Abstract
BackgroundTo 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.ObjectiveThis 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.MethodsA 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.ResultsFrom 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).ConclusionsIn 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.
Highlights
Health information technologies (HIT) can effectively improve the quality and efficiency of medical services, distribution of health care resources, safety in health care, and output of scientific research
The scale and regional coverage of the 2007-2018 China Hospital Information Management Association (CHIMA) annual survey of hospital information systems are shown in Figure 2 below
In China, all hospitals are categorized by a government board into three levels: primary, secondary, and level III [19]
Summary
Health information technologies (HIT) can effectively improve the quality and efficiency of medical services, distribution of health care resources, safety in health care, and output of scientific research. Governments of various countries have set up ambitious plans to develop HIT and invested enormous amounts of money in this development, using HIT as an important starting point for the reformation of medical services and medical systems. $19 billion of this investment was used to promote nationalized and interoperable health information systems and implement them through the Health Information Technology for Economic and Clinical Health (HITECH) Act [1]. 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
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