Perceived Value of Electronic Medical Records in Community Health Services: A National Cross-Sectional Survey of Primary Care Workers in Mainland China

Abstract

Objective: To evaluate the degree to which electronic medical records (EMRs) were used in primary care and the value of EMRs as perceived by primary care workers in China. Methods: A cross-sectional survey was conducted on 2719 physicians (n = 2213) and nurses (n = 506) selected from 462 community health centres across all regions of mainland China except for Tibet. Regional differences in the responses regarding the functionality of existing EMR systems and the perceived value of EMRs were examined using Chi-square tests and ordinal regression analyses. Results: Less than 59% of the community health centres had adopted EMRs. More than 89% of the respondents believed that it was necessary to adopt EMRs in primary care. Of the existing EMR systems, 50% had access to telehealth support for laboratory, imaging or patient consultation services. Only 38.4% captured data that met all task needs and 35.4% supported referral arrangements. “Management of chronic conditions” was voted (66%) as the top preferred feature of EMRs. Higher levels of recognition of the value of EMRs were found in the relatively more developed eastern region compared with their counterparts in other regions. Conclusions: Rapid EMR adoption in primary care is evident in mainland China. The low level of functionality in data acquisition and referral arrangements runs counter to the requirements for “management of chronic conditions”, the most preferred feature of EMRs in primary care. Regional disparities in the realised value of EMRs in primary care deserve policy attention.

Nurses' Perception on the Implementation of Nursing Care Documentation Using Electronic Medical Record: A Literature Review

“…16 Other results showed that the majority of respondents supported the development of EMR systems in primary care. 17 EMR functions that received approval from respondents included decision support, information sharing between organizations, improving work efficiency, and providing real-time health questions. 18 However, differences in perception were found between less developed and more advanced regions.…”

Barriers to Community-Based Primary Health Care Delivery in Urban China: A Systematic Mapping Review

“…Many recent studies reveal that the workforce is vital to patient management in CB-PHC settings [13,45]. The number and level of training of community health workers are significant predicators of service utilization, quality of health supervision, and the proper use of medical equipment [51,54]. Although painstaking efforts have been made to address these issues by Chinese authorities, such as intensified university education for medical students, the cosmetic and unsystematic on-the-job training provided for active health workers con-siderably impairs human resources in CB-PHC settings [13].…”

“…Community health practitioners are often incapable of giving up-todate health advice, applying evidence-based practices, understanding and implementing emerging state policies and recommendations, and effectively monitoring antibiotic use, cases of depression, psychological problems, and the ethics of relationships with patients because of inadequate training [51][52][53]. Moreover, the shortage of qualified practitioners has obstructed the progress of the digitalization of CB-PHC services and the modernization of the national healthcare system [54].…”

“…The second-rate equipment has, of course, had a negative effect on CB-PHC service delivery. On the side of service providers, second-rate equipment makes updating patients' health records, accessing medical data, making referrals, and sharing information unnecessarily grueling; the innovative care practices recommended by national guidelines are difficult to follow; and state-of-the-art learning materials and protocols are in short supply [45,51,52,54]. From the patients' point of view, the lack of advanced equipment is discouraging and reinforces the preference for specialist care in hospitals, contributing to the imbalance of service use between different levels of healthcare institutions [55].…”

Barriers to community healthcare delivery in urban China: a nurse perspective

“…The handling of patient information remains substandard, jeopardizing treatment feedback and follow-up examinations (H. Li et al, 2016 ; Liu et al, 2021 ). The lack of competent healthcare practitioners and equipment leads to heavy workloads, discouraging innovative treatments and modern medicine (Xia et al, 2020 ).…”