses electronictools to reduce administrativeburden for deliveringhealthcareReceives electronicalerts/reminders while seeingpatientsUses computerized clinicaldecision support systems tohelp make diagnostic andtreatment decisions whileseeing patientsReceives clinical resultselectronically that populatepatients’ EMRHas electronic access toclinical data about a patientwho has been seen by adifferent health organizationElectronically sends orderrequests to labs56%57%40%17%64%50%44%15%36%50%17%15%44%50%19%18%58%61%34%21%78%55%45%24%62% 67% 36% 41% 50% 62%26% 42% 31% 44% 34% 45%22% 12% 18% 17% 47% 57%35% 33% 19% 26% 11% 10% 26% 21% 47% 55%16% 15% 16% 17% 27% 32%39% 31%12% 12%25% 29%5% 6%32% 24% 24% 17% 32% 29% 44% 30%11% 7% 7% 4% 36% 49% 25% 33%12% 15% 11% 11% 23% 19% 29% 32%10% 9% 14% 13% 39% 19% 15% 12%Electronically sends/receivesreferrals to/from healthprofessionals in otherorganizationsCommunicates electronicallywith clinicians in otherorganizationsElectronically e-PrescribesElectronically notified ofpatients’ interactions withother health organizationsCommunicates electronicallywith patients to supportremote consultation anddiagnosticsSource: Accenture Doctors Survey25% 13% 20% 16% 25% 23%5% 6% 8% 8% 49% 65%15% 20% 13% 12% 19% 19%6% 5% 6% 6% 13% 13%Figure 2. The global healthcare IT functionality landscapeHealthcare IT functions overall showed several increases among the eight countries surveyed.
4 | Accenture Doctors SurveySource: Accenture Doctors SurveyQuestion: How frequently do you use/perform the following functions/activities?Source: Accenture Doctors SurveyQuestion: How frequently do you use/perform the following functions/activities?Function 2011 % “routine” use 2012 % “routine” use1. Has electronic access to clinical data about a patient who has been seen bya different healthcare organization33% 47%2. Electronically e-Prescribes 18% 21%3. Received electronic alerts/reminders while seeing patients 31% 36%4. Electronically enters patient notes either during or after consultations 58% 66%5. Electronically notified of patients’ interactions with other healthcareorganizations18% 20%Function 2011 % “routine” use 2012 % “routine” use1. Electronically enters patient notes either during or after consultations 58% 66%2. Receives clinical results electronically that populate patient’s EMR 53% 54%3. (due to tie) Organization uses electronic tools to reduce administrativeburden for delivering healthcare54% 47%4. (due to tie) Has electronic access to clinical data about a patient who hasbeen seen by a different healthcare organization33% 47%5. Received electronic alerts/reminders while seeing patients 31% 36%Figure 3: On the rise: These functions represent the top five increases in routine use of healthcare ITThese routine uses of clinical data showed the greatest uptick between 2011 and 2012. Electronic access to clinical data about apatient who has been seen by a different healthcare organization was the biggest jump of the year.Figure 4: Part of the routine: Top five healthcare IT functions for today’s digital doctorDigital doctors are routinely using these functions more than any others.
Accenture Doctors Survey | 5Figure 5. Countries are showing increases in connected health maturity across both HIE and EMR.Source: Accenture Doctors SurveyConnected Health Maturity Index: Total Doctors, 2011-201210 20 30 40 50 60X AxisEMR adoption and use (% routine users)Y AxisHealthinformationexchange(%routineusers)102030405060SpainUSUSSingaporeSingaporeEnglandAustraliaAustraliaEnglandFranceFranceCanadaCanadaGermanyGermany2011 2012SpainHealthcare IT and healthinformation exchange (HIE) aretaking hold globallyIt is encouraging to see that the rise of thedigital doctor is happening in the eightcountries surveyed. These countries havematured in either their routine use ofHIE, adoption and use of healthcare IT—orboth—over the past year. Doctors in theUS and Singapore saw increases in bothadoption of healthcare IT and HIE from2011 to 2012, and doctors in Spain andthe US showed the highest adoption ofhealthcare IT and HIE for 2012.The Accenture Doctors Survey alsoexamined the differences in maturitybetween primary and secondary caredoctors. The findings showed an increasein healthcare IT and HIE adoption amongboth types of physicians, particularly inthe US, and also Singapore.• Primary care: Primary care physiciansin the US, Canada and Singapore sawincreases in adoption of healthcare ITand HIE from 2011 to 2012. In 2012,Spain and England continue to havehigh healthcare IT and HIE adoptionamong primary care physicians.• Secondary care: Among secondary carephysicians, adoption of healthcare ITand HIE increased in Singapore, Franceand the US from 2011 to 2012.
6 | Accenture Doctors SurveyFunction % of “routine” use1. Communicates electronically to support remote consultation and diagnostics 10%2. Electronically notified of patients’ interactions with other health organizations 20%3. Electronically e-Prescribes 21%4. (due to tie) Communicates electronically with clinicians in other organizations 22%5. (due to tie) Uses computerized clinical decision support systems to help make diagnostic andtreatment decisions while seeing patients22%Figure 6: Top five least-used functionsThese healthcare IT areas represent the lowest percentages of routine use in 2012.Do age and size of practice influence perceptions?Although not surprising, doctors under 50 years of age are more likely to feel that the quality of patient care throughout thehealthcare system has improved due to the use of EMR. Findings related to size of practice did not reveal any major differences.Source: Accenture Doctors SurveyQuestion: How frequently do you use/perform the following functions/activities?Under 5067%Age 50+52%By age: By type of practice:Single-specialty groupSolo practiceMulti-specialty group58%53%68%The digital disconnectIt is clear that doctors believe in thebenefits of healthcare IT, however, theAccenture survey reveals they aren’troutinely using technology to interactwith their patients or colleagues.Globally, the percentage of doctorssurveyed who routinely communicateelectronically with patients was essentiallyunchanged at 10 percent.Across all countries surveyed, therewas also a decrease in the percentageof doctors who routinely communicateelectronically with clinicians in otherorganizations. The global percentagedecreased from 30 percent in 2011 to 22percent in 2012.
Accenture Doctors Survey | 7Figure 7: Top 10 functions where doctors globally perceive a positive impactof EMR and HIESource: Accenture Doctors SurveyQuestion: To what extent is the use of electronic medical records and health information exchange (HIE) enabling the following benefits?3% 27% 70%2% 28% 69%5% 31% 64%5% 40% 55%4% 44% 52%21%3% 76%24% 74%2%24%2% 74%24% 74%2%5% 21% 74%Reduction in medical errorsImproved coordinationof care across caresettings/service boundariesImproved health outcomesIncreased speed ofaccess to health servicesReduced # of unnecessaryinterventions/proceduresImproved patient access tospecialist health care servicesBetter access to qualitydata for clinical researchImproved cross-organizationalworking processesImproved quality oftreatment decisionsImproved diagnostic decisionsImpacts positively No impact Impacts negativelyA good prognosis for EMR and HIEDoctors across all eight countries believeEMR and HIE enable benefits. The topfour areas where doctors surveyed seethe most positive impact are in reductionof medical errors (76 percent globally, up4 percent from last year), better accessto quality data for clinical research (74percent), improved cross-organizationalworking processes (74 percent) andimproved quality of treatment decisions(74 percent). The areas where physiciansfeel the use of EMR and HIE has had apositive impact are primarily consistentwith 2011. See the top 10 functions wheredoctors perceive a positive impact inFigure 7 below.The future of digital healthcareThe trend toward IT-enabled healthcare isexpected to continue, as doctors continueto go digital. And as the adoption andusage of EMR and HIE continues torise, there will be greater penetrationof electronic health records. Accordingto the Accenture survey, globally, eightout of ten physicians agree that they arecommitted to promoting electronic healthrecords in their clinical practices—becausethey believe in it. Nearly three-quarters(74 percent) of physicians surveyed agreethat electronic health records are integralto effective patient care today andglobally, eight out of ten physicians agreethat electronic health records will becomeintegral to effective patient care in thenext two years.Although the maturity levels of healthcareIT adoption vary across the eightcountries surveyed, there is one commondenominator: doctors today believe in thebenefits of healthcare IT, and thereforewill continue to make it part of theirpractice.