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Healthc Inform Res. 2017 Oct;23(4):314-321. English. Original Article.
Ji H , Yoo S , Heo EY , Hwang H , Kim JW .
Office of e-Health Research and Business, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Otorhinolaryngology, Seoul National University Bundang Hospital, Seongnam, Korea.


This study aimed to identify problems and issues that arise with the implementation of online health information exchange (HIE) systems in a medical environment and to identify solutions to facilitate the successful operation of future HIE systems in primary care clinics and hospitals.


In this study, the issues that arose during the establishment and operation of an HIE system in a hospital were identified so that they could be addressed to enable the successful establishment and operation of a standard-based HIE system. After the issues were identified, they were reviewed and categorized by a group of experts that included medical information system experts, doctors, medical information standard experts, and HIE researchers. Then, solutions for the identified problems were derived based on the system development, operation, and improvement carried out during this work.


Twenty-one issues were identified during the implementation and operation of an online HIE system. These issues were then divided into four categories: system architecture and standards, documents and data items, consent of HIE, and usability. We offer technical and policy recommendations for various stakeholders based on the experiences of operating and improving the online HIE system in the medical field.


The issues and solutions identified in this study regarding the implementation and operate of an online HIE system can provide valuable insight for planners to enable them to successfully design and operate such systems at a national level in the future. In addition, policy support from governments is needed.

Copyright © 2019. Korean Association of Medical Journal Editors.