International Medical Graduates and Health Information Technology Use in the United States

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Advances in Health Care Management



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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.


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).


This study draws attention to the need for further research regarding barriers to HIT adoption and use among IMGs.


Electronic Health Records/Utilization; Female; Foreign Medical Graduates; Health information technology; Humans; Information storage and retrieval systems – Medical care; Male; Medical Informatics/Statistics & Numerical Data; Medical records – Data processing; Physicians; United States


Health and Medical Administration | Health Information Technology | Health Services Administration




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