Insight Driven Health

Insight Driven Health Eight-Country Survey of Doctors Shows Agreement on Top Healthcare Information Technology Benefits, But a Generational Divide Exists Research finds that routine users of healthcare IT are more positive about its benefits While the majority of doctors are convinced that Connected Health brings benefits, a surprising amount of doctors are skeptical of the associated healthcare IT benefits. Research among more than 3,700 doctors in eight countries reveals ripe opportunities to accelerate a broad national Connected Health initiative, according to a new survey from Accenture. The survey illuminates prevailing perceptions (based on demographics and geography) among doctors today over the future of Connected Health. While the survey illustrates similarities and differences in perceptions of healthcare IT, the findings clearly show that the broadest, fastest path to integrated, effective health practices requires outreach, education and changing mindsets among some doctors, especially those over 50 who are not actively using healthcare IT. Connected Health is an approach to healthcare delivery that leverages the systematic application of healthcare IT to facilitate the accessing and sharing of information, as well as subsequent analysis of health data across healthcare systems. It is using knowledge and technology in new ways for more effective, efficient and affordable healthcare. The future of healthcare entails systems and infrastructures that enable information management, analysis and sharing it is the engine of what Accenture calls Insight Driven Health. Many doctors, however, remain unconvinced that healthcare technologies, such as electronic medical records (EMR) and health information exchanges (HIE), will improve patient outcomes, improve access to services or reduce unneeded procedures. Interestingly, these are the benefits most often touted for widespread adoption of EMR and HIE and, therefore, this disconnect creates barriers to fully realizing the benefits of a truly Connected Health ecosystem. Accenture conducted this survey in Australia, Canada, England, France, Germany, Singapore, Spain and the United States from August to September 2011. Accenture surveyed approximately 500 doctors per country (200 in Singapore) on their attitudes towards and perceived benefits of healthcare IT. This survey is one part of a comprehensive Connected Health study that will be published in early 2012. The study incorporates results from this doctor survey as well as input from interviews with more than 150 industry experts, and 10 case studies of successful Connected Health implementations. It was surprising that a high percentage of doctors either did not know of or did not associate a positive impact on the use of EMR and HIE with some of the main selling points of a Connected Health system. Among the key findings: Almost half of doctors surveyed, 44 percent, are not convinced that healthcare IT will help reduce the number of unnecessary interventions and procedures. Forty-three percent of doctors are not convinced that healthcare IT systems will result in increased speed of access to health services. Almost 40 percent are not convinced that the use of healthcare IT will bring improved outcomes for patients. The Accenture physician survey was designed to ask the question: Are we making progress in Connected Health? And we now know that the answer is yes. Doctors are beginning to see the benefits of using healthcare IT solutions to improve integration of care delivery, said Rick Ratliff, global lead, Accenture Connected Health Services. The challenge is to encourage behavioral change across the healthcare system through education and ongoing communication, helping physicians to embrace greater use of healthcare IT to demonstrate the value of Connected Health.

Survey Question: To what extent is the use of electronic medical records and health information exchange enabling the following benefits? Figure 1: Total Survey Average - Top 10 EMR and HIE benefits Despite overall sentiments that healthcare IT brings about benefits, there is still need for a clearer business case for doctors who perceive a negative or no impact, or simply don t know. The top ten impacts: positive, negative, no impact and don t know Better access to quality data for clinical research Improved coordination across care settings/service boundaries Improved cross-organizational working process Positive Negative No Impact Don t Know Reduction in medical errors Improved quality treatment decisions Improved diagnostic decisions Improved health outcomes for patients Increased speed of access to health services for patients Reduced numbers of unnecessary interventions/procedures Reduced risk of litigation 0% 10% 20% 30% 40% 50% 60% 70% 80% High-level benefits of Connected Health include: Better access to quality data for clinical research Improved coordination of care across care settings and service boundaries Improved health outcomes for patients 1

Survey Question: To what extent is the use of electronic medical records and health information exchange enabling the following benefits? Figure 2. Highest-Ranking Benefits By Country Doctors have similar perceptions about the top benefits of healthcare IT. Singapore and Spain perceive an overall more positive impact versus their counterparts in US, Canada and Australia who are more skeptical. Impact by country (net benefit) Australia Canada England France Germany Singapore Spain USA Better access to quality data for clinical research 67.3% 61.0% 71.4% 72.3% 68.1% 69.1% 81.8% 57.5% Reduction in medical errors 63.9% 60.0% 64.9% 59.8% 59.7% 60.3% 71.7% 55.2% Improved coordination of care across care settings/service boundaries Improved cross-organizational working processes Improved quality of treatment decisions Improved health outcomes for patients 59.9% 58.2% 67.1% 68.7% 72.6% 62.3% 82.2% 57.9% 53.5% 58.2% 62.9% 69.3% 78.2% 58.8% 82.0% 56.6% 57.1% 54.6% 64.7% 62.2% 64.7% 66.7% 73.9% 46.7% 60.5% 56.2% 61.6% 58.0% 55.4% 65.2% 67.3% 44.6% Improved diagnostic decisions 55.5% 53.4% 62.7% 62.9% 67.1% 67.6% 71.7% 45.1% Reduced numbers of unnecessary interventions / procedures Increased speed of access to health services for patients 44.3% 47.8% 52.0% 58.6% 57.3% 68.6% 62.7% 40.3% 47.5% 39.0% 55.3% 41.6% 66.7% 65.2% 64.9% 41.0% Reduced risk of litigation 49.1% 37.0% 44.1% 40.0% 32.5% 55.9% 53.3% 31.7% Average score 55.8% 52.5% 60.7% 59.3% 62.2% 64.0% 71.1% 47.7% Most frequently ranked benefit Second most frequently ranked benefit Third most frequently ranked benefit Country comparison There was strong similarity, however, in how doctors across all eight countries perceive the top benefits of healthcare IT, including: Better access to quality data for clinical research (70.9 percent) Better coordination of care across care settings and service boundaries (69.1 percent) Improved cross-organizational working processes (67.9 percent) Reduced medical errors (66 percent) While some doctors do not yet see all the benefits such as reducing unneeded procedures (43.6 percent reported either a negative impact, no impact or didn t know), improving access to services (43 percent) or improving patient outcomes (39.2 percent) those physicians who are routine users of healthcare IT rated the benefits more positively than their counterparts who are less actively involved with these technologies. The age divide There was a statistically significant contrast in attitudes among doctors over and under 50 years of age. The Accenture survey found that doctors under 50 are more likely to believe that healthcare IT has a positive impact across a wide range of perceived benefits, including improved health outcomes for patients, increased speed of access to health services and reductions in medical errors. More than 72 percent of doctors under 50 think EMR and HIE will improve care coordination across settings and service boundaries. And, 73 percent believe these technologies will offer better access to quality data for clinical research. These numbers vary, however, for doctors over 50 only 65 percent and 68 percent respectively perceive the same benefits. The age disparity may have to do with the reluctance that older doctors have with using information technology during patient interactions. Many younger doctors may be accustomed to typing while talking to a patient, whereas older doctors may prefer a conversation with a patient that does not introduce the unnatural element of technology. Frequent users are more likely to be believers in healthcare IT The Accenture survey asked physicians about the extent to which they used 12 different functions of EMR and HIE such as electronic entry of patient notes, electronic referrals to or from other physicians, electronic ordering, electronic prescribing and communicating with other physicians or patients via secure email. The results showed that physicians who are routine users of a wider range of healthcare IT functions have a more positive attitude toward the benefits these technologies bring. The survey shows that, on average across all the countries, as physicians start to use more functions the more positive they are about the benefits. 2 3

Bridging the disconnect Despite all eight countries being at a relatively early stage of the Connected Health journey, there is evidence that doctors truly desire change. These findings clearly signal ways that governments and healthcare organizations can speed progress toward Connected Health. There is work ahead to fully convince physicians that healthcare IT will ensure better patient care, lower healthcare costs and make them more effective and efficient. Building organizational development and change management capabilities are crucial steps for success to help convince the majority of doctors of the value of healthcare IT, and thus drive its progress. Strategic change management is among the six dynamics that must be fully executed for a country to realize the full benefits of Connected Health. The soonto-be-released study will explore all six of these dynamics in detail. Clinician involvement especially among doctors is also a central theme of those organizations and systems that are succeeding in the development of Connected Health. This is more than simple communication. It requires doctors active involvement in planning change and guiding its implementation with their peers and colleagues. Change must be manageable. Where topdown, whole-system re-engineering has been attempted at a national level, there have been as many failures as successes. When policymakers and health leaders have identified achievable targets and tangible, medium-term outcomes, rapid progress is possible. Accenture will release its comprehensive, eight-country Accenture Connected Health Study in 2012, including international research drawing on case studies, interviews with global health leaders and more details of this quantitative survey of doctors. Number of Number functions of functions used routinely used routinely vs. vs. average benefits - Global We talk a lot about technology, but most of the challenges relate to changing attitudes, processes, recognition, clinical leadership and governance. That is a harder road to move down, but it is the critical one for success. survey respondent in Australia Connecting the US Health System With the introduction of stimulus funding and Meaningful Use criteria, the US federal government is building momentum for healthcare IT adoption and health information exchange, but more needs to be done to make the case to physicians. While the survey shows that there is some convergence in physicians perceptions of the benefits of healthcare IT across countries (for example, in reducing medical errors and improving coordination of care across care settings and service boundaries), in most cases, US physicians are more skeptical about the benefits of healthcare IT than their international counterparts. The Accenture survey revealed an average response of 48 percent in terms of the net benefit of healthcare IT, compared to the global average of 59 percent across all eight countries. When considering the net benefit scores, the survey revealed some statistically significant gaps, particularly in relation to aspects of care management: 100% 90% 80% 2% 33% 1% 22% 1% 12% The US had the lowest percentage of doctors (45 percent) who think healthcare IT use will improve diagnostic decisions, compared to their international colleagues (61 percent). 70% 60% 50% 40% 30% 45% 57% 49% Impacts very negatively Impacts somewhat negatively No impact Impacts somewhat positively Impacts very positively Only 47 percent of US doctors reported that technology has helped improve quality of treatment decisions compared to a survey average of 61 percent. Just 45 percent report that healthcare IT leads to improved health outcomes for patients, against a survey average of 59 percent. 20% 38% 10% 19% 20% 0% 0-4 functions used 5-8 functions used 9-12 functions used 4 5

About the Physician Survey Methodology Accenture conducted an online survey of 3,727 physicians across eight countries, including Australia, Canada, England, France, Germany, Singapore, Spain and the United States. Approximately 500 physicians per country (200 for Singapore) participated in the survey between August and September 2011. The survey assessed doctors attitudes and perceptions on the benefits of health information and communications technology. The analysis provided comparisons by country, sector, age and use. Accenture: Insight Driven Health Insight Driven Health is the foundation of more effective, efficient and affordable healthcare. That s why the world s leading healthcare providers and health plans choose Accenture for a wide range of insight driven health services that help them use knowledge in new ways--from the back office to the doctor s office. Our committed professionals combine realworld experience, business and clinical insights and innovative technologies to deliver the power of Insight Driven Health. For more information, visit: www.accenture.com/insightdrivenhealth. About Accenture Accenture is a global management consulting, technology services and outsourcing company, with more than 244,000 people serving clients in more than 120 countries. Combining unparalleled experience, comprehensive capabilities across all industries and business functions, and extensive research on the world s most successful companies, Accenture collaborates with clients to help them become high-performance businesses and governments. The company generated net revenues of US$25.5 billion for the fiscal year ended Aug. 31, 2011. Its home page is www.accenture.com. For more information, please contact: Rick Ratliff richard.ratliff@accenture.com +1 703 947 2525 Copyright 2011 Accenture All rights reserved. Accenture, its Signature, and High Performance Delivered are trademarks of Accenture.