A user needs assessment to inform health information exchange design and implementation

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This is a review of Lammers’ article "A user needs assessment to inform health information exchange design and implementation. ".[1]


Health Information Exchanges (HIE) possess many barriers to its adoption. These include its usability and interface issues. More importantly, they are implemented without performing an assessment of what end users, clinicians need. The purpose of this article is to review the performed user needs assessment for clinicians on the process of obtaining clinical information from other healthcare organizations and to identify information most relevant on a patient care standpoint. [1]


Both quantitative and qualitative analysis were used in performing an evaluation. The process to obtain and use outside clinical information was evaluated through semi-structured interviews of 16 internists, 750 hours of direct observation, and utilizing operational data from 30,461 hospital encounters in the EMR system. The internal medicine department of a public teaching hospital in Tampa, Florida was used for this assessment. [1]


From their findings, 13.7% of hospitalizations created at least one request for outside clinical information. Physicians estimated that it would take about 18 hours to receive that outside information. They also perceived that outside information was not useful 33-66% of the time since the information tends not to be relevant or timely. Barriers to outside information included poor accessibility. Big drivers for this information were the interest in trending lab and imaging abnormalities to help understand medical history of critically ill or hospital transfer patients. Overall, around 85% of the physicians believed HIE would have a positive effect on improving healthcare delivery. [1]


Despite the challenges in obtaining outside clinical information, many clinicians working in the hospital recognize the value of specific outside clinical information in enhancing patient care. HIE systems would likely be utilized if specific patient clinical information can be retrieved in a timely fashion to the correct users. [1]


Benefits of HIE are being widely explored. This article is of great interest since it continues to explore these benefits. Retrieving clinical information from outside sources can be a big barrier in delivering continuity of care. This can result in repeated tests, missed conditions and allergies. Therefore, this study shows the importance of providing a user assessment on the needs of end users, especially that of physicians. It may differ from department to department and organizations which is why it is needed. In the end, it appears timely delivery of relevant information can help the cause of HIEs.


  1. 1.0 1.1 1.2 1.3 1.4 Strauss, A., Martinez, D., Garcia-Arce, A., Taylor, S., Mateja, C., Fabri, P., & Zayas-Castro, J. (2015). A user needs assessment to inform health information exchange design and implementation. BMC Med Inform Decis Mak BMC Medical Informatics and Decision Making. Retrieved November 11, 2015, from http://www.biomedcentral.com/1472-6947/15/81