Countries with varied health systems see similar health technology issues

Julia Adler-Milstein

Despite different health care systems and diverse approaches to investing in health information and communications technologies (ICTs), countries around the world face similar challenges in implementing and utilizing technology to improve care for chronically ill patients, according to a study by School of Information and School of Public Health Assistant Professor Julia Adler-Milstein.

Adler-Milstein worked with Ashish Jha, Nandini Sarma and Liana Woskie from the Harvard School of Public Health on the study, which will appear in the September issue of Health Affairs. The team of researchers examined ICT strategies in Australia, Canada, Denmark and the United States to identify common challenges and opportunities for cross-national learning. 

These countries were chosen because they vary in their health ICT policies and are at different stages of maturity in implementing them. Therefore, they represent a broad cross-section of both successes and challenges in ICT use for chronic care.

Although all four countries have a national strategy for ICT adoption, their plans are implemented and adapted on a regional basis, which can lead to inconsistencies and difficulties in spreading successful efforts across regions. Each country also struggled with how to ensure that clinical information follows patients seamlessly between care settings. 

The four nations are each pursuing telehealth initiatives, which include applications such as remote home monitoring of patients, tele-ICUs, and tele-radiology. The study found that these efforts usually stand alone and are not well-integrated into other ICT solutions, such as electronic health records, which has resulted in information fragmentation and missed opportunities for broader use.

Health ICT policies in each country were also found to be making progress in improving patient access to clinical data, but have not fully succeeded in engaging patients to apply the data to improve care. 

Overall, the strategies and challenges faced by each country reflect many similarities that are likely shared by other nations, despite varying lengths of time for ICT implementation and different health care systems. 

The study suggests that collaborative efforts to pursue transparent cataloguing and benchmarking of national health ICT strategies, as well as partnerships and existing forums that bring together international health ICT leaders, represent substantial opportunities for cross-national learning about effective ways to improve chronic care. 

The paper is titled, “A Comparison Of How Four Countries Use Health IT To Support Care For People With Chronic Conditions.” Health Affairs is a peer-reviewed monthly journal focusing on health policy thought and research.

Posted September 8, 2014