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

Background The adoption rate of electronic health records (EHRs) in hospitals has become a main index to measure digitalization in medicine in each country. Objective This study summarizes and shares the experiences with EHR adoption in China and in the United States. Methods Using 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. Results From 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. Conclusions The 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.

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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 (Preprint)

10.2196/preprints.24813 ◽

2020 ◽

Author(s):

Jun Liang ◽

Ying Li ◽

Zhongan Zhang ◽

Dongxia Shen ◽

Jie Xu ◽

...

Keyword(s):

United States ◽

Information Technology ◽

Electronic Health Records ◽

Health Information ◽

Survey Data ◽

The United States ◽

Annual Average ◽

Health Records ◽

The Past ◽

Ehr Adoption

BACKGROUND The adoption rate of electronic health records (EHRs) in hospitals has become a main index to measure digitalization in medicine in each country. OBJECTIVE This study summarizes and shares the experiences with EHR adoption in China and in the United States. METHODS Using 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. RESULTS From 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. CONCLUSIONS The 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.

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The Promises and Challenges of Health Information Technology

User-Driven Healthcare ◽

10.4018/978-1-4666-2770-3.ch004 ◽

2012 ◽

pp. 57-76

Author(s):

Brian Gugerty ◽

Michael J. Maranda

Keyword(s):

United States ◽

Information Technology ◽

Health Information ◽

The United States ◽

Personal Health Records ◽

Healthcare Information Technology ◽

Health Records ◽

Recent Developments ◽

The Impact ◽

The Relationship

This chapter explores the application of Information Technology to healthcare in the United States. Recent developments and trends in healthcare information technology (HIT) are presented and discussed. Widespread adoption of HIT promises to save lives, save money, and improve health. Definitions, descriptions, and examples of electronic health records (EHRs) and personal health records (PHRs) are provided. The significant efforts to broadly and meaningfully adopt HIT over the next several years are discussed. The significant challenges in implementing EHRs are discussed, including transformation of clinical processes. Finally, the impact of HIT on the concept of ownership of the healthcare record and how it may change the relationship between the patient and healthcare provider are explored. Implementing effective HIT on a nationwide scale will require considerable effort.

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Emergency Physician Experiences with Electronic Health Records in the United States and Norway: Qualitative Study (Preprint)

10.2196/preprints.28762 ◽

2021 ◽

Author(s):

Gracie Palmer ◽

Christopher Crenner

Keyword(s):

United States ◽

Electronic Health Records ◽

Health Information ◽

User Experience ◽

Emergency Physician ◽

User Satisfaction ◽

The United States ◽

Physician Attitudes ◽

Health Records ◽

Electronic Health

BACKGROUND Physician attitudes regarding Electronic Health Records (EHR) are widely recognized. It has also been established that both human and technologic components contribute to user satisfaction. This study compares emergency physician EHR experiences between the United States and Norway. OBJECTIVE The primary outcome analyzes individual perceptions of Health Information Technology (HIT). It examines independent variables that influence overall user experience within a socio-political-technical context. Fundamental differences between nations will also be addressed. METHODS This exploratory study used semi-structured, respondent-driven, in-depth interviews (n=12) that were recorded and transcribed. Thematic analysis was conducted using grounded theory and ethnography. RESULTS Potential benefits and disadvantages were acknowledged by all physicians. Both cohorts reported increased clerical burden. Overall, Norwegians were more likely to report positive EHR experiences while American dissatisfaction was disproportionally high. US frustrations were multifactorial all resulting with similar consequences- generation of excessive data with little clinical value. They also felt EHRs prioritized capital gain over healthcare optimization. Norwegian complaints mainly involved technology dysfunction. The initiative “One Patient, One Record” (Én innbygger - én journal) will soon result in a single EHR provider (Epic Systems) for the entire nation. Currently, all EHRs in Norway are connected to a national health information exchange (HIE) platform known as the “core journal” (Kjernejouralen) which contains prescription and critical medical information to providers across the country. US physicians expressed interest in having a version of this tool as they often cannot obtain outside patient records. CONCLUSIONS Despite differences spanning geographic, organizational, and cultural boundaries much is to be learned by direct comparison of individual experiences. This study suggests policy, regulation, and culture may have greater influence on overall user experience rather than technology itself. Global EHR optimization requires additional investigation and these results help establish foundation for future research.

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The Promises and Challenges of Health Information Technology

Impact of E-Business Technologies on Public and Private Organizations ◽

10.4018/978-1-60960-501-8.ch010 ◽

2011 ◽

pp. 159-178

Author(s):

Brian Gugerty ◽

Michael J. Maranda

Keyword(s):

United States ◽

Information Technology ◽

Health Information ◽

The United States ◽

Personal Health Records ◽

Healthcare Information Technology ◽

Health Records ◽

Recent Developments ◽

The Impact ◽

The Relationship

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Safe Use of Electronic Health Records and Health Information Technology Systems

Journal of Patient Safety ◽

10.1097/pts.0b013e3182a8c2b2 ◽

2013 ◽

Vol 9 (4) ◽

pp. 177-189 ◽

Cited By ~ 22

Author(s):

Charles R. Denham ◽

David C. Classen ◽

Stephen J. Swenson ◽

Michael J. Henderson ◽

Thomas Zeltner ◽

...

Keyword(s):

Information Technology ◽

Electronic Health Records ◽

Health Information Technology ◽

Health Information ◽

Health Records ◽

Electronic Health ◽

Technology Systems

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1665. Using Electronic Health Records to Describe TB in Community Health Settings: a Cohort Analysis in a Large Safety-Net Population

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1843 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S819-S820

Author(s):

Jonathan Todd ◽

Jon Puro ◽

Matthew Jones ◽

Jee Oakley ◽

Laura A Vonnahme ◽

...

Keyword(s):

United States ◽

Risk Factors ◽

Electronic Health Records ◽

Safety Net ◽

The United States ◽

Research Network ◽

Health Records ◽

Treatment Regimens ◽

Data Source ◽

Electronic Health

Abstract Background Over 80% of tuberculosis (TB) cases in the United States are attributed to reactivation of latent TB infection (LTBI). Eliminating TB in the United States requires expanding identification and treatment of LTBI. Centralized electronic health records (EHRs) are an unexplored data source to identify persons with LTBI. We explored EHR data to evaluate TB and LTBI screening and diagnoses within OCHIN, Inc., a U.S. practice-based research network with a high proportion of Federally Qualified Health Centers. Methods From the EHRs of patients who had an encounter at an OCHIN member clinic between January 1, 2012 and December 31, 2016, we extracted demographic variables, TB risk factors, TB screening tests, International Classification of Diseases (ICD) 9 and 10 codes, and treatment regimens. Based on test results, ICD codes, and treatment regimens, we developed a novel algorithm to classify patient records into LTBI categories: definite, probable or possible. We used multivariable logistic regression, with a referent group of all cohort patients not classified as having LTBI or TB, to identify associations between TB risk factors and LTBI. Results Among 2,190,686 patients, 6.9% (n=151,195) had a TB screening test; among those, 8% tested positive. Non-U.S. –born or non-English–speaking persons comprised 24% of our cohort; 11% were tested for TB infection, and 14% had a positive test. Risk factors in the multivariable model significantly associated with being classified as having LTBI included preferring non-English language (adjusted odds ratio [aOR] 4.20, 95% confidence interval [CI] 4.09–4.32); non-Hispanic Asian (aOR 5.17, 95% CI 4.94–5.40), non-Hispanic black (aOR 3.02, 95% CI 2.91–3.13), or Native Hawaiian/other Pacific Islander (aOR 3.35, 95% CI 2.92–3.84) race; and HIV infection (aOR 3.09, 95% CI 2.84–3.35). Conclusion This study demonstrates the utility of EHR data for understanding TB screening practices and as an important data source that can be used to enhance public health surveillance of LTBI prevalence. Increasing screening among high-risk populations remains an important step toward eliminating TB in the United States. These results underscore the importance of offering TB screening in non-U.S.–born populations. Disclosures All Authors: No reported disclosures

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