JMIR Publications

ABSTRACT

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 of EHR adoption in China and in the United States of America (U.S.).

Methods:

Using the 2007-2018 annual hospital survey data by the Chinese CHIMA and the 2008-2017 U.S. AHA IT Supplement survey data, we compared the trends of EHR adoption rates in China and in the U.S. We then used the Bass model to fit these data and to analyze the modes of diffusion of EHRs in these two countries. Finally, using the 2007, 2010, and 2014 CHIMA and HIMSS survey data, we analyzed the major challenges faced by hospitals in China and in the U.S. in developing HIT.

Results:

From 2007 to 2018, the average adoption rates (AAR) of the sampled hospitals in China increased from 18.6% to 85.3%, compared to the increase from 9.4% to 96% in U.S. hospitals from 2008 to 2017. The annual AAR in Chinese and in U.S. hospitals was 6.1% and 9.6%, respectively. However, the annual average number of hospitals adopting EHRs was 1,500 in China and 534 in the U.S., indicating that the former might require more effort. Both countries faced similar major challenges to hospital digitalization.

Conclusions:

The adoption rates of hospital EHRs in China and in the U.S. have both increased significantly in the past ten years. The number of hospitals that adopted EHRs in China exceeded 16,000, which was 3.3 times that of the 4,814 non-federal U.S. 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.