The Critical Role of Rehabilitation Informatization: Insights from Department Heads at Southwest Hospital, Peking University Third Hospital, Xiangya Boai Rehabilitation Hospital, and Zhujiang Hospital

As a clinical department on par with internal medicine, surgery, obstetrics and gynecology, and pediatrics, the Department of Rehabilitation Medicine has only gained significant attention and entered a phase of rapid development in recent years. The gradual expansion of the department’s floor space, bed capacity, staffing, and rehabilitation service offerings has led to increased management complexity.

Given the unique characteristics and complexity of rehabilitation medicine, hospital-wide information systems designed for general administrative purposes fail to meet the specific needs of rehabilitation departments. Consequently, the development of specialized informatics systems for rehabilitation has become an urgent priority.

However, what exactly distinguishes rehabilitation informatics from hospital-wide information systems, and what changes can it bring to the discipline of rehabilitation medicine? To understand the evolving needs in this field, VCBeat has conducted a series of interviews with Zhou Mouwang, Director of the Department of Rehabilitation Medicine at Peking University Third Hospital; Liu Hongliang, Director of the Department of Rehabilitation Medicine at Southwest Hospital of Army Medical University; Gao Xianbin, Director of the Information Department at Xiangya Boai Rehabilitation Hospital; and Huang Guozhi, Director of the Department of Rehabilitation Medicine at Zhujiang Hospital of Southern Medical University, to gain insights into their genuine perspectives and frontline experiences with rehabilitation informatics systems.

Huang Guozhi, Director of the Department of Rehabilitation Medicine, Zhujiang Hospital of Southern Medical University

Huang Guozhi, Director of the Department of Rehabilitation Medicine at Zhujiang Hospital of Southern Medical University, told VCBeat that his department began advancing rehabilitation informatization in 2008, achieving wireless coverage within the department to enable mobile ward rounds. The department has also engaged in bilateral collaborations with multiple domestic information technology companies, assisting in the development of several rehabilitation informatization management platforms.

In the early days before the department achieved informatization,Numerous issues exist in inter-departmental communication, redundant work, and manual statistical analysis.。

Communication barriers within the department are mainly manifested in two aspects: doctor-patient communication and communication between clinicians and medical technologists.. Early treatment protocols were primarily disseminated via paper-based methods, requiring physicians to thoroughly explain each step of the process to patients to ensure their arrival at the treatment department for therapy at the scheduled time.

Furthermore, as a team, rehabilitation physicians and therapists need to communicate in real time regarding patients’ rehabilitation goals, treatment progress, and other relevant information. Previously, departments often relied on in-person meetings or telephone calls for such communication, which was not only inefficient but also failed to generate effective medical documentation, thereby preventing detailed recording of discussion contents and consensus opinions.

If the Therapy Department has further recommendations for rehabilitation treatment based on the patient’s functional impairments, it is necessary to notify the physician by telephone for discussion and communication.

InRepetitive WorkIn the absence of information systems, all tasks were performed manually by medical staff. For instance, in rehabilitation assessments, due to the lack of specialized templates within the electronic medical record system, departments had to print Word documents for evaluation purposes.

When SchedulingEach treatment room must also coordinate patient treatment schedules independently. Upon completion of treatment, therapists are required to record the details in an Excel spreadsheet and manually enter the billing information into the HIS system after their shift ends.

Every MonthStatistical Costs and Workload Performance..., manual data statistics are still required, involving a significant amount of manual work. Therapists need to devote considerable energy to these tedious daily tasks.

According to Director Huang, the Department of Rehabilitation at Zhujiang Hospital previously collaborated with an IT vendor, but the system failed to be effectively implemented due to unsatisfactory system interface performance. Later, the Chinese Association of Rehabilitation Medicine facilitated a partnership between the department and Huawei Company through a research project under the China Association for Science and Technology, marking the department’s first step in information technology infrastructure development.

Since 2017, the Department of Rehabilitation Medicine at Zhujiang Hospital has progressively implemented modules including the Physician Workstation, Assessment Workstation, Therapy Workstation, Statistical Reports, Scheduling and Queue Management, Medical Record Search, Electronic Rehabilitation Documentation, Medical Record Folder, Rehabilitation Dashboard, and Touchscreen Inquiry Terminals. In 2019, the mobile APP was also launched.。

To date, the information system has resolved the majority of operational issues within the department. Physicians can now issue treatment orders through the system, which are received by the Treatment Department. Physicians can also view patients’ treatment schedules and implementation status via the system. Both physicians and patients have access to assessment results, treatment records, and other documentation generated by the Treatment Department.

During treatment, therapists can schedule appointments on the system, which will identify available time slots for both patients and therapists, eliminating the need for manual coordination by the therapists.

The rehabilitation information system has also integrated with the Hospital Information System (HIS) and established a billing interface.. Therapists no longer need to perform manual billing; fee registration can be completed within the system, which also enables statistical analysis of charges based on service delivery.

AtAfter the launch of the mobile app, therapists no longer need to use Word documents to edit assessment scales and reports; they can conduct assessments using an iPad, record videos of patients during the evaluation, save the data in the system afterward, and allow physicians and other therapists to access the records at any time.

Treatment execution does not necessarily require operation at a computer; therapists can directly use an iPad or handheld terminal to register patients and confirm charges, thereby freeing them from being tethered to a desktop computer.

Director Huang finally told VCBeat that after the rehabilitation information system goes online, all medical records and treatment logs of patients in the Rehabilitation Department will be stored within the system. This allows for on-demand access to patients’ historical treatment prescriptions, treatment records, documentation, and even video footage.. These can help doctors and therapists gain a more accurate understanding of patients' conditions, make correct diagnoses, and provide better medical services.

Liu Hongliang, Director of the Department of Rehabilitation Medicine, Southwest Hospital

The informatization construction of rehabilitation at Southwest Hospital originated from the research project “Disciplinary Innovation Collaborative Project—Digital Research on Diagnosis and Treatment in Rehabilitation Medicine,” which was submitted by the Chinese Association of Rehabilitation Medicine to the China Association for Science and Technology in March 2016. After the project was approved, Southwest Hospital, as one of the collaborating units, worked with Huawei Company and more than ten other domestic rehabilitation departments to develop and refine the specialized information system for rehabilitation.

In the early stages of Huawei’s collaboration with the Department of Rehabilitation Medicine at Southwest Hospital, Liu Hongliang, Director of the department, required Huawei’s product managers, rehabilitation specialists, and IT engineers to be stationed in the hospital’s rehabilitation department for one month to gain a comprehensive understanding of its pain points, needs, and workflows. Director Liu Hongliang stated that only by fully understanding the department’s requirements and circumstances could engineers communicate effectively with rehabilitation staff and develop information technology products that meet the department’s needs.

The purpose of establishing an information system for rehabilitation specialties is to achieve full coverage and standardization of the rehabilitation process., the information system of the Department of Rehabilitation Medicine at Southwest Hospital has already implemented functions such as automated scheduling, automated performance calculation, efficient communication, documentation of rehabilitation processes, and facilitation of the implementation of standardized departmental work models.

Gao Xianbin, Director of the Information Department at Xiangya Boai Rehabilitation Hospital

Since the preparatory work began in 2011, Gao Xianbin, Director of the Information Department at Xiangya Bo’ai Rehabilitation Hospital, has witnessed the entire development process of the hospital’s rehabilitation information system and has participated in the optimization of the hospital’s overall informatization construction. In 2011, when Xiangya Bo’ai initiated its preparatory phase, informatization construction was incorporated into the hospital’s planning from the outset, with the institution positioning itself as a specialized provider of rehabilitation medical services.

There are significant differences in the construction of information systems between specialized rehabilitation hospitals and the rehabilitation departments of general hospitals.. After completing its basic information technology infrastructure in early 2013, Xiangya Boai began exploring the development of a specialized rehabilitation medical information system. After three years of arduous trial and error, during which multiple systems were implemented, none yielded satisfactory results.

In 2016, Chengdu Huawei also aspired to develop a rehabilitation medical management system with genuine practical value, while Xiangya Boai Rehabilitation Hospital was in urgent need of such a system. With aligned objectives, the two parties collaborated to advance the comprehensive informatization of professional rehabilitation services across the entire hospital.

Initially, Huawei Company’s existing rehabilitation information system, like the rehabilitation systems previously used by the hospital, presented a model based on the rehabilitation departments of general hospitals. However, based on Director Gao’s assessment drawn from prior implementation experience, this system fell significantly short of meeting the informatization requirements of a specialized rehabilitation hospital.

Huawei Company is curious: since the functionalities of these systems are specifically designed for rehabilitation frameworks, why does this system fail to meet your needs?

Director Gao stated that they had previously collaborated with certain companies that showcased information systems designed for rehabilitation departments; however, these systems failed to meet the operational requirements of rehabilitation hospitals.

Director Gao stated,Rehabilitation specialty hospitals operate under a different system from the rehabilitation departments of general hospitals, where most are still managed as medical technology departments.。

HoweverRehabilitation specialty hospitals prioritize this service as their core focus, organizing distinct rehabilitation domains into separate departments or centers.For example, Xiangya Boai Hospital has established specialized centers including the Neurological Rehabilitation Center, the Bone and Joint Rehabilitation Center, the Spinal Cord Injury Rehabilitation Center, the Pediatric Rehabilitation Center, and the Geriatric Rehabilitation Center.

In terms of rehabilitation service structure, there are specialized departments for rehabilitation assessment, physical therapy (PT), speech therapy (ST), and occupational therapy (OT), with further multi-level subdivisions. Different functional rehabilitation units assign dedicated one-on-one therapists to patients, a level of personalized care that many rehabilitation institutions struggle to provide.

All such content must be documented and assigned, with different personnel having distinct responsibilities. These varying roles and functions must all be reflected in the information system. A rehabilitation information system designed solely for a single medical technology department is unlikely to achieve this objective.

From a horizontal perspective, the information system of a rehabilitation hospital must cover all departments potentially involved in patient care, including the Rehabilitation Center, Department of Laboratory Medicine, Department of Radiology, Department of Clinical Nutrition, and extending to specialized areas such as Vocational Rehabilitation. From a vertical perspective, it must encompass the entire rehabilitation process, beginning with rehabilitation assessment and concluding with rehabilitation assessment.。

Compared with the information systems of individual rehabilitation departments, the rehabilitation information system of a rehabilitation hospital is essentially the aggregate of multiple departmental rehabilitation information systems and auxiliary department information systems. It is hospital-wide and synchronized across the entire institution.

Additionally,Another highlight of the rehabilitation information system at Xiangya Boai Rehabilitation Hospital is that, throughout the entire construction process, CARF concepts were implemented in every detail.

CARF is an invisible standard, yet it is reflected in every aspect of rehabilitation. CARF mandates that all processes emphasize continuous improvement; therefore, the best way to evaluate such improvement is through accurate documentation.。

Therefore, the development of information systems is of paramount importance, requiring every process and module to achieve the objective of “documenting what is done and doing what is documented,” while leveraging recorded data to drive continuous improvement and enhancement. This embodies the spirit and requirements of CARF.。

To implement the spirit and requirements of CARF, hospitals initially documented their work on paper in the absence of information technology. Later, with the introduction of a basic information system, functions such as execution, registration, and billing of rehabilitation therapy records were realized.

With the implementation of hospital-wide information systems, hospitals have achieved comprehensive informatization in rehabilitation medicine, enabling end-to-end digital management and data recording throughout the rehabilitation process. This encompasses team building, multidisciplinary team meetings, rehabilitation assessments, discussions and confirmation of rehabilitation treatment plans, delivery of rehabilitation therapy, documentation of rehabilitation treatments, scheduling, electronic medical record (EMR) documentation, and post-discharge follow-up.

This meets the CARF requirements for the entire process of “document what is done, do what is documented” and the goals and capabilities of continuous improvement. It has also achieved the exploration and construction of electronic medical records (EMR) for rehabilitation, with improvements made in content, templates, quality control, and time limits, achieving full digitalization. Director Gao stated that the digitized rehabilitation medical records lay the foundation for the subsequent development of an intelligent and precise rehabilitation information system.

Hospitals can leverage artificial intelligence (AI) technologies to analyze extensive and comprehensive rehabilitation medical records, thereby developing an AI-based precision rehabilitation auxiliary management information system. This system assists physicians in formulating rehabilitation plans more efficiently, provides intelligent automated alerts to both rehabilitation specialists and patients based on therapeutic outcomes, and delivers more precise rehabilitation protocols. These capabilities enhance the effectiveness of rehabilitation and effectively mitigate treatment risks arising from human oversight or incomplete consideration.。

Speaking about his years of experience in building rehabilitation informatics, Director Gao Xianbin told VCBeat, “After years of exploration, our greatest advantage lies in the numerous pitfalls we have encountered on the path to building rehabilitation information systems. If we can offer anything to the development of such systems, I would say we are much like combat engineers clearing minefields. Having made many mistakes ourselves, we can at least provide valuable guidance to other teams embarking on this journey.”

Zhou Mouwang, Director of the Department of Rehabilitation Medicine, Peking University Third Hospital

Peking University Third Hospital has undertaken the work of the National Center for Quality Control in Rehabilitation Medicine. Regarding the value of rehabilitation informatics,Zhou Mouwang, Director of the Department of Rehabilitation Medicine, stated that the informatization of rehabilitation departments would facilitate quality control management in rehabilitation medicine across China.。

Rehabilitation medicine in China started late and received insufficient attention in the past, with the national rehabilitation medicine still in a development stage. There are significant differences in the development of rehabilitation medicine across various regions. Establishing a national quality management system for rehabilitation medicine is of great significance for standardizing diagnosis and treatment behaviors, reducing medical accidents, and improving medical standards.

Director Zhou Mouwang told VCBeat,Compared with other departments in the hospital, the Department of Rehabilitation Medicine has its particularities. In addition to physicians and nurses, the department also includes rehabilitation therapists. While other departments require only collaboration between physicians and nurses, the Department of Rehabilitation Medicine necessitates pairwise or tripartite collaboration among physicians, nurses, and rehabilitation therapists. Rehabilitation therapists are further categorized into physical therapists, occupational therapists, and speech-language pathologists, among others. The greater the number of roles involved, the more complex the management and coordination become.。

AtClinical Diagnosis and Treatment ProtocolIn terms of other departments, they are responsible for diagnosis and treatment,The Rehabilitation Department has added one more assessment task., the assessment work also requires multi-party collaboration.

Patients undergo a wide range of rehabilitation programs, which often involve multiple physicians and rehabilitation therapists.

These factors make the diagnosis, treatment, and management processes in the Department of Rehabilitation Medicine significantly more complex, thereby imposing more stringent requirements on quality control.

Additionally,The ultimate goal of quality control is to achieve real-time dynamic management, which requires rehabilitation departments across China to establish robust and interoperable rehabilitation information management systems.。

The implementation of the aforementioned functionalities makes it possible to advance the establishment of specialized rehabilitation medical consortia.. Liu Cheng, General Manager of Chengdu Huawei Technology, introduced that many regions across China are currently establishing multi-tiered rehabilitation networks.

District-level multi-tier rehabilitation networks are typically led by a specialized rehabilitation hospital or a Grade 3A tertiary hospital, providing support to approximately 20 community health centers. Provincial specialized rehabilitation medical consortia are generally spearheaded by provincial Grade 3A tertiary hospitals, which join forces with the rehabilitation departments of 200–300 hospitals within the province to form a specialized rehabilitation alliance.

Rehabilitation departments in hospitals within the alliance require guidance and training from rehabilitation departments at top-tier tertiary (Grade A) hospitals. However, given the limited human and material resources of tertiary hospitals, support for subordinate rehabilitation departments must be underpinned by information technology, such as teleconsultation and remote rehabilitation training. For instance, Southern Medical University has established a specialized rehabilitation alliance, aiming to promote its standardized rehabilitation pathways for stroke, lumbar disc herniation, and neck-shoulder-waist-leg pain throughout the alliance.

Huawei has integrated its rehabilitation pathway protocols—including text, images, and video guidance—into an information system. Once the rehabilitation departments of alliance members install this system, they can quickly master standardized assessment and diagnosis-and-treatment procedures by following the system’s guidance. The digitized assessment tools and rehabilitation scales also facilitate oversight by specialists from tertiary hospitals, making it immediately apparent whether operational practices comply with standards or not.

Following digitalization, changes in patients’ recovery processes can be presented as data through scale-based assessments, assisting rehabilitation therapists in adjusting rehabilitation plans.

Addressing market demand for rehabilitation informatics, Liu Cheng told VCBeat that the rapid development in this field over the past two years has been driven by two R&D initiatives led by the China Association for Science and Technology (CAST) and the Chinese Association of Rehabilitation Medicine: the “Disciplinary Innovation Collaboration Project—Digitalization of Diagnosis and Treatment in Rehabilitation Medicine” and the “Enterprise-Association Collaborative Innovation Program—Digitalization of the Entire Clinical Diagnosis and Treatment Process for Rehabilitation in General Hospitals.”

Throughout this process, Huawei has achieved theoretical framework development, physical restructuring, and software iteration and updates for rehabilitation informatics through collaborations with the Chinese Association of Rehabilitation Medicine and leading domestic rehabilitation medicine departments or rehabilitation hospitals.

It is precisely due to the benchmark effect of these rehabilitation departments and the positive changes brought about by the informatization of rehabilitation that Huawei’s rehabilitation information system has been implemented in the rehabilitation departments and institutions of hundreds of hospitals across China within a few years. Partner hospitals include the Chinese PLA General Hospital (301 Hospital), Peking University Third Hospital, Beijing Hospital, Xuanwu Hospital of Capital Medical University, China-Japan Friendship Hospital, Huashan Hospital of Fudan University, Ruijin Hospital of Shanghai Jiao Tong University, Zhujiang Hospital of Southern Medical University, Southwest Hospital of Army Medical University, Bayi Rehabilitation Center, and Xiangya Bo’ai Rehabilitation Hospital, among others.

Especially in Beijing, Shanghai, Sichuan-Chongqing and other regions, many hospitals have been increasing their attention and investment in the field of rehabilitation this year. Rehabilitation departments at hospitals of all levels are either building rehabilitation information systems or actively integrating into multi-tier rehabilitation networks led by leading hospitals.

According to Liu Cheng, rehabilitation departments with a team of more than 10 rehabilitation specialists and over 30 hospital beds all have a demand for establishing rehabilitative information systems.Moreover, rehabilitation departments in hospitals that currently possess rehabilitation information systems generally report annual revenues exceeding RMB 10 million. While there are over 1,000 such rehabilitation departments and specialized rehabilitation hospitals in China, only one-tenth have completed their informatization construction, indicating substantial untapped opportunities for the future.。

Overall, the informatization of rehabilitation is just getting underway. Following the developmental patterns of rehabilitation diagnosis and treatment and keeping pace with advances in medical informatics, it is evolving from within hospitals to beyond hospital walls, from serving physicians, nurses, and caregivers to connecting patients and their families, from local area network systems to internet-based cloud platforms, and from clinical application systems to intelligent rehabilitation big data platforms. The journey toward comprehensive rehabilitation informatization is long, yet its prospects are promising.