Mazurenko Olena, Gupte Gouri, Yeager Valerie A
Department of Health Services Administration, University of Alabama at Birmingham, AL, USA.
Adv Health Care Manag. 2012;12:121-40. doi: 10.1108/s1474-8231(2012)0000012010.
Health information technology (HIT) holds promise for improving the quality of health care and reducing health care system inefficiencies. Numerous studies have examined HIT availability, specifically electronic health records (EHRs), and utilization among physicians in individual countries. However, no one has examined EHR use among physicians who train in one country and move to practice in another country. In the United States, physicians who complete medical school outside the country but practice within the United States are commonly referred to as International Medical Graduates (IMGs). IMGs have a growing presence in the United States, yet little is known about the availability and use of HIT among these physicians. The purpose of this study is to explore the availability and use of HIT among IMGs practicing in United States.
DESIGN/METHODOLOGY/APPROACH: The Health Tracking Physician Survey (2008) was used to examine the relationship between availability and use of HIT and IMG status controlling for several physician and practice characteristics. Our analysis included responses from 4,720 physicians, 20.7% of whom were IMGs.
Using logistic regression, controlling for physician gender, specialty, years in practice, practice type, ownership status and geographical location, we found IMGs were significantly less likely to have a comprehensive EHR in their practices (OR = 0.84; p = 0.005). In addition, findings indicate that IMGs are more likely to have and use several so-called first generation HIT capabilities, such as reminders for clinicians about preventive services (OR = 1.31; p = 0.001) and other needed patient follow-up (OR = 1.26; p = 0.007).
ORIGINALITY/VALUE: This study draws attention to the need for further research regarding barriers to HIT adoption and use among IMGs.
健康信息技术（HIT）有望提高医疗保健质量并减少医疗保健系统的低效率。许多研究已经考察了HIT的可用性，特别是电子健康记录（EHRs），以及个别国家医生对其的使用情况。然而，没有人研究过在一个国家接受培训然后到另一个国家执业的医生对电子健康记录的使用情况。在美国，在国外完成医学院学业但在美国境内执业的医生通常被称为国际医学毕业生（IMGs）。IMGs在美国的数量日益增加，但对于这些医生中HIT的可用性和使用情况却知之甚少。本研究的目的是探讨在美国执业的IMGs中HIT的可用性和使用情况。
设计/方法/途径：采用《健康跟踪医生调查（2008）》来考察HIT的可用性和使用情况与IMG身份之间的关系，并对若干医生和执业特征进行控制。我们的分析纳入了4720名医生的回复，其中20.7%为IMGs。
通过逻辑回归分析，在控制医生性别、专业、执业年限、执业类型、所有权状况和地理位置后，我们发现IMGs在其执业中拥有全面电子健康记录的可能性显著更低（比值比=0.84；p=0.005）。此外，研究结果表明，IMGs更有可能拥有并使用几种所谓的第一代HIT功能，例如为临床医生提供预防服务提醒（比值比=1.31；p=0.001）以及其他所需的患者随访提醒（比值比=1.26；p=0.007）。
原创性/价值：本研究提请注意有必要进一步研究IMGs采用和使用HIT的障碍。
