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Research Article: How does national power promote the improvement of the application level of electronic medical record

Date Published: 2026-06-22

Abstract:
Like many low- and middle-income countries, the development of electronic medical record (EMR) systems in China was slow due to the lack of funds. It was not until 2019, when the government incorporated the evaluation of EMR systerms into the assessment indicators for large public hospitals that the application of EMR systems achieved a qualitative improvement. Our hospital was one of the pilot hospitals for this reform. This study employs single-case exploratory study. China's EMR application levels are classified from 0 to 8, with Levels 1–3 representing basic electronic data collection, Levels 4–5 indicating hospital-wide integration, and Levels 6–8 reflecting regional information sharing. We tracked EMR level progression at our hospital from 2011 to 2024 and compared these trends with national and provincial averages using data from the National Health Commission's annual evaluations (2011–2024). From 2011 to 2017, our hospital promoted the development of the EMR system from level 0–4 through internal demands. After 2019, the national power prompted our hospital to raise the EMR system to level 5 in 2020 and level 6 in 2023. In 2012, 2020, and 2023, the average level of EMR systems in hospitals participating in the “National Examination” across the country was 1, 2.43, and 3.24; The number of hospitals with EMR system ratings at and above level 5 was 5–7, 176, and 395. In countries that cannot provide sufficient funds for the reform of medical informatization, a system for rating EMR and hospital assessment similar to the one in this study can be established.

Introduction:
Like many low- and middle-income countries, the development of electronic medical record (EMR) systems in China was slow due to the lack of funds. It was not until 2019, when the government incorporated the evaluation of EMR systerms into the assessment indicators for large public hospitals that the application of EMR systems achieved a qualitative improvement. Our hospital was one of the pilot hospitals for this reform.

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