Key influencing factors of vertical integration of electronic health records in medical consortiums

Background: Similar to other countries around the world, China has incorporated the recording of electronic health data into its national strategy. After the completion of the decentralized construction phase, the con-struction of electronic health records in China has reached the stages of integration, sharing, and utilization. "Vertical integration" is the premise and foundation of "shared utilization" of electronic health records within the medical consortium, but it is also a bottleneck in realizing this goal. Objective: The main purpose of this paper is to find out the key factors affecting the vertical integration of electronic health records in the medical consortiums, and to clarify the impact mechanism of these key factors, so as to provide reference for improving relevant policies.Methods: In this study, an index system of influencing factors is established for cross-institutional vertical inte-gration of electronic health records within a medical consortium, identifying key influencing factors using the combined fuzzy-DEMATEL-ASIM method and revealing the influence relationship and action mechanism among the key influencing factors using a multi-layer hierarchical influence structure model.Results: There are 32 factors influencing the vertical integration of electronic health records in the medical consortium, 17 of which are key factors. According to the hierarchical structure of key influencing factors, they can be divided into three categories: surface-level factors, middle-level factors and deep-level factors. Conclusions: In practice, these key factors should be prioritized for improvement and optimization to promote integration projects. In the future, we should focus on key influencing factors to precisely implement policies, such as introducing special promotion policies, unifying development planning, changing health insurance payment methods, establishing sharing standards, and raising public awareness.