It is generally accepted that information systems should be designed to benefit the end user. However, it is often unclear who the end user is. The answer to this question seems even more unclear in health information systems.
Thomas Goetz, executive editor or Wired and author of "The Decision Tree: Taking Control of Your Health in the New Era of Personalized Medicine" articulates a great argument that the end user of health information systems should be the patient.
I've held this same opinion for quite some time. Watching this TED talk causes me to think back to my studies of the Kimball Group's method of data warehouse implementation, outlined in their book, The Data Warehouse Lifestyle Toolkit. A large portion of this book was dedicated to end user identification and needs assessment.
While there are many stakeholders in health care, and any one of them may be an end user for an individual application, the ultimate beneficiary of all health care information systems should be the patient. In the field of Clinical Knowledge Management, this means the focus must be maintained on ensuring that knowledge for improved decision making is made available not only to clinicians, but also to patients.