ArticlePloS one2025
When access ≠ acceptance: How clinical specialty demands shape mutual recognition on medical examination/test result reuse in Chinese hospitals: A study on a pilot province of China's medical digital reform.
Article in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.
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- The translational chasm in machine learning for triple-negative breast cancer: a quantitative landscape assessment.Frontiers in oncology · 2026Pooled it
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6 authors.
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Abstract
backgroundDespite widespread electronic health records adoption, interoperability for sharing examination/test results across healthcare institutions remains limited, leading to redundant testing, increased costs, and compromised care. China's mutual recognition policy for medical examination/test results, implemented via the interoperable results sharing platform(IRSP), aims to address this. However, variations in adoption across clinical specialties and the impact of hospital-level pathway interventions are poorly understood.
methodsUtilizing hospital-level administrative data from Zhejiang Province's IRSP (Oct 2023 - Sep 2024), this quasi-experimental study compared three intervention hospitals (blocking the "Overlook Access" pathway) with three control hospitals. We analyzed core recognition metrics (Access Rate-AR, Total Recognition Rate-TRR, Cross-Hospital Access Rate-CHAR, Cross-Hospital Recognition Rate-CHRR) across 12 clinical specialties. Analyses employed magnitude-based inference for intervention effects, Spearman correlations for specialty variations, and descriptive statistics for hospital-type comparisons.
resultsBlocking the "Overlook Access" pathway significantly increased access metrics (AR: Intervention median 98.9% vs. Control 44.6%, Cohen's d = 2.02; CHAR: 99.5% vs. 57.6%, d = 2.85) but paradoxically decreased TRR (18.2% vs. 44.3%, d = -2.72), with minimal impact on CHRR. Substantial variations existed across specialties: Orthopedics and traditional Chinese medicine showed consistently higher access and recognition, while hepatobiliary and endocrinology faced significant challenges. Pediatrics exhibited high access but critically low recognition (e.g., Hospital H: TRR 2.05%, CHRR 2.82%), attributed to rapid physiological changes and data applicability concerns. Strong correlations existed within access metrics (AR-CHAR, ρ = 0.92, p < 0.001) and within recognition metrics (TRR-CHRR, ρ = 0.88, p < 0.001), but weak correlations between access and recognition.
conclusionThis study reveals a critical distinction between access to external medical records and their actual clinical recognition, demonstrating that information interventions alone are insufficient to improve the recognition rates. Clinical specialty-specific factors significantly influence recognition behaviors, reflecting variations in data utility, stability, and diagnostic practices. Institutional success in promoting mutual recognition depends on comprehensive, multi-level strategies. The IRSP exemplifies China's progress in health data interoperability, yet sustainable mutual recognition ultimately hinges on clinical relevance rather than mere accessibility.
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