A survey of health information techology development in public hospitals Guangzhou between 2008-2010

Abstract

Objective: In order to evaluate the current situation of health information technology (HIT) in Guangzhou, to assess the different status of HIT between different classifications of public hospitals, and find out the influencing factors, to identify the core barriers affecting the development of HIT, I conducted a comprehensive survey, to analyze the framework of HIT from various aspects. Through this study, we would accurately grasp the development level of HIT in Guangzhou, and provide basic information for guideline making in the future.

Methods: This is a cross-sectional & descriptive study design. I was responsible for organizing the survey, and monitoring the project cycle and work on a regular basis. I designed the questionnaire based on “The questionnaire of the development situation of national health information technology in 2009 in China”. Cluster sampling method was used, 415 public hospitals (based on the health statistics in Guangzhou in 2009) were selected for the analysis. I sent the questionnaires to all these public hospitals, and collected and entered the data with my colleague Miss LIU. I analyzed the data and wrote up the report solely by myself. At the other side, in order to evaluate the acceptance of HIT among different stakeholders, an interview was conducted by two interviewers among 20 public hospitals (using systematic sampling method, every 10th public hospital was selected). What’s more, in order to explore the characteristics of the development status of HIT in Guangzhou, diverse approaches like descriptive statistics, linear regression, t-test, and chi-square were used for the analysis.

Outcome measures: Basic information of public hospitals includes the classifications of the public hospitals; the usage status of basic infrastructure, including the utilization rates of a variety of hardware, system software, new technologies and standards; the application situation of information system, including the utilization rates of a variety of information systems, such as HIS, LIS, PACS, EHR and RHIS; the status of input of funding. In addition, the information includes the core barriers affecting the development of HIT and the acceptance of HIT.

Results: 205 of the public hospitals participated in this study, and the total response rate was 49.4%. Data showed that 91% of the public hospitals adopted at least one standard; 36.3% of them had established the Main Patient Index (MPI); 34.8%, 29.4.0%, 31.5% and 37.8% of the public hospitals implemented the Inpatient Doctor Workstation System, Inpatient Nurse Workstation System, Electronic Medical Records (EMR) and Laboratory Information System (LIS), respectively. Only12.1% of the public hospitals had participated in the development of region health information system (RHIS). Besides, “high speed Ethernet”, “bar code technology” and “data safety technology” were the top three information technologies in public hospitals, and the utilization rates were 91.2%, 44.1% and 29.4% respectively. In addition, the top three main barriers were “lack of funding”, “human resources which is not enough” and “on the part of device makers or software developers their lack of abilities to provide products and services”, these three accounted for 84.8%, 56.9% and 47.1% respectively. Data showed that the total investments were 235 million RMB, 270 million RMB and 320 million RMB in 2008, 2009 and 2010, respectively. On average, the accumulative total investments had doubled digit growth in the past 3 years. [1, 2]

Conclusion: In general, data displayed that public hospitals in Guangzhou had made significant progress in HIT development in the past few years, which has greatly contributed to hospital management and the delivery of healthcare services. In recent years, there were increasing investments, more and more public hospitals began to implement HIT, a large number of new technologies were used (such RFID, cloud computing), and certain core information systems, liking HIS, LIS, PACS, EMR and RHIS were implemented. At the other side, the development direction of HIT had shifted from hospital management stage to clinical information stage. Although the process of health information in Guangzhou was rapidly developing in the past few years, however, there still have many barriers and shortages in it, for instance, shortage of IT professional and lack of funding are still the main factors that affects the development of HIT; the overall utilization level of basic infrastructure is still not satisfied; the development of information systems is unbalanced, meanwhile the breadth and depth of the information systems are not well enough.