China’s EMR Market

Posted on October 30, 2013 I Written By

James Ritchie is a freelance writer with a focus on health care. His experience includes eight years as a staff writer with the Cincinnati Business Courier, part of the American City Business Journals network. Twitter @HCwriterJames.

Last week I wrote about what’s not happening in China: American firms getting a slice of the EMR market.

This time I thought it’d be interesting to look at what is happening with health IT in the world’s most populous country.

As I mentioned, that’s often easier said than done. The healthcare system has peculiarities, and the government doesn’t necessarily say what it’s planning. Some research firms have shied away from reporting on China’s EMR scene altogether.

But a case study released over the summer provides some fascinating market intelligence. The work by Arthur Daemmrich, associate professor at the University of Kansas School of Medicine, follows Shanghai Kingstar Winning Software Co. Ltd. as its founder seeks to increase its growth rate.

Three options that Zhou Wei was considering as the first quarter of 2013 drew to a close included continuing to grow organically, merging with another company and expanding into other geographies, including South Asia or even the United States.

Points worth noting:

  • Winning, with 1,000 employees, competed for hospital IT projects with five other large firms. A few hundred smaller companies provided more specialized offerings.
  • The government owned more than 90 percent of the country’s hospitals.
  • Winning had achieved 50 percent revenue growth in 2012 and expected the same in 2013, but Zhou was not satisfied. He felt that even more rapid growth was needed.
  • In 2008, 1 percent of China’s hospitals were using EMRs. By 2012, about 32 percent of higher-ranked hospitals — tier-II and tier-III institutions — had EMRs.
  • Medical record-keeping in China came nearly to a halt during World War II and the country’s civil war. Many leftover records were destroyed during the Cultural Revolution of the 1960s and 1970s. The country then began rebuilding its records infrastructure. Daemmrich wrote, “Outpatient visits and prescriptions were recorded on small booklets that patients kept and brought with them to the hospital or other specialized clinic. Most hospitals issued their own booklets, so patients could end up with several different sets of medical records at home.”
  • Zhou’s firm undertook a project at an 850-bed Chinese traditional medicine (TCM) hospital. At such institutions, treatments such as acupuncture and therapeutic massage are common. The company’s R&D director, Ma Wei Min, explained, “The interfaces of western medicine and TCM EMR systems are alike, because the patient flow paths at both kinds of hospitals are almost the same. But going back to the software writing stage, TCM EMRs required a different logic and very different terminology.”

It’s easy to get immersed in the health IT considerations of our own country and forget that other regions are undertaking similar efforts. In China, the goals of the EMR push are largely the same as they are in the United States, but it’s interesting how much local flavor comes into play. The fact that Winning’s founder was seeing 50 percent revenue growth but still expected more was amazing and speaks to the country’s pace of economic development. And the background on China’s record-keeping shows that the country’s task is not just to digitize processes that have long been in place, but to define exactly what a medical record is and how it should work.