title: A comparison of how four countries use health IT to support care for people with chronic conditions.
abstract: Countries around the globe are investing in health information and communications technologies (ICTs) as critical tools for improving care for chronically ill patients. We profiled four high-income nations with varied health ICT strategies--Australia, Canada, Denmark, and the United States--to describe their use of ICTs to improve chronic care. Our goal was to identify common challenges and opportunities for cross-national learning. We found four key themes. First, although all four countries have a national strategy for health ICT adoption, strategies are implemented and adapted to chronic care needs regionally, which creates the challenge of spreading successful efforts across regions. Second, each country struggles with how to ensure that clinical information follows patients seamlessly between care settings. Third, although each nation is pursuing telehealth solutions as a component of chronic care, the telehealth initiatives are usually stand-alone efforts that are not well integrated into other ICT solutions, such as electronic health records. Finally, countries have made progress in improving patients' access to their clinical data but have not fully succeeded in engaging patients to apply the data to improve care. These common themes suggest that although the four nations have different health care systems and ICT strategies, all of them face a similar set of challenges, creating an opportunity for cross-national learning.
authors.affiliation: Julia Adler-Milstein (juliaam@umich.edu) is an assistant professor in the School of Information and the School of Public Health, University of Michigan, in Ann Arbor.
authors.forename: Julia
authors.initials: J
authors.lastname: Adler-Milstein
authors.affiliation: Nandini Sarma is a research assistant in the Department of Health Policy and Management at the Harvard School of Public Health, in Boston, Massachusetts.
authors.forename: Nandini
authors.initials: N
authors.lastname: Sarma
authors.affiliation: Liana R. Woskie is a program manager in the Department of Health Policy and Management at the Harvard School of Public Health.
authors.forename: Liana R
authors.initials: LR
authors.lastname: Woskie
authors.affiliation: Ashish K. Jha is a professor of health policy and management at the Harvard School of Public Health.
authors.forename: Ashish K
authors.initials: AK
authors.lastname: Jha
mesh_terms: D001315:Australia; D002170:Canada; D002908:Chronic Disease / Q000628:therapy*; D003695:Delivery of Health Care / Q000458:organization & administration; D003718:Denmark; D019468:Disease Management; D057286:Electronic Health Records; D006302:Health Services Research; D006801:Humans; D008490:Medical Informatics / Q000639:trends*; D017146:Models, Organizational; D014481:United States
keywords: Developed World < International/global health studies; Information Technology; Organization and Delivery of Care