Constructing a nationwide interoperable health information system in China: The case study of Sichuan Province

Abstract Objectives China has set up an ambitious goal to complete the construction of a nationwide interoperable health information system (HIS) by the end of 2020. This paper provides a policy analysis, from the perspective of a province, on how China achieves nationwide interoperability through integrating Population Health Information Platforms (PHIP), developed by healthcare authorities at different levels, with HIS implemented by healthcare institutions. Methods An analytical framework, with a focus on interoperability between PHIPs and healthcare institutions’ HIS, is proposed and used to analyze Sichuan Province׳s interoperable HIS to shed light on China׳s approach. To assure the validity of our research, this study analyzed data collected from multiple sources including literature review, web-based search, and interviews with staff from healthcare institutions. Results China׳s approach to constructing a nationwide HIS offers great potential and flexibility through delegating PHIP construction to healthcare authorities at different levels. Our findings reveal that developed PHIPs have strong capacities for health information exchange. China׳s approach provides clear guidelines and standards such that healthcare authorities able to complete the construction of PHIPs on time. However, remedial policies are needed to improve the effective use and sustainability of completed systems. Conclusions To maximize use of developed systems, China government should: a) define a monitoring policy to ensure full observation of construction guidelines; b) promote a new payment mechanism to motivate information sharing; c) clarify the role of PHIPs, at different levels, to assure their effective use; d) provide incentives for non-public institutions to participate in EMR adoption.