Editing Health informatics (section)

===Asia and Oceania===
In Asia and Australia-New Zealand, the regional group called the [[Asia Pacific Association for Medical Informatics]] (APAMI)<ref>{{cite web |url=http://www.apami.org |title=Asia Pacific Association of Medical Informatics}}</ref> was established in 1994 and now consists of more than 15 member regions in the Asia Pacific Region.

==== Australia ====
The [[Australasian College of Health Informatics]] (ACHI) is the professional association for health informatics in the Asia-Pacific region. It represents the interests of a broad range of clinical and non-clinical professionals working within the health informatics sphere through a commitment to quality, standards and ethical practice.<ref>{{cite web|url=http://www.ACHI.org.au|title=Australasian College of Health Informatics|access-date=3 May 2010}}Australasian College of Health Informatics</ref> ACHI is an academic institutional member of the [[International Medical Informatics Association]] (IMIA)<ref>{{cite web|url=http://www.imia.org/members/profiles/academic.lasso?-Search=Action&-Table=CGI&-MaxRecords=1&-SkipRecords=2&-Database=organizations&-SortField=english_vers&-SortOrder=ascending&type=academic&approved=yes|title=International Medical Informatics Association – Academic Institutional Members |publisher =Australian College of Health Informatics|date=12 August 2009|access-date=22 February 2010|archive-url=https://web.archive.org/web/20100706094511/http://imia.org/members/profiles/academic.lasso?-Search=Action&-Table=CGI&-MaxRecords=1&-SkipRecords=2&-Database=organizations&-SortField=english_vers&-SortOrder=ascending&type=academic&approved=yes|archive-date=6 July 2010}}</ref> and a full member of the Australian Council of Professions.<ref>{{cite web | url = http://www.ACHI.org.au | title = ACHI Memberships | work =  Australasian College of Health Informatics (ACHI) }}</ref>
ACHI is a sponsor of the "e-Journal for Health Informatics",<ref>{{cite web | url = http://www.ejhi.net/ojs/index.php/ejhi/about/journalSponsorship | title = eJHI Journal of Health Informatics | archive-url = https://web.archive.org/web/20110723113638/http://www.ejhi.net/ojs/index.php/ejhi/about/journalSponsorship | archive-date = 2011-07-23 }} (open access journal)</ref> an indexed and peer-reviewed professional journal. ACHI has also supported the "[[Australian Health Informatics Education Council]]" (AHIEC) since its founding in 2009.<ref>{{cite web | url = http://www.AHIEC.org.au | work = Australian Health Informatics Education Council (AHIEC) | title = AHIEC Auspicing Organisations }}</ref>

Although there are a number of health informatics organizations in Australia, the [[Health Informatics Society of Australia]]<ref>{{cite web|url=http://www.hisa.org.au|title=Health Informatics Society of Australia Ltd|access-date=3 April 2010}}</ref> (HISA) is regarded as the major umbrella group and is a member of the [[International Medical Informatics Association]] (IMIA). Nursing informaticians were the driving force behind the formation of HISA, which is now a company limited by guarantee of the members. The membership comes from across the informatics spectrum that is from students to corporate affiliates. HISA has a number of branches (Queensland, New South Wales, Victoria and Western Australia) as well as special interest groups such as nursing (NIA), pathology, aged and community care, industry and medical imaging (Conrick, 2006).

==== China ====
After 20 years, [[China]] performed a successful transition from its planned economy to a [[socialist market economy]]. Along this change, China's health care system also experienced a significant reform to follow and adapt to this historical revolution. In 2003, the data (released from [[Ministry of Health of the People's Republic of China]] (MoH)), indicated that the national health care-involved expenditure was up to [[RMB]] 662.33&nbsp;billion totally, which accounted for about 5.56% of nationwide gross domestic products. Before the 1980s, the entire health care costs were covered in central government annual budget. Since that, the construct of health care-expended supporters started to change gradually. Most of the expenditure was contributed by health insurance schemes and private spending, which corresponded to 40% and 45% of total expenditure, respectively. Meanwhile, the financially governmental contribution was decreased to 10% only. On the other hand, by 2004, up to 296,492 health care facilities were recorded in statistic summary of MoH, and an average of 2.4 clinical beds per 1000 people were mentioned as well.<ref name="IJMI76-p614-620">{{cite journal | vauthors = Zhang Y, Xu Y, Shang L, Rao K | title = An investigation into health informatics and related standards in China | journal = International Journal of Medical Informatics | volume = 76 | issue = 8 | pages = 614–20 | date = August 2007 | pmid = 16793329 | doi = 10.1016/j.ijmedinf.2006.05.003 }}</ref>

[[File:Proportion of nation-wide hospitals with HIS.tif|thumbnail|Proportion of nationwide hospitals with HIS in China by 2004]]
Along with the development of information technology since the 1990s, health care providers realized that the information could generate significant benefits to improve their services by computerized cases and data, for instance of gaining the information for directing patient care and assessing the best patient care for specific clinical conditions. Therefore, substantial resources were collected to build China's own health informatics system.

Most of these resources were arranged to construct [[hospital information system]] (HIS), which was aimed to minimize unnecessary waste and repetition, subsequently to promote the efficiency and quality-control of health care.<ref>{{cite journal | vauthors = Guo J, Takada A, Niu T, He M, Tanaka K, Sato J, Suzuki M, Takahashi K, Daimon H, Suzuki T, Nakashima Y, Araki K, Yoshihara H | title = Enhancement of CLAIM (clinical accounting information) for a localized Chinese version | journal = Journal of Medical Systems | volume = 29 | issue = 5 | pages = 463–71 | date = October 2005 | pmid = 16180482 | doi = 10.1007/s10916-005-6103-7 | s2cid = 17540005 }}</ref> By 2004, China had successfully spread HIS through approximately 35–40% of nationwide hospitals.<ref name="pmid15569497">{{cite journal | vauthors = Wang XJ, Hu J, Wang K, Yu H, Luo M, Lei WY | title = Setting-up and preliminary performance of the interactive teleradiological conference system based on virtual private network | journal = Chinese Medical Journal | volume = 117 | issue = 11 | pages = 1735–38 | date = November 2004 | pmid = 15569497 }}</ref> However, the dispersion of hospital-owned HIS varies critically. In the east part of China, over 80% of hospitals constructed HIS, in northwest of China the equivalent was no more than 20%. Moreover, all of the [[Centers for Disease Control and Prevention]] (CDC) above rural level, approximately 80% of health care organisations above the rural level and 27% of hospitals over town level have the ability to perform the transmission of reports about real-time epidemic situation through public health information system and to analysis infectious diseases by dynamic statistics.<ref>{{cite journal |vauthors= Rao KQ, Wang CY, Hu JP |title= Introduction of the National Public Health Emergency Response Information Systems Project |journal= [[Chinese Journal of Integrative Medicine]] |volume=1 |pages=2–5 |year=2005}}</ref>

China has four tiers in its health care system. The first tier is street health and workplace clinics and these are cheaper than hospitals in terms of medical billing and act as prevention centers. The second tier is district and enterprise hospitals along with specialist clinics and these provide the second level of care. The third tier is provisional and municipal general hospitals and teaching hospitals which provided the third level of care. In a tier of its own is the national hospitals which are governed by the Ministry of Health. China has been greatly improving its health informatics since it finally opened its doors to the outside world and joined the World Trade Organization (WTO). In 2001, it was reported that China had 324,380 medical institutions and the majority of those were clinics. The reason for that is that clinics are prevention centers and Chinese people like using traditional Chinese medicine as opposed to Western medicine and it usually works for the minor cases. China has also been improving its higher education in regards to health informatics.

At the end of 2002, there were 77 medical universities and medical colleges. There were 48 university medical colleges which offered bachelor, master, and doctorate degrees in medicine. There were 21 higher medical specialty institutions that offered diploma degrees so in total, there were 147 higher medical and educational institutions. Since joining the WTO, China has been working hard to improve its education system and bring it up to international standards.<ref>{{cite journal|url=http://jhi.sagepub.com/content/9/4/211.full.pdf|volume=9|issue=4|pages=211–23|doi=10.1177/1460458203094008|date=December 2003| vauthors = Wu MX, Yu P, Soar J |title=The Current Status of Health Informatics Higher Education in China|journal=Health Informatics Journal|s2cid=1699875}}</ref>
SARS played a large role in China quickly improving its health care system. Back in 2003, there was an outbreak of SARS and that made China hurry to spread HIS or Hospital Information System and more than 80% of hospitals had HIS. China had been comparing itself to Korea's health care system and figuring out how it can better its own system. There was a study done that surveyed six hospitals in China that had HIS. The results were that doctors did not use computers as much so it was concluded that it was not used as much for clinical practice than it was for administrative purposes. The survey asked if the hospitals created any websites and it was concluded that only four of them had created websites and that three had a third-party company create it for them and one was created by the hospital staff. In conclusion, all of them agreed or strongly agreed that providing health information on the Internet should be utilized.<ref>{{cite journal | vauthors = Kim J, Piao M, Jingwu W | title = The Current Status of Hospital Information Systems in Yanbian, China. | journal = Journal of Korean Society of Medical Informatics | date = March 2009 | volume = 15 | issue = 1 | pages = 133–40 | doi = 10.4258/jksmi.2009.15.1.133 | hdl = 10371/81954 | url = http://synapse.koreamed.org/Synapse/Data/PDFData/0088JKSMI/jksmi-15-133.pdf | archive-url = https://web.archive.org/web/20200710231011/https://synapse.koreamed.org/Synapse/Data/PDFData/0088JKSMI/jksmi-15-133.pdf | archive-date = 10 July 2020 | hdl-access = free }}</ref>

Collected information at different times, by different participants or systems could frequently lead to issues of misunderstanding, dis-comparing or dis-exchanging. To design an issues-minor system, health care providers realized that certain standards were the basis for sharing information and interoperability, however a system lacking standards would be a large impediment to interfere the improvement of corresponding information systems. Given that the standardization for health informatics depends on the authorities, standardization events must be involved with government and the subsequently relevant funding and supports were critical. In 2003, the Ministry of Health released the Development Lay-out of National Health Informatics (2003–2010)<ref>{{cite web|url=http://www.moh.gov.cn/uploadfile/200406/2004629144259379.doc |title=Development Layout of National Health Information|access-date=2017-11-03}}</ref> indicating the identification of standardization for health informatics which is 'combining adoption of international standards and development of national standards'.

In China, the establishment of standardization was initially facilitated with the development of vocabulary, [[Medical classification|classification and coding]], which is conducive to reserve and transmit information for premium management at national level. By 2006, 55 international/ domestic standards of vocabulary, classification and coding have served in hospital information system. In 2003, the 10th revision of the International Statistical Classification of Diseases and Related Health Problems ([[ICD-10]]) and the [[ICD-10 Clinical Modification]] (ICD-10-CM) were adopted as standards for diagnostic classification and acute care procedure classification. Simultaneously, the [[International Classification of Primary Care]] (ICPC) were translated and tested in China 's local applied environment.<ref>{{cite journal | vauthors = Kalra D, Beale T, Heard S | title = The openEHR Foundation | journal = Studies in Health Technology and Informatics|volume=115|pages=153–73|year=2005| pmid = 16160223 }}</ref>
Another coding standard, named [[Logical Observation Identifiers Names and Codes]] (LOINC), was applied to serve as general identifiers for clinical observation in hospitals.

Personal identifier codes were widely employed in different information systems, involving name, sex, nationality, family relationship, educational level and job occupation. However, these codes within different systems are inconsistent, when sharing between different regions. Considering this large quantity of vocabulary, classification and coding standards between different jurisdictions, the health care provider realized that using multiple systems could generate issues of resource wasting and a non-conflicting national level standard was beneficial and necessary. Therefore, in late 2003, the health informatics group in Ministry of Health released three projects to deal with issues of lacking national health information standards, which were the Chinese National Health Information Framework and Standardization, the Basic Data Set Standards of Hospital Information System and the Basic Data Set Standards of Public Health Information System.

The objectives of the Chinese National Health Information Framework and Standardization project were:<ref name="IJMI76-p614-620" />
# Establish national health information framework and identify in what areas standards and guidelines are required
# Identify the classes, relationships and attributes of national health information framework. Produce a conceptual health data model to cover the scope of the health information framework
# Create [[logical data model]] for specific domains, depicting the logical data entities, the data attributes, and the relationships between the entities according to the conceptual health data model
# Establish uniform represent standard for data elements according to the data entities and their attributes in conceptual data model and logical data model
# Circulate the completed health information framework and health data model to the partnership members for review and acceptance
# Develop a process to maintain and refine the China model and to align with and influence international health data models

===== Comparing China's EHR Standard and ASTM E1384 =====
In 2011, researchers from local universities evaluated the performance of China's [[Electronic Health Record]] (EHR) Standard compared with the [[American Society for Testing and Materials]] Standard Practice for Content and Structure of Electronic Health Records in the United States (ASTM E1384 Standard, withdrawn in 2017).<ref>{{cite journal |vauthors = Xu W, Guan Z, Cao H, Zhang H, Lu M, Li T |title = Analysis and evaluation of the Electronic Health Record standard in China: a comparison with the American national standard ASTM E1384 |journal = International Journal of Medical Informatics |volume = 80 |issue = 8 |pages = 555–61 |date = August 2011 |pmid = 21680236 |doi = 10.1016/j.ijmedinf.2011.05.003}}</ref> The deficiencies that were found are listed in the following.
# The lack of supporting on privacy and security. The ISO/TS 18308 specifies "The EHR must support the ethical and legal use of personal information, in accordance with established privacy principles and frameworks, which may be culturally or jurisdictionally specific" ([[ISO]] 18308: Health Informatics-Requirements for an Electronic Health Record Architecture, 2004). However this China's EHR Standard did not achieve any of the fifteen requirements in the subclass of privacy and security.
# The shortage of supporting on different types of data and reference. Considering only [[ICD-9]] is referenced as China's external international coding systems, other similar systems, such as [[SNOMED CT]] in clinical terminology presentation, cannot be considered as familiar for Chinese specialists, which could lead to internationally information-sharing deficiency.
# The lack of more generic and extensible lower level data structures. China's large and complex EHR Standard was constructed for all medical domains. However, the specific and time-frequent attributes of clinical data elements, value sets and templates identified that this once-for-all purpose cannot lead to practical consequence.<ref name="Lévy_2006">{{cite journal |vauthors = Lévy PP, Duché L, Darago L, Dorléans Y, Toubiana L, Vibert JF, Flahault A |title = ICPCview: visualizing the International Classification of Primary Care |journal = Studies in Health Technology and Informatics |volume = 116 |pages = 623–28 |year = 2005 |pmid = 16160327}}</ref>

In [[Hong Kong]], a computerized patient record system called the Clinical Management System (CMS) has been developed by the [[Hospital Authority]] since 1994. This system has been deployed at all the sites of the authority (40 hospitals and 120 clinics). It is used for up to 2&nbsp;million transactions daily by 30,000 clinical staff. The comprehensive records of 7&nbsp;million patients are available on-line in the [[electronic patient record]] (ePR), with data integrated from all sites. Since 2004 radiology image viewing has been added to the ePR, with radiography images from any HA site being available as part of the ePR.

The [[Hong Kong Hospital Authority]] placed particular attention to the [[governance]] of clinical systems development, with input from hundreds of clinicians being incorporated through a structured process. The health informatics section in the Hospital Authority<ref>{{cite web | url = http://www.ha.org.hk/hi/Welcome.html | title = Health informatics section in Hong Kong Hospital Authority }}</ref> has a close relationship with the information technology department and clinicians to develop health care systems for the organization to support the service to all public hospitals and clinics in the region.

The [[Hong Kong Society of Medical Informatics]] (HKSMI) was established in 1987 to promote the use of information technology in health care. The eHealth Consortium has been formed to bring together clinicians from both the private and public sectors, medical informatics professionals and the IT industry to further promote IT in health care in Hong Kong.<ref>{{cite web | url = http://www.iproa.org/ProjectDetail.action?id=270 | title = eHealth Consortium | archive-url = https://web.archive.org/web/20060628223826/http://www.iproa.org/ProjectDetail.action?id=270 | archive-date=2006-06-28 | work = Internet Professional Association Limited }}</ref>

==== India ====
{{See also|Indian Association for Medical Informatics}}
* eHCF School of Medical Informatics<ref>{{cite web | url = http://www.ehcfsmi.edu.in | title = eHCF School of Medical Informatics }}</ref>
* eHealth-Care Foundation<ref>{{cite web | url = http://www.ehealth-care.net | title = eHealth-Care Foundation }}</ref>

==== Malaysia ====
Since 2010, the Ministry of Health (MoH) has been working on the [[Malaysian Health Data Warehouse]] (MyHDW) project. MyHDW aims to meet the diverse needs of timely health information provision and management, and acts as a platform for the standardization and integration of health data from a variety of sources (Health Informatics Centre, 2013). The Ministry of Health has embarked on introducing the electronic Hospital Information Systems (HIS) in several public hospitals including Putrajaya Hospital, Serdang Hospital and Selayang Hospital. Similarly, under Ministry of Higher Education, hospitals such as University of Malaya Medical Centre (UMMC) and University Kebangsaan Malaysia Medical Centre (UKMMC) are also using HIS for healthcare delivery.

A [[hospital information system]] (HIS) is a comprehensive, integrated information system designed to manage the administrative, financial and clinical aspects of a hospital. As an area of medical informatics, the aim of hospital information system is to achieve the best possible support of patient care and administration by electronic data processing. HIS plays a vital role in planning, initiating, organizing and controlling the operations of the subsystems of the hospital and thus provides a synergistic organization in the process.

==== New Zealand ====
Health informatics is taught at five New Zealand universities. The most mature and established programme has been offered for over a decade at Otago.<ref>{{cite web |url=http://homepages.mcs.vuw.ac.nz/~peterk/healthinformatics/tec-hi-report-06.pdf |title=Health Informatics Capability Development in New Zealand – A Report to the Tertiary Education Commission |first1=Karolyn |last1=Kerr |first2=Rowena |last2=Cullen |first3=Jan |last3=Duke |first4=Alec |last4=Holt | name-list-style = vanc |year=2006 |access-date=2009-01-08 |archive-url=https://web.archive.org/web/20080920185858/http://homepages.mcs.vuw.ac.nz/~peterk/healthinformatics/tec-hi-report-06.pdf |archive-date=2008-09-20 }}</ref> Health Informatics New Zealand (HINZ), is the national organization that advocates for health informatics. HINZ organizes a conference every year and also publishes a journal, ''Healthcare Informatics Review Online''.