Objectives: Many factors affect adoption of health information systems, user involvement and satisfaction are some of the main factors of user adoption of health information systems. Despite the benefits due to social, cultural, organizational and technological factors some of the benefits become complex and difficult to achieve in practice. Both users and development team lack time due to busy schedules, sometimes disagreements between the users and the project team to reach concurrence, user at time might lack the necessary skills and knowledge to effectively participate in the design process. This study will investigate the user involvements and satisfaction levels of health information systems during the design and development phase. Methods: Cross sectional survey was utilized. Several existing tools were modified and used for the study namely Patient Satisfaction Questionnaire, Usefulness, Satisfaction, and Ease of use (USE) Questionnaire and Purdue Usability Testing Questionnaire. Structured equation models (SEM) analysis was used in the analysis. Ordinal regression statistics was used. Results: User involvement and satisfaction measure as the dependent variable and the user participation during the design and development of the health information systems as the independent variables. For every one unit increase in independent variable there is a predicted increase (of a certain amount) in the log odds falling at a higher level of the dependent variable. Generally showing that as scores increase on the independent variables, there is an increase probability falling at a higher level on the dependent variable. Conclusions: User involvement and participation has positive impact on the satisfaction levels of users during the design and development of the health information system.