Xu Jian
Department of Health Policy, Beijing Municipal Health Big Data and Policy Research Center, Beijing, China.
JMIR Med Inform. 2024 Feb 5;12:e52080. doi: 10.2196/52080.
In the 21st century, Chinese hospitals have witnessed innovative medical business models, such as online diagnosis and treatment, cross-regional multidepartment consultation, and real-time sharing of medical test results, that surpass traditional hospital information systems (HISs). The introduction of cloud computing provides an excellent opportunity for hospitals to address these challenges. However, there is currently no comprehensive research assessing the cloud migration of HISs in China. This lack may hinder the widespread adoption and secure implementation of cloud computing in hospitals.
The objective of this study is to comprehensively assess external and internal factors influencing the cloud migration of HISs in China and propose promotional strategies.
Academic articles from January 1, 2007, to February 21, 2023, on the topic were searched in PubMed and HuiyiMd databases, and relevant documents such as national policy documents, white papers, and survey reports were collected from authoritative sources for analysis. A systematic assessment of factors influencing cloud migration of HISs in China was conducted by combining a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis and literature review methods. Then, various promotional strategies based on different combinations of external and internal factors were proposed.
After conducting a thorough search and review, this study included 94 academic articles and 37 relevant documents. The analysis of these documents reveals the increasing application of and research on cloud computing in Chinese hospitals, and that it has expanded to 22 disciplinary domains. However, more than half (n=49, 52%) of the documents primarily focused on task-specific cloud-based systems in hospitals, while only 22% (n=21 articles) discussed integrated cloud platforms shared across the entire hospital, medical alliance, or region. The SWOT analysis showed that cloud computing adoption in Chinese hospitals benefits from policy support, capital investment, and social demand for new technology. However, it also faces threats like loss of digital sovereignty, supplier competition, cyber risks, and insufficient supervision. Factors driving cloud migration for HISs include medical big data analytics and use, interdisciplinary collaboration, health-centered medical service provision, and successful cases. Barriers include system complexity, security threats, lack of strategic planning and resource allocation, relevant personnel shortages, and inadequate investment. This study proposes 4 promotional strategies: encouraging more hospitals to migrate, enhancing hospitals' capabilities for migration, establishing a provincial-level unified medical hybrid multi-cloud platform, strengthening legal frameworks, and providing robust technical support.
Cloud computing is an innovative technology that has gained significant attention from both the Chinese government and the global community. In order to effectively support the rapid growth of a novel, health-centered medical industry, it is imperative for Chinese health authorities and hospitals to seize this opportunity by implementing comprehensive strategies aimed at encouraging hospitals to migrate their HISs to the cloud.
在21世纪,中国医院见证了创新的医疗商业模式,如在线诊断与治疗、跨地区多科室会诊以及医学检验结果的实时共享,这些模式超越了传统医院信息系统(HIS)。云计算的引入为医院应对这些挑战提供了绝佳机遇。然而,目前尚无全面评估中国医院信息系统向云迁移的研究。这种缺失可能会阻碍云计算在医院中的广泛应用和安全实施。
本研究旨在全面评估影响中国医院信息系统云迁移的内外部因素,并提出推广策略。
在PubMed和慧医网数据库中检索2007年1月1日至2023年2月21日关于该主题的学术文章,并从权威来源收集国家政策文件、白皮书和调查报告等相关文献进行分析。通过结合优势、劣势、机会和威胁(SWOT)分析与文献综述方法,对影响中国医院信息系统云迁移的因素进行系统评估。然后,基于内外部因素的不同组合提出各种推广策略。
经过全面检索和审查,本研究纳入了94篇学术文章和37份相关文献。对这些文献的分析表明,云计算在中国医院中的应用和研究不断增加,已扩展到22个学科领域。然而,超过一半(n = 49,52%)的文献主要关注医院中特定任务的基于云的系统,而只有22%(n = 21篇文章)讨论了跨整个医院、医疗联盟或地区共享的集成云平台。SWOT分析表明,中国医院采用云计算受益于政策支持、资本投入以及社会对新技术的需求。然而,它也面临数字主权丧失、供应商竞争、网络风险和监管不足等威胁。推动医院信息系统云迁移的因素包括医疗大数据分析与应用、跨学科协作、以健康为中心的医疗服务提供以及成功案例。障碍包括系统复杂性、安全威胁、缺乏战略规划和资源分配、相关人员短缺以及投资不足。本研究提出了4种推广策略:鼓励更多医院迁移、增强医院的迁移能力、建立省级统一的医疗混合多云平台、加强法律框架并提供强大的技术支持。
云计算是一项创新技术,已受到中国政府和国际社会的高度关注。为了有效支持以健康为中心的新型医疗行业的快速发展,中国卫生当局和医院必须抓住这一机遇,实施全面战略,鼓励医院将其医院信息系统迁移到云端。