Yongchuan District, Chongqing Achieves Interoperability of Medical Data Across the Region

In recent years, Yongchuan District in Chongqing has successfully broken down “information silos” by integrating information resources and unifying data standards. This has achieved interconnectivity of information data among tertiary medical institutions across the district, thereby awakening the vast amounts of “dormant” data held by various healthcare providers. These efforts have reduced the burden on patients seeking medical care, facilitated the implementation of tiered diagnosis and treatment, and to some extent alleviated the difficulties and high costs associated with accessing healthcare.

Integrating Resources and Unifying Standards to Break Down Medical "Information Silos"

Prior to 2013, medical institutions in Yongchuan District had each established their own medical information systems. However, due to inconsistent data standards and insufficient integration efforts, these institutions operated as isolated “information silos,” thereby increasing the financial burden on patients and resulting in the waste of medical resources.

Zou Guangming, Director of the Yongchuan District Health and Family Planning Commission, stated that in 2012, Yongchuan District deployed dedicated networks across medical institutions at all levels and invested nearly RMB 8 million to establish a regional data center. This initiative centralized data information from healthcare facilities throughout the district, including electronic medical records, electronic prescriptions, and resident health archives, thereby laying the data foundation for breaking down “information silos.”

The lack of uniform data standards across medical institutions is the biggest obstacle to breaking down “information silos.” In 2013, Yongchuan District cleaned up and integrated health information data across the entire district, leveraging professional tools to achieve heterogeneous data collection, cleaning, and transformation into standardized data, thereby enabling interoperability of healthcare information data at the district, township, and village levels.

Reporters observed that by entering a resident’s name into the integrated system of the Yongchuan District Medical Data Center, their file information, medical visit records across all healthcare institutions, and examination reports become immediately visible. The system also encompasses data on lifestyle habits, past medical history, and family medical history. Meanwhile, the information platform remains in a state of continuous real-time updates; electronic prescriptions issued by medical personnel throughout the district, as well as drug procurement information from healthcare institutions, are synchronously uploaded to the platform.

Furthermore, to protect patient privacy, Yongchuan District has implemented a tiered classification system for medical information based on its sensitivity and established differentiated access permissions for healthcare institutions at various levels. For instance, medical personnel are only authorized to access the records of patients who have registered for consultation with them. Additionally, regulations have been issued explicitly stipulating that diagnostic and treatment information shall be used solely for the purpose of providing medical services to patients.

Awakening “Dormant Data” to Alleviate the “Difficulty and High Cost of Medical Care”

Reporters’ research has found that breaking down “information silos” in Yongchuan District has successfully unlocked vast amounts of data “lying dormant” across various medical institutions, reduced the healthcare burden on patients, facilitated the implementation of tiered diagnosis and treatment, and to some extent alleviated the difficulties and high costs associated with accessing medical care.

——Medical information sharing and utilization reduce the burden of healthcare for patients. Jiang Bing, a physician at Yongchuan Hospital Affiliated to Chongqing Medical University, stated that previously, there was no access to patients’ prior visits, medication history, test results, or medical records, forcing clinicians to “start from scratch” with every new encounter. Now, simply entering a patient’s name provides immediate access to their comprehensive medical information. Leveraging patients’ health big data helps avoid redundant diagnoses and duplicate testing, thereby alleviating patients’ healthcare burdens and significantly conserving medical resources.

— Convenient online “two-way referral” facilitates tiered diagnosis and treatment. Xiong Enyuan, a 70-year-old patient with pneumothorax from Shengli Subdistrict in Yongchuan District, required referral due to the severity of his condition, which exceeded the treatment capacity of the Shengli Subdistrict Community Health Center. With just a few clicks on the medical information platform, the physician printed a referral form for the Yongchuan Hospital Affiliated to Chongqing Medical University. Mr. Xiong, who had anticipated that seeking care at a large hospital would be time-consuming and cumbersome, was able to bypass registration and proceed directly to the Department of Respiratory Medicine for inpatient treatment using the referral form, completing the entire process in under 15 minutes.

“Previously, referrals required filling out paper referral forms and calling large hospitals to coordinate arrangements. Patients also had to wait in line for examinations upon arrival, which took at least several hours,” said Zhou Yongping, a physician at the Shengli Subdistrict Community Health Center. Nowadays, it is only necessary to click the “Referral” button in the medical information system to transmit patient data to higher-level hospitals. Once approved, patients can be directly admitted for inpatient treatment. When their condition improves, they can also be referred back to the community for rehabilitation through the same process.

——Interconnectivity of operational data enhances administrative management. Zou Guangming stated that in the past, health administrative departments primarily relied on on-site spot checks to supervise issues such as excessive prescribing and antibiotic misuse in hospitals, which posed significant challenges. “Now, through real-time updates of medical operational data, we can dynamically monitor prescription patterns, inventory movements of pharmaceuticals and consumables, and antibiotic usage. This enables dynamic oversight of medical institutions and end-to-end tracking of pharmaceutical distribution, while also compelling hospitals to standardize their clinical practices.”

According to statistics, from 2013 to the present, Yongchuan District has leveraged an interconnected medical information platform to save a total of RMB 678,000 for the public, while reducing patients’ average consultation time by more than half compared with traditional healthcare models. Meanwhile, the proportion of pharmaceutical costs in medical institutions decreased by 2.6 percentage points year on year; the average cost per outpatient visit dropped by 4.9% year on year; and the consumption of sanitary materials per RMB 100 of medical revenue declined by 3.9% year on year.

Enhancing Features to Build the “Health Cloud”: Policy Support Needed for Replication and Promotion

Li Ling, a professor at the National School of Development at Peking University and an expert on healthcare reform issues, stated that the significance of Yongchuan District’s innovative practice in Chongqing lies in its achievement of interconnectivity and interoperability of medical information data within a prefecture-level administrative region for the first time. Previously, similar initiatives in other regions were limited to individual hospitals or between select hospitals. Replicating and promoting this model would undoubtedly facilitate the smooth advancement of healthcare reform.

Taking Taiwan as an example, its interconnected healthcare information system covers all medical institutions, forming a vast “cloud-based medication history” database. This enables the sharing and review of patients’ medical records across different hospitals, effectively avoiding issues such as redundant diagnoses and duplicate prescriptions, and saving nearly RMB 1 billion annually.

Li Ling stated that this requires coordination and integration by higher-level government authorities. It is essential to gradually unify standards for medical informatization while addressing the concerns of hospitals, thereby incentivizing physicians, hospital administrators, and enterprises to actively participate. Only through such efforts can interoperability of medical data be achieved on a broader scale.

Source: Economic Information Daily