Journal of Medical Systems

, Volume 36, Issue 5, pp 3195–3204 | Cite as

How are Health Professionals Using Health Information Exchange Systems? Measuring Usage for Evaluation and System Improvement

  • Joshua R. VestEmail author
  • ‘Jon (Sean) Jasperson


Health information exchange (HIE) is an avenue to improving patient care and an important priority under the Meaningful Use requirements. However, we know very little about the usage of HIE systems. Understanding how healthcare professionals actually utilize HIE systems will provide practical insights to system evaluation, help guide system improvement, and help organizations assess performance. We developed a novel way of describing professionals’ HIE usage from the log files of an operational HIE-facilitating organization. The system employed a webpage-style interface. The screen number, types, and variation served to cluster all sessions in to five categories of HIE usage: minimal usage, repetitive searching, clinical information, mixed information, and demographic information. This method reduced the 1,661 different patterns into five recognizable groups for analysis. Overall, most users engaged with the system in a minimal fashion. In terms of user characteristics, minimal usage was highest among physicians and the highest percentage of clinical information usage was among nurses. Usage also differed by organization with repetitive searching most common in settings with scheduled encounters and uncommon in the faster-paced emergency department. Lastly, usage also varied by timing of the patient encounter. Within a single HIE system, discernible types of users behavior existed and varied across jobs, organizations, and time. This approach relied on objective data and can be replicated. In addition, our approach demonstrates that substantial variation in user behaviors exists beyond the more simplistic measures of adoption/non-adoption or access/no-access applied in previous research. This approach can help leaders and evaluators assess their own and other organizations.


Health information technology Information seeking behavior Workplace Evaluation 



This work was supported by Award Number R21CA138605 from the National Cancer Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. We would like to thank Dan Brown and Anjum Khurshid at the Integrated Care Collaboration of Central Texas for their assistance with obtaining the data for this study.


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Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Jiann-Ping Hsu College of Public HealthGeorgia Southern UniversityStatesboroUSA
  2. 2.Mays Business School, Department of Information & Operations ManagementTexas A&M UniversityTexasUSA

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