Table 4.

Opinions about existing problems in hospital information exchange (HIE).

Group	Quotes
Patients	“I was told to do so. Administrative procedures at the hospital seem pretty complicated, so I just did what they told me to do without any doubts. I didn’t know about such a great system [HIE service] because no one told me. I would have used it if I knew…” “I really needed a service like this. I visit the hospital often, and so do the elderly in my family… But, do I need to go to the hospital to use it?” “I’ve heard of the health information exchange service, but I don’t feel the need to use it because I don't switch hospitals often unless the information is shared somewhere else.”
Physicians	“There is too much unnecessary information. The time is limited, and I get confused because some of the information is not what I need for treatment. It would be great if the exam results are related to the actual referral be highlighted.” “In ophthalmology, blood test results in the system are not very useful for us. The referral written on paper actually has more relevant information.” “Because not all hospitals participate in the system, sometimes patient information cannot be searched. Also, it’s difficult to find out the situation of the institution I’m referring the patient to. For example, I’d like to refer a patient to get an abdominal ultrasound after 6 months, but I can’t tell if that institution can perform abdominal ultrasound. When I’m referring a patient to several departments, I’m not sure if I need to fill out the information for each department separately or do it as a whole.”
Developers	“No improvement is necessary in terms of the system. The biggest problem is that its utilization is low. Legal or systematic actions should be taken to standardize data exchange and make it mandatory.” “It’s not being used widely after development. Various cases need to be discovered to make advancements for higher effectiveness. I’m disappointed that the usage rate is so low.”