PMID- 19202496
OWN - NLM
STAT- MEDLINE
DCOM- 20090227
LR  - 20151119
IS  - 1938-808X (Electronic)
IS  - 1040-2446 (Linking)
VI  - 83
IP  - 12
DP  - 2008 Dec
TI  - Performing without a net: transitioning away from a health information 
      technology-rich training environment.
PG  - 1179-86
LID - 10.1097/ACM.0b013e31818c6d57 [doi]
AB  - PURPOSE: In many academic medical centers (AMCs), health information technology 
      (HIT) has become a foundational component of patient care. Medical training in 
      these environments generates dependence on HIT. The authors conducted this study 
      to determine how transitioning from an HIT-rich environment affects 
      practitioners' self-perceptions of competence, practice efficiency, and patient 
      safety. METHOD: In 2004 and 2005, the authors performed a cross-sectional survey 
      study involving medical students and residents who had graduated from Vanderbilt 
      University Medical Center (VUMC), an HIT-rich AMC. The authors distributed 
      surveys to 679 graduates from 2001 to 2003 who transferred to other institutions. 
      RESULTS: Although 128 surveys were returned undelivered because of wrong 
      addresses, 328 (60%) were returned complete and analyzed. Among respondents, 255 
      (78%) reported transitioning to environments with less HIT than VUMC. The authors 
      compared responses from this group with those of peers who transitioned to 
      environments with the same or greater HIT penetration. After controlling for 
      confounding effects, the authors found that graduates who transitioned to 
      lower-HIT institutions reported feeling less able to practice safe patient care 
      (P = .02), to utilize evidence at the point of care (P = .05), to work 
      efficiently (P < .001), to share and communicate information (P = .03), and to 
      work effectively within the local system (P = .007). CONCLUSIONS: Providers who 
      transition away from HIT-rich environments may perceive their care as less safe 
      and less efficient. These results support greater adoption of HIT and underscore 
      the need for formal education for new trainees, faculty, and staff transitioning 
      to a new system of care.
FAU - Johnson, Kevin
AU  - Johnson K
AD  - Vanderbilt University, Nashville, Tennessee, USA. kevin.johnson@vanderbilt.edu
FAU - Chark, Davin
AU  - Chark D
FAU - Chen, Qingxia
AU  - Chen Q
FAU - Broussard, Alexis
AU  - Broussard A
FAU - Rosenbloom, S Trent
AU  - Rosenbloom ST
LA  - eng
GR  - 5K22 LM008576-02/LM/NLM NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PL  - United States
TA  - Acad Med
JT  - Academic medicine : journal of the Association of American Medical Colleges
JID - 8904605
SB  - IM
MH  - Academic Medical Centers/*organization & administration
MH  - Adult
MH  - Biomedical Technology/organization & administration
MH  - Cross-Sectional Studies
MH  - Education, Medical/*statistics & numerical data
MH  - Female
MH  - Humans
MH  - Internship and Residency/statistics & numerical data
MH  - Male
MH  - *Medical Informatics/trends
MH  - Physicians/*statistics & numerical data
MH  - Quality of Health Care/*standards
MH  - Schools, Medical/*organization & administration
MH  - Students, Medical/*statistics & numerical data
MH  - Surveys and Questionnaires
MH  - Tennessee
EDAT- 2009/02/10 09:00
MHDA- 2009/02/28 09:00
CRDT- 2009/02/10 09:00
PHST- 2009/02/10 09:00 [entrez]
PHST- 2009/02/10 09:00 [pubmed]
PHST- 2009/02/28 09:00 [medline]
AID - 00001888-200812000-00032 [pii]
AID - 10.1097/ACM.0b013e31818c6d57 [doi]
PST - ppublish
SO  - Acad Med. 2008 Dec;83(12):1179-86. doi: 10.1097/ACM.0b013e31818c6d57.