JMIR Medical Informatics Clinical informatics, decision support for health professionals, electronic health records, and eHealth infrastructures Volume 8 (2020), Issue 2 ISSN: 2291-9694 Contents Original Papers Evaluating the Applications of Health Information Technologies in China During the Past 11 Years: Consecutive Survey Data Analysis (e17006) Jun Liang, Ying Li, Zhongan Zhang, Dongxia Shen, Jie Xu, Gang Yu, Siqi Dai, Fangmin Ge, Jianbo Lei. 3 Intellectual Structure and Evolutionary Trends of Precision Medicine Research: Coword Analysis (e11287) Xiaoguang Lyu, Jiming Hu, Weiguo Dong, Xin Xu. 19 Analyzing Medical Research Results Based on Synthetic Data and Their Relation to Real Data Results: Systematic Comparison From Five Observational Studies (e16492) Anat Reiner Benaim, Ronit Almog, Yuri Gorelik, Irit Hochberg, Laila Nassar, Tanya Mashiach, Mogher Khamaisi, Yael Lurie, Zaher Azzam, Johad Khoury, Daniel Kurnik, Rafael Beyar. 39 Detection of Postictal Generalized Electroencephalogram Suppression: Random Forest Approach (e17061) Xiaojin Li, Shiqiang Tao, Shirin Jamal-Omidi, Yan Huang, Samden Lhatoo, Guo-Qiang Zhang, Licong Cui. 53 The Impact of Electronic Health Records on the Duration of Patients'Visits:Time and Motion Study (e16502) Abdulrahman Jabour. 64 Optimizing Antihypertensive Medication Classification in Electronic Health Record-Based Data: Classification System Development and Methodological Comparison (e14777) Caitrin McDonough, Steven Smith, Rhonda Cooper-DeHoff, William Hogan. 73 Evaluation of Privacy Risks of Patients' Data in China: Case Study (e13046) Mengchun Gong, Shuang Wang, Lezi Wang, Chao Liu, Jianyang Wang, Qiang Guo, Hao Zheng, Kang Xie, Chenghong Wang, Zhouguang Hui. 85 Identifying Acute Low Back Pain Episodes in Primary Care Practice From Clinical Notes: Observational Study (e16878) Riccardo Miotto, Bethany Percha, Benjamin Glicksberg, Hao-Chih Lee, Lisanne Cruz, Joel Dudley, Ismail Nabeel. 94 A Communication Infrastructure for the Health and Social Care Internet of Things: Proof-of-Concept Study (e14583) Vincenzo Della Mea, Mihai Popescu, Dario Gonano, Tomaž Petaros, Ivo Emili, Maria Fattori. 109 Analysis of Massive Online Medical Consultation Service Data to Understand Physicians' Economic Return: Observational Data Mining Study (e16765) Jinglu Jiang, Ann-Frances Cameron, Ming Yang. 120 JMIR Medical Informatics 2020 | vol. 8 | iss. 2 | p.1 XSL·FO RenderX Just Because (Most) Hospitals Are Publishing Charges Does Not Mean Prices Are More Transparent (e14436) Cody Mullens, J Hernandez, Evan Anderson, Lindsay Allen. 133 Expedited Safety Reporting Through an Alert System for Clinical Trial Management at an Academic Medical Center: Retrospective Design Study (e14379) Yu Park, HaYeong Koo, Young-Kwang Yoon, Sumi Park, Young-Suk Lim, Seunghee Baek, Hae Kim, Tae Kim. 139 Explanatory Model of Dry Eye Disease Using Health and Nutrition Examinations: Machine Learning and Network-Based Factor Analysis From a National Survey (e16153) Sang Nam, Thomas Peterson, Atul Butte, Kyoung Seo, Hyun Han. 148 JMIR Medical Informatics 2020 | vol. 8 | iss. 2 | p.2 XSL·FO RenderX JMIR MEDICAL INFORMATICS Liang et al Original Paper Evaluating the Applications of Health Information Technologies in China During the Past 11 Years: Consecutive Survey Data Analysis Jun Liang1, MS; Ying Li2, MD; Zhongan Zhang3, BS; Dongxia Shen4, MS; Jie Xu1, MS; Gang Yu5, MS; Siqi Dai6, MSc; Fangmin Ge7, MS; Jianbo Lei8,9,10, MD, PhD 1IT Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China 2Department of Burn and Plastic Surgery, Affiliated Hospital of Southwest Medical University, Luzhou, China 3Performance Management Department, Qingdao Central Hospital, Qingdao, China 4Editorial Department of Journal of Practical Oncology, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China 5IT Center, Children's Hospital, School of Medicine, Zhejiang University, Hangzhou, China 6School of Medicine, Zhejiang University, Hangzhou, China 7International Network Medical Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China 8Center for Medical Informatics, Peking University, Beijing, China 9Institute of Medical Technology, Health Science Center, Peking University, Beijing, China 10School of Medical Informatics and Engineering, Southwest Medical University, Luzhou, China Corresponding Author: Jianbo Lei, MD, PhD Institute of Medical Technology Health Science Center Peking University 38 Xueyuan Rd, Haidian District Beijing, 100191 China Phone: 86 8280 5901 Email: [email protected] Abstract Background: To achieve universal access to medical resources, China introduced its second health care reform in 2010, with health information technologies (HIT) as an important technical support point. Objective: This study is the first attempt to explore the unique contributions and characteristics of HIT development in Chinese hospitals from the three major aspects of hospital HITÐhuman resources, funding, and materialsÐin an all-around, multi-angled, and time-longitudinal manner, so as to serve as a reference for decision makers in China and the rest of the world when formulating HIT development strategies. Methods: A longitudinal research method is used to analyze the results of the CHIMA Annual Survey of Hospital Information System in China carried out by a Chinese national industrial association, CHIMA, from 2007 to 2018. The development characteristics of human resources, funding, and materials of HIT in China for the past 12 years are summarized. The Bass model is used to fit and predict the popularization trend of EMR in Chinese hospitals from 2007 to 2020. Results: From 2007 to 2018, the CHIMA Annual Survey interviewed 10,954 hospital CIOs across 32 administrative regions in Mainland China. Compared with 2007, as of 2018, in terms of human resources, the average full time equivalent (FTE) count in each hospital's IT center is still lower than the average level of US counterparts in 2014 (9.66 FTEs vs. 34 FTEs). The proportion of CIOs with a master's degree or above was 25.61%, showing an increase of 18.51%, among which those with computer-related backgrounds accounted for 64.75%, however, those with a medical informatics background only accounted for 3.67%. In terms of funding, the sampled hospitals'annual HIT investment increased from ¥957,700 (US $136,874) to ¥6.376 million (US $911,261), and the average investment per bed increased from ¥4,600 (US $658) to ¥8,100 (US $1158). In terms of information system construction, as of 2018, the average EMR implementation rate of the sampled hospitals exceeded the average level of their US https://medinform.jmir.org/2020/2/e17006 JMIR Med Inform 2020 | vol. 8 | iss. 2 | e17006 | p.3 (page number not for citation purposes) XSL·FO RenderX JMIR MEDICAL INFORMATICS Liang et al counterparts in 2015 and their German counterparts in 2017 (85.26% vs. 83.8% vs. 68.4%, respectively). The results of the Bass prediction model show that Chinese hospitals will likely reach an adoption rate of 91.4% by 2020 (R2=0.95). Conclusions: In more than 10 years, based on this top-down approach, China's medical care industry has accepted government instructions and implemented the unified model planned by administrative intervention. With only about one-fifth of the required funding, and about one-fourth of the required human resources per hospital as compared to the US HITECH project, China's EMR coverage in 2018 exceeded the average level of its US counterparts in 2015 and German counterparts in 2017. This experience deserves further study and analysis by other countries. (JMIR Med Inform 2020;8(2):e17006) doi:10.2196/17006 KEYWORDS medical informatics; health information technologies; China; health care reform; hospitals For details of the investment and expected results, see Introduction Multimedia Appendix 1. According to the latest administrative Health information technologies (HIT) can effectively improve directive issued by the National Health Commission of the the quality and efficiency of medical services, distribution of People's Republic of China in August 2018, the use of electronic health care resources, safety in health care, and output of medical records (EMR) in hospitals should be included in the scientific research. Therefore, governments of various countries index system for hospital performance evaluation [7]. have set up ambitious plans to develop HIT and invested Despite the formulation of very active macro policies and the enormous amounts of money in this development, using HIT investment of a large amount of funds, governments of various as an important starting point for the reformation of medical countries have always faced significant challenges in the services and medical systems. technological research and development, project implementation, The US government invested $787 billion in the American effect evaluation, and speed of advancement of HIT. Recovery and Reinvestment Act of 2009. In particular, $19 Governments, academic circles, and industries have constantly billion of this investment was used to promote nationalized and presented the relevant experience and lessons. Kruse et al [8] interoperable health information systems and implement them collected 3636 articles and selected 37 articles for final research; through the Health Information Technology for Economic and they found that 81% of the research projects believed that the Clinical Health (HITECH) Act [1]. Its core Meaningful Use HIT