It is necessary to have sunk cost consciousness in the reconstruction of public hospital informatization

In order to implement the spirit of the new medical reform, build an information system that meets the needs of health reform and development, and improve the level of health services and management, the Ministry of Health issued document No. 38 in 2012, which put forward clear requirements for the overall framework, basic principles and work objectives of the information construction work of various hospitals across the country. However, in view of the current situation of hospital informatization construction in China, the medical strategy team, after in-depth analysis, believes that hospital leaders have sunk cost awareness in informatization reconstruction.

The Sunk Cost is a cost that has already occurred due to a past decision and cannot be changed by any decision now or in the future. In economics, there is a hypothesis called "rational economic man" : it is assumed that people are self-interested, and when faced with more than two options, they will always choose the more favorable option for themselves, and in any case, rational economic man will seek to maximize his own interests at all costs. For example, since the acquisition of Siemens, BenQ has invested 600 million euros, but there is no recovery and continued losses. In order to avoid damaging the interests of BenQ's parent company, BenQ's board of directors has passed a resolution to stop investing in the German mobile phone subsidiary.

Rational economic man with sunk cost consciousness is rational in the eyes of the third party, but in many cases the parties are often confused. Most of the second class hospitals in China have more or less used HIS software. In the process of information reconstruction, the leaders of many hospitals used to "further improve the original basis to save costs". They did not know that before the release of HIS standards, each software company developed according to its own data interface conventions. If you do not have sunk cost awareness and make repairs with the original intention of saving costs, you may not only waste a lot of time, but also waste more money, and software compatibility is difficult to meet the requirements.

For the information construction under the new medical reform situation, the Ministry of Health requires a change from "management-centered" to "patient-centered, business personnel as the main body, and comprehensively improve the level of medical decision-making, hospital management and diagnosis and treatment". At the same time, among the five key points it emphasizes, two are related to information sharing and docking, and the smooth progress of information sharing and docking. It is necessary to unify the standard of document data group and data element in database in the process of informatization reconstruction. At present, most of the HIS systems that have been implemented have a certain distance from the standards required by the Ministry of Health, and if the existing information system is constantly modified, its workload may be much more than the new system.

In the process of hospital informatization reconstruction, sunk cost awareness needs to stand in the perspective of regional health information sharing and interoperability, and boldly reform the previous business system. For the modules that have been applied but have a big gap with interactive sharing, we would rather re-choose the software that meets the new norms of the Ministry of Health (that is, the previous investment is used as sunk cost). Nor is it forced to repair the old system that has not adapted to the new requirements of informatization.