Background: Patients' attitudes towards sharing their personal health information are critical for implementation of Health Information Exchange (HIE). Nurses contribute significantly to information sharing within the care continuum in hospitals and community. The purpose of this study was to examine the awareness and readiness of chronic ill patients and nurses to use HIE.Methods: A cross sectional study among 312 inpatients with a chronic illness, 110 nurses working in internal wards, and 55 contact nurses working in a large Health Maintenance Organization. Multiple linear regressions were performed to assess the associations between knowledge, attitudes, socio-demographics, and both the readiness and intention to use HIE. Results: Mean levels of awareness were low across all three groups. The readiness to share information with medical healthcare providers was higher than the readiness to share information with agents not involved in direct care. Contact nurses expressed more positive attitudes than internal ward nurses or patients (F=11.25; p=.0001) and were more willing than patients to share information with health care workers (F=16.786; p=0001). All nurses (Internal ward and contact) were more willing to share information with medical agents not involved in direct care as compared to patients (F=8.072; p=.0001). Contact nurses expressed a significantly greater intention to use HIE than did internal ward nurses or patients (F=9.825; p=.0001), Knowledge, attitudes and being a nurse predicted the intention to share information on HIE with medical health care providers (F=29.91), and with agents not involved in direct care (F=19.65).Conclusions: Before implementation of an HIE system, it is important to raise awareness, readiness, and intention to use HIE among the general public, nurses, and other medical staff. Policy makers should organize national campaigns under the auspices of the Ministry of Health, in order to present the advantages of HIE and provide detailed information about the systems.

The study of errors in the health system today is a topic of considerable interest aimed at reducing errors through analysis of the phenomenon and the conclusions reached. Errors that occur frequently among health professionals have also been observed among nursing students. True, in most cases they are actually “near errors,” but these could be a future indicator of therapeutic reality and the effect of nurses' work environment on their personal performance. There are two different approaches to such errors: (a) The EPP (error prone person) approach lays full responsibility at the door of the individual involved in the error, whether a student, nurse, doctor, or pharmacist. According to this approach, handling consists purely in identifying and penalizing the guilty party. (b) The EPE (error prone environment) approach emphasizes the environment as a primary contributory factor to errors. The environment as an abstract concept includes components and processes of interpersonal communications, work relations, human engineering, workload, pressures, technical apparatus, and new technologies. The objective of the present study was to examine the role played by factors in and components of personal performance as compared to elements and features of the environment. The study was based on both of the aforementioned approaches, which, when combined, enable a comprehensive understanding of the phenomenon of errors among the student population as well as a comparison of factors contributing to human error and to error deriving from the environment. The theoretical basis of the study was a model that combined both approaches: one focusing on the individual and his or her personal performance and the other focusing on the work environment. The findings emphasize the work environment of health professionals as an EPE. However, errors could have been avoided by means of strict adherence to practical procedures. The authors examined error events in the administration of medication by nursing students during 1999–2006 using narrative analysis and the qualitative triangulation method. The findings result in a recommendation to reconsider the mode of approaching errors in educational processes, the handling of errors in the clinical field, and improvement of the safety climate.