Riding the HIT Tide: Lianzhong Wisdom's 20-Year Reflection and Vision
“Bad debts of state-owned enterprises, the bleakness of neighboring economies, and the fashionable makeup of young women—these unstable receipts surrounded my shallow pond.” In his book *Turbulent Thirty Years: A History of Chinese Enterprises*, Wu Xiaobo cites this passage from Zhai Yongming’s poem “The Submarine’s Sorrow” as the epigraph for the chapter dedicated to 1999.
The year at the turn of the century witnessed the widespread decline of many old economic systems, as well as the scattered emergence of new economic frameworks that would later exert a profound influence. When people look back on 1999, they habitually regard it as the starting point for the explosive proliferation of internet-based entities, where online model innovations began to disrupt various industries and transform people’s offline lifestyles.
In fact, even within the walls of hospitals, where internet thinking is widely considered difficult to penetrate, the transformation driven by new-generation information technologies has already begun to take shape. On December 14, 1998, the State Council issued the Decision on Establishing the Basic Medical Insurance System for Urban Employees, which required that basic medical insurance achieving 100% coverage for urban employees be established in all cities and prefectures across China within the following year (1999).
This major institutional reform of the healthcare system, launched after a decade-long pilot phase, played a pivotal role in promoting the widespread adoption of hospital informatization. Subsequently, China’s Health Information Technology (HIT) industry reached its first critical turning point. With the completion of two integrated hospital management information systems led by the Ministry of Health and the General Logistics Department Health Ministry, HIT officially embarked on an industrialized development path in China.
In April 1999, the Zhejiang Provincial Department of Health seconded seven technical staff from the information departments of three major hospitals in the province—the First Affiliated Hospital of Zhejiang University, the Second Affiliated Hospital of Zhejiang University, and Hangzhou First People’s Hospital—to form the precursor of Zhejiang Mediinfo Health Information Technology Co., Ltd. (hereinafter referred to as “Mediinfo”). Under the guidance of faculty members from the College of Computer Science at Zhejiang University, the team began developing an integrated hospital management information system.
At that time, China’s hospital information industry was flourishing. The Basic Functional Specifications for Hospital Information System Software, issued by the Ministry of Health, not only facilitated the review of in-use systems conducted by provincial health authorities but also provided a reference guide for the subsequent development of more hospital information systems. During this phase, earlier attempts at technological application matured into sophisticated and complex software products, while previously fragmented technical capabilities converged into a robust industrial momentum, driven by policy support and funding.
Counting from his part-time joining of the R&D team at MediInfo, Hu Shunfu has been with the company for 20 years. Prior to this, Hu Shunfu was a faculty member at the College of Computer Science and Technology, Zhejiang University. He currently serves as the company’s Technical Advisor and is affectionately referred to by colleagues as “Teacher Hu.” In modest offices on Jiefang Road and in hospital information center computer rooms that required removing shoes and donning white lab coats for entry, Teacher Hu and his colleagues dedicated all their spare time, working day and night, to develop MediInfo’s first hospital informatics product.
Although the “China Hospital Information System (CHIS),” launched in 1995, had been successfully implemented at Peking University People’s Hospital, the development of hospital management information systems remained an exploratory endeavor. According to Professor Hu, team members at the time lacked comprehensive experience in commercial software and information system integration, with every stage of system development built upon repeated trial and error.
After five months of development, the HIS 1.0 outpatient system was launched at the First Affiliated Hospital of Zhejiang University School of Medicine in September 1999. Recalling the day of the launch, Professor Hu noted that the original patient care processes came to a halt, causing undiverted patients to congest the hospital lobby to capacity. “We lacked experience in deploying information systems, and our preparatory work was inadequate, resulting in over an hour of paralysis in the outpatient services of the First Affiliated Hospital of Zhejiang University.”
Informatization transforms lives, with experience accumulating through the continuous correction of intricate errors. Even an imperfect beginning has provided ZHEJIANG MEDIINFO I.T.CO.,LTD with greater room for reflection as it charts its own course in hospital informatization construction.
Over the following nine years, hospital information system products evolved from the dominance of Hospital Information Systems (HIS) to a diversified landscape featuring HIS, Picture Archiving and Communication Systems (PACS), Laboratory Information Systems (LIS), and Electronic Medical Records (EMR). This transition marked a shift from process management toward clinical operational activities, with the Health Information Technology (HIT) market beginning to take shape. The 2009 new healthcare reform further elevated health informatization by incorporating it into central government documents. At the National Health Work Conference, then-Minister of Health Chen Zhu vividly described the spirit of the new healthcare reform as a framework of “one cap, four beams, and eight pillars,” with HIT serving as one of these pillars. This raised the status and emphasis on medical informatization to an unprecedented level.
Starting in 2009, the Zhejiang Provincial Department of Health gradually divested its state-owned shares in Medinfo Technology. After relocating to the Hangzhou E-Commerce Building, Medinfo Technology was renamed Medinfo Smart Technology. During the era of rapid internet development marked by the rise of e-commerce, the company sought to transform healthcare access through internet-based medical software such as “Medi-Garden” and “Dian Dian Jiu Yi.”
ZHEJIANG MEDIINFO I.T.CO.,LTD is fully committed to building the nationally leading “Hangzhou Smart Healthcare Model.” Over the past decade, ZHEJIANG MEDIINFO has accompanied Hangzhou on its journey to advance smart healthcare, making the outline of a demonstration zone for Healthy China clearly visible. By implementing numerous patient-friendly and beneficial measures—such as time-slot-based outpatient appointment scheduling, in-clinic registration and check-in, and “treatment first, payment later”—the company has effectively implemented the healthcare industry’s “At Most One Visit” initiative. As of June 2019, cumulative convenient services had been provided to 107.2 million patient visits, each reducing in-hospital stay by at least two hours. Based on an eight-hour workday, this smart healthcare model has saved the equivalent of 26.8 million workdays for the city’s residents, generating substantial social and economic benefits.
“In Mr. Hu’s recollection, ZHEJIANG MEDIINFO I.T.CO.,LTD accomplished two major milestones during this period. ‘The first was the launch of the information system at Peking Union Medical College Hospital, which marked our expansion beyond Zhejiang Province and the establishment of our presence across China.’”
Another significant milestone was participating in the exploration of the “Wenzhou Model” for new healthcare reform as a technology provider for data-sharing platforms, which stands out as a highlight in MediInfo’s regional healthcare informatization business.
Wenzhou has implemented initiatives such as internet-based healthcare, tiered diagnosis and treatment, data-sharing platforms, and family doctor contracting services to address the challenge of unequal distribution of medical resources. In May 2016, China Central Television (CCTV) featured a special report on the “Wenzhou Model” of healthcare reform.
At tertiary hospitals in Wenzhou, all appointment slots are hosted on a unified online platform and shared in real time through the deployment of China’s most advanced registration kiosks. The system promotes real-name registration using second-generation resident identity cards, links elderly patients with their children, records medical data in patients’ files, and logs billing information under guardians’ profiles. It also promotes mobile outpatient services to reduce the burden of repeated trips for patients with chronic diseases.
Underpinning the “Wenzhou Model” is a data platform built during the advancement of healthcare informatization, which serves as foundational support. Leveraging the Wenzhou Health Cloud+ function expansion project, information technology has been utilized to the fullest extent to implement a citywide unified referral coordination information platform. Mr. Hu told VCBeat that ZHEJIANG MEDIINFO I.T.CO.,LTD assisted the Wenzhou Municipal Health Commission in pioneering the rollout of an informatized data-sharing platform in China, enabling the sharing of medical records across 294 hospitals in the city.
“In its launch year, the Wenzhou Health Information Sharing Tier-1 Platform accumulated 1.28 billion records, covering 95% of the medical and health records of the city’s 9 million permanent residents across all medical institutions since 2014.” In Mr. Hu’s view, these early practices gradually cemented ZHEJIANG MEDIINFO I.T.CO.,LTD’s leading position among healthcare IT service providers in Zhejiang Province and enabled its business to expand nationwide.
At an internal event held by ZHEJIANG MEDIINFO I.T.CO.,LTD to celebrate its 20th anniversary of business operations, Mr. Hu shared two recent data points: the expansion of annual business revenue from RMB 300 million to RMB 500 million within one year, and the addition of 157 new employees in 2019. This represents a significant scale-up unprecedented in the company’s history.
Teacher Hu told VCBeat that since 2017, ZHEJIANG MEDIINFO I.T.CO.,LTD has undertaken sweeping reforms to its modern corporate governance structure, establishing subsidiaries across various business lines to systematically advance nationwide market coverage in China.
Currently, legacy Hospital Information System (HIS) platforms have reached the limits of their productivity. Many hospitals have initially established various information systems, including HIS, Picture Archiving and Communication Systems (PACS), Laboratory Information Systems (LIS), Intensive Care Unit (ICU) management systems, Electronic Medical Records (EMR), electrocardiogram (ECG) systems, and anesthesia and surgery management systems, giving rise to a new generation of hospital informatization architecture. Zhejiang Mediinfo I.T. Co., Ltd. adopts a strategy of promoting construction through evaluation, helping hospitals efficiently achieve desired ratings in assessments of electronic medical records and interoperability maturity.
Currently, 24 hospitals in Zhejiang Province have passed the Level 4 or above evaluation for information interconnectivity, among which 8 are clients of ZHEJIANG MEDIINFO I.T.CO.,LTD, accounting for 33%. Notably, Hangzhou First People's Hospital was among the first batch nationwide to pass the Level 4 interconnectivity evaluation; The Affiliated Hospital of Hangzhou Normal University was the first in Zhejiang Province to achieve the Level 4 Grade A certification; and Hangzhou Seventh People's Hospital was the first psychiatric specialty hospital in Zhejiang Province to obtain the Level 4 Grade A certification.
Five hospitals in Zhejiang Province passed the Electronic Medical Record (EMR) system evaluation, with three of them being clients of Zhejiang MediInfo, accounting for 60%. Among them, Hangzhou First People’s Hospital is the first Grade A tertiary general hospital in Zhejiang Province to pass the Level 5 EMR evaluation; Jiande First People’s Hospital is the first hospital in Zhejiang Province to pass the Level 5 EMR evaluation; and Hangzhou Red Cross Hospital is the first integrated traditional Chinese and Western medicine hospital in Zhejiang Province to pass the Level 5 EMR evaluation.
Five hospitals have implemented the Heterogeneous System Information Integration Platform: Xiaoshan District First People's Hospital, Ningbo First Hospital, Taizhou First People's Hospital, The First Affiliated Hospital of Xi'an Jiaotong University, and The Second Affiliated Hospital of Xi'an Jiaotong University. Among them, The First Affiliated Hospital of Xi'an Jiaotong University is the first hospital in Shaanxi Province to complete the construction of a data center.
Information Systems and Data Integration Are Key Future Trends in Healthcare Informatics. The traditional approach to healthcare informatization, which prioritized the implementation of Hospital Information Systems (HIS) and then built various other information systems on top of this foundation, has shown insufficient potential in supporting core clinical workflows and enhancing the quality of care. With diminishing returns on investment and signs of unsustainable development, it has become an industry consensus that hospital-wide informatization systems urgently need a revolutionary transformation.
Standing at the new starting point of its 20th anniversary, ZHEJIANG MEDIINFO I.T.CO.,LTD has launched a new integrated Hospital Information System (HIS) named HALO (Halo, Glory), based on a microservices architecture. This system is designed to meet the hospital’s increasingly refined operational needs and truly realize data-intelligence-driven business operations. The HALO system is characterized by its microservices-based, intelligent, platform-oriented, and integrated nature (covering electronic medical records and physician orders, outpatient/emergency and inpatient care, physicians and nurses, clinical and management functions, etc.). It achieves loose coupling between modules and standardized exchange among heterogeneous business systems, while continuously evolving to adapt to internal and external business changes. By incorporating knowledge bases and rule engines, it integrates intelligent management and control into business processes.
When asked what Zhejiang Mediinfo, as an industry veteran, considers the most critical core competency for healthcare IT enterprises, Mr. Hu responded that it lies in product advantages and corporate management capabilities. Indeed, with demands and the market changing rapidly, agile corporate governance enables products to adapt to emerging trends, thereby ensuring long-term business sustainability.