First, the list of all participating enterprises (including enterprise name, exhibition booth, and keywords; Figure 1) was obtained from the conference’s official website [10]. We compared the list with the on-site list on the participation day one by one to exclude enterprises that did not attend the conference. Second, we used the TianYanCha website [12] to search all exhibitors and obtain basic information about the enterprises, including a brief introduction, region, establishment time, personnel scale, financing rounds, registered capital, and listing. Finally, we used the VBDATA company library [13] to obtain deep-seated information, such as the industrial field, application technology, and company concept of each enterprise. All data collection was completed by May 6, 2021.

We used Microsoft Excel 2019 for data storage and analysis. Percentages, bar charts, Venn charts, and statistical charts were used to display the exhibitors’ basic information, industrial and commercial information, classification, and grade data. Percentiles, medians, and quartile ranges were used to describe skew continuity data. We analyzed the data results according to the actual development of China's medical information industry.

A total of 207 cooperative enterprises were listed on the official website of CHINC. After checking each enterprise one by one on the conference day, the results indicated that 205 enterprises attended the conference. The participating enterprises were established from 1987 to 2021. A total of 61.9% (127/205) of enterprises were established from 2009, and 43.3% (55/127) of them were established from 2015 (Figure 2). A total of 79.02% (162/205) of the enterprises were from Beijing, Zhejiang, Guangdong, Shanghai, and Jiangsu Provinces, and 2 of them were from New Zealand (Figure 3). The enterprises’ scale is shown in Figure 4. Most enterprises (62/205, 30.02%) have fewer than 50 members, followed by 54/205 (34%) enterprises with 101-500 members.

The median registered capital of the 205 enterprises participating in the conference is 16.67 million RMB (a currency exchange rate of RMB 1=US $0.16 is applicable; IQR 10-60 million RMB, maximum value=30 billion RMB; Table 1). In addition, 35 (17.1%) enterprises have a registered capital of more than 100 million RMB; see Table 2. Furthermore, 99 (48.3%) enterprises provided their financing information, of which 17 (8.3%) were initial public offerings (Figure 5).

The nature of the enterprises, current hot concept directions, and the essence behind it could be analyzed by the keywords of exhibitors provided by the CHINC official website and the industrial field, applied technology, and concept of the enterprises provided by the VBDATA company library.

The conference's official website provided 151 enterprise keywords, which indicated the exhibition direction of the participating enterprises. We created word frequency statistics for the keywords. The keyword “smart hospitals” appeared 41 times at most and “internet hospitals” 22 times. The rest is shown in Table 3. We drew a cloud map according to the keyword frequency.

A total of 126 enterprises were found in the VBDATA company library. All (100%) companies disclosed their industrial field, 57 (45.2%) companies disclosed the technology used, and 114 (90.5%) companies provided the relevant concept labels. In the industry field, the number of information technology vendors was the largest (39/126, 30.9%), followed by EMRs (34/126, 26.9%). The distribution of industrial fields is shown in Figure 6. We also calculated statistics of the technologies used by enterprises. Of the 57 application technology enterprises, 16 (28.1%) use artificial intelligence (AI) technology and are ranked first, and 15 (26.3%) use the internet of things technology and are ranked second. The distribution of other technologies is shown in Figure 7. The VBDATA company library also provides conceptual labels of current mainstream products and innovative technologies of each enterprise, similar to the keywords given on the official CHINC website. We compared the top 15 concepts with the highest frequency by comparative analysis, and the results are shown in Table 3. Both smart medicine and internet hospitals were the focus of enterprises, and big data appeared most in VBDATA, but they were rarely mentioned at this conference.

Many information manufacturers have emerged in the past 10 years, and hospital information has basically completed the primary stage of popularization. Our research group has predicted that by 2021, the popularization rate of EMRs in domestic secondary hospitals or higher hospitals may exceed 80%. The popularization rate of EMRs in tertiary hospitals may even exceed 95% [14]. According to official Chinese documents published by the National Health Commission, the rate of tertiary public hospitals participating in grading the EMR application level in 2019 was 99.36%, which confirmed our prediction. From the perspective of enterprises, approximately half of the information-based manufacturers were established in the past 10 years, of which approximately 25% were established in the past 6 years (see the Exhibitors’ Characteristics section). With the help of innovative technologies, including AI and the internet of things (see the Analysis of Industrial Fields, Applied Technologies, and Related Concepts section), they have launched information-based solutions for various scenarios in hospitals.

It can be foreseen that the traditional basic content-related market in hospital information construction, for example, hospital information system (HIS), EMRs, laboratory information system (LIS), and picture archiving and communication system (PACS), has been gradually saturated. Therefore, the discussion of traditional hospital information systems and the exhibition of related products at this conference are not particularly ongoing. A new generation of hospital management systems began to appear in 2017, but few hospitals have the courage to carry out thorough information reform [15]. However, the National Health Commission of China has adopted the policy of linking EMR ratings with hospital performance appraisals in the past 3 years. COVID-19 will further strengthen the basic content of hospital informatization construction and gradually encourage new directions of construction. The reform will promote interconnection and high integration between information systems, provide high-quality management and treatment support by using operation data and clinical data, rebuild the hospital management system, and finally complete the digital and intelligent transformation of hospitals [16].

Under the background that the informatization of tertiary hospitals has been basically completed and is steadily being carried out in secondary hospitals, the National Health Commission issued related official documents and further released a document revision in May 2020. At present, the complete definition and construction standards of smart hospitals have not been unified at the national level, and the focus and direction in the exploration of smart hospital construction are not the same among hospitals. The government pointed out that the scope of smart hospitals mainly includes three areas: smart medical care for medical personnel, smart service for patients, and smart management for hospital management. However, it is certain that different from the previous informatization handing over the paper process to the computer for processing, the essence of smart hospitals is to collect, use, and analyze the data inside and outside the hospital. The purpose of smart hospitals is to provide basic support for hospital scientific research, clinical and management activities, and, finally, feedback to doctors and leaders for decision making.

Meanwhile, the government has put forward strict scoring requirements for the performance appraisal of 3-level public hospitals for several consecutive years. The performance appraisal includes data quality on the first page of EMRs, the application level of EMRs, comparability of clinical tests, the degree of intelligence of medical services, and the equality of rational use of liquid medicine. This is also an important factor in promoting the construction of smart hospitals.

The largest focus of enterprises in this conference is smart hospitals, which can be seen in Figure 6 and Table 3. Smart hospital solutions emerge one after another, mainly including the following points: First, we focus on scientific research systems and advocate data governance. Natural language processing helps the knowledge graph build a hospital special disease database and assist doctors in efficient scientific research to realize intelligent medical treatment. Related projects were carried out by Hangzhou Century Co Ltd., Shanghai Senyi Intelligent Technology Co Ltd., and Anxiang Medical Technology (Shenzhen) Co Ltd. Second, EMR quality control and diagnosis-related group (DRG)/big data diagnosis-intervention packet (DIP) are continuously hot. Automatic coding technology based on AI is introduced to promote exemplary management of hospitals and meet the quality of the first page of EMRs. Companies such as Hangzhou Firetree Technology Co Ltd. and BaseBit AI have designed intelligent operation systems. Third, the clinical decision support system (CDSS) still focuses on a single disease, and a knowledge graph is still the main technology. Deep learning methods are still used in medical image recognition. Companies such as Beijing Shenrui Bolian Technology Co Ltd, Beijing Airdoc Technology Co. Ltd., and Suzhou Mediston Medical Technology Co Ltd. are involved in this type of business. Fourth, we emphasize the ability of the middle platform and build an office automation (OA) system of smart hospitals. We also realize the personalization of different hospitals by using a middle platform and promote the office mode of a new generation of smart hospitals, on which DingTalk advocates and Xiniu Health Technology (Zhejiang) Co Ltd. is focusing. Fifth, the internet of things is hardware-upgraded to ensure intranet security and clinical efficiency. Hardware companies, such as Ruijie Networks Co Ltd. and Onco Information Technology (Shanghai) Co Ltd., have launched hospital dual-network routers based on Wi-Fi 6.0 and 5G to ensure strict internal and external network isolation, realizing intelligent wards.

The year 2021 was the first year of the 14th 5-year plan. Under the guidance of the above policies, the construction of smart hospitals has received more attention from hospitals. Starting from this demand, enterprises at conferences have launched customized smart hospital construction services.

Compared with other countries, China faces more severe challenges in the distribution of medical services. Although China has the largest number of hospitals globally, the distribution of medical resources is extremely uneven: 80% of medical resources and patients are concentrated in large hospitals and 20% in community general clinics [17]. China introduced the market mechanism into the medical service system in the 1980s, and people can go to any level of medical institutions according to their wishes. Primary medical institutions no longer play the role of health gatekeepers. Many patients give priority to higher-level medical institutions when they need medical assistance. This has led to a large reduction in patients in grassroots hospitals, a decline in the level of grassroots health service personnel [18], and a rapid increase in medical expenditure [19]. The concentration of medical resources in high-level medical institutions further weakens the ability of grassroots health services, resulting in more detours and more waste.

The Chinese government is trying to solve the uneven distribution of medical services by promoting the integration of regional health services. With the Chinese government's strong push for health care reform in 2009, the first contact point between the hierarchical medical service system and grassroots medical institutions was proposed as a key task. The reform strategy notes that the construction of a regional medical consortium is the key to promoting hierarchical diagnosis and treatment [20]. At present, the construction methods of the medical union in China mainly include the Cross-Regional Professional Alliance, the Urban Medical Group, and the County Medical Community. The importance of a compact county medical community is particularly prominent for China’s large rural population. Therefore, carrying out the integration of health services, realizing cooperation between medical institutions at all levels in rural areas, and improving the quality of health services, treatment rate, and patient satisfaction is the fundamental way to truly enable the majority of grassroots residents to obtain health-centered, equal, homogeneous, and integrated health care services [21].

Information construction is an important basis for the construction of compact county medical communities. There are obvious information system breaks between different medical institutions in county medical communities. In the past, the township-level health institution system lacked unified development and business processes, data processes lacked unified norms, and the phenomenon of information islands was serious [22]. County medical communities require a high degree of entity integration and information interconnection to ensure the high continuity of medical services and truly realize the original intention of common service, common interests, common responsibilities, and common development.

The market scale of medical community information construction is huge. China officially issued a document to determine Shanxi and Zhejiang Provinces as pilot provinces of the medical community and 567 counties as pilot counties in September 2019. The compact county medical community is developing rapidly, and a unified, efficient, and easy-to-use regional health information system is one of the important information supports. According to national statistics, there are 2843 county-level divisions in China, and the informatization project of the medical community in each county is approximately 40-80 million. It is roughly estimated that the market scale reaches approximately 113.7-227.4 billion RMB. A new county-level medical and health service system with clear objectives, clear rights and responsibilities, and division of labor and cooperation should be preliminarily established in 500 county-level units, gradually forming a community of services, responsibilities, interests, and management, and finally used throughout China [23]. At this conference, the county medical community informatization solution has become the struggle focus of major medical IT enterprises. Enterprises, such as YLZ Information Technology Co., Ltd., proposed establishing a regional information platform and achieving regional information interconnection, data sharing, and aggregation through unified data standards and service specifications. Big data mining and analysis technology can also be used to conduct intelligent analysis and judgment on operation management, providing intelligent auxiliary services for managers' scientific decision making.

It is worth mentioning that with many information manufacturers in hospitals and relatively mature solutions, there is a huge potential development space for targeting the market for out-of-hospital medical services, and several new technologies and solutions have emerged. These products are mainly named after the concepts of special disease bank, scientific research follow-up, whole-course management, and digital therapeutics (DTX). It is widely recognized that most chronic diseases need comprehensive management outside the hospital and cannot be cured by short-term drugs in the hospital. At present, the best intervention measure is to carry out various self-management measures of the patients' diet, exercise, and medication outside the hospital. This requires patients to have a certain reserve of medical knowledge, to grasp their own disease changes clearly, and to have high compliance. Digital therapy based on emerging technologies, such as mobile medicine, big data, and AI, is the potential best solution. DTX is an intervention program driven by software programs and based on evidence-based medicine that is used to treat, manage, or prevent diseases [24]. Digital therapy transforms the existing medical principles, medical guidelines, or standard treatment schemes into application software–driven interventions by digital means, which can effectively improve the compliance and accessibility of patients' chronic disease management. It is an innovative way to overcome the limitations of traditional drug treatment [25]. Compared with the application of assisted diagnosis, telemedicine, and all new technologies in health, digital therapy can be used alone or together with other therapies to promote disease remission [26].

At this conference, we can see that several companies, such as Weimai Technology Co., Ltd. and Hangzhou Zhuojian Information Technology Co., Ltd., mentioned the concept of digital therapy and proposed corresponding solutions. However, the clinical effect of such schemes has not been verified. This lack of progress may be related to several reasons. On the one hand, the landing effect of products is poor, and the products labeled with digital therapy are often simple technical upgrades of traditional business products. On the other hand, most products have not been clinically verified or recognized by peers. Whole-course management and digital therapy are mostly based on concepts. The process of scientific research and standardized verification based on inquiry medicine in the clinic should be accelerated. Due to the relatively mature informatization in hospitals and the large gap and imagination space of out-of-hospital medical services, the corresponding informatization has a large development space and many opportunities in the future, which may form new hotspots.

China's tertiary hospital informatization construction has basically completed the primary stage of popularization, showing two characteristics. First, China's medical information industry is focusing on the construction of smart hospitals. The most important directions include a smart system to support doctors' scientific research, a DRG smart operation system and an OA system to support hospital management, a single-disease CDSS to assist doctors in clinical practice, and the smart internet of things for logistics. Second, under the guidance of the practical needs for improving the quality of grassroots health services and national policies, the construction of a compact county medical community has become a new focus of enterprises. In addition, it can be foreseen that whole-course management and digital therapy will become new hotspots in the future. The process of scientific research and standardized verification should be accelerated.