Article thumbnail

Organizational Challenges in Developing One of the Nationwide Health Information Network Trial Implementation Awardees

By Aram Dobalian, Maria L. Claver, Joshua M. Pevnick, Harris R. Stutman, Alan Tomines and Paul Fu


Health care in the United States is rarely delivered in a coordinated manner. Current methods to share patient information are inefficient and may lead to medical errors, higher readmission rates, and delays in the delivery of needed health services. This qualitative study describes lessons learned concerning the early implementation of one Nationwide Health Information Network (NHIN) site in Long Beach, CA during its first year of operation. The Long Beach Network for Health (LBNH) focused on an incremental effort to exchange health information. Despite a limited concentration on emergency department care, virtually all respondents noted concerns regarding the sustainability, or business case, for the exchange of health information. Nevertheless, respondents were encouraged by progress on technological challenges and user requirements during this first year. The early gains in this process may, in turn, have laid the groundwork for future efforts to expand beyond the emergency department

Topics: Original Paper
Publisher: Springer US
OAI identifier:
Provided by: PubMed Central

Suggested articles


  1. (2007). Contracts for Trial Implementations of the Nationwide Health Information Network.
  2. (1994). Designing medical informatics research and library–resource projects to increase what is learned.
  3. (2010). Dobalian A et al. Provider stakeholders’ perceived benefit from a nascent health information exchange: A qualitative analysis.
  4. EA. Creating sustainable local health information exchanges: Can barriers to stakeholder participation be overcome? Res.
  5. (2010). eHealth Initiative Launches 2010 Survey on Health Information Exchange.
  6. (2008). Electronic medical records in diabetes consultations: Participants’ gaze as an interactional resource. Qual Health Res 18:1247–63,
  7. (2007). Emergency physicians’ perceptions of health information exchange.
  8. (2004). Future directions in evaluation research: People, organizational, and social issues. Methods Inf Med 43:215–31,
  9. (2007). Health information technology and health information exchange in New York State: New initiatives in implementation and evaluation.
  10. (2003). Integrating quantitative and qualitative methods in patient care information system evaluation: Guidance for the organizational decision maker.
  11. (2006). Medicine, Hospital-based emergency care: At the breaking point. National Academy,
  12. (2003). Moving Toward Health Information Exchange. Interim Report on Santa Barbara County Care Data Exchange: California Healthcare Foundation;
  13. (2007). Playing smallball: Approaches to evaluating pilot health information exchange systems.
  14. (1990). Qualitative evaluation and research methods, 2nd edition. Sage,
  15. (2002). Research methods in anthropology: Qualitative and quantitative approaches, 3rd edition.
  16. (2007). Retrospective: Lessons learned from the Santa Barbara project and their implications for health information exchange. Health Aff (Millwood)
  17. (2005). Smallball” evaluation: A prescription for studying community-based information interventions.
  18. (2008). The state of regional health information organizations: Current activities and financing. Health Aff (Millwood)
  19. (2005). The value of health care information exchange and interoperability. Health Aff. (Millwood). Suppl Web Exclusives:
  20. (2008). US regional health information organizations and the nationwide health information network: Any lessons for Canadians? Healthc Q 11:96–101,
  21. (2008). Why RHIOs aren’t working: Views from an American who can see White Rock, British Columbia, from his backyard. Healthc Q 11:102–3,

To submit an update or takedown request for this paper, please submit an Update/Correction/Removal Request.