Study On The Mechanism Of Admission And Diffusion Of Electronic Medical Record System

In order to adapt to the development of the growing health needs from people and the new demand of the social economic development for the health promotion, and according to the requirement of reform scheme of the medical and health system, the State Council puts forward the 12th Five-Year Plan about the health development, it pointed out that the state must put the promoting the medical and health information construction as a priority task in the future five years. As the important task and technology support of the deepening of China’s reform of the medical and health system, the implementation of velocity and depth of health information construction will directly affect the medical and health service level. Now, we are during the stage of clinical information construction, and the electronic medical record system is the core and key to the stage of construction, therefore,focus on the adoption and diffusion of EMR has important theoretical and practical significance to promote the informationization of medical industry and achieve meaningful use.Accordingly, under the background of the medical information construction in our country, based on the theory of information systems adoption and diffusion and survival analysis, this paper choose the medical organizations as the research object, to build the Cox model which is a semi-parametric research method. It includes the hospital level, teach status, age, size, age*size and environment characteristics such as geographical location as influencing factors. Meanwhile, according to the research results of theories and researchers, puts forward 10 research hypotheses on the relationship between the factors and the adoption behavior.The article uses empirical study to verify the proposed hypothesis. Firstly, according to the factors, designing the questionnaire, and using the field survey, network survey method, to investigate the electronic medical record system construction of hospitals that above the level two in Yunnan Province, and 222 usable questionnaires were collected; secondly, statistical analysis the characteristics and the various factors; thirdly, using Statal2.0 to test the proportion hazard(PH) rate fix of variables by graphic method and residual Schoenfeld, besides the hospital level does not conform to the PH is fixed, the remaining variables are in line with the conditions; fourth, using Cox analysis module in the software to analysis the Cox model and strata Cox model layered with hospital level; fifth, repeat the analysis process using the sample removing special hospital data; finally, according to the results of the three different conditions of Cox model, show that teaching status, size and age are positive factors, geographical location and age*size as negative factors, but the influence of the hospital level is not obvious, and the year of 2012 is the diffusion peak of EMR.With the results of empirical analysis, summarizes the factors influence and diffusion mechanism that the hospital adopted the EMR, and provides reasonable suggestions to speed up the process of informatization construction for the use of EMR subject, providers and implementation of the Department, and at the same time, points out the limitations of this study and suggestions for future research.