Practicing health care without Health Information Technology (HIT) is unthinkable these days. But what if your used to working in an environment HIT-rich environment and have to switch to a less high HIT environment as can happen to many residents during their education or after their education. They are used to the academic medical centers were health information technology has become a foundational component of patient care. Medical training in these environments generates dependence on HIT.
These physicians who transition away from HIT-rich environments perceive their care as less safe and less efficient.
What is Health Information Technology?
Health Information Technology consists of tools that allow comprehensive, timely, and secure access to and management of medical information by both providers and consumers.
You can think of:
- Telemedicine systems (medical information is transferred via telephone, the Internet or other networks for the purpose of consulting, and sometimes remote medical procedures or examinations.
- Personal digital assistants.
- Wearable sensors.
- Inpatient and outpatient-focused electronic health records (EHRs).
- Bar code medication administration systems.
- Personal health records.
- Best practice guidelines and evidence databases
How was this study done?
a cross-sectional survey study involving medical students and residents who had graduated from Vanderbilt University Medical Center (VUMC), an HIT-rich Academic Medical Center. The authors distributed surveys to 679 graduates from 2001 to 2003 who transferred to other institutions.
60% of surveys were returned and analyzed. 78% of them reported a transition to a less rich HIT environment. In comparison with the group who transitioned to a higher or comparable environment of HIT they reported:
- feeling less able to practice safe patient care
- to be hampered to utilize evidence at the point of care
- to work less efficiently, it was taking more time to gather patient history information and to
retrieve pertinent documentation
- were less able to share and communicate information
- to work less effectively within the local system
- more issues with handwriting interpretation and felt less confident about drug interactions and prescribing safely
There are some down sides to rich HIT environments as well. There was a significant difference between the perception of communication with colleagues, with those in HIT-rich environments perceiving worse
Health Information Technology is very useful for prescribing drugs (warning for interactions, dosing), readable health records and information retrieval such as guidelines and evidence information for patient care as well as patient history. HIT acts as a safety net that help trainees deliver safe care with confidence.
This safety net provides a level of comfort for trainees acquiring the skills of their
profession while frequently battling anxiety and fatigue.
Maybe they should also train residents for environments that do not provide a technological safety net, they may help their graduates make smoother transitions.
Performing Without a Net: Transitioning Away From a Health Information Technology-Rich Training Environment.
Kevin Johnson, MD, MS, Davin Chark, MD, MSc, Qingxia Chen, PhD, Alexis Broussard,
and S. Trent Rosenbloom, MD, MPH
Acad Med. 2008; 83:1179–1186