JMIR Publications

ABSTRACT

Background:

China has continuously issued policies to speed up the interconnection, mutual recognition and sharing of cross regional and inter institutional medical information systems and data integration management. However, the vertical integration of EHRs within the medical consortium has the shackles of “poor mechanism and insufficient power”, and the phenomenon of “free riding” when participating medical institutions, which makes the integration less effective.

Objective:

We hope to clarify the game mechanism of stakeholders in the vertical integration of electronic health records, and put forward targeted policy suggestions for improvement.

Methods:

We constructed the “government-hospital -patient” tripartite evolutionary game model based on the detailed analysis of the research problems and their assumptions. Following, we used the method of system dynamics to simulate the game strategies and results of each player, in order to reveal the long-term strategy evolution mechanism of the core subject in the vertical integration of EHRs in medical consortium, as well as the influencing factors and action mechanisms of the strategy evolution of each party, to provide reference for improving relevant policies.

Results:

The evolutionary game system could finally reach the best equilibrium state, but where the government was required to be in a leading position, patient supervision was required to have a positive role, and a reasonable reward and punishment mechanism can promote the active participation of hospitals.

Conclusions:

The effective way to achieve the goal of vertical integration of EHRs in the medical consortium is to build a multi-agent coordination mechanism under the guidance of the government. At the same time, it is necessary to establish a scientific integration performance evaluation mechanism, reward and punishment mechanism and benefit distribution mechanism to promote the healthy development of vertical integration of EHRs in the medical consortium.