Empowering village doctors and enhancing rural healthcare using cloud computing in a rural area of mainland China

Che-Wei Lin; Shabbir Syed Abdul; Daniel L Clinciu; Jeremiah Scholl; Xiangdong Jin; Haifei Lu; Steve S Chen; Usman Iqbal; Maxwell J Heineck; Yu-Chuan Li

doi:10.1016/j.cmpb.2013.10.005

Empowering village doctors and enhancing rural healthcare using cloud computing in a rural area of mainland China

Comput Methods Programs Biomed. 2014 Feb;113(2):585-92. doi: 10.1016/j.cmpb.2013.10.005. Epub 2013 Nov 9.

Authors

Affiliations

¹ Graduate Institute of Medical Informatics, Taipei Medical University and Taipei Medical University Hospital, Taipei, Taiwan.
² College of Medical Science and Technology, Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan; Institute of Biomedical Informatics, National Yang Ming University, Taipei, Taiwan.
³ College of Medical Science and Technology, Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan; Institute of Translational Medicine, Taipei Medical University, Taipei, Taiwan.
⁴ Health Informatics Centre, Karolinska Institutet, Sweden.
⁵ Healthgrid Technology Inc., Beijing, China.
⁶ College of Medical Science and Technology, Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan.
⁷ Institute of Industrial Management, King Fahd University, Dhahran, Saudi Arabia.
⁸ College of Medical Science and Technology, Graduate Institute of Biomedical Informatics, Taipei Medical University, Taipei, Taiwan; Department of Dermatology, Wanfang Hospital, Taipei, Taiwan. Electronic address: jack@tmu.edu.tw.

PMID: 24296075
DOI: 10.1016/j.cmpb.2013.10.005

Abstract

Background: China's healthcare system often struggles to meet the needs of its 900 million people living in rural areas due to major challenges in preventive medicine and management of chronic diseases. Here we address some of these challenges by equipping village doctors (ViDs) with Health Information Technology and developing an electronic health record (EHR) system which collects individual patient information electronically to aid with implementation of chronic disease management programs.

Methods: An EHR system based on a cloud-computing architecture was developed and deployed in Xilingol county of Inner Mongolia using various computing resources (hardware and software) to deliver services over the health network using Internet when available. The system supports the work at all levels of the healthcare system, including the work of ViDs in rural areas. An analysis done on 291,087 EHRs created from November 2008 to June 2011 evaluated the impact the EHR system has on preventive medicine and chronic disease management programs in rural China.

Results: From 2008 to 2011 health records were created for 291,087 (26.25%) from 1,108,951 total Xilingol residents with 10,240 cases of hypertension and 1152 cases of diabetes diagnosed and registered. Furthermore, 2945 hypertensive and 305 diabetic patients enrolled in follow-up. Implementing the EHR system revealed a high rate of cholecystectomies leading to investigations and findings of drinking water contaminated with metals. Measures were taken to inform the population and clean drinking water was supplied.

Conclusions: The cloud-based EHR approach improved the care provision for ViDs in rural China and increased the efficiency of the healthcare system to monitor the health status of the population and to manage preventive care efforts. It also helped discover contaminated water in one of the project areas revealing further benefits if the system is expanded and improved.

Keywords: Cloud computing; Electronic health record; Health information technology; Rural healthcare; Village doctor.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

China
Computer Security
Electronic Health Records*
Humans
Medical Informatics*
Physicians / psychology*
Power, Psychological*
Quality of Health Care*
Rural Health Services* / standards
User-Computer Interface
Workforce