uic school of public health

UIC SCHOOL OF PUBLIC HEALTHUIC SCHOOL OF PUBLIC HEALTH DORENFEST CHINA HEALTHCARE GROUPDORENFEST CHINA HEALTHCARE GROUP

UICUICSCHOOL OF PUBLIC HEALTH SCHOOL OF PUBLIC HEALTH

OVERVIEW OF CHINA HEALTHCARE OVERVIEW OF CHINA HEALTHCARE AND ITS USE OF INFORMATION AND ITS USE OF INFORMATION TECHNOLOGYTECHNOLOGY

CHICAGO, ILLINOIS APRIL 21, 2010

UIC SCHOOL OF PUBLIC HEALTHUIC SCHOOL OF PUBLIC HEALTH 2 DORENFEST CHINA HEALTHCARE GROUPDORENFEST CHINA HEALTHCARE GROUP

TODAY’S PRESENTATIONTODAY’S PRESENTATION

DESCRIBE DORENFEST AND ITS BUSINESS IN CHINADESCRIBE DORENFEST AND ITS BUSINESS IN CHINA

OVERVIEW OF HEALTHCARE IN CHINAOVERVIEW OF HEALTHCARE IN CHINA

THE EVOLUTION OF H.I.T. AROUND THE WORLD AS A FRAME OF REFERENCE THE EVOLUTION OF H.I.T. AROUND THE WORLD AS A FRAME OF REFERENCE TO BETTER UNDERSTAND H.I.T. IN CHINATO BETTER UNDERSTAND H.I.T. IN CHINA

THE CURRENT STATUS AND FUTURE DIRECTION OF H.I.T. IN CHINESE THE CURRENT STATUS AND FUTURE DIRECTION OF H.I.T. IN CHINESE HOSPITALSHOSPITALS

EVOLUTION OF RHNs IN THE U.S. AND CHINAEVOLUTION OF RHNs IN THE U.S. AND CHINA

THE CITY OF SHENZHEN, AS AN EXAMPLE OF REGIONAL HEALTH NETWORKS THE CITY OF SHENZHEN, AS AN EXAMPLE OF REGIONAL HEALTH NETWORKS IN CHINAIN CHINA

OPPORTUNITIES AND CHALLENGES FOR WESTERN COMPANIES IN CHINA H.I.T. OPPORTUNITIES AND CHALLENGES FOR WESTERN COMPANIES IN CHINA H.I.T.

Q&AQ&A


THE DORENFEST GROUPTHE DORENFEST GROUP

HEALTHCARE CONSULTING AND INVESTMENT FOCUSHEALTHCARE CONSULTING AND INVESTMENT FOCUS

OFFER HEALTHCARE IMPROVEMENT SERVICES TO SUPPORT A MORE OFFER HEALTHCARE IMPROVEMENT SERVICES TO SUPPORT A MORE POSITIVE WORLD FUTUREPOSITIVE WORLD FUTURE

HELP HEALTHCARE ORGANIZATIONS TO IMPROVE HEALTHCARE SERVICES HELP HEALTHCARE ORGANIZATIONS TO IMPROVE HEALTHCARE SERVICES WHILE REDUCING COSTS BY IMPROVING WORK PROCESSES, MANAGEMENT WHILE REDUCING COSTS BY IMPROVING WORK PROCESSES, MANAGEMENT SYSTEMS, SERVICES TO PATIENTS, AND QUALITY OF MEDICAL CARESYSTEMS, SERVICES TO PATIENTS, AND QUALITY OF MEDICAL CARE

IN 2006 THE DORENFEST GROUP FORMED THE DORENFEST CHINA IN 2006 THE DORENFEST GROUP FORMED THE DORENFEST CHINA HEALTHCARE GROUP, BASED IN SHANGHAI, TO BRING OUR SKILL, HEALTHCARE GROUP, BASED IN SHANGHAI, TO BRING OUR SKILL, TECHNOLOGY, AND CAPITAL TO CHINA IN A TWO-PHASE PROGRAMTECHNOLOGY, AND CAPITAL TO CHINA IN A TWO-PHASE PROGRAM

WE ARE NOW OPERATING IN PHASE 1 OF THIS PROGRAM, OFFERING A WE ARE NOW OPERATING IN PHASE 1 OF THIS PROGRAM, OFFERING A VARIETY OF CONSULTING, TRAINING, AND EDUCATION SERVICES TO THE VARIETY OF CONSULTING, TRAINING, AND EDUCATION SERVICES TO THE CHINA HEALTHCARE SYSTEMCHINA HEALTHCARE SYSTEM

WE EXPECT TO ENTER PHASE 2 OF OUR ACTIVITIES IN CHINA IN LATE 2010 OR WE EXPECT TO ENTER PHASE 2 OF OUR ACTIVITIES IN CHINA IN LATE 2010 OR 2011 WHEN WE WILL BEGIN TO MAKE INVESTMENTS IN WELL-DEFINED, GOOD 2011 WHEN WE WILL BEGIN TO MAKE INVESTMENTS IN WELL-DEFINED, GOOD BUSINESS PROJECTS, IN PARTNERSHIP WITH CHINESE HEALTH BUREAUS AND BUSINESS PROJECTS, IN PARTNERSHIP WITH CHINESE HEALTH BUREAUS AND HOSPITALSHOSPITALS


DORENFEST 2005 INVESTIGATION OF HEALTHCARE IN CHINADORENFEST 2005 INVESTIGATION OF HEALTHCARE IN CHINA

1.1. VISITED 17 CITIES IN CHINAVISITED 17 CITIES IN CHINA

2.2. MET 100’S OF HEALTHCARE INDUSTRY LEADERS IN CHINAMET 100’S OF HEALTHCARE INDUSTRY LEADERS IN CHINA

3.3. VISITED OVER 100 HOSPITALS TO REVIEW HOSPITAL OPERATIONS AND VISITED OVER 100 HOSPITALS TO REVIEW HOSPITAL OPERATIONS AND DEFINE OPPORTUNITIES FOR IMPROVEMENTDEFINE OPPORTUNITIES FOR IMPROVEMENT

4.4. MET PROVINCIAL AND CITY HEALTH BUREAU LEADERS IN CITIES VISITEDMET PROVINCIAL AND CITY HEALTH BUREAU LEADERS IN CITIES VISITED

5.5. MET WITH MANY COMPANIES SELLING PRODUCTS AND SERVICES TO THE MET WITH MANY COMPANIES SELLING PRODUCTS AND SERVICES TO THE HEALTHCARE INDUSTRY IN CHINAHEALTHCARE INDUSTRY IN CHINA

6.6. EVALUATED A GROUP OF HOSPITAL OWNERSHIP AND MANAGEMENT EVALUATED A GROUP OF HOSPITAL OWNERSHIP AND MANAGEMENT OPPORTUNITIES AND ASSESSED VIABILITY OF THE DORENFEST “MODEL OPPORTUNITIES AND ASSESSED VIABILITY OF THE DORENFEST “MODEL HOSPITAL” IN CHINAHOSPITAL” IN CHINA

7.7. DEVELOPED A STRATEGY FOR BRINGING DORENFEST SKILL AND DEVELOPED A STRATEGY FOR BRINGING DORENFEST SKILL AND EXPERIENCE TO CHINAEXPERIENCE TO CHINA


DORENFEST CHINA PHASE 1 BUSINESS OPERATIONSDORENFEST CHINA PHASE 1 BUSINESS OPERATIONS

HOSPITAL AND HEALTH BUREAU MANAGEMENT CONSULTING HOSPITAL AND HEALTH BUREAU MANAGEMENT CONSULTING

– OPERATIONS IMPROVEMENT AND CHANGE MANAGEMENTOPERATIONS IMPROVEMENT AND CHANGE MANAGEMENT

– STRATEGIC PLANNING FOR NEW I.T. SYSTEMSSTRATEGIC PLANNING FOR NEW I.T. SYSTEMS

– I.T. SYSTEM SELECTIONI.T. SYSTEM SELECTION

– I.T. SYSTEM IMPLEMENTATIONI.T. SYSTEM IMPLEMENTATION

– WORK PROCESS IMPROVEMENTWORK PROCESS IMPROVEMENT

– MANAGEMENT TRAININGMANAGEMENT TRAINING

– INTERIM I.T. MANAGEMENT SERVICESINTERIM I.T. MANAGEMENT SERVICES

– OTHER SERVICES OTHER SERVICES

GENERAL MANAGEMENT CONSULTING FOR HEALTHCARE COMPANIESGENERAL MANAGEMENT CONSULTING FOR HEALTHCARE COMPANIES

– CHINA ENTRY STRATEGIESCHINA ENTRY STRATEGIES

– MARKET ANALYSESMARKET ANALYSES

– PRODUCT STRATEGIESPRODUCT STRATEGIES

– MARKET RESEARCHMARKET RESEARCH

– IMPLEMENTATION CONSULTINGIMPLEMENTATION CONSULTING

EDUCATIONAL PROGRAMS FOR HOSPITAL AND HEALTHCARE BUREAU LEADERS EDUCATIONAL PROGRAMS FOR HOSPITAL AND HEALTHCARE BUREAU LEADERS


SOME RECENT CLIENT EXAMPLES IN CHINASOME RECENT CLIENT EXAMPLES IN CHINA

EXAMPLES OF HEALTH BUREAU CLIENTS EXAMPLES OF HEALTH BUREAU CLIENTS

– SHENZHENSHENZHEN

– CHONGQINGCHONGQING

EXAMPLES OF HOSPITAL CLIENTSEXAMPLES OF HOSPITAL CLIENTS

– SHANGHAI CHANGNING MATERNITY AND INFANT HEALTH INSTITUTESHANGHAI CHANGNING MATERNITY AND INFANT HEALTH INSTITUTE

– PEKING UNIVERSITY MEDICAL COLLEGE #3 HOSPITALPEKING UNIVERSITY MEDICAL COLLEGE #3 HOSPITAL

– RIZHAO CITY PEOPLE’S HOSPITAL RIZHAO CITY PEOPLE’S HOSPITAL

EXAMPLES OF HELPING CLIENTS FROM OTHER LOCATIONS TO BRING THEIR EXAMPLES OF HELPING CLIENTS FROM OTHER LOCATIONS TO BRING THEIR SKILLS TO MAINLAND CHINA SKILLS TO MAINLAND CHINA

– HONG KONG HOSPITAL AUTHORITY HONG KONG HOSPITAL AUTHORITY

– MICROSOFTMICROSOFT


DORENFEST EDUCATION IN CHINA – TONGREN HOSPITAL, BEIJING 2005DORENFEST EDUCATION IN CHINA – TONGREN HOSPITAL, BEIJING 2005


DORENFEST EDUCATION IN CHINA – ZHEJIANG MEDICAL ASSOCIATION 2009DORENFEST EDUCATION IN CHINA – ZHEJIANG MEDICAL ASSOCIATION 2009


OVERVIEW OF OVERVIEW OF HEALTHCARE IN CHINAHEALTHCARE IN CHINA

UIC SCHOOL OF PUBLIC HEALTHUIC SCHOOL OF PUBLIC HEALTH


BRIEF OVERVIEW OF THE DEVELOPMENT OF HEALTHCARE IN CHINABRIEF OVERVIEW OF THE DEVELOPMENT OF HEALTHCARE IN CHINA

IN THE CHANGE TO A MORE MARKET DRIVEN ECONOMY IN CHINA, THERE WAS IN THE CHANGE TO A MORE MARKET DRIVEN ECONOMY IN CHINA, THERE WAS A SHIFT FROM GOVERNMENT FUNDING OF THE HEALTHCARE SYSTEM TO A SHIFT FROM GOVERNMENT FUNDING OF THE HEALTHCARE SYSTEM TO CITIZEN FUNDING, WHICH HAS MADE CHINA THE HIGHEST “PATIENT PAY OUT CITIZEN FUNDING, WHICH HAS MADE CHINA THE HIGHEST “PATIENT PAY OUT OF THEIR POCKET” HEALTHCARE SYSTEM IN THE WORLDOF THEIR POCKET” HEALTHCARE SYSTEM IN THE WORLD

CHINA’S HEALTHCARE COSTS IN TOTAL MAKE IT ONE OF THE MOST EFFICIENT CHINA’S HEALTHCARE COSTS IN TOTAL MAKE IT ONE OF THE MOST EFFICIENT HEALTHCARE SYSTEMS IN THE WORLDHEALTHCARE SYSTEMS IN THE WORLD

CHINA’S OUTPATIENT CARE FOLLOWS A DIFFERENT MODEL THAN THE REST CHINA’S OUTPATIENT CARE FOLLOWS A DIFFERENT MODEL THAN THE REST OF THE WORLD, WITH ALMOST ALL URBAN OUTPATIENT CARE IN THE OF THE WORLD, WITH ALMOST ALL URBAN OUTPATIENT CARE IN THE COUNTRY IS NOW PROVIDED AS PART OF THE HOSPITAL SYSTEM AND COUNTRY IS NOW PROVIDED AS PART OF THE HOSPITAL SYSTEM AND LOCATED ON THE HOSPITAL CAMPUSLOCATED ON THE HOSPITAL CAMPUS

BECAUSE CHINA HAS BEEN AN EFFICIENT INVESTOR IN HEALTHCARE,THE BECAUSE CHINA HAS BEEN AN EFFICIENT INVESTOR IN HEALTHCARE,THE FACILITIES HAVE NOT KEPT UP WITH THE NEEDS OF THE COUNTRY, AND FACILITIES HAVE NOT KEPT UP WITH THE NEEDS OF THE COUNTRY, AND MOST OUTPATIENT CARE HAS BEEN OFFERED IN VERY CROWDED SETTINGSMOST OUTPATIENT CARE HAS BEEN OFFERED IN VERY CROWDED SETTINGS

WITH THE DEVELOPMENT OF CHINA, THIS IS CHANGING. THE PEKING WITH THE DEVELOPMENT OF CHINA, THIS IS CHANGING. THE PEKING UNIVERSITY THIRD HOSPITAL NEW OUTPATIENT BUILDING IS PART OF A UNIVERSITY THIRD HOSPITAL NEW OUTPATIENT BUILDING IS PART OF A TREND THAT OTHER HOSPITALS IN CHINA ARE FOLLOWING, AS SOME OF THE TREND THAT OTHER HOSPITALS IN CHINA ARE FOLLOWING, AS SOME OF THE BEST CLASS 3 HOSPITALS IN CHINA WITH HIGH OUTPATIENT VOLUMES HAVE BEST CLASS 3 HOSPITALS IN CHINA WITH HIGH OUTPATIENT VOLUMES HAVE BUILT OR ARE BUILDING NEW FACILITIESBUILT OR ARE BUILDING NEW FACILITIES


BRIEF OVERVIEW OF THE DEVELOPMENT OF HEALTHCARE IN CHINABRIEF OVERVIEW OF THE DEVELOPMENT OF HEALTHCARE IN CHINA(CONTINUED)(CONTINUED)

CHINESE OUTPATIENT CARE IS CHARACTERIZED BY THE FOLLOWING:CHINESE OUTPATIENT CARE IS CHARACTERIZED BY THE FOLLOWING:

– EXTREMELY HIGH OUTPATIENT VOLUMES COMPARED TO OUTPATIENT EXTREMELY HIGH OUTPATIENT VOLUMES COMPARED TO OUTPATIENT VOLUMES IN HOSPITAL SETTINGS IN OTHER COUNTRIESVOLUMES IN HOSPITAL SETTINGS IN OTHER COUNTRIES

– LONG WAIT TIMES FOR OUTPATIENT CARELONG WAIT TIMES FOR OUTPATIENT CARE

– THE VAST MAJORITY OF PATIENTS ARE SEEN ON A WALK-IN OR “SAME THE VAST MAJORITY OF PATIENTS ARE SEEN ON A WALK-IN OR “SAME DAY” BASIS. WHEN RESERVATIONS SYSTEMS ARE USED, IT IS IN A DAY” BASIS. WHEN RESERVATIONS SYSTEMS ARE USED, IT IS IN A VERY LIMITED MANNERVERY LIMITED MANNER

– A VERY LIMITED TIME DURING THE OUTPATIENT VISIT IS BUDGETED A VERY LIMITED TIME DURING THE OUTPATIENT VISIT IS BUDGETED FOR THE PATIENT TO SPEND TIME WITH THE PHYSICIAN FOR THE PATIENT TO SPEND TIME WITH THE PHYSICIAN

– THE COLLECTION OF MONEY FROM THE PATIENT FOR EACH ACTIVITY THE COLLECTION OF MONEY FROM THE PATIENT FOR EACH ACTIVITY PERFORMED IS A CRITICAL ELEMENT OF THE OUTPATIENT WORK PERFORMED IS A CRITICAL ELEMENT OF THE OUTPATIENT WORK PROCESS AND ADDS TO PROCESS AND ADDS TO THE LONG WAIT TIMES THE LONG WAIT TIMES IN OUTPATIENT IN OUTPATIENT SETTINGS IN CHINASETTINGS IN CHINA

– CUSTOMER SERVICE IS A LOW PRIORITYCUSTOMER SERVICE IS A LOW PRIORITY


HEALTHCARE REFORM IN CHINA IS BRINGING MANY CHANGES TO THE HEALTHCARE REFORM IN CHINA IS BRINGING MANY CHANGES TO THE HEALTHCARE SITUATIONHEALTHCARE SITUATION

THE POOR PEOPLE WILL NOW BE GETTING BASIC HEALTHCARE WITH THE POOR PEOPLE WILL NOW BE GETTING BASIC HEALTHCARE WITH GOVERNMENT ASSISTANCE, WHICH SHOULD RAISE THE LEVEL OF HEALTHCARE IN GOVERNMENT ASSISTANCE, WHICH SHOULD RAISE THE LEVEL OF HEALTHCARE IN CHINACHINA

CHINA IS PROVIDING LARGE STIMULUS SPENDING TO IMPROVE HEALTHCARECHINA IS PROVIDING LARGE STIMULUS SPENDING TO IMPROVE HEALTHCARE

THE STIMULUS THE STIMULUS SPENDING SPENDING IS FUELING MAJOR CHANGES IN THE HEALTHCARE IS FUELING MAJOR CHANGES IN THE HEALTHCARE SYSTEM IN CHINASYSTEM IN CHINA

SOME CHANGES INCLUDE THE FOLLOWING:SOME CHANGES INCLUDE THE FOLLOWING:

– THE DEVELOPMENT OF COMMUNITY CLINICS TO EASE THE OUTPATIENT THE DEVELOPMENT OF COMMUNITY CLINICS TO EASE THE OUTPATIENT LOAD IN CLASS 3 HOSPITALSLOAD IN CLASS 3 HOSPITALS

– THE MODERNIZING OF FACILITIES IN CHINA TO CREATE A BETTER PATIENT THE MODERNIZING OF FACILITIES IN CHINA TO CREATE A BETTER PATIENT EXPERIENCE IN THE OUTPATIENT SETTINGEXPERIENCE IN THE OUTPATIENT SETTING

– ENCOURAGEMENT OF ADVANCE APPOINTMENT SYSTEMS IN THE ENCOURAGEMENT OF ADVANCE APPOINTMENT SYSTEMS IN THE OUTPATIENT AREA OUTPATIENT AREA

– A VARIETY OF OTHER PUBIC HOSPITAL REFORMSA VARIETY OF OTHER PUBIC HOSPITAL REFORMS

ALL OF THESE ACTIVITIES AND MANY MORE ARE BEING SUPPORTED BY THE ALL OF THESE ACTIVITIES AND MANY MORE ARE BEING SUPPORTED BY THE STIMULUS FUNDING BEING MADE AVAILABLE FOR NEW FACILITIES AND BETTER STIMULUS FUNDING BEING MADE AVAILABLE FOR NEW FACILITIES AND BETTER CUSTOMER SERVICE CUSTOMER SERVICE

THE CHALLENGE FOR CHINA WILL BE TO DIGEST THESE CHANGES IN A SHORT THE CHALLENGE FOR CHINA WILL BE TO DIGEST THESE CHANGES IN A SHORT PERIOD OF TIME TO ACCOMPLISH THE DESIRED OUTCOMES PERIOD OF TIME TO ACCOMPLISH THE DESIRED OUTCOMES


CHINA HEALTHCARE EXPENDITURES WILL GROW RAPIDLYCHINA HEALTHCARE EXPENDITURES WILL GROW RAPIDLY($ AND RMB IN BILLIONS)($ AND RMB IN BILLIONS)

-

200

400

600

800

1,000

1,200

1,400

1,600

1,800

2,000

1990 1995 2000 2002 2003 2004 2005 2006 2007 2010

GovernmentGovernment

Social InsuranceSocial Insurance

Out-of-pocketOut-of-pocket

SOURCE: MINISTRY OF HEALTH ANNUAL STATISTICS YEARBOOKSOURCE: MINISTRY OF HEALTH ANNUAL STATISTICS YEARBOOK

RMB inRMB in

BillionsBillions

13.8%13.8% 15.2%15.2% 14.1%14.1% 13.6%13.6%

Annual Growth Rate Annual Growth Rate

14.6%14.6%

75 RMB75 RMB

($9.6)($9.6)

216 RMB216 RMB

($27.8)($27.8)

459 RMB459 RMB

($59.1)($59.1)

579 RMB579 RMB

($74.7)($74.7)

659 RMB659 RMB

($84.9 ($84.9 ))

759 RMB759 RMB

($97.0) ($97.0)

984 RMB984 RMB

($144.0 ) ($144.0 ) 866 RMB866 RMB

($126.7 ) ($126.7 )

1128 RMB1128 RMB

($165.0) ($165.0)

Forecasted GrowthForecasted GrowthRate – 15% in 2008 and Rate – 15% in 2008 and 20% in 2009 and 201020% in 2009 and 2010

1900 RMB1900 RMB($275.0)($275.0)


AVERAGE MEDICAL EXPENSE PER OUTPATIENT HOSPITAL VISIT ($ AND RMB)AVERAGE MEDICAL EXPENSE PER OUTPATIENT HOSPITAL VISIT ($ AND RMB)

0

25

50

75

100

125

150

175

1995 2000 2004 2005 2006 2007

DrugDrug

Exam/TestExam/Test

Medical ServicesMedical Services

40 RMB40 RMB

($5.8 )($5.8 )

86 RMB86 RMB ($12.6) ($12.6)

118 RMB118 RMB ($17.3)($17.3)

127 RMB127 RMB ($18.6)($18.6)

129 RMB129 RMB ($18.8)($18.8)

136 RMB136 RMB($19.9)($19.9)

RMBRMB



OUTPATIENT REGISTRATION AT THE OLD OUTPATIENT BUILDING IS AN OUTPATIENT REGISTRATION AT THE OLD OUTPATIENT BUILDING IS AN EXAMPLE OF THE OLD METHOD OF OUTPATIENT CARE IN CHINAEXAMPLE OF THE OLD METHOD OF OUTPATIENT CARE IN CHINA


ANOTHER EXAMPLE IS THE REGISTRATION PAYMENT FOR CLINIC VISITS AT ANOTHER EXAMPLE IS THE REGISTRATION PAYMENT FOR CLINIC VISITS AT PEKING UNIVERSITY THIRD HOSPITALPEKING UNIVERSITY THIRD HOSPITAL


THE OUTPATIENT HEALTH RECORD WHICH PATIENT KEEPSTHE OUTPATIENT HEALTH RECORD WHICH PATIENT KEEPS


CUSTOMER SERVICE IS A LOWER PRIORITYCUSTOMER SERVICE IS A LOWER PRIORITY

1.1. LONG WAIT TIMESLONG WAIT TIMES

2.2. VERY FEW ADVANCE APPOINTMENT SYSTEMSVERY FEW ADVANCE APPOINTMENT SYSTEMS

3.3. AVERAGE TIME OF PHYSICIAN VISIT IS 2-5 MINUTESAVERAGE TIME OF PHYSICIAN VISIT IS 2-5 MINUTES

4.4. COLLECTING MONEY AND MAKING PROFITS ARE A MAJOR FOCUSCOLLECTING MONEY AND MAKING PROFITS ARE A MAJOR FOCUS


AVERAGE MEDICAL EXPENSE PER INPATIENT HOSPITAL STAY ($ AND RMB)AVERAGE MEDICAL EXPENSE PER INPATIENT HOSPITAL STAY ($ AND RMB)

-

1,000

2,000

3,000

4,000

5,000

6,000

1995 2000 2004 2005 2006 2007

1668 RMB1668 RMB($244.1)($244.1)

3084 RMB3084 RMB ($451.3)($451.3)

4285 RMB4285 RMB ($627.1)($627.1)

4662 RMB4662 RMB ($682.2)($682.2)

4669 RMB4669 RMB ($683.3)($683.3)

4974 RMB4974 RMB ($728.3)($728.3)

RMBRMB


DrugDrug

Exam/TestExam/Test

Medical ServicesMedical Services


CHALLENGES OF THE CHINESE HEALTHCARE SYSTEMCHALLENGES OF THE CHINESE HEALTHCARE SYSTEM

1.1. ALMOST 60% OF HEALTHCARE COSTS ARE PAID DIRECTLY BY PATIENTS OUT OF ALMOST 60% OF HEALTHCARE COSTS ARE PAID DIRECTLY BY PATIENTS OUT OF THEIR POCKETTHEIR POCKET

2.2. ACCESS TO HEALTHCARE FOR THE POOR HAS BEEN LIMITED, BUT NOW CHANGINGACCESS TO HEALTHCARE FOR THE POOR HAS BEEN LIMITED, BUT NOW CHANGING

3.3. THE MIDDLE AND UPPER CLASSES ARE DISSATISFIED WITH HEALTHCARE THE MIDDLE AND UPPER CLASSES ARE DISSATISFIED WITH HEALTHCARE SERVICES SERVICES

4.4. DOCTOR INCOME EARNING METHODS WEAKEN THE DOCTOR-PATIENT DOCTOR INCOME EARNING METHODS WEAKEN THE DOCTOR-PATIENT RELATIONSHIPRELATIONSHIP

5.5. DRUGS AND TESTS FUND TOO MUCH OF THE HEALTHCARE SYSTEM DRUGS AND TESTS FUND TOO MUCH OF THE HEALTHCARE SYSTEM

6.6. HOSPITALS NEED TO EARN PROFITS TO SUPPORT THEMSELVESHOSPITALS NEED TO EARN PROFITS TO SUPPORT THEMSELVES

7.7. PRIMARY CARE IS JUST BEGINNING TO SEPARATE FROM HOSPITALS TO NEWLY-PRIMARY CARE IS JUST BEGINNING TO SEPARATE FROM HOSPITALS TO NEWLY-DEVELOPED COMMUNITY CLINICSDEVELOPED COMMUNITY CLINICS

8.8. HEALTHCARE SYSTEM CHANGES WILL CAUSE HEALTHCARE COSTS TO RISE MORE HEALTHCARE SYSTEM CHANGES WILL CAUSE HEALTHCARE COSTS TO RISE MORE RAPIDLYRAPIDLY


THE EVOLUTION OF H.I.T. THE EVOLUTION OF H.I.T. AROUND THE WORLD AS A FRAME AROUND THE WORLD AS A FRAME

OF REFERENCE TO BETTER OF REFERENCE TO BETTER UNDERSTAND H.I.T. IN CHINAUNDERSTAND H.I.T. IN CHINA



U.S. HEALTHCARE COSTS AS A PERCENT OF GDP ($ IN BILLIONS)U.S. HEALTHCARE COSTS AS A PERCENT OF GDP ($ IN BILLIONS)

SOURCE: CENTERS FOR MEDICARE AND MEDICAID SERVICESSOURCE: CENTERS FOR MEDICARE AND MEDICAID SERVICES

7.2%

8.8%

10.1%

12.0%

13.4% 13.3%

16.0%

0%

5%

10%

15%

20%

1970 1975 1980 1985 1990 1995 2000 2005 2015

$1,987.7

$75.1

$245.8

$426.8

$696.0

$990.3 $1,299.5

CMS ForecastCMS Forecast

15%

10%

5%

0%

20% $4,043.6

19701970 19751975 19801980 19851985 19901990 19951995 20002000 20052005

20.0%

20152015


$ in billions

$16.0

$19.0$21.6

$20.0

Actual

$18.5

17.6% 15.6% 2.7%ANNUALGROWTH RATE: 8.0%5.2%

$23.6$25.8

Forecast 2006

9.3% 9.3%

$28.0

8.9%

$30.5

8.9%

GROWTH OF H.I.T. SPENDING IN U.S.GROWTH OF H.I.T. SPENDING IN U.S.($ IN BILLIONS)($ IN BILLIONS)

$13.6

17.2%

$11.6$10.0

$8.5$7.5

16.0%17.6%13.3%6.7%

SOURCE: SHELDON I. DORENFEST & ASSOCIATES, LTD.SOURCE: SHELDON I. DORENFEST & ASSOCIATES, LTD.


OPPORTUNITIES TO IMPROVE THE HEALTHCARE DELIVERY PROCESSOPPORTUNITIES TO IMPROVE THE HEALTHCARE DELIVERY PROCESSHAVE BEEN PURSUED FOR MANY YEARSHAVE BEEN PURSUED FOR MANY YEARS

GREAT REDUNDANCY OF INFORMATIONGREAT REDUNDANCY OF INFORMATION

HIGH ERROR POTENTIALHIGH ERROR POTENTIAL

LACK OF TIMELINESSLACK OF TIMELINESS

HIGH COSTHIGH COST

ORGANIZATION COMPLEXITYORGANIZATION COMPLEXITY


U.S. HOSPITALS STARTED USING H.I.T. IN THE 1960s AND SOUGHT AN EHR U.S. HOSPITALS STARTED USING H.I.T. IN THE 1960s AND SOUGHT AN EHR THROUGH FOUR GENERATIONS OF I.T. SYSTEMSTHROUGH FOUR GENERATIONS OF I.T. SYSTEMS

FINANCE SYSTEMS (LATE 1960S-1970s)FINANCE SYSTEMS (LATE 1960S-1970s)

LIMITED CLINICAL SYSTEMS (LATE 1970s AND 1980s)LIMITED CLINICAL SYSTEMS (LATE 1970s AND 1980s)

MORE ADVANCED CLINICAL SYSTEMS (1990s)MORE ADVANCED CLINICAL SYSTEMS (1990s)

ELECTRONIC HEALTH RECORDS (2000s)ELECTRONIC HEALTH RECORDS (2000s)


BUT POORLY IMPLEMENTED CHANGE LAYERED REDUNDANT WORK ON TOP BUT POORLY IMPLEMENTED CHANGE LAYERED REDUNDANT WORK ON TOP OF ORIGINAL INEFFICIENCYOF ORIGINAL INEFFICIENCY

Legacy I.T. Systems

ManualManual BEFORE I.T.=1x

2x

3x

4x

GROWTH IN GROWTH IN

REDUNDANCYREDUNDANCY

TOTAL HOSPITAL WORK PROCESSTOTAL HOSPITAL WORK PROCESS


U.S. HAS MADE MORE PROGRESS RECENTLYU.S. HAS MADE MORE PROGRESS RECENTLY

TODAY OVER 100 HOSPITALS HAVE IMPLEMENTED CPR WITH CPOETODAY OVER 100 HOSPITALS HAVE IMPLEMENTED CPR WITH CPOE

MANY OTHERS ARE IMPLEMENTING CPR AND CPOE RIGHT NOWMANY OTHERS ARE IMPLEMENTING CPR AND CPOE RIGHT NOW

I.T. IS A MAJOR TOOL FOR IMPROVING HOSPITAL PERFORMANCEI.T. IS A MAJOR TOOL FOR IMPROVING HOSPITAL PERFORMANCE


BUT U.S. HOSPITALS HAVE BEEN INEFFICIENT INVESTORSBUT U.S. HOSPITALS HAVE BEEN INEFFICIENT INVESTORS

OVERSIMPLIFICATION OF I.T. INVESTMENT CONSIDERATIONS (I.E., DID NOT OVERSIMPLIFICATION OF I.T. INVESTMENT CONSIDERATIONS (I.E., DID NOT KNOW WHAT THEY DID NOT KNOW)KNOW WHAT THEY DID NOT KNOW)

POOR PROJECT PLANNINGPOOR PROJECT PLANNING

IMPROPER ASSESSMENT OF SOFTWARE PRODUCT CAPABILITIESIMPROPER ASSESSMENT OF SOFTWARE PRODUCT CAPABILITIES

IMPLEMENTED A SERIES OF “1/2 SYSTEMS” WITHOUT PROPERLY IMPLEMENTED A SERIES OF “1/2 SYSTEMS” WITHOUT PROPERLY REDESIGNING THE WORK PROCESSREDESIGNING THE WORK PROCESS

INDUSTRY MANAGEMENT DID NOT LEARN ENOUGH FROM PAST MISTAKES, INDUSTRY MANAGEMENT DID NOT LEARN ENOUGH FROM PAST MISTAKES, AND THEREFORE, CONTINUED TO REPEAT THE SAME MISTAKESAND THEREFORE, CONTINUED TO REPEAT THE SAME MISTAKES

THIS LEFT THE NATION WITH REDUNDANT, CONVOLUTED, EXPENSIVE, ERROR THIS LEFT THE NATION WITH REDUNDANT, CONVOLUTED, EXPENSIVE, ERROR PRONE WORK PROCESSES THAT PRESENTLY CRIPPLE THE COUNTRY’S PRONE WORK PROCESSES THAT PRESENTLY CRIPPLE THE COUNTRY’S HEALTHCARE SYSTEMHEALTHCARE SYSTEM


H.I.T. EVOLUTION IN THE REST OF THE WORLDH.I.T. EVOLUTION IN THE REST OF THE WORLD

CANADA STARTED IN THE LATE 1970sCANADA STARTED IN THE LATE 1970s

EUROPE AND AUSTRALIA BEGAN IN THE EARLY 1980sEUROPE AND AUSTRALIA BEGAN IN THE EARLY 1980s

ASIA BEGAN IN THE 1990sASIA BEGAN IN THE 1990s

CANADA, FRANCE, GERMANY, ENGLAND, AND AUSTRALIA ALL STARTED LATER CANADA, FRANCE, GERMANY, ENGLAND, AND AUSTRALIA ALL STARTED LATER THAN THE U.S., INVESTED LESS, AND HAVE MADE MORE PROGRESSTHAN THE U.S., INVESTED LESS, AND HAVE MADE MORE PROGRESS

HONG KONG STARTED EVEN LATER, INVESTED EVEN LESS, AND IS NOW AT HONG KONG STARTED EVEN LATER, INVESTED EVEN LESS, AND IS NOW AT THE STATE OF THE ART IN H.I.T. THE STATE OF THE ART IN H.I.T.

CHINA H.I.T. IS NOW AT AN EARLIER STAGE OF DEVELOPMENT. CHINA HAS CHINA H.I.T. IS NOW AT AN EARLIER STAGE OF DEVELOPMENT. CHINA HAS THE GOALS AND DESIRE TO “LEAPFROG” THE REST OF THE WORLD IN H.I.T. THE GOALS AND DESIRE TO “LEAPFROG” THE REST OF THE WORLD IN H.I.T. USE IN THE NEXT FEW YEARS USE IN THE NEXT FEW YEARS


SUMMARYSUMMARY

U.S. SPENDS A MUCH LARGER SHARE OF GDP ON HEALTHCARE, BUT, THIS U.S. SPENDS A MUCH LARGER SHARE OF GDP ON HEALTHCARE, BUT, THIS GREATER EXPENDITURE DOES NOT PRODUCE GREATER HEALTHCARE GREATER EXPENDITURE DOES NOT PRODUCE GREATER HEALTHCARE RESULTSRESULTS

U.S. SPENDS A LARGER SHARE OF ITS TOTAL HOSPITAL OPERATING COSTS U.S. SPENDS A LARGER SHARE OF ITS TOTAL HOSPITAL OPERATING COSTS ON I.T. EFFORTSON I.T. EFFORTS

U.S. HAS BEEN INVESTING HEAVILY IN H.I.T. FOR OVER 40 YEARS. WHILE THIS U.S. HAS BEEN INVESTING HEAVILY IN H.I.T. FOR OVER 40 YEARS. WHILE THIS SUBSTANTIAL INVESTMENT HAS NOT PRODUCED ADEQUATE RETURN, THERE SUBSTANTIAL INVESTMENT HAS NOT PRODUCED ADEQUATE RETURN, THERE IS MUCH TO LEARN FROM WHAT WORKED AND DID NOT WORK IN U.S. H.I.T. IS MUCH TO LEARN FROM WHAT WORKED AND DID NOT WORK IN U.S. H.I.T. STRATEGIES AND APPROACHESSTRATEGIES AND APPROACHES

U.S. HAS BEEN THROUGH AT LEAST FOUR GENERATIONS OF HOSPITAL U.S. HAS BEEN THROUGH AT LEAST FOUR GENERATIONS OF HOSPITAL SOFTWARE PRODUCTS IN THE PAST FORTY YEARSSOFTWARE PRODUCTS IN THE PAST FORTY YEARS

THE REST OF THE WORLD STARTED AUTOMATION EFFORTS LATER, INVESTED THE REST OF THE WORLD STARTED AUTOMATION EFFORTS LATER, INVESTED LESS, AND HAVE RECEIVED A HIGHER RETURN ON H.I.T. INVESTMENT THAN LESS, AND HAVE RECEIVED A HIGHER RETURN ON H.I.T. INVESTMENT THAN THE U.S.THE U.S.

THERE IS STILL MUCH TO DO TO IMPROVE H.I.T. ROI EVERYWHERE IN THE THERE IS STILL MUCH TO DO TO IMPROVE H.I.T. ROI EVERYWHERE IN THE WORLDWORLD


THE CURRENT STATUS AND THE CURRENT STATUS AND FUTURE DIRECTION OF H.I.T. IN FUTURE DIRECTION OF H.I.T. IN

CHINESE HOSPITALSCHINESE HOSPITALS



EVOLUTION OF H.I.T. IN CHINAEVOLUTION OF H.I.T. IN CHINA

CHINA BEGAN TO COMPUTERIZE ITS HOSPITALS IN THE EARLY 90’SCHINA BEGAN TO COMPUTERIZE ITS HOSPITALS IN THE EARLY 90’S

INITIALLY PROGRESS WAS SLOW, WITH A FOCUS ON FINANCIAL SYSTEMSINITIALLY PROGRESS WAS SLOW, WITH A FOCUS ON FINANCIAL SYSTEMS

IN THE EARLY 2000’S, CHINESE HOSPITALS BEGAN TO IMPLEMENT I.T. FOR IN THE EARLY 2000’S, CHINESE HOSPITALS BEGAN TO IMPLEMENT I.T. FOR CLINICAL SYSTEMSCLINICAL SYSTEMS

MANY SOFTWARE SOLUTIONS AVAILABLE, WITH SEVERAL HUNDRED SMALLER MANY SOFTWARE SOLUTIONS AVAILABLE, WITH SEVERAL HUNDRED SMALLER SOFTWARE COMPANIES EMERGINGSOFTWARE COMPANIES EMERGING

IN 2005, CHINA SPENT LESS THAN 1% OF TOTAL HEALTHCARE COSTS ON I.T. OR IN 2005, CHINA SPENT LESS THAN 1% OF TOTAL HEALTHCARE COSTS ON I.T. OR ABOUT $600 MILLION (USD)ABOUT $600 MILLION (USD)

IN 2007, CHINA SPENT OVER $1 BILLION (USD) ON H.I.T.IN 2007, CHINA SPENT OVER $1 BILLION (USD) ON H.I.T.

GROWTH IN H.I.T. INVESTMENT IS EXPECTED TO ACCELERATE, RISING TO ALMOST GROWTH IN H.I.T. INVESTMENT IS EXPECTED TO ACCELERATE, RISING TO ALMOST $3 BILLION USD IN 2010 $3 BILLION USD IN 2010


FACTORS CONTRIBUTING TO FUTURE SPENDING GROWTH IN CHINA H.I.T.FACTORS CONTRIBUTING TO FUTURE SPENDING GROWTH IN CHINA H.I.T.

1.1. CHINA HOSPITAL WORK PROCESSES ARE REDUNDANT, EXPENSIVE, AND ERROR-PRONECHINA HOSPITAL WORK PROCESSES ARE REDUNDANT, EXPENSIVE, AND ERROR-PRONE

2.2. THE MINISTRY OF HEALTH (MOH) GUIDELINES FOR HEALTH I.T. DEVELOPMENT CALL FOR THE MINISTRY OF HEALTH (MOH) GUIDELINES FOR HEALTH I.T. DEVELOPMENT CALL FOR ALL CITIES IN CHINA TO HAVE REGIONAL HEALTH NETWORKS AND ELECTRONIC MEDICAL ALL CITIES IN CHINA TO HAVE REGIONAL HEALTH NETWORKS AND ELECTRONIC MEDICAL RECORDS AUTOMATED BETWEEN 2003 AND 2010RECORDS AUTOMATED BETWEEN 2003 AND 2010

PROVIDED MUCH MOMENTUMPROVIDED MUCH MOMENTUM

NOT MUCH SUCCESS TO DATENOT MUCH SUCCESS TO DATE

HEALTHCARE REFORM INCREASED INVESTMENT AND MOMENTUMHEALTHCARE REFORM INCREASED INVESTMENT AND MOMENTUM

3.3. CHINESE HOSPITAL LEADERS WANT TO TAKE A BIG LEAP FORWARD IN IMPROVING WORK CHINESE HOSPITAL LEADERS WANT TO TAKE A BIG LEAP FORWARD IN IMPROVING WORK PROCESSES AND IN DIGITIZING CHINESE HOSPITALSPROCESSES AND IN DIGITIZING CHINESE HOSPITALS

4.4. IMPROVED USE OF I.T. IS ONE OF 8 PILLARS OF THE NEW CHINA HEALTHCARE REFORM IMPROVED USE OF I.T. IS ONE OF 8 PILLARS OF THE NEW CHINA HEALTHCARE REFORM PLAN. FOCUSES INCLUDE: PLAN. FOCUSES INCLUDE:

ELECTRONIC HEALTH RECORDSELECTRONIC HEALTH RECORDS

DATA SHARING THROUGH REGIONAL HEALTH NETWORKSDATA SHARING THROUGH REGIONAL HEALTH NETWORKS

IMPROVED HOSPITAL I.T. SYSTEMSIMPROVED HOSPITAL I.T. SYSTEMS

I.T. SYSTEMS TO SUPPORT HEALTH INSURANCEI.T. SYSTEMS TO SUPPORT HEALTH INSURANCE


FACTORS IMPEDING SUCCESS IN CHINA H.I.T.FACTORS IMPEDING SUCCESS IN CHINA H.I.T.

CHINESE HOSPITALS HAVE INVESTED TOO LITTLE IN I.T. SYSTEMS AND I.T. CHINESE HOSPITALS HAVE INVESTED TOO LITTLE IN I.T. SYSTEMS AND I.T. INFRASTRUCTUREINFRASTRUCTURE

SOFTWARE PRODUCTS AND INTEGRATION TOOLS ARE NOT GOOD ENOUGH SOFTWARE PRODUCTS AND INTEGRATION TOOLS ARE NOT GOOD ENOUGH

INEXPERIENCE IN SOFTWARE BUYING RESULTS IN BAD BUYING DECISIONS INEXPERIENCE IN SOFTWARE BUYING RESULTS IN BAD BUYING DECISIONS AND POOR IMPLEMENTATIONAND POOR IMPLEMENTATION

THIS HAS RESULTED IN NEW I.T. SYSTEMS, OFTEN ADDING WORK AND THIS HAS RESULTED IN NEW I.T. SYSTEMS, OFTEN ADDING WORK AND CREATING UNNECESSARILY REDUNDANT WORK PROCESSESCREATING UNNECESSARILY REDUNDANT WORK PROCESSES

HOSPITAL LEADERS, NOT KNOWING WHAT THEY DO NOT KNOW, CONTINUE TO HOSPITAL LEADERS, NOT KNOWING WHAT THEY DO NOT KNOW, CONTINUE TO USE POOR BUYING AND IMPLEMENTATION APPROACHES BECAUSE THEY DO USE POOR BUYING AND IMPLEMENTATION APPROACHES BECAUSE THEY DO NOT KNOW BETTER WAYS ARE POSSIBLE, AND THERE IS A STRONG NOT KNOW BETTER WAYS ARE POSSIBLE, AND THERE IS A STRONG MOMENTUM TO CONTINUE WITH THESE APPROACHES MOMENTUM TO CONTINUE WITH THESE APPROACHES


THE COMPETITIVE ENVIRONMENTTHE COMPETITIVE ENVIRONMENT

THERE ARE HUNDREDS OF SMALL SOFTWARE VENDORS ACTIVE IN CHINA THERE ARE HUNDREDS OF SMALL SOFTWARE VENDORS ACTIVE IN CHINA H.I.T. H.I.T.

THE MARKET SEGMENTS WITH THE MOST VENDORS ARE EMR, H.I.S., PACS, THE MARKET SEGMENTS WITH THE MOST VENDORS ARE EMR, H.I.S., PACS, R.I.S., AND LABR.I.S., AND LAB

ALL H.I.T. VENDORS IN THE MARKET STARTED IN A CITY AND MOST ARE STILL ALL H.I.T. VENDORS IN THE MARKET STARTED IN A CITY AND MOST ARE STILL OPERATING IN THAT CITY OR A SMALL REGION AROUND THE CITY. SOME OPERATING IN THAT CITY OR A SMALL REGION AROUND THE CITY. SOME H.I.T. VENDORS ARE BEGINNING TO BECOME MORE NATIONAL IN SCOPEH.I.T. VENDORS ARE BEGINNING TO BECOME MORE NATIONAL IN SCOPE

MANY VENDORS IN THE H.I.S. MARKET OFFER HEAVILY CUSTOMIZED MANY VENDORS IN THE H.I.S. MARKET OFFER HEAVILY CUSTOMIZED SOLUTIONS RATHER THAN STANDARD SOLUTIONS. THESE CUSTOMIZED SOLUTIONS RATHER THAN STANDARD SOLUTIONS. THESE CUSTOMIZED SOLUTIONS CREATE GREATER DEPENDENCY ON THE VENDOR AND ARE SOLUTIONS CREATE GREATER DEPENDENCY ON THE VENDOR AND ARE MORE DIFFICULT/EXPENSIVE TO KEEP CURRENT AS VENDORS PERIODICALLY MORE DIFFICULT/EXPENSIVE TO KEEP CURRENT AS VENDORS PERIODICALLY RELEASE UPDATESRELEASE UPDATES

CHINESE HOSPITAL LEADERS WOULD LIKE TO SEE A NEW GENERATION OF CHINESE HOSPITAL LEADERS WOULD LIKE TO SEE A NEW GENERATION OF H.I.T. SOFTWARE DEVELOPED FOR THE COUNTRY TO ASSIST IN HELPING H.I.T. SOFTWARE DEVELOPED FOR THE COUNTRY TO ASSIST IN HELPING THEM ACCOMPLISH THEIR “LEAPFROG” OBJECTIVES THEM ACCOMPLISH THEIR “LEAPFROG” OBJECTIVES


ALLOCATION OF H.I.T. INVESTMENT AROUND THE WORLDALLOCATION OF H.I.T. INVESTMENT AROUND THE WORLD

SOURCE: CCW ResearchSOURCE: CCW Research

2005 GLOBAL H.I.T. INVESTMENT STRUCTURE

28.9%20.2%

27.8%

50.3%

64.7%12.2%

13.2%

20.7%

11.8%

22.3%58.9%

66.6%

51.5%37.9%

13.0%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Global USA WestEurope

Canada China

Service

Software

Hardware


EXPECTED EVOLUTION OF H.I.T. IN CHINA EXPECTED EVOLUTION OF H.I.T. IN CHINA

IMPROVED BUYING AND IMPLEMENTATION OF I.T. SOFTWARE WITH MORE IMPROVED BUYING AND IMPLEMENTATION OF I.T. SOFTWARE WITH MORE USER INVOLVEMENTUSER INVOLVEMENT

BETTER USE OF I.T. TO SUPPORT HOSPITAL MANAGEMENTBETTER USE OF I.T. TO SUPPORT HOSPITAL MANAGEMENT

BETTER USE OF I.T. IN CLINICAL SERVICESBETTER USE OF I.T. IN CLINICAL SERVICES

DIGITAL HOSPITALS WITH ELECTRONIC HEALTH RECORDS WILL EVOLVE WITH DIGITAL HOSPITALS WITH ELECTRONIC HEALTH RECORDS WILL EVOLVE WITH GREATER FREQUENCYGREATER FREQUENCY

BETTER SYSTEMS INTEGRATION AND MORE STANDARDS TO SUPPORT I.T. BETTER SYSTEMS INTEGRATION AND MORE STANDARDS TO SUPPORT I.T. PROGRESS AND THE USE OF MULTIPLE VENDORS IN THE I.T. ENVIRONMENTPROGRESS AND THE USE OF MULTIPLE VENDORS IN THE I.T. ENVIRONMENT

REGIONAL HEALTH NETWORKS WILL EVOLVEREGIONAL HEALTH NETWORKS WILL EVOLVE

CHINA’S GOAL IS TO LEAPFROG THE WORLD IN H.I.T. ACCOMPLISHMENTCHINA’S GOAL IS TO LEAPFROG THE WORLD IN H.I.T. ACCOMPLISHMENT


CHINA HEALTHCARE LEADERS WANT TO “LEAPFROG” THE WORLDCHINA HEALTHCARE LEADERS WANT TO “LEAPFROG” THE WORLD

CHINESE HOSPITALS AND HEALTH BUREAUS ARE CAREFULLY CONSIDERING HOW CHINESE HOSPITALS AND HEALTH BUREAUS ARE CAREFULLY CONSIDERING HOW TO BE MORE SUCCESSFUL IN TAKING NEXT STEPS FORWARD IN I.T. USETO BE MORE SUCCESSFUL IN TAKING NEXT STEPS FORWARD IN I.T. USE

THERE IS A RECOGNITION THAT FOR CHINA TO ACCOMPLISH ITS OBJECTIVES IN THERE IS A RECOGNITION THAT FOR CHINA TO ACCOMPLISH ITS OBJECTIVES IN H.I.T. REQUIRES THE FOLLOWING :H.I.T. REQUIRES THE FOLLOWING :

– LEARNING QUICKLY FROM THE GLOBAL EXPERIENCELEARNING QUICKLY FROM THE GLOBAL EXPERIENCE

– OVERCOMING RESISTANCE TO CHANGEOVERCOMING RESISTANCE TO CHANGE

– KNOWING HOW TO MANAGE CHANGEKNOWING HOW TO MANAGE CHANGE

– DOING MORE OF WHAT THE REST OF THE WORLD DID RIGHT AND LESS OF DOING MORE OF WHAT THE REST OF THE WORLD DID RIGHT AND LESS OF WHAT THEY DID WRONG TO AVOID MISTAKES OTHER COUNTRIES HAVE WHAT THEY DID WRONG TO AVOID MISTAKES OTHER COUNTRIES HAVE MADE AND CHINA IS STILL MAKINGMADE AND CHINA IS STILL MAKING

– DEVELOPING MORE EXPERTISE IN THESE AREAS OF NEEDDEVELOPING MORE EXPERTISE IN THESE AREAS OF NEED


EVOLUTION OF RHNs IN EVOLUTION OF RHNs IN THE U.S. AND CHINATHE U.S. AND CHINA



RHNs WERE FIRST INTRODUCED AS CHINS IN THE U.S. IN THE EARLY 1990sRHNs WERE FIRST INTRODUCED AS CHINS IN THE U.S. IN THE EARLY 1990s

Hospital A

Doctor’s Office Doctor’s Office

GovernmentReimbursement

Blood BankHome Health Agency

Hospital B

Patient DataDoctor’s Office

Insurance Payor

Nursing Home

Outpatient Clinic

Outpatient Clinic

Outpatient Clinic


SUMMARY OF EVOLUTION OF RHNs IN THE U.S.SUMMARY OF EVOLUTION OF RHNs IN THE U.S.

COMMUNITY HEALTH INFORMATION NETWORKS (CHINs) BEGAN IN 1990 AS COMMUNITY HEALTH INFORMATION NETWORKS (CHINs) BEGAN IN 1990 AS THE FIRST GENERATION OF RHNs IN THE UNITED STATES THE FIRST GENERATION OF RHNs IN THE UNITED STATES

– FORMED WITH A FORMED WITH A BROAD BROAD VISION OF SHARING INFORMATION AMONG VISION OF SHARING INFORMATION AMONG HEALTH ORGANIZATIONS WITHIN A CITY OR STATE HEALTH ORGANIZATIONS WITHIN A CITY OR STATE

– UNCLEAR OBJECTIVESUNCLEAR OBJECTIVES

– LACK OF VALUE TO POTENTIAL PARTICIPANTSLACK OF VALUE TO POTENTIAL PARTICIPANTS

– MUCH MONEY INVESTED BY MANY CHIN PROJECTS MUCH MONEY INVESTED BY MANY CHIN PROJECTS

INTEGRATED DELIVERY INTEGRATED DELIVERY OWNERSHIP MODELS OWNERSHIP MODELS EMERGED IN 1993 AS THE EMERGED IN 1993 AS THE HOSPITAL ANSWER TO THE CLINTON HEALTHCARE REFORM PROPOSAL HOSPITAL ANSWER TO THE CLINTON HEALTHCARE REFORM PROPOSAL

BY THE MIDDLE 1990s, INTEGRATED DELIVERY SYSTEMS EMERGED IN EVERY BY THE MIDDLE 1990s, INTEGRATED DELIVERY SYSTEMS EMERGED IN EVERY CITY IN THE UNITED STATES, AND THE CHIN CONCEPT DISAPPEARED BY 1996 CITY IN THE UNITED STATES, AND THE CHIN CONCEPT DISAPPEARED BY 1996


THE VISION OF INTEGRATED DELIVERY SYSTEMTHE VISION OF INTEGRATED DELIVERY SYSTEM OWNERSHIP MODELS OWNERSHIP MODELS

Hospital A

Doctor’s Office Doctor’s Office

GovernmentReimbursement

Blood BankHome Health Agency

Hospital B

Patient DataDoctor’s Office

Insurance Payor

Nursing Home

Outpatient Clinic

Outpatient Clinic

Outpatient Clinic


RHIOs EMERGE IN THE DECADE OF THE 2000s RHIOs EMERGE IN THE DECADE OF THE 2000s

RHIOs WERE THE SECOND GENERATION OF RHNs IN THE U.S.RHIOs WERE THE SECOND GENERATION OF RHNs IN THE U.S.

– MANY DIFFERENT ORGANIZATIONS PROMOTED THEM IN THE EARLY MANY DIFFERENT ORGANIZATIONS PROMOTED THEM IN THE EARLY 2000s2000s

– BY 2004, NATIONAL POLICY EMERGED BY 2004, NATIONAL POLICY EMERGED THROUGH THROUGH THE OFFICE OF THE THE OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY (ONCHIT) (ONCHIT)

IN THE ENSUING SEVERAL YEARS BETWEEN 2004 ANDIN THE ENSUING SEVERAL YEARS BETWEEN 2004 AND NOW NOW, , ALMOST 100ALMOST 100 OFFICIALLY DESIGNATED RHIOs EMERGEDOFFICIALLY DESIGNATED RHIOs EMERGED

– HEAVY INVESTMENT IN THESE RHIOs WITH MOST FUNDS USED IN HEAVY INVESTMENT IN THESE RHIOs WITH MOST FUNDS USED IN THEIR START-UPTHEIR START-UP

– MANY WERE UNABLE TO FIND A SUSTAINABLE OPERATING MODEL AND MANY WERE UNABLE TO FIND A SUSTAINABLE OPERATING MODEL AND APPROACHED FINANCIAL COLLAPSEAPPROACHED FINANCIAL COLLAPSE

– SOME LONG TERM SUCCESSES EMERGEDSOME LONG TERM SUCCESSES EMERGED TO SHARE LIMITED DATA TO SHARE LIMITED DATA


WHAT ARE THE LESSONS TO BE LEARNED?WHAT ARE THE LESSONS TO BE LEARNED?

BROAD VISIONS BROAD VISIONS NEEDS DETAILED PLANSNEEDS DETAILED PLANS

OVERSIMPLIFIED IMPLEMENTATION APPROACHES OVERSIMPLIFIED IMPLEMENTATION APPROACHES CREATE FLAWED AND CREATE FLAWED AND LIMITED SUCCESSLIMITED SUCCESS

LACK OF STAKEHOLDER COMMITMENT LACK OF STAKEHOLDER COMMITMENT CREATED FAILED PROGRAMSCREATED FAILED PROGRAMS

HEAVY INVESTMENT IN POORLY CONCEIVED IDEAS HEAVY INVESTMENT IN POORLY CONCEIVED IDEAS WASTED MONEYWASTED MONEY

SUCCESS ACCOMPLISHED THROUGH LIMITED, WELL THOUGHT THROUGH SUCCESS ACCOMPLISHED THROUGH LIMITED, WELL THOUGHT THROUGH FIRST STEPS AND STRONG STAKEHOLDER PARTICIPATION AND SUPPORTFIRST STEPS AND STRONG STAKEHOLDER PARTICIPATION AND SUPPORT


EVOLUTION OF RHNs IN CHINAEVOLUTION OF RHNs IN CHINA

THE MINISTRY OF HEALTH (MOH) GUIDELINES FOR HEALTH I.T. DEVELOPMENT THE MINISTRY OF HEALTH (MOH) GUIDELINES FOR HEALTH I.T. DEVELOPMENT CALLED FOR REGIONAL HEALTH NETWORKS AND DIGITAL HOSPITALS TO BE CALLED FOR REGIONAL HEALTH NETWORKS AND DIGITAL HOSPITALS TO BE IMPLEMENTED THROUGHOUT CHINA BETWEEN 2003 AND 2010IMPLEMENTED THROUGHOUT CHINA BETWEEN 2003 AND 2010

THIS PROVIDED MUCH MOMENTUM AS MANY HEALTH BUREAUS UNDERTOOK THIS PROVIDED MUCH MOMENTUM AS MANY HEALTH BUREAUS UNDERTOOK REGIONAL HEALTH NETWORK AND DIGITAL HOSPITAL INVESTMENTREGIONAL HEALTH NETWORK AND DIGITAL HOSPITAL INVESTMENT

IN THE LAST IN THE LAST FEW FEW YEARS DATA SHARING YEARS DATA SHARING HAS HAS BEGUN TO EMERGE IN CHINA AS BEGUN TO EMERGE IN CHINA AS SOME RHNs SHARE LIMITED DATA SUCH AS SOME RHNs SHARE LIMITED DATA SUCH AS TEST/DIAGNOSTICTEST/DIAGNOSTIC RESULTS RESULTS AND AND SOME PATIENT INFORMATIONSOME PATIENT INFORMATION

HEALTHCARE REFORM HEALTHCARE REFORM CALLS FOR E-HEALTH RECORDS AND CALLS FOR E-HEALTH RECORDS AND HAS PROVIDED HAS PROVIDED SUBSTANTIAL ADDITIONAL FUNDING IN A VARIETY OF WAYS, SO IT IS SUBSTANTIAL ADDITIONAL FUNDING IN A VARIETY OF WAYS, SO IT IS EXPECTED THAT SUBSTANTIAL ADDITIONAL PROGRESS WILL BE MADE IN THE EXPECTED THAT SUBSTANTIAL ADDITIONAL PROGRESS WILL BE MADE IN THE NEXT FEW YEARSNEXT FEW YEARS

MUCH MORE ACTIVITYMUCH MORE ACTIVITY AND FUNDING AND FUNDING IN MANY CITIES AND PROVINCES IN MANY CITIES AND PROVINCES WITH WITH EVEN U.S. FUNDING FOREVEN U.S. FUNDING FOR ONE OR TWO MAJOR ONE OR TWO MAJOR PLANNING PLANNING PROJECTS PROJECTS


THE CURRENT SITUATION WITH RHN DEVELOPMENT AND ELECTRONIC HEALTH THE CURRENT SITUATION WITH RHN DEVELOPMENT AND ELECTRONIC HEALTH RECORDS IN CHINA RESEMBLES THE U.S. SITUATION OF RECORDS IN CHINA RESEMBLES THE U.S. SITUATION OF PASTPAST

BROAD VISIONBROAD VISION

MOREMORE MONEY AVAILABLE MONEY AVAILABLE

POORPOOR DEFINITION OF DEFINITION OF FIRST STEPSFIRST STEPS

LACK OF STAKEHOLDER COMMITMENT TO SPECIFIC DATA SHARINGLACK OF STAKEHOLDER COMMITMENT TO SPECIFIC DATA SHARING


BUILDING SUCCESS THROUGH A STRONG FOUNDATIONBUILDING SUCCESS THROUGH A STRONG FOUNDATION

CAREFULLY DEFINE FIRST STEPSCAREFULLY DEFINE FIRST STEPS

LIMITED DATA SETS WITH HIGH BENEFIT TO MANY STAKE HOLDERS WOULD LIMITED DATA SETS WITH HIGH BENEFIT TO MANY STAKE HOLDERS WOULD BE ADVANTAGEOUSBE ADVANTAGEOUS

WHEN FIRST STEPS PROVE BENEFICIAL, MORE AGGRESSIVE SECOND STEPS WHEN FIRST STEPS PROVE BENEFICIAL, MORE AGGRESSIVE SECOND STEPS CAN BE TAKEN CAN BE TAKEN


THE CITY OF SHENZHEN AS AN THE CITY OF SHENZHEN AS AN EXAMPLE OF REGIONAL HEALTH EXAMPLE OF REGIONAL HEALTH

NETWORKS IN CHINANETWORKS IN CHINA



SHENZHEN REGIONAL HEALTH NETWORK VISIONSHENZHEN REGIONAL HEALTH NETWORK VISION

SHENZHEN, A CITY OF 12 MILLION PEOPLE, SELECTED BY MINISTRY OF HEALTH SHENZHEN, A CITY OF 12 MILLION PEOPLE, SELECTED BY MINISTRY OF HEALTH IN IN 2004 2004 TO BE A PILOT SITE IN DEVELOPING REGIONAL HEALTH INFORMATION TO BE A PILOT SITE IN DEVELOPING REGIONAL HEALTH INFORMATION NETWORKS AND DIGITAL HOSPITALSNETWORKS AND DIGITAL HOSPITALS

THE GOALS OF THE RHN ARE TO ACCOMPLISH THE FOLLOWING:: THE GOALS OF THE RHN ARE TO ACCOMPLISH THE FOLLOWING::

– PROVIDING BETTER TOOLS AND INFORMATION TO IMPROVE HEALTH PROVIDING BETTER TOOLS AND INFORMATION TO IMPROVE HEALTH MANAGEMENT IN THE CITYMANAGEMENT IN THE CITY

– SHARING HEALTH INFORMATION THROUGHOUT THE CITYSHARING HEALTH INFORMATION THROUGHOUT THE CITY

– REDUCING “ISLANDS OF INFORMATION” THROUGHOUT THE CITY REDUCING “ISLANDS OF INFORMATION” THROUGHOUT THE CITY

– PROMOTING AND ADOPTING TECHNOLOGY STANDARDS THAT WILL FACILITATE PROMOTING AND ADOPTING TECHNOLOGY STANDARDS THAT WILL FACILITATE INTEROPERABILITY OF HEALTH INFORMATION INTEROPERABILITY OF HEALTH INFORMATION

THE PLAN IS TO DEVELOP AN INFORMATION NETWORK THAT CAN BE ACCESSED AND THE PLAN IS TO DEVELOP AN INFORMATION NETWORK THAT CAN BE ACCESSED AND USED BY HEALTHCARE PROVIDERS THROUGHOUT THE CITY OF SHENZHENUSED BY HEALTHCARE PROVIDERS THROUGHOUT THE CITY OF SHENZHEN


SHENZHEN REGIONAL HEALTH NETWORK VISION (CONTINUED)SHENZHEN REGIONAL HEALTH NETWORK VISION (CONTINUED)

THE RHN WILL CONSIST OF “ONE CENTER, THREE PLATFORMS, AND NINE THE RHN WILL CONSIST OF “ONE CENTER, THREE PLATFORMS, AND NINE SYSTEMS” SYSTEMS”

ONE CENTER REFERS TO SHENZHEN HEALTHCARE DATA CENTERONE CENTER REFERS TO SHENZHEN HEALTHCARE DATA CENTER

THREE PLATFORMS REFERS TO:THREE PLATFORMS REFERS TO:

– DATA SHARING AND EXCHANGE PLATFORM DATA SHARING AND EXCHANGE PLATFORM

– HEALTHCARE MACRO MANAGEMENT AND DECISION-MAKING SUPPORT HEALTHCARE MACRO MANAGEMENT AND DECISION-MAKING SUPPORT PLATFORM PLATFORM

– HEALTHCARE I.T. PUBLICATION AND VALUE-ADDED SERVICE PLATFORMHEALTHCARE I.T. PUBLICATION AND VALUE-ADDED SERVICE PLATFORM

NINE SYSTEMS REFERS TO NINE SYSTEMS REFERS TO THE I.T. SYSTEMS FOR THE FOLLOWING THE I.T. SYSTEMS FOR THE FOLLOWING ::

– HOSPITAL OPERATIONS HOSPITAL OPERATIONS

– PUBLIC HEALTH EMERGENCY RESPONSE PUBLIC HEALTH EMERGENCY RESPONSE

– DISEASE PREVENTION AND CONTROL DISEASE PREVENTION AND CONTROL

– HEALTHCARE SUPERVISION AND LAW ENFORCEMENT HEALTHCARE SUPERVISION AND LAW ENFORCEMENT

– EMERGENCY CAREEMERGENCY CARE

– MATERNAL AND CHILD HEALTH MATERNAL AND CHILD HEALTH

– COMMUNITY HEALTHCARE COMMUNITY HEALTHCARE

– HEALTH EDUCATION HEALTH EDUCATION

– OTHER SYSTEMS FOR HEALTHCARE OPERATIONS OTHER SYSTEMS FOR HEALTHCARE OPERATIONS


SHENZHEN REGIONAL HEALTH NETWORK SHENZHEN REGIONAL HEALTH NETWORK CURRENT CURRENT STATUSSTATUS

CITY LEADERS WOULD LIKE TO SPEED-UP THE DEVELOPMENT OF THE REGIONAL CITY LEADERS WOULD LIKE TO SPEED-UP THE DEVELOPMENT OF THE REGIONAL HEALTH NETWORK IN 2009 HEALTH NETWORK IN 2009

HEALTH DATA CENTER IS UNDER CONSTRUCTIONHEALTH DATA CENTER IS UNDER CONSTRUCTION

VPN (VIRTUAL PRIVATE NETWORK) SYSTEM IS BEING DEVELOPEDVPN (VIRTUAL PRIVATE NETWORK) SYSTEM IS BEING DEVELOPED

BASIC STANDARDS FOR INFORMATION SYSTEMS ARE NOW UNDER DEVELOPMENTBASIC STANDARDS FOR INFORMATION SYSTEMS ARE NOW UNDER DEVELOPMENT

A EXCHANGE SERVER PLATFORM PROTOTYPE TO SHARE DATA AMONG HOSPITALS IS A EXCHANGE SERVER PLATFORM PROTOTYPE TO SHARE DATA AMONG HOSPITALS IS BEING DEVELOPEDBEING DEVELOPED

PROGRESS HAS BEEN MADE IN THE DEVELOPMENT OF THE COMMUNITY HEALTH PROGRESS HAS BEEN MADE IN THE DEVELOPMENT OF THE COMMUNITY HEALTH SERVICE INFORMATION SYSTEM SERVICE INFORMATION SYSTEM

A PILOT PROGRAM TO BUILD A DIGITAL HOSPITAL A PILOT PROGRAM TO BUILD A DIGITAL HOSPITAL IS IN ITS EARLY STAGE OF IS IN ITS EARLY STAGE OF DEVELOPMENT DEVELOPMENT


SHENZHEN REGIONAL HEALTH NETWORK SHENZHEN REGIONAL HEALTH NETWORK CURRENT CHALLENGES CURRENT CHALLENGES

1.1. A STRONGER CITY GOVERNANCE STRUCTURE IS NEEDED A STRONGER CITY GOVERNANCE STRUCTURE IS NEEDED TO OVERSEE THE TO OVERSEE THE ENTIRE REGIONAL HEALTH NETWORK AND DIGITAL HOSPITAL PROJECTENTIRE REGIONAL HEALTH NETWORK AND DIGITAL HOSPITAL PROJECT

2.2. THE PROJECT NEEDS BETTER I.T. PROJECT AND CHANGE MANAGEMENT SKILL THE PROJECT NEEDS BETTER I.T. PROJECT AND CHANGE MANAGEMENT SKILL

3.3. APPLICATION SOFTWARE NEEDS TO BE ACQUIRED FOR THE DIGITAL HOSPITAL APPLICATION SOFTWARE NEEDS TO BE ACQUIRED FOR THE DIGITAL HOSPITAL PROJECT, AS WELL AS THE REGIONAL HEALTH NETWORK PROJECT, AS WELL AS THE REGIONAL HEALTH NETWORK

4.4. DATA EXCHANGE STANDARDS NEED TO BE DEVELOPED DATA EXCHANGE STANDARDS NEED TO BE DEVELOPED

5.5. HOSPITAL RESISTANCE TO SHARING DATA NEEDS TO BE OVERCOMEHOSPITAL RESISTANCE TO SHARING DATA NEEDS TO BE OVERCOME


OPPORTUNITIES AND CHALLENGESOPPORTUNITIES AND CHALLENGESFOR WESTERN COMPANIES FOR WESTERN COMPANIES

IN CHINA H.I.T. IN CHINA H.I.T.



WESTERN COMPANIES IN CHINA HEALTHCARE WESTERN COMPANIES IN CHINA HEALTHCARE

MANY WESTERN COMPANIES OPERATE IN THE PHARMACEUTICAL, MEDICAL MANY WESTERN COMPANIES OPERATE IN THE PHARMACEUTICAL, MEDICAL DEVICE, AND MEDICAL IMAGING SEGMENTS OF CHINESE HEALTHCAREDEVICE, AND MEDICAL IMAGING SEGMENTS OF CHINESE HEALTHCARE

MULTINATIONAL TECHNOLOGY COMPANIES OPERATING IN CHINA, SUCH AS MULTINATIONAL TECHNOLOGY COMPANIES OPERATING IN CHINA, SUCH AS IBM, HEWLETT PACKARD, CISCO, MICROSOFT, AND INTEL, HAVE BUSINESS IN IBM, HEWLETT PACKARD, CISCO, MICROSOFT, AND INTEL, HAVE BUSINESS IN HEALTHCARE HEALTHCARE

UNTIL RECENTLY, THE CHINA H.I.T. MARKET DID NOT LOOK LIKE AN UNTIL RECENTLY, THE CHINA H.I.T. MARKET DID NOT LOOK LIKE AN OPPORTUNITY AREA FOR WESTERN COMPANIESOPPORTUNITY AREA FOR WESTERN COMPANIES

WHILE ALMOST ALL SOFTWARE IN CHINA IS PROVIDED BY CHINESE WHILE ALMOST ALL SOFTWARE IN CHINA IS PROVIDED BY CHINESE COMPANIES, THE EXPECTED GROWTH IN CHINA H.I.T. MARKET AND LACK OF COMPANIES, THE EXPECTED GROWTH IN CHINA H.I.T. MARKET AND LACK OF GOOD APPLICATION SOLUTIONS ARE MOTIVATING MANY WESTERN GOOD APPLICATION SOLUTIONS ARE MOTIVATING MANY WESTERN COMPANIES TO LOOK AT THE CHINA H.I.T. MARKET AS A MAJOR COMPANIES TO LOOK AT THE CHINA H.I.T. MARKET AS A MAJOR OPPORTUNITY OPPORTUNITY

THE U.S. TRADE AND DEVELOPMENT AGENCY (TDA) IS FUNDING A BIG THE U.S. TRADE AND DEVELOPMENT AGENCY (TDA) IS FUNDING A BIG PROJECT FOR THE SICHUAN PROVINCIAL HEALTH BUREAUPROJECT FOR THE SICHUAN PROVINCIAL HEALTH BUREAU


OPPORTUNITIES ARE EMERGING FOR WESTERN COMPANIES IN CHINA H.I.T. OPPORTUNITIES ARE EMERGING FOR WESTERN COMPANIES IN CHINA H.I.T.

CHINA’S SPENDING ON HEALTHCARE AND H.I.T. IS GROWING RAPIDLY CHINA’S SPENDING ON HEALTHCARE AND H.I.T. IS GROWING RAPIDLY

PAST INVESTMENTS IN H.I.T. HAS RESULTED IN A GREAT DEAL OF PAST INVESTMENTS IN H.I.T. HAS RESULTED IN A GREAT DEAL OF DISSATISFACTION WITH APPLICATION SOLUTIONS NOW AVAILABLE IN CHINA DISSATISFACTION WITH APPLICATION SOLUTIONS NOW AVAILABLE IN CHINA

A NEW GENERATION OF H.I.T. PRODUCT SOLUTIONS IS FELT TO BE NEEDED A NEW GENERATION OF H.I.T. PRODUCT SOLUTIONS IS FELT TO BE NEEDED BY HEALTHCARE LEADERS IN CHINA BY HEALTHCARE LEADERS IN CHINA

BETTER CHANGE MANAGEMENT SKILL AND EXPERIENCE IS AN EVEN BETTER CHANGE MANAGEMENT SKILL AND EXPERIENCE IS AN EVEN GREATER NEED, BUT THIS NEED IS LESS EVIDENT TO CHINESE HEALTHCARE GREATER NEED, BUT THIS NEED IS LESS EVIDENT TO CHINESE HEALTHCARE LEADERS AT THE PRESENT TIME LEADERS AT THE PRESENT TIME

WESTERN EXPERIENCE IS WELCOMED BY CHINESE HOSPITAL AND HEALTH WESTERN EXPERIENCE IS WELCOMED BY CHINESE HOSPITAL AND HEALTH BUREAU LEADERS BUREAU LEADERS AS THEY MOVE FORWARD TO ACCOMPLISH THEIR H.I.T. AS THEY MOVE FORWARD TO ACCOMPLISH THEIR H.I.T. AND WORK PROCESS IMPROVEMENT OBJECTIVESAND WORK PROCESS IMPROVEMENT OBJECTIVES


CHALLENGES FOR WESTERN COMPANIES IN CHINA H.I.T. CHALLENGES FOR WESTERN COMPANIES IN CHINA H.I.T.

IT HAS TAKEN MANY YEARS FOR IBM, HEWLETT PACKARD, GE, AND SIEMENS IT HAS TAKEN MANY YEARS FOR IBM, HEWLETT PACKARD, GE, AND SIEMENS TO ESTABLISH POSITIONS IN THE CHINA H.I.T. MARKET TO ESTABLISH POSITIONS IN THE CHINA H.I.T. MARKET

MANY OTHER WESTERN COMPANIES HAVE STUDIED OR ENTERED THE CHINA MANY OTHER WESTERN COMPANIES HAVE STUDIED OR ENTERED THE CHINA H.I.T. MARKET FOR BRIEF PERIODSH.I.T. MARKET FOR BRIEF PERIODS

DIFFICULTIES FOR WESTERN COMPANIES INCLUDE THE FOLLOWING:DIFFICULTIES FOR WESTERN COMPANIES INCLUDE THE FOLLOWING:

– WESTERN PRODUCTS DO NOT FIT CHINA WORK PROCESSES, WESTERN PRODUCTS DO NOT FIT CHINA WORK PROCESSES, BUT BUT WESTERN COMPANIES DO NOT FULLY UNDERSTAND THE CHANGES WESTERN COMPANIES DO NOT FULLY UNDERSTAND THE CHANGES THAT MUST BE MADE THAT MUST BE MADE

– WESTERN PRICES FOR SOFTWARE PRODUCTS ARE TOO HIGH FOR WESTERN PRICES FOR SOFTWARE PRODUCTS ARE TOO HIGH FOR CHINESE HOSPITALSCHINESE HOSPITALS

– CHINA IS A VERY DIFFERENT MARKET THAN MOST OTHER COUNTRIES, CHINA IS A VERY DIFFERENT MARKET THAN MOST OTHER COUNTRIES, AND THE DIFFICULTIES ARE NOT FULLY RECOGNIZED. THERE ARE AND THE DIFFICULTIES ARE NOT FULLY RECOGNIZED. THERE ARE PITFALLS AND WESTERN COMPANIES MAKE MANY MISTAKES DURING PITFALLS AND WESTERN COMPANIES MAKE MANY MISTAKES DURING THEIR LEARNING PERIOD THEIR LEARNING PERIOD

– THE CHINESE ARE VERY SELECTIVE WHEN SPENDING MONEY, SO THE CHINESE ARE VERY SELECTIVE WHEN SPENDING MONEY, SO WESTERNERS MUST PROVE THEMSELVES THROUGH PERFORMANCEWESTERNERS MUST PROVE THEMSELVES THROUGH PERFORMANCE


THANK YOUTHANK YOU

QUESTIONS?QUESTIONS?FOR MORE INFORMATION CONTACT:FOR MORE INFORMATION CONTACT:

SHELDON I. DORENFESTSHELDON I. DORENFEST

THE DORENFEST GROUPTHE DORENFEST GROUP THE DORENFEST CHINATHE DORENFEST CHINANBC TOWER, SUITE 2725NBC TOWER, SUITE 2725 HEALTHCARE GROUPHEALTHCARE GROUP455 N. CITYFRONT PLAZA DRIVE455 N. CITYFRONT PLAZA DRIVE RENMIN ROAD NO. 988RENMIN ROAD NO. 988CHICAGO, IL 60611-5555CHICAGO, IL 60611-5555 JINGTIANDI INTERNATIONAL TOWERJINGTIANDI INTERNATIONAL TOWERUNITED STATES OF AMERICAUNITED STATES OF AMERICA SUITE 908SUITE 908PHONE: 312-464-3000PHONE: 312-464-3000 SHANGHAI, CHINASHANGHAI, CHINAFAX: 312-467-0541FAX: 312-467-0541 PHONE: 021-63203522, 63269722PHONE: 021-63203522, 63269722

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