Transcript Exhibits -- Sharing Resources: Opportunities for Smaller Primary

Exhibit 1. Smaller Practices Lag Behind Large Practices
in Health Information Technology
Percent of practices
Solo practices
Small and medium practices (2–9 physicians)
Large practices (10 or more physicians)
100
75
75
50
49
50
27
25
21
7
0
Use electronic medical records in practice
High electronic information functionality*
* To assess HIT multifunctionality, a 14-count scale was developed. The multifunctional HIT capacity summary variable,
counting the number of functions and categorized systems, includes low (0–3), middle (4–8), and high (9–14).
Source: The Commonwealth Fund International Health Policy Survey of Primary Care Physicians, 2009.
Exhibit 2. Practices That Share Resources Have Higher Use of
Electronic Medical Records and Health Information Technology
Small and medium practices (2–9 physicians), no share
Small and medium practices (2–9 physicians), share
Large practices (10 or more physicians)
Percent of practices
100
75
75
58
50
50
44
39
25
20
0
Use electronic medical records in practice
High electronic information functionality*
* To assess HIT multifunctionality, a 14-count scale was developed. The multifunctional HIT capacity summary variable,
counting the number of functions and categorized systems, includes low (0–3), middle (4–8), and high (9–14).
Source: The Commonwealth Fund International Health Policy Survey of Primary Care Physicians, 2009.
Exhibit 3. Smaller Practices Lag Behind Large Practices
in Office System Support
Percent of practices*
Solo practices
Small and medium practices (2–9 physicians)
Large practices (10 or more physicians)
75
52
50
43
37
35
28
25
21
19
13
9
11
17
8
0
All laboratory tests
ordered are tracked
until results reach
clinicians
Doctor receives
Doctor receives alert Patients sent reminder
reminder for guideline- or prompt to provide notices when it is time
based intervention
patients with test
for regular preventive
and/or screening tests
results
or follow-up care
* Percent of practices who routinely performed tasks using a computerized system.
Source: The Commonwealth Fund International Health Policy Survey of Primary Care Physicians, 2009.
Exhibit 4. Practices That Share Resources More Often Have
Office System Support
Percent of practices*
75
Small and medium practices (2–9 physicians), no share
Small and medium practices (2–9 physicians), share
Large practices (10 or more physicians)
52
50
43
39
37
30
25
22
12
35
30
16
25
13
0
All laboratory tests
ordered are tracked
until results reach
clinicians
Doctor receives
Doctor receives alert Patients sent reminder
reminder for guideline- or prompt to provide notices when it is time
based intervention
patients with test
for regular preventive
and/or screening tests
results
or follow-up care
* Percent of practices who routinely performed tasks using a computerized system.
Source: The Commonwealth Fund International Health Policy Survey of Primary Care Physicians, 2009.
Exhibit 5. Practices That Share Resources Are More Likely to Provide
After-Hours Care and Support Patient Self-Management
Small and medium practices (2–9 physicians), no share
Small and medium practices (2–9 physicians), share
Large practices (10 or more physicians)
Percent of practices*
75
50
44
43
35
32
25
22
36
29
22
23
0
Practice has an after-hours
care arrangement
Practice routinely provides
Practice routinely gives
patients with a written list of the patients with chronic diseases
medications they are currently written instructions on how to
taking
manage their own care
* Percent of practices who routinely performed tasks using a computerized system.
Source: The Commonwealth Fund International Health Policy Survey of Primary Care Physicians, 2009.
Exhibit 6. Smaller Practices Lag Behind Large Practices in
Quality Monitoring and Clinical Benchmarking
Percent of practices
100
Solo practices
Small and medium practices (2–9 physicians)
Large practices (10 or more physicians)
75
73
75
55
50
46
43
34
66
60
42
36
27
20
25
0
Routinely receive and
review data on
patients’ clinical
outcomes
Routinely receive and
review data on
surveys of patient
satisfaction
Review areas of
physicians’ own
clinical performace
against targets
annually
Routinely receive
information on how
clinical performance of
practice compares to
others
Source: The Commonwealth Fund International Health Policy Survey of Primary Care Physicians, 2009.
Exhibit 7. Practices That Share Resources More Often Conduct
Quality Monitoring and Clinical Benchmarking
Percent of practices
Small and medium practices (2–9 physicians), no share
Small and medium practices (2–9 physicians), share
Large practices (10 or more physicians)
100
82
81
75
73
75
56
57
55
47
50
39
35
42
21
25
0
Routinely receive and
review data on
patients’ clinical
outcomes
Routinely receive and
review data on
surveys of patient
satisfaction
Review areas of
physicians’ own
clinical performace
against targets
annually
Routinely receive
information on how
clinical performance of
practice compares to
others
Source: The Commonwealth Fund International Health Policy Survey of Primary Care Physicians, 2009.