Adoption of Electronic Health Records (EHRs) in China During the Past 10 Years: Consecutive Survey Data Analysis and Comparison of Sino-American Challenges and Experiences.

Jun Liang,Jianbo Lei,Zhongan Zhang,Dongxia Shen,Ying Li,Tong Wang,Jie Xu,Xu Zheng,Buzhou Tang,Jiajie Zhang

doi:10.2196/24813

Abstract

BackgroundThe adoption rate of electronic health records (EHRs) in hospitals has become a main index to measure digitalization in medicine in each country.ObjectiveThis study summarizes and shares the experiences with EHR adoption in China and in the United States.MethodsUsing the 2007-2018 annual hospital survey data from the Chinese Health Information Management Association (CHIMA) and the 2008-2017 United States American Hospital Association Information Technology Supplement survey data, we compared the trends in EHR adoption rates in China and the United States. We then used the Bass model to fit these data and to analyze the modes of diffusion of EHRs in these 2 countries. Finally, using the 2007, 2010, and 2014 CHIMA and Healthcare Information and Management Systems Services survey data, we analyzed the major challenges faced by hospitals in China and the United States in developing health information technology.ResultsFrom 2007 to 2018, the average adoption rates of the sampled hospitals in China increased from 18.6% to 85.3%, compared to the increase from 9.4% to 96% in US hospitals from 2008 to 2017. The annual average adoption rates in Chinese and US hospitals were 6.1% and 9.6%, respectively. However, the annual average number of hospitals adopting EHRs was 1500 in China and 534 in the US, indicating that the former might require more effort. Both countries faced similar major challenges for hospital digitalization.ConclusionsThe adoption rates of hospital EHRs in China and the United States have both increased significantly in the past 10 years. The number of hospitals that adopted EHRs in China exceeded 16,000, which was 3.3 times that of the 4814 nonfederal US hospitals. This faster adoption outcome may have been a benefit of top-level design and government-led policies, particularly the inclusion of EHR adoption as an important indicator for performance evaluation and the appointment of public hospitals.

Highlights

Electronic health records (EHRs) are the most important component of health information technology (HIT), and their adoption rate in hospitals indicates a country’s level of digitalization in medicine
The number of hospitals that adopted EHRs in China exceeded 16,000, which was 3.3 times that of the 4814 nonfederal US hospitals. This faster adoption outcome may have been a benefit of top-level design and government-led policies, the inclusion of EHR adoption as an important indicator for performance evaluation and the appointment of public hospitals
In Asia, the EHR adoption rate increased from 15.1% in 2010 to 58.1% in 2015 in Korean hospitals [4] and from 21% in 2008 to 53% in 2014 in Japanese public hospitals [5]

Summary

Introduction

Electronic health records (EHRs) are the most important component of health information technology (HIT), and their adoption rate in hospitals indicates a country’s level of digitalization in medicine. The 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act allocated approximately US $3 billion to accelerate the meaningful use of EHRs in US hospitals. In China, the “Technical Specifications for Hospital Information Platforms based on EMRs” issued by the National Health Commission in 2015 defines electronic medical records (EMRs, corresponding to hospital EHRs) as complete and detailed clinical information resources that are created, stored, and used electronically by medical institutions and are generated and recorded for citizens in all visits to medical institutions [7]. The adoption rate of electronic health records (EHRs) in hospitals has become a main index to measure digitalization in medicine in each country

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Conclusion