Health Information Technology Policy in Germany, Austria, and Switzerland: Lessons for US Policy Development

While U.S. policy makers continue to struggle with determining the role of government in health information technology policy, many European countries have proceeded to develop policy and now are far enough along in the implementation process than evaluation can be meaningful. Three European countries which share a common language, but which have distinct health care delivery systems, have taken three distinct pathways in the role of government in health information technology policy. Germany's healthcare delivery system resembles the U.S. Medicare program, while Austria's system is more like a state Medicaid program, and Switzerland's system is similar to private sector employer-based health insurance paying for care in private facilities. Lessons from the implementation of health information technology policy in theses three countries can be applied to U.S. policy decisions in three distinct sectors of the health care economy. This strategy may allow policy makers with diverse viewpoints to work together in formulating U.S. policy, allowing more progress in the adoption of electronic health records. Our policy analysis address the following questions: How have the governments of Germany, Austria, and Switzerland approached the interoperability, accessibility, financing, and regulation of electronic health records? How are the health care delivery systems of Germany, Austria, and Switzerland structured and regulated? How do these systems resemble and differ from difference sectors of the U.S. health care system? What barriers to adoption of electronic medical records have appeared in these three countries? What strategies have been used to overcome these barriers, if any? Which strategies have succeeded and which have failed? Why? How have interoperability challenges been met? What assessment of outcomes related to quality, cost, and privacy have been assessed? What results were found in these assessments? What changes have been made/are planned as a result of evaluation and assessment?