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(1) Estimates using national data provide tentative evidence of a positive relationship between health information technology (HIT) and clinical quality. Electronic medical records (EMRs) are associated with a statistically significant aversion of two post-operative infections per year at the average U.S. acute care hospital. (2) The study found no significant relationships for two other types of HIT - nurse charting and picture archiving communication systems (PACS) - or for two other measures of patient safety - post-operative hemorrhages/hematomas and post-operative pulmonary embolism/deep vein thrombosis (DVT) - which could reflect either the true value of the HIT or limitations of the study.

Reflections on Implementing Medicare, originally printed in the spring of 1993, provides a historical reflection on the early days of a program enacted in 1965 to provide health care coverage to 19 million elderly Americans. This second edition was released by the study panel on Medicare Management and Governance as part of the Academy's Restructuring Medicare for the Long Term Project. The report provides useful insights into the intentions of Medicare's founders and an historical benchmark against which to gauge the program's evolution over the last three-and-a-half decades.

Growth in the industrial support of university research in the life sciences and more specifically in biotechnology has raised questions concerning its effects, both positive and negative, on the educational experiences of graduate students and post-doctoral fellows. A survey of 693 graduate students and post-doctoral fellows at six research intensive universities in the United States reveals that 19 percent of the responding students and fellows receive direct industry support for their research or training and that another 15 percent work with faculty advisors supported by industrial funds. On average students and fellows in this sample believe that the benefits of relationships with private firms outweigh the risks. In addition, students funded by private firms are more likely than those without industry connections to report patents resulting from their research. No relationship is found between industry support and young scientists' career plans or their rating of the quality of their educational experiences. However, the data suggest the existence of some risks: industry support is associated with fewer or delayed publications, inhibition of scientific communication on the part of some trainees, and some restrictions on students' and fellows' research. In a few cases, students are supported by funds from companies in which faculty advisors hold equity, a situation that creates potential conflicts of interest for students' mentors. To protect students, university administrators must monitor the relationships with industry that give rise to these potential problems. Future research into industrial support of research and training is needed to extend these results.

A 1984 study of biotechnology companies reveals that nearly one-half of all such firms fund research in universities. Industry may support as much as one-quarter of all biotechnology research in institutions of higher education. These investments seem to be yielding substantial benefits to involved firms. Per dollar invested, university research is generating more patent applications than is other company research. Research relationships do pose some risks to traditional university values such as openness of communication among scholars. These risks may be greater in relationships involving small firms. The data also reveal that government is now, and seems likely to remain, the principal source of support for university research in biotechnology.

The growth of university-industry research relationships in biotechnology has raised questions concerning their effects, both positive and negative, on universities. A survey of over 1200 faculty members at 40 major universities in the United States reveals that biotechnology researchers with industrial support publish at higher rates, patent more frequently, participate in more administrative and professional activities and earn more than colleagues without such support. At the same time, faculty with industry funds are much more likely than other biotechnology faculty to report that their research has resulted in trade secrets and that commercial considerations have influenced their choice of research projects. Although the data do not establish a causal connection between industrial support and these faculty behaviors, our findings strongly suggest that university-industry research relationships have both benefits and risks for academic institutions. The challenge for universities is to find ways to manage these relationships that will preserve the benefits while minimizing the risks.An analysis is provided of a survey of over 1,200 faculty members at 40 major U.S. universities concerning their research activities and funding by industrial sources. The survey findings suggest that university-industry biotechnology research relationships have both benefits and risks for the university. Faculty members receiving industry support tend to be more productive. They publish, patent, and earn more. They participate in more administrative and professional activities, while teaching as much as other faculty members. However, their research also leads to more unpublished trade secrets, and commercial considerations may influence their choice of projects. The authors recommend public as well as commercial funding of research, protection of the right to publish research results, and university-industry agreements that do not unduly restrict faculty behavior.

This research was supported by the Andrew Mellon Foundation and the Department of Health and Human Services, grant DHHS-100A-83. We thank our colleagues, Thomas A. Louis, Jack Fowler, Stanley E. Seashore, Ronald G. Corwin, James Hearn, and David Wise for their helpful comments on earlier drafts, as well as three anonymous ASQ reviewers. The remaining flaws are, of course, our own. This paper explores entrepreneurship in the research university, a setting in which there has been a marked change over the past half century in norms governing relationships between scholars and the commercial sector. A survey of life science faculty members in research universities is used to distinguish five types of academic entrepreneurship: (1) engaging in large-scale science (externally funded research), (2) earning supplemental income, (3) gaining industry support for university research, (4) obtaining patents or generating trade secrets, and (5) commercialization-forming or holding equity in private companies based on a faculty member's own research. The results suggest models for the different types of entrepreneurship. Individual characteristics and attitudes are the most important predictors of large-scale science and supplemental income, which are more traditional, while local group norms play a more important role in predicting active involvement in commercialization. University policies and structures have little effect on entrepreneurship. Implications for organizational theory and the role of the university are discussed.'