title: Health Information Technology Systems profoundly impact users: a case study in a dental school.
abstract: The purpose of this study was to increase our understanding of the impact of Health Information Technology Systems (HITS) on dental school users when the systems are integrated into chair-side patient care. We used qualitative research methods, including interviews, focus groups, and observations, to capture the experiences of HITS users at a single institution. Users included administrators, clinical faculty members, predoctoral students, support staff, and residents. The data were analyzed using a grounded theory approach, and nine themes emerged: 1) HITS benefits were disproportionate among users; 2) communicating about the HITS was challenging; 3) users experienced a range of strong emotions; 4) the instructor persona diminished; 5) there were shifts in the school's power structure; 6) allocation of end-users' time shifted; 7) the training and support needs of end-users were significant; 8) perceived lack of HITS usability made documentation cumbersome for clinicians; and 9) clinicians' workflow was disrupted. HITS integration into patient care impacts the work of all system users, especially end-users. The themes highlight areas of potential concern for implementers and users in integrating a HITS into patient care.
authors.affiliation: Department of Medical Informatics and Clinical Epidemiology, School of Medicine, Oregon Health & Science University, USA. hillhe@ohsu.edu
authors.forename: Heather K
authors.initials: HK
authors.lastname: Hill
authors.forename: Denice C L
authors.initials: DC
authors.lastname: Stewart
authors.forename: Joan S
authors.initials: JS
authors.lastname: Ash
mesh_terms: D001291:Attitude of Health Personnel; D003144:Communication Barriers; D003200:Computer User Training; D003740:Dental Clinics; D048048:Dental Informatics; D003792:Dental Records; D004497:Education, Dental / Q000379:methods*; D018961:Educational Technology; D057286:Electronic Health Records; D006801:Humans; D016490:Integrated Advanced Information Management Systems; D019982:Organizational Case Studies; D010377:Pediatric Dentistry / Q000193:education*; D036301:Qualitative Research; D012575:Schools, Dental; D057188:Workflow