[2026 Parliamentary Audit] 8 in 10 'Clinical Information Exchange' participants sent nothing all year

Participating institutions increased by 3,330 over four years, but the number of institutions actually using the service rose by only 613
Rep. Seo Youngseok: "Actual usage should be tracked as a performance indicator"

Eight out of every 10 medical institutions participating in the Clinical Information Exchange project, which enables medical institutions to share medical records and images, sent no clinical information at all last year. Although the number of participating institutions has continued to grow, actual use has remained stagnant, and critics say the reasons for nonuse have not even been properly identified.

Rep. Seo Young-seok of the Democratic Party of Korea delivers procedural remarks during a parliamentary audit of the National Health Insurance Service and the Health Insurance Review and Assessment Service, held at the NHIS headquarters in Wonju, Gangwon Province, on the 16th. Yonhap News Agency

According to data submitted by the Korea Health Information Service to Seo Youngseok, a Democratic Party of Korea lawmaker on the National Assembly Health and Welfare Committee, as of the end of September 2026, 10,463 medical institutions were participating in the Clinical Information Exchange project, accounting for 25.3% of all medical institutions (41,430).

However, only 1,854 medical institutions sent clinical information at least once in 2025, just 17.9% of the 10,332 participating institutions at the time. The remaining 8,478 institutions (82.1%) had no transmission activity at all, and only 1,419 institutions (13.6%) had records of transmissions through the end of September 2026.

The data also showed that the growth in participating institutions had not led to greater actual use. The number of participants rose by 3,330, from 7,002 in 2021 to 10,332 in 2025, but the number of institutions that actually used the service increased by only 613 over the same period, from 1,241 to 1,854. The usage rate also remained virtually unchanged, rising from 17.7% to 17.9%.

By type of medical institution, the 2025 usage rate was 93.6% (44 of 47) among tertiary general hospitals and 73.2% (183 of 250) among general hospitals. In contrast, the rate was just 17.2% (211 of 1,226) for hospitals and 16.9% (1,404 of 8,295) for clinics.

Exchange activity was also concentrated among large hospitals. Of the 1.13 million clinical information exchanges in 2025, 82.0% took place at 297 tertiary general hospitals and general hospitals, which together accounted for just 2.9% of all participating institutions. Clinics, which made up 80.3% of participating institutions, accounted for 149,000 exchanges, or just 13.3% of the total. The data also showed that only 250 (41.7%) of the 600 participating institutions used the image information exchange service in 2025.

The problem, critics say, is that no effort has been made to identify the reasons for low usage. The Korea Health Information Service said it had neither surveyed institutions with no usage activity about why they did not use the service nor requested related status reports. It speculated that reasons for nonuse could include having few cases requiring patient transfers, institutions not knowing how to use the service because the staff responsible had changed, or institutions handling the same work through the Health Insurance Review and Assessment Service's referral and return intermediary system.

The Clinical Information Exchange project enables medical institutions to share information, reducing the burden on patients of repeatedly submitting the same test results or documents and allowing medical staff to review patients' medical histories. A fee of at least 11,500 won and up to 38,000 won is also recognized for clinical information referrals. Nevertheless, 9,044 participating institutions had no record of sending information through September 2026.

Rep. Seo said, "Clinical Information Exchange is a worthwhile project that keeps patients from having to repeat the same tests and submit the same documents, but its results have been inadequate. Instead of touting a 25% participation rate, we need to first examine the fact that more than 80% of participating institutions did not send a single item of information in an entire year." He added, "Since the Korea Health Information Service said it had never investigated why institutions were not using the service, it should examine the reasons by type of medical institution, medical specialty and time of participation. It should also track the actual usage rate as a performance indicator, in addition to the number of participating institutions."

This content was produced with the assistance of AI translation services.