Presentation (CTI)

OBJECTIVES: China hosts one of the world’s largest and most diverse healthcare systems. Over the past decade, the adoption of Electronic Health Records (EHRs) across hospitals has surged, driven by national policies promoting digitalization. This study provides an overview of Chinese EHR databases for generating real-world evidence (RWE), highlighting their potential and challenges.
METHODS: Drawing from our experience in implementing RWE studies in China to inform Health Technology Assessments (HTA), we summarize key characteristics of available EHR databases, their suitability for therapeutic areas (TA), and the opportunities and challenges in RWE generation.
RESULTS: 1) EHR key features: Geographic coverage (a) Regional databases integrate data from most hospitals within a city/region, providing comprehensive patient-level data across care settings. While geographically limited, they capture continuity of care, making them suitable for TAs requiring frequent, multi-facility care. (b) Multi-regional databases pool data from multiple cities, focusing on large hospitals, supporting large-scale studies in areas like oncology and rare diseases. Data variety: (a) Structured data includes demographics, diagnoses, procedures, visits, prescriptions and costs across inpatient and outpatient care. (b) Unstructured data, such as physician notes, provides important clinical and treatment information (e.g. BMI or disease-specific scores/stages).
2) Opportunities: Cross-regional hospital data allow to support studies in diverse TAs by leveraging databases with comprehensive and/or partial regional/city coverage. Advances in Natural Language Processing (NLP) enable detailed analyses of unstructured data. Government support for digitalization promotes continuous improvements in data quality.
3) Challenges: Data standardization issues persist, with inconsistent coding and formatting requiring extensive curation. Fragmented EHRs with limited interoperability delay large-scale integration. Urban-rural disparities restrict data representation, while gaps in linking databases (e.g., claims data) limit economic burden analyses.
CONCLUSIONS: EHR databases in China hold immense potential for large-scale RWE generation. Addressing challenges in standardization, interoperability, and coverage will enhance their utility in supporting robust HTAs and healthcare decision-making.