Designing a Mobile Health Data Service for Rural China

A rural population of more than 100 million in China has no medical care. China's healthcare reform has a core goal of improving healthcare access for rural patients. To facilitate delivery of a web-based multi-specialty telemedicine program for chronic disease management in rural areas, and to better utilize health information resources in village clinics, we propose establishment of a mobile health data service. To design the software used by village physicians and mobile staff, we focus on the current international standards and open source technologies of health informatics. We propose a field study of this approach as an ancillary service of a telemedicine program in sample regions of rural China.;We explored four areas of public domain and/or open source software applications: electronic health record system, clinical data acquisition modalities, health information exchange, and web-based telemedicine. The key to a successful software package for Chinese users is software localization, from the international standards to China's national standards. We must use standards to guide the design and development of healthcare software applications. We also analyze the operational role and opportunities of health informatics in China's rural healthcare reform.;We design the field study to start from the sample regions of an existing telemedicine program. With input from local providers, we will customize software to local user requirements. We will train technicians and deploy them to rural clinics on scheduled days to collect health data, or to exchange information with local providers who have no Internet access. When technicians return to a health information exchange hub where Internet is available, the collected local information will be forwarded to a web-based multi-specialty telemedicine service. Appropriate returning messages will be routed to local providers through physical delivery to ensure information integrity. Phone calls or text messaging will be used only during a medical emergency. With lessons learned from this field study, we will establish a workable model of health information exchange and telemedicine to connect rural patients with medical services available only in the cities.