Adoption of electronic medical records in Taiwan: A sociological analysis of government's policy imperatives

Background: Like in many countries, electronic medical records (EMRs) have allured growing attention in Taiwan. In recent years, the government of Taiwan has allocated a lot of financial support, established incentives, promulgated new provisions, and launched pilot programs, asserting that the application of EMRs would improve quality of care, reduce medical cost, and simultaneously boost the country's economy. Objective: In this paper, we delineated the government's policies regarding EMRs, and analyzed the social and political underpinnings for policy development. Methods: We conducted a sociological analysis of the interaction among the state, the industries, and the academics, as it relates to the formation of EMR policy. Information was obtained through multiple methods, including literature review, interviews with policy participants, and participatory observation in medical organizations. Results: Some social factors encourage the adoption of EMRs in Taiwan. From technology aspect, the abundance of information technology (IT) industries in Taiwan provides necessary technological infrastructure. Concerning the health care system, the compulsory National Health Insurance (NHI) system, covering up to 97% of residents in Taiwan, makes it readily feasible to further digitalized information from medical records. The government, acting as a single payer under NHI, also has a predominant role in making rules and enforcing policies concerning EMRs. From political and economic aspects, EMRs, while evoking great interest from local IT industries, have been perceived by the government as having potentials to transform Taiwan' role of original equipment manufacturer (OEM) in the global economy. This policy has also been greatly welcome by biomedical scientists, who considered electronic health records a valuable resource for research purposes. Conclusion: There has been little resistance to the new policy. All these factors make EMR more easily adopted in Taiwan as compared to other countries.