National Health Commission Issues Measures to Reduce Grassroots Burden through Health Informatization Reform
On September 3, to implement the spirit of the Notice issued by the General Office of the CPC Central Committee on Addressing Prominent Issues of Formalism and Reducing Burdens at the Grassroots Level, and to resolve prominent issues reported by grassroots units such as “excessive system-based reporting,” “duplicate reporting to multiple authorities,” and “difficulties in data sharing,” the National Health Commission released the Notice on Issuing Measures to Leverage National Health Informatics to Reduce Burdens at the Grassroots Level. The notice emphasizes that for reports required by direct mandates or through third-party agencies from grassroots units, those not included in the national health statistical survey system will, in principle, no longer be required, ensuring a reduction of more than 30% in the number of reports. The National Health Commission will streamline and integrate its existing more than 200 information systems, publish a catalog of these systems, and allow grassroots units to refuse data submission for any systems not listed in the catalog.
The “Notice” proposes the following specific measures to advance national health informatization and reduce burdens on primary-level institutions:
(1) Strengthen the management of data resources.
Strictly implement the National Health Commission’s Measures for the Management and Service of Data Resources within the Commission (Trial), strengthen unified data collection and standardized management, further optimize work processes, and reduce reporting frequency through administrative measures (Timeline: Long-term; Responsible Unit: Department of Planning). Formulate and issue the Guiding Opinions on Strengthening Health Statistics Work and the Administrative Measures for National Health Statistics Work, enhance top-level design, strengthen unified management, and eliminate inconsistent data sources at their origin (Timeline: By the end of December 2019; Responsible Unit: Department of Planning). Implement the National Hospital Data Reporting Management Plan and the National Hospital Reported Data Statistical Analysis Indicator Set, establish a comprehensive set of hospital data collection standards covering patient services and operational management, alleviate the burden of data reporting on hospitals, and reduce redundant multi-channel reporting through institutional mechanisms (Timeline: Long-term; Responsible Unit: Department of Planning).
(2) Implement the statistical survey system.
Comprehensively review all types of data reports required by various departments (units) within the Commission to be submitted by grassroots levels, ascertain the baseline figures, establish a register, and standardize management. (Deadline: By the end of September 2019; Responsible units: Department of Planning, Department of Primary Health Care, Statistical Information Center). For reports required from grassroots levels either directly or through commissioned third-party agencies, those not included in the National Health and Family Planning Statistical Survey System shall, in principle, no longer be required for submission, ensuring a reduction of more than 30% in the number of reports. (Deadline: By the end of December 2019; Responsible units: Relevant departments and units). For reports outside the statistical survey system that are indeed necessary due to actual work requirements, submission must be reviewed and approved by the principal leader and the leader in charge of the Commission, and filed with the Office of the Leading Group for Cybersecurity and Informatization of the Commission. (Timeline: Long-term; Responsible units: Relevant departments and units).
(3) Standardize the collection of data resources.
Accelerate the construction of the national-level population health information platform, gradually achieve unified access for information systems, and ensure that collected data resources are authentic, accurate, complete, and timely (Deadline: by the end of December 2020; Responsible units: Department of Planning, Statistical Information Center, and relevant departments and entities). Relying on the national-level population health information platform, improve the Commission’s data resource catalog in accordance with the principle of “those who manage provide, those who collect provide,” confirm the entities responsible for data, and oversee the sharing and application of collected data (Deadline: by the end of September 2019; Responsible units: Department of Planning, Statistical Information Center, and relevant departments and entities). In line with the principles of “one datum from one source, multiple uses from one source, unified standards, and integrated sharing,” all data collected through the national-level population health information platform shall be shared and applied by the lead department responsible for such data. Other departments (entities) shall, in principle, no longer conduct duplicate data collection, ensuring a reduction of over 40% in the number of data indicators collected (Deadline: by the end of September 2019; Responsible units: relevant departments and entities).
(4) Clean up “zombie” information systems.
In accordance with the principles of “large-scale platform, big data, and integrated systems,” we will streamline and consolidate the more than 200 existing information systems under our Commission. All “zombie” systems—those that have not conducted statistical analysis, have remained idle for extended periods, or have had their operation and maintenance discontinued—will be cleared and decommissioned (deadline: by the end of September 2019; responsible entities: relevant departments and units). Following the cleanup, a catalog of information systems will be published. For any system not included in this catalog, grassroots units may refuse to submit data and shall report such instances to the Office of the Leading Group for Cybersecurity and Informatization of the Commission (deadline: by the end of September 2019; responsible entities: Department of Planning, Statistical Information Center).
(5) Promote the integration of information systems.
Integrate overlapping and fragmented independent information systems within the Commission. In principle, each department (entity) shall retain only one business information system and connect it to the National Population Health Information Platform, ensuring a reduction of more than 50% in the total number of information systems (Deadline: By the end of December 2019; Responsible entities: Relevant departments and entities). Integrate the Commission’s fragmented and independent information systems into an interconnected, collaboratively operational, and information-sharing “mega-system” via an integration platform, and interface with the National Data Sharing and Exchange Platform to achieve the integration and sharing of government affairs information (Deadline: By the end of December 2019; Responsible entities: Department of Planning, Statistical Information Center). Where genuinely required by operational needs, certain business information systems may be retained, subject to review and approval by the principal leader and the leader in charge of the Commission, and filed with the Office of the Leading Group for Cybersecurity and Informatization of the Commission (Timeline: Long-term; Responsible entities: Department of Planning, Statistical Information Center).
(6) Standardize data submission channels.
Coordinate the construction of provincial-level population health information platforms in a comprehensive manner. In accordance with the principles of “single-window login, tiered authorization, integrated data entry, and consolidated sharing,” guide localities in developing unified provincial-level data collection information systems for primary healthcare institutions, gradually achieving the goal of “entering data only once” at the primary care level (Deadline: by the end of December 2019; Responsible units: Department of Planning, Department of Primary Healthcare, Statistical Information Center). Strengthen informatization at the primary care level by promoting the use of mobile terminal applications in primary healthcare institutions to enable one-time data collection and real-time upload. Promote service apps suitable for family contract physicians to help primary healthcare personnel complete information entry, follow-up visits, diagnosis and treatment, and other contracted services in a single operation (Deadline: by the end of December 2020; Responsible units: Department of Planning, Department of Primary Healthcare). The data collection information system shall open interfaces to primary care entities, achieve interoperability with the information systems of primary healthcare institutions, and automatically generate indicator summaries and statistical analyses, thereby reducing the need for manual secondary reporting and consolidation (Deadline: by the end of December 2019; Responsible units: Department of Planning, Department of Primary Healthcare, Statistical Information Center).
(7) Standardize the construction, operation, and maintenance safeguards. In principle, departments (units) shall not add new information systems outside the National Population Health Information Platform, thereby avoiding additional burdens on grassroots levels. If it is indeed necessary to add new information systems due to work requirements, such additions must be reviewed and approved by the principal leader and the leader in charge of the Commission, and filed with the Office of the Leading Group for Cybersecurity and Informatization of the Commission (Timeline: Long-term; Responsible Units: Relevant departments and units). Establish a mechanism for consultation and joint sign-off on investment and operation and maintenance funding. Projects for population health informatization that do not meet the requirements for co-construction and sharing shall not be approved, and no operation and maintenance funds shall be allocated to information systems that fail to meet integration and sharing requirements or refuse to integrate and share as required (Timeline: By the end of September 2019; Responsible Units: Department of Planning and Development, Department of Finance).
(8) Promote the sharing of data resources.
Relying on the National Government Information Sharing and Exchange Platform, achieve cross-departmental sharing of data resources from health departments, including full population data, birth registration, medical birth certificates, and medical death certificates, to support government services that facilitate public convenience, such as individual income tax reform. Gradually expand the scope of the internal data resource sharing list to achieve cross-business sharing of data resources such as physician practice registration, nurse practice registration, medical institution practice registration, large-scale medical equipment, and medical education (Deadline: End of September 2019; Responsible Units: Department of Planning, Statistical Information Center). Achieve cross-departmental sharing within the health sector of external data resources such as the national unified social credit code, basic population information, marriage registration information, and basic enterprise information. In accordance with actual work needs, gradually enrich data content and expand the scope of sharing to support convenient and beneficial applications in the health sector (Deadline: End of December 2019; Responsible Units: Department of Planning, Statistical Information Center). Promote "Internet + Government Services," relying on the National Integrated Online Government Service Platform, to ensure that all administrative service matters in the health sector are available online and handled through a single network, striving to enable the public to complete procedures with "at most one visit" (Deadline: End of September 2019; Responsible Units: Department of Planning, General Office, Statistical Information Center).
(9) Accelerate the integration with vertical systems.
Strengthen the construction of provincial-level national health information platforms, and promote real-time data integration with the National Health Information Platform for 10 key vertical systems—including disease control and prevention, maternal and child health, the physician and nurse practice registration systems under medical administration, and the medical education system under science and education. Enhance cross-level information sharing of vertical system data between national and provincial platforms. (Deadline: By the end of December 2019; Responsible units: Department of Planning, Bureau of Disease Control and Prevention, Bureau of Medical Administration, Department of Science and Education, Department of Maternal and Child Health, Statistical Information Center)
(10) Strengthen the application of data analysis.
All departments and units shall strengthen the analysis and application of submitted data, provide feedback on the results to grassroots levels through appropriate channels, and report to the Leading Group Office for Cybersecurity and Informatization of the Commission (Timeline: Ongoing; Responsible Units: Relevant departments and units). Enhance data application services, promote visualization of data resources within the Commission, and improve the Health Decision-Making APP to make data “visible, tangible, and usable,” thereby providing strong support for scientific decision-making by administrative organs (Timeline: By the end of September 2019; Responsible Units: Department of Planning and Development, Statistical Information Center). Promote statistical analysis and utilization of basic patient visit information, outpatient and emergency diagnosis and treatment records, and front pages of inpatient medical records from the 44 hospitals affiliated with or under the administration of the Commission, so as to serve hospital management and patient care (Timeline: By the end of December 2019; Responsible Units: Department of Planning and Development, Statistical Information Center).
See detailed illustrated interpretation:
Source: Department of Planning Development and Informatization, Healthy China