General Practitioners in Scandinavia, Netherlands and UK Are Using IT More Than Other Doctors in European Countries and More Than Primary Care Physicians in the U.S.

Harris Poll - August 2002 - As American health care leaders try to find ways to increase the use of the Internet and electronic medical records -- which they believe would improve the quality of care and reduce medical errors -- they might take a look at what is happening in some, but by no means all, European countries. Specifically they should look at what is happening in medical practices in Finland, the Netherlands, Sweden, Denmark and the United Kingdom (UK), which are using information technology (IT) more than most other European countries.

Use of Computers and PDAs in Medical Practice

Ninety-five percent or more of all primary care physicians in Finland, the Netherlands, Sweden, Germany and the UK use computers in their practice. This is also true of two-thirds or more of the general practitioners in all the other fifteen countries of the European Union (EU), except for Greece (52%) and Portugal (37%). The average for all fifteen EU countries is 80%.

When it comes to use of PDAs, the Netherlands is clearly far ahead of other countries in Europe. The leaders, in terms of percentages of general practitioners who are using PDAs in their practice are:

   *  The Netherlands (31%);
   *  The United Kingdom (18%);
   *  Spain (17%);
   *  France (11%); and
   *  Germany (10%).

At the other end of the spectrum, virtually no general practitioners are using PDAs in Luxembourg or Italy. The EU average is 11%.

Going Online: The Use of the Internet or General Practitioner Networks

There are also huge variations among the percentages of general practitioners who (from their practices) are connected to the Internet or to general practitioner (GP) networks which allow them to communicate with other physicians and, potentially, to use electronic medical records. The countries with the highest proportions of general practitioners who are using the Internet in their practice or who are linked to general practitioner networks are:

   *  Finland (100%);
   *  The Netherlands (100%);
   *  Sweden (93%);
   *  The United Kingdom (87%);
   *  France (80%); and
   *  Austria (64%).

At the other end of the spectrum only 19% of general practitioners in Portugal and 27% in Greece are online in this way. The EU average is 61%.

Use of Electronic Medical Records

The countries where the largest proportions of general practitioners are using electronic medical records are:

   *  Sweden (90%);
   *  The Netherlands (88%);
   *  Denmark (62%);
   *  The United Kingdom (58%);
   *  Finland (56%); and
   *  Austria (55%).

Only five percent of general practitioners in Portugal, nine percent in Spain and seventeen percent in Greece are using electronic medical records. The EU average is 29%.

Use of Practice Websites

The countries with the largest proportions of general practitioners who have websites for their practices are:

   *  Finland (63%);
   *  The Netherlands (47%);
   *  Sweden (42%);
   *  The United Kingdom (27%); and
   *  Germany (26%).

  The average for all EU countries is 13%.  

Sources for this Information and Methodology

These numbers all come from the EuroBarometer 104 conducted in June - July 2001, published by the European Union. The actual percentages used here were recalculated by Harris Interactive on the base of all general practitioners. The survey was based on interviews with 3,504 general practitioners in the fifteen countries of the European Union with the sample sizes varying from 400 in France to 150 in Finland and 80 in Luxembourg.

The question asked about the use of the Internet did not distinguish between the Internet and a dedicated GP network (which could handle electronic medical records).

Comparisons with the USA

A Word of Caution

Some caution should be used when comparing these European data with Harris Interactive data for the United States, which used slightly different questions at slightly different times. The U.S. data was collected twelve to six months before the European data and may therefore understate American use of IT. Most of the American data is based on a survey of 377 primary care physicians surveyed in January or February 2001.

Another reason for caution is that U.S. "primary care physicians" include many specialists who provide primary care; they are not identical to the general practitioners surveyed in Europe.

For what they are worth, the comparisons indicate that American medical use of IT is somewhat higher for computers, PDAs and the Internet and somewhat lower for electronic medical records than the average for all fifteen EU countries. However, the European countries with the highest IT use -- Finland, the Netherlands, and Sweden -- have numbers which are substantially higher than the U.S.

When it comes to the use of electronic medical records -- which many people regard as a very important tool for reducing medical errors and improving quality -- the U.S. (at 17% usage) is far behind all but a handful of European countries. Indeed, six European countries show 55% or more of the general practitioners using them. The reason for these big differences are, we believe, clear. In a single payer system, that payer can (and often does) dictate what physicians must do. In the U.S. pluralistic "thousand points of payment" system, that is much tougher.

                                 TABLE 1
           GENERAL PRACTITIONERS' USE OF ELECTRONIC TECHNOLOGY


                             Use       Use       Use        Use    Practice
                           Computer    PDA     Internet  Electronic   Has
                              in        in      or GP     Medical      a
                           Practice  Practice  Network    Records   Website


  Finland                %    100         4       100        56        63
  Netherlands            %    100        31       100        88        47
  Sweden                 %     98         3        93        90        42
  Germany                %     95        10        53        48        26
  United Kingdom         %     95        18        87        58        27
  France                 %     89        11        80         6        11
  Austria                %     82         2        64        55        18
  Ireland                %     72         6        48        28         6
  Spain                  %     71        17        43         9         6
  Denmark                %     70         1        62        62        13
  Luxembourg             %     68         0        46        30        12
  Italy                  %     66         0        48        37         6
  Belgium                %     66         7        51        42         9
  Greece                 %     52         3        27        17         4
  Portugal               %     37         3        19         5         2
  European Union Average %     80        11        61        29        13
  U.S.A.                 %    94*       17*       79*      17**       39*

  * January/February 2001
  **June 2000

Sources: European Union EuroBarometer June, July 2001 (numbers repercentaged by Harris Interactive) and Harris Interactive Surveys for USA in June 2001 and January/February 2001.

About Harris Interactive

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