Evaluating the Applications of Health Information Technologies in China During the Past 11 Years: Consecutive Survey Data Analysis

Abstract

Background To achieve universal access to medical resources, China introduced its second health care reform in 2010, with health information technologies (HIT) as an important technical support point. Objective This study is the first attempt to explore the unique contributions and characteristics of HIT development in Chinese hospitals from the three major aspects of hospital HIT—human resources, funding, and materials—in an all-around, multi-angled, and time-longitudinal manner, so as to serve as a reference for decision makers in China and the rest of the world when formulating HIT development strategies. Methods A longitudinal research method is used to analyze the results of the CHIMA Annual Survey of Hospital Information System in China carried out by a Chinese national industrial association, CHIMA, from 2007 to 2018. The development characteristics of human resources, funding, and materials of HIT in China for the past 12 years are summarized. The Bass model is used to fit and predict the popularization trend of EMR in Chinese hospitals from 2007 to 2020. Results From 2007 to 2018, the CHIMA Annual Survey interviewed 10,954 hospital CIOs across 32 administrative regions in Mainland China. Compared with 2007, as of 2018, in terms of human resources, the average full time equivalent (FTE) count in each hospital’s IT center is still lower than the average level of US counterparts in 2014 (9.66 FTEs vs. 34 FTEs). The proportion of CIOs with a master’s degree or above was 25.61%, showing an increase of 18.51%, among which those with computer-related backgrounds accounted for 64.75%, however, those with a medical informatics background only accounted for 3.67%. In terms of funding, the sampled hospitals’ annual HIT investment increased from ¥957,700 (US $136,874) to ¥6.376 million (US $911,261), and the average investment per bed increased from ¥4,600 (US $658) to ¥8,100 (US $1158). In terms of information system construction, as of 2018, the average EMR implementation rate of the sampled hospitals exceeded the average level of their US counterparts in 2015 and their German counterparts in 2017 (85.26% vs. 83.8% vs. 68.4%, respectively). The results of the Bass prediction model show that Chinese hospitals will likely reach an adoption rate of 91.4% by 2020 (R2=0.95). Conclusions In more than 10 years, based on this top-down approach, China’s medical care industry has accepted government instructions and implemented the unified model planned by administrative intervention. With only about one-fifth of the required funding, and about one-fourth of the required human resources per hospital as compared to the US HITECH project, China’s EMR coverage in 2018 exceeded the average level of its US counterparts in 2015 and German counterparts in 2017. This experience deserves further study and analysis by other countries.

A Comparison of the Development of Medical Informatics in China and That in Western Countries from 2008 to 2018: A Bibliometric Analysis of Official Journal Publications

“… EN-Cluster 2 (“Clinical and HIS”) and CN-Cluster 1 (“HIS and EMR”): clinical informatics [ 37 ], especially the use of computers in hospital management, clinical diagnosis, and treatment, is the focus of global researchers and industrial workers in this field, including medical order entry systems, electronic medical records, and other HIS. We think that the reason may be that HIS have been extensively applied in hospitals [ 38 ] and that HIT has been gradually approved by the medical field [ 39 ]. Moreover, along with the deepening of medical reforms in China in recent years, the National Health Commission of China has expanded the connotations of Chinese HIS and proposed the goal of “digital hospitals” [ 40 ].…”

The pattern of hospital-community-home (HCH) nursing in tracheostomy patients with severe traumatic brain injury: is it feasible?

“…At present, the medical consortium has been promoted by the national health department in China [44]. The establishment of the medical consortium promotes the integration of regional human resources [45]. We have developed HCH nursing care model to link the hospital, community and family three by integrating the hospital's advantages in diagnosis and treatment, and the community's advantages in location and service and long-term home care.…”

The pattern of hospital‐community‐home (HCH) nursing in tracheostomy patients with severe traumatic brain injury: Is it feasible?

“…At present, the medical consortium has been promoted by the national health department in China 43 . The establishment of the medical consortium promotes the integration of regional human resources 44 . We have developed the HCH nursing care model to link the hospital, community and family by integrating the hospital's advantages in diagnosis and treatment, and the community's advantages in location and service and long‐term home care.…”