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J Am Med Inform Assoc. 2017 Sep 1;24(5):933-941. doi: 10.1093/jamia/ocx023.

Information needs of physicians, care coordinators, and families to support care coordination of children and youth with special health care needs (CYSHCN).

Author information

Intermountain Healthcare, Murray, UT, USA.
Department of Biomedical Informatics, University of Utah, Salt Lake City, UT, USA.
VA Medical Center, Salt Lake City, UT, USA.
Department of Pediatrics, University of Utah Health Sciences Center, Salt Lake City, UT, USA.
Partners HealthCare, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.



Identify and describe information needs and associated goals of physicians, care coordinators, and families related to coordinating care for medically complex children and youth with special health care needs (CYSHCN).

Materials and Methods:

We conducted 19 in-depth interviews with physicians, care coordinators, and parents of CYSHCN following the Critical Decision Method technique. We analyzed the interviews for information needs posed as questions using a systematic content analysis approach and categorized the questions into information need goal types and subtypes.


The Critical Decision Method interviews resulted in an average of 80 information needs per interview. We categorized them into 6 information need goal types: (1) situation understanding, (2) care networking, (3) planning, (4) tracking/monitoring, (5) navigating the health care system, and (6) learning, and 32 subtypes.

Discussion and Conclusion:

Caring for CYSHCN generates a large amount of information needs that require significant effort from physicians, care coordinators, parents, and various other individuals. CYSHCN are often chronically ill and face developmental challenges that translate into intense demands on time, effort, and resources. Care coordination for CYCHSN involves multiple information systems, specialized resources, and complex decision-making. Solutions currently offered by health information technology fall short in providing support to meet the information needs to perform the complex care coordination tasks. Our findings present significant opportunities to improve coordination of care through multifaceted and fully integrated informatics solutions.


CYSHCN; Children and youth with special health care needs; Critical Decision Method; care coordination; information needs

[Indexed for MEDLINE]
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