THE 3 RD CHINA INTERNATIONAL EMR AND REGIONAL HEALTH CARE FAIR

THE 3THE 3RDRD CHINA INTERNATIONAL EMR AND REGIONAL CHINA INTERNATIONAL EMR AND REGIONAL HEALTH CARE FAIRHEALTH CARE FAIR DORENFEST CHINA HEALTHCARE GROUPDORENFEST CHINA HEALTHCARE GROUP

THE 3THE 3RDRD CHINA INTERNATIONAL EMR CHINA INTERNATIONAL EMR AND REGIONAL HEALTH CARE FAIRAND REGIONAL HEALTH CARE FAIR

HIT AND RHN EXPERIENCE IN THE U.S. HIT AND RHN EXPERIENCE IN THE U.S.

AND WHAT IT MEANS TO CHINAAND WHAT IT MEANS TO CHINA

BEIJING CHINA OCT 25 2009

THE 3THE 3RDRD CHINA INTERNATIONAL EMR AND CHINA INTERNATIONAL EMR AND REGIONAL HEALTH CARE FAIRREGIONAL HEALTH CARE FAIR

DORENFEST CHINA HEALTHCARE GROUPDORENFEST CHINA HEALTHCARE GROUP2

AGENDAAGENDA

LEARNING FROM THE H.I.T. EXPERIENCE OF THE U.S.LEARNING FROM THE H.I.T. EXPERIENCE OF THE U.S.

THE CURRENT STATUS OF I.T. USE IN CHINESE HOSPITALSTHE CURRENT STATUS OF I.T. USE IN CHINESE HOSPITALS

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

EVOLUTION OF RHNs IN CHINAEVOLUTION OF RHNs IN CHINA



DORENFEST GROUPDORENFEST GROUP

IN 2006 THE DORENFEST GROUP FORMED THE DORENFEST IN 2006 THE DORENFEST GROUP FORMED THE DORENFEST CHINA HEALTHCARE GROUP, BASED IN SHANGHAI. WE OFFER CHINA HEALTHCARE GROUP, BASED IN SHANGHAI. WE OFFER A VARIETY OF CONSULTING, TRAINING, AND EDUCATION A VARIETY OF CONSULTING, TRAINING, AND EDUCATION SERVICES TO THE CHINA HEALTHCARE SYSTEM TO HELP SERVICES TO THE CHINA HEALTHCARE SYSTEM TO HELP THEM IMPROVEMENT IT MANAGEMENT, OPTIMIZE HOSPITAL THEM IMPROVEMENT IT MANAGEMENT, OPTIMIZE HOSPITAL WORKFLOW, IMPORVE QUALITY OF CARE AND REDUCE COST.WORKFLOW, IMPORVE QUALITY OF CARE AND REDUCE COST.

OUR CLIENTS INCLUDE:OUR CLIENTS INCLUDE: – SHANGHAI CHANGNING MATERNITY AND INFANT HEALTH SHANGHAI CHANGNING MATERNITY AND INFANT HEALTH

INSTITUTEINSTITUTE– PEKING UNIVERSITY MEDICAL COLLEGE #3 HOSPITALPEKING UNIVERSITY MEDICAL COLLEGE #3 HOSPITAL– SHANDONG RIZHAO PEOPLE’S HOSPITALSHANDONG RIZHAO PEOPLE’S HOSPITAL– SHENZHEN CITY HEALTH BUREAUSHENZHEN CITY HEALTH BUREAU– CHONGQING CITY HEALTH BUREAUCHONGQING CITY HEALTH BUREAU– HONGKONG HOSPITAL AUTHORITYHONGKONG HOSPITAL AUTHORITY– MICROSOFTMICROSOFT



THE 3THE 3RDRD CHINA INTERNATIONAL EMR AND REGIONAL HEALTH CARE FAIR CHINA INTERNATIONAL EMR AND REGIONAL HEALTH CARE FAIR

LEARNING FROM THE H.I.T. EXPERIENCE OF LEARNING FROM THE H.I.T. EXPERIENCE OF THE U.S.THE U.S.



HEALTH EXPENDITURES AS A PERCENTAGE OF GDP (IN BILLION)HEALTH EXPENDITURES AS A PERCENTAGE OF GDP (IN BILLION)

来源：来源： CENTERS FOR MEDICARE AND MEDICAID SERVICESCENTERS FOR MEDICARE AND MEDICAID SERVICES

17.1%16.1% 16.4%

7.2%

8.0%8.8%

10.1%

12.0%

13.4% 13.3%

16.0%

0%

5%

10%

15%

20%

1970 1975 1980 1985 1990 1995 2000 2004 2005 2006 2007

$1,877.6

$75.1

$245.8

$426.8

$696.0

$990.3 $1,299.5

$2,016.0 $2,169.5$2,325.7

$160.0



$ in billions

$16.0

$19.0$21.6

$20.0$18.5

17.6% 15.6% 2.7%年增长率： 8.0%5.2%

$23.6$25.8

9.3% 9.3%

$28.0

8.9%

$30.5

8.9%

H.I.T. MARKET GROWTH IN THE U.S. (IN BILLION)H.I.T. MARKET GROWTH IN THE U.S. (IN BILLION)

$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.



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 (1970s)FINANCE SYSTEMS (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)



HIMSS AnalyticsHIMSS Analytics ReportReport –EMR–EMR Stage ModelStage Model

StageStage DefinitionDefinition HospitalHospital （（%% ））

Stage 7Stage 7 Complete EMR; CCD transactions to share data; Data warehousing; Data continuity with ED, Complete EMR; CCD transactions to share data; Data warehousing; Data continuity with ED, ambulatory, OPambulatory, OP

0.4%0.4%

Stage 6Stage 6 Physician documentation (structured templates), full CDSS (variance & compliance(, full R-Physician documentation (structured templates), full CDSS (variance & compliance(, full R-PACSPACS

1.4%1.4%

Stage 5Stage 5 Closed loop medication administrationClosed loop medication administration 1.5%1.5%

Stage 4Stage 4 CPOE, Clinical Decision Support (clinical protocols)CPOE, Clinical Decision Support (clinical protocols) 2.5%2.5%

Stage 3Stage 3 Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside Nursing/clinical documentation (flow sheets), CDSS (error checking), PACS available outside RadiologyRadiology

35.7%35.7%

Stage 2Stage 2 CDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capableCDR, Controlled Medical Vocabulary, CDS, may have Document Imaging; HIE capable 31.4%31.4%

Stage 1Stage 1 Ancillaries –Lab, Rad, Pharmacy – All InstalledAncillaries –Lab, Rad, Pharmacy – All Installed 11.5%11.5%

Stage 0Stage 0 All three Ancillaries Not InstalledAll three Ancillaries Not Installed 15.6%15.6%

Le

vel o

f Co

mp

lexi

ty

Source: HIMSS Analytics Database (derived from the Dorenfest IHDS+Database) 2009 年

成熟

层次

(N=5,073) 。



U.S. H.I.T. EXPERIENCE IN THE LAST 30 YEARSU.S. H.I.T. EXPERIENCE IN THE LAST 30 YEARS

HOSPITAL MANAGEMENT REALIZE AND EMPHASIZE THE IMPORTANCE OF HOSPITAL MANAGEMENT REALIZE AND EMPHASIZE THE IMPORTANCE OF IT. IT IS CONSIDERED AS AN INVESTMENT INSTEAD OF COST.IT. IT IS CONSIDERED AS AN INVESTMENT INSTEAD OF COST.

IT PLANNING IS CRITICAL. PLANNING IS TO ANSWER THE QUESTION WHY IT PLANNING IS CRITICAL. PLANNING IS TO ANSWER THE QUESTION WHY THE APPLICATION IS AIMED TO DO AND WHAT ARE THE BENEFITS?THE APPLICATION IS AIMED TO DO AND WHAT ARE THE BENEFITS?

FOCUS ON ROI OF IT PROJECTS. IT INVESTMENT RETURNS CAN’T BE FOCUS ON ROI OF IT PROJECTS. IT INVESTMENT RETURNS CAN’T BE REALIZED UNTIL THE RETURNS ARE WELL DEFINED.REALIZED UNTIL THE RETURNS ARE WELL DEFINED.

CLINICIAN PARTICIPATION IN HOSPITAL IT DEVELOPMENT HAS A DIRECT CLINICIAN PARTICIPATION IN HOSPITAL IT DEVELOPMENT HAS A DIRECT IMPACT ON THE LONG TERM EFFECT OF THE IT INVESTMENT. RECENT IMPACT ON THE LONG TERM EFFECT OF THE IT INVESTMENT. RECENT SUCCESS EXPERIENCE IN THE U.S. DEMONSTRATE THE SIGNIFICANT SUCCESS EXPERIENCE IN THE U.S. DEMONSTRATE THE SIGNIFICANT IMPACT FACTORS OF SYSTEM PLANNING, SYSTEM SELECTION AND IT IMPACT FACTORS OF SYSTEM PLANNING, SYSTEM SELECTION AND IT MANAGEMENT (THROUGH COMMITTEE AND PROJECT). EFFECTIVE IT MANAGEMENT (THROUGH COMMITTEE AND PROJECT). EFFECTIVE IT GOVERNANCE STRUCTURE CAN GUARANTEE CLINICIAN’S PARTICIPATIONGOVERNANCE STRUCTURE CAN GUARANTEE CLINICIAN’S PARTICIPATION

IMPLEMENTING IT APPLICATION SYSTEM IS NOT JUST SOFTWARE IMPLEMENTING IT APPLICATION SYSTEM IS NOT JUST SOFTWARE IMPLEMENTATION BUT RATHER WORKFLOW CHANGE AND IMPLEMENTATION BUT RATHER WORKFLOW CHANGE AND ORGANIZATIONAL CHANGE. SYSTEM IMPLEMENTATION REQUIRES STRONG ORGANIZATIONAL CHANGE. SYSTEM IMPLEMENTATION REQUIRES STRONG CAPABILITY OF PROJECT MANAGEMENT AND CHANGE MANAGEMENT AND CAPABILITY OF PROJECT MANAGEMENT AND CHANGE MANAGEMENT AND GOOD UNDERSTANDING OF USER NEEDS AND HOSPITL WORKFLOW.GOOD UNDERSTANDING OF USER NEEDS AND HOSPITL WORKFLOW.

CIO AND BUSINESS EXECUTIVES MUST ESTABLISH A GOOD PARTNERSHIP.CIO AND BUSINESS EXECUTIVES MUST ESTABLISH A GOOD PARTNERSHIP.



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. SystemsLegacy I.T. Systems

ManualManual BEFORE I.T.=1xBEFORE I.T.=1x

2x2x

3x3x

4x4x

GROWTH IN GROWTH IN

REDUNDANCYREDUNDANCY

TOTAL HOSPITAL WORK PROCESSTOTAL HOSPITAL WORK PROCESS



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

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

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




THE CURRENT STATUS OF I.T. USE IN CHINESE THE CURRENT STATUS OF I.T. USE IN CHINESE HOSPITALSHOSPITALS



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

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

CHINA MADE SLOW PROGRESS WITH INITIAL FOCUS ON FINANCIAL SYSTEMSCHINA MADE SLOW PROGRESS WITH INITIAL FOCUS ON FINANCIAL SYSTEMS

ABOUT 5 YEARS AGO CHINESE HOSPITALS BEGAN TO MOVE MORE ABOUT 5 YEARS AGO CHINESE HOSPITALS BEGAN TO MOVE MORE AGGRESSIVELY TOWARD I.T. USE FOR CLINICAL SYSTEMS.AGGRESSIVELY TOWARD I.T. USE FOR CLINICAL SYSTEMS.

ALONG THE WAY, MANY SOFTWARE SOLUTIONS WERE DEVELOPED WITH ALONG THE WAY, MANY SOFTWARE SOLUTIONS WERE DEVELOPED WITH SEVERAL HUNDRED SMALL SOFTWARE COMPANIES EMERGING IN CHINA.SEVERAL HUNDRED SMALL SOFTWARE COMPANIES EMERGING IN CHINA.

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.

WE PREDICT RAPID GROWTH WILL ACCELERATE OVER THE NEXT THREE YEARSWE PREDICT RAPID GROWTH WILL ACCELERATE OVER THE NEXT THREE YEARS WITH H.I.T. INVESTMENT IN CHINA RISING TO BETWEEN $2 AND $3 BILLION (USD) WITH H.I.T. INVESTMENT IN CHINA RISING TO BETWEEN $2 AND $3 BILLION (USD) BY 2010BY 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 CHINA HOSPITAL WORK PROCESSES ARE REDUNDANT, EXPENSIVE AND ERROR PRONE WITH GREAT OPPORTUNITIES FOR IMPROVEMENT WITH ERROR PRONE WITH GREAT OPPORTUNITIES FOR IMPROVEMENT WITH APPROPRIATE USE OF I.TAPPROPRIATE USE OF I.T

2.2. CHINESE HOSPITAL LEADERS WOULD LIKE TO TAKE A BIG LEAP FORWARD IN CHINESE HOSPITAL LEADERS WOULD LIKE TO TAKE A BIG LEAP FORWARD IN IMPROVING WORK PROCESSES AND IN DIGITIZING CHINESE HOSPITALSIMPROVING WORK PROCESSES AND IN DIGITIZING CHINESE HOSPITALS

3.3. THE MINISTRY OF HEALTH (MOH) GUIDELINES FOR HEALTH I.T. DEVELOPMENT THE MINISTRY OF HEALTH (MOH) GUIDELINES FOR HEALTH I.T. DEVELOPMENT CALLS FOR ELECTRONIC MEDICAL RECORDS AND REGIONAL HEALTH CALLS FOR ELECTRONIC MEDICAL RECORDS AND REGIONAL HEALTH NETWORKS TO BE IMPLEMENTED BETWEEN 2003 AND 2010 PROVIDING MUCH NETWORKS TO BE IMPLEMENTED BETWEEN 2003 AND 2010 PROVIDING MUCH MOMENTUM FOR HOSPITALS AND HEALTH BUREAUS TO INVEST MORE IN I.T. MOMENTUM FOR HOSPITALS AND HEALTH BUREAUS TO INVEST MORE IN I.T. NOWNOW

4.4. THE SOON TO BE FINALIZED HEALTHCARE REFORM IN CHINA WILL BE THE SOON TO BE FINALIZED HEALTHCARE REFORM IN CHINA WILL BE FACILITATED BY BETTER USE OF I.T. IN CHINESE HOSPITALSFACILITATED BY BETTER USE OF I.T. IN CHINESE HOSPITALS



1.1. CHINESE HOSPITALS’ INVESTMENT ON IT IS RELATIVELY LOWCHINESE HOSPITALS’ INVESTMENT ON IT IS RELATIVELY LOW

2.2. THE POOR RESULTS ACCOMPLISHED FROM PAST THE POOR RESULTS ACCOMPLISHED FROM PAST INVESTMENTS IN I.T. ARE CAUSING HESITATION AMONG INVESTMENTS IN I.T. ARE CAUSING HESITATION AMONG LEADERS OF CHINESE HOSPITALS TO MAKE FUTURE LEADERS OF CHINESE HOSPITALS TO MAKE FUTURE INVESTMENTS IN I.T.INVESTMENTS IN I.T.

3.3. THERE IS CONCERN AMONG H.I.T. EXPERTS IN CHINA ABOUT THERE IS CONCERN AMONG H.I.T. EXPERTS IN CHINA ABOUT THE READINESS OF H.I.T. SOFTWARE PRODUCTS AND THE READINESS OF H.I.T. SOFTWARE PRODUCTS AND INTEGRATION TOOLS TO FACILITATE THE ACCOMPLISHMENT INTEGRATION TOOLS TO FACILITATE THE ACCOMPLISHMENT OF CHINA’S GOALSOF CHINA’S GOALS

4.4. INEXPERIENCE IN THE BUYING OF H.I.T. SOFTWARE PRODUCTSINEXPERIENCE IN THE BUYING OF H.I.T. SOFTWARE PRODUCTS

5.5. THE IMPLEMENTATION SKILL, PROCESS IMPROVEMENT SKILL THE IMPLEMENTATION SKILL, PROCESS IMPROVEMENT SKILL AND CHANGE MANAGEMENT EXPERIENCE NEEDED FOR CHINA AND CHANGE MANAGEMENT EXPERIENCE NEEDED FOR CHINA TO TAKE THE BIG LEAP FORWARD THAT IT WOULD LIKE TO TO TAKE THE BIG LEAP FORWARD THAT IT WOULD LIKE TO TAKE IS NOT YET AVAILABLE AT THE LEVEL REQUIRED FOR TAKE IS NOT YET AVAILABLE AT THE LEVEL REQUIRED FOR CHINA TO ACCOMPLISH ITS GOALSCHINA TO ACCOMPLISH ITS GOALS

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



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

来源：计世咨讯来源：计世咨讯



WHAT HOSPITALS NEED TO DO TO IMPROVE THE RETURN ON IT INVESTMENTWHAT HOSPITALS NEED TO DO TO IMPROVE THE RETURN ON IT INVESTMENT

1.1. IMPROVE THE IT GOVERNANCE STRUCTUREIMPROVE THE IT GOVERNANCE STRUCTURE 　　

2.2. PROMOTE BETTER PARTICIPATION OF CLINICIANS IN IT PROMOTE BETTER PARTICIPATION OF CLINICIANS IN IT BUILDINGBUILDING

3.3. DURING NEW SYSTEM IMPLEMENTATION, HOSPITAL NEEDS DURING NEW SYSTEM IMPLEMENTATION, HOSPITAL NEEDS TO TAKE MORE RESPONSIBILITY ON CHANGE MANAGEMENT TO TAKE MORE RESPONSIBILITY ON CHANGE MANAGEMENT AND PROCESS IMPROVEMENTAND PROCESS IMPROVEMENT

4.4. RE-POSITION IT DEPARTMENT TO MORE FACILITATE, RE-POSITION IT DEPARTMENT TO MORE FACILITATE, EDUCATE AND TRAIN HOSPITAL MANAGEMENT AND USERS EDUCATE AND TRAIN HOSPITAL MANAGEMENT AND USERS TO PARTICIPATE IN IT DEVELOPMENTTO PARTICIPATE IN IT DEVELOPMENT

5.5. REDUCE THE HOSPITAL’S DEPENDENCE ON SOFTWARE REDUCE THE HOSPITAL’S DEPENDENCE ON SOFTWARE VENDORSVENDORS




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



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

COMMUNITY HEALTH INFORMATION NETWORKS (CHINs) COMMUNITY HEALTH INFORMATION NETWORKS (CHINs) BEGAN IN 1990 AS THE FIRST GENERATION OF RHNs IN THE BEGAN IN 1990 AS THE FIRST GENERATION OF RHNs IN THE UNITED STATES. CHINs FAILED BECAUSE OF UNCLEAR UNITED STATES. CHINs FAILED BECAUSE OF UNCLEAR OBJECTIVES AND LACK OF VALUE TO POTENTIAL OBJECTIVES AND LACK OF VALUE TO POTENTIAL PARTICIPANTSPARTICIPANTS

INTEGRATED DELIVERY EMERGED IN 1993 AS THE HOSPITAL INTEGRATED DELIVERY EMERGED IN 1993 AS THE HOSPITAL ANSWER TO THE CLINTON HEALTHCARE REFORM ANSWER TO THE CLINTON HEALTHCARE REFORM PROPOSALPROPOSAL

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



THE VISION OF INTEGRATED DELIVERY SYSTEMS THE VISION OF INTEGRATED DELIVERY SYSTEMS

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 AND THE OFFICE OF THE BY 2004, NATIONAL POLICY EMERGED AND THE OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY (ONCHIT) WAS CREATED(ONCHIT) WAS CREATED

IN THE ENSUING SEVERAL YEARS BETWEEN 2004 AND 2007, ABOUT 65 IN THE ENSUING SEVERAL YEARS BETWEEN 2004 AND 2007, ABOUT 65 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

– THESE MODELS TOOK ON DIFFERENT NAMES, AND SOME LONG TERM THESE MODELS TOOK ON DIFFERENT NAMES, AND SOME LONG TERM SUCCESSES EMERGEDSUCCESSES EMERGED



LESSONS LEARNEDLESSONS LEARNED

BROAD VISIONS BUT LACK OF IMPLEMENTABLE ACTION BROAD VISIONS BUT LACK OF IMPLEMENTABLE ACTION PLANPLAN

OVERSIMPLIFIED IMPLEMENTATION APPROACHESOVERSIMPLIFIED IMPLEMENTATION APPROACHES

LACK OF STAKEHOLDER COMMITMENTLACK OF STAKEHOLDER COMMITMENT

HEAVY INVESTMENT IN POORLY CONCEIVED IDEASHEAVY INVESTMENT IN POORLY CONCEIVED IDEAS

MUCH FAILURE AND LITTLE SUCCESSMUCH FAILURE AND LITTLE SUCCESS




THE MINISTRY OF HEALTH (MOH) GUIDELINES FOR HEALTH I.T. THE MINISTRY OF HEALTH (MOH) GUIDELINES FOR HEALTH I.T. DEVELOPMENT CALLED FOR REGIONAL HEALTH NETWORKS AND DIGITAL DEVELOPMENT CALLED FOR REGIONAL HEALTH NETWORKS AND DIGITAL HOSPITALS TO BE IMPLEMENTED THROUGHOUT CHINA BETWEEN 2003 AND HOSPITALS TO BE IMPLEMENTED THROUGHOUT CHINA BETWEEN 2003 AND 20102010

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

ONLY IN THE LAST TWO YEARS HAS DATA SHARING BEGUN TO EMERGE IN ONLY IN THE LAST TWO YEARS HAS DATA SHARING BEGUN TO EMERGE IN CHINA AS SOME RHNs SHARE LIMITED DATA SUCH AS LAB RESULTSCHINA AS SOME RHNs SHARE LIMITED DATA SUCH AS LAB RESULTS

HEALTHCARE REFORM HAS PROVIDED SUBSTANTIAL ADDITIONAL FUNDING HEALTHCARE REFORM HAS PROVIDED SUBSTANTIAL ADDITIONAL FUNDING IN A VARIETY OF WAYS, SO IT IS EXPECTED THAT SUBSTANTIAL ADDITIONAL IN A VARIETY OF WAYS, SO IT IS EXPECTED THAT SUBSTANTIAL ADDITIONAL PROGRESS WILL BE MADE IN THE NEXT FEW YEARSPROGRESS WILL BE MADE IN THE NEXT FEW YEARS

MUCH MORE ACTIVITY IN MANY CITIES AND PROVINCES. USTDA WILL BE MUCH MORE ACTIVITY IN MANY CITIES AND PROVINCES. USTDA WILL BE FUNDING ONE OR TWO MAJOR PROJECTSFUNDING ONE OR TWO MAJOR PROJECTS



SUCCESSFUL RHN NEEDS A SOLID FOUNDATIONSUCCESSFUL RHN NEEDS A SOLID FOUNDATION

RHN DEVELOPMENT IS LIKE BUILDING A 50-FLOOR BUILDING. RHN DEVELOPMENT IS LIKE BUILDING A 50-FLOOR BUILDING. THE FOUNDATION IS THE KEY. SUCCESSFUL RHN THE FOUNDATION IS THE KEY. SUCCESSFUL RHN PROGRAMES HAVE CAREFULLY DEFINED THE FIRST STEPSPROGRAMES HAVE CAREFULLY DEFINED THE FIRST STEPS

LIMITED DATA SETS WITH HIGH BENEFIT TO MANY STAKE LIMITED DATA SETS WITH HIGH BENEFIT TO MANY STAKE HOLDERS (SUCH AS HOSPITALS, COMMUNITY HEALTH HOLDERS (SUCH AS HOSPITALS, COMMUNITY HEALTH CENTERS AND GOVERNMENT) WOULD BE ADVANTAGEOUSCENTERS AND GOVERNMENT) WOULD BE ADVANTAGEOUS

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



THANK YOU.THANK YOU.FOR MORE INFORMATION CONTACT:FOR MORE INFORMATION CONTACT:

YU ZHIYUAN (GRACE)YU ZHIYUAN (GRACE)

THE DORENFEST CHINA HEALTHCARE GROUPTHE DORENFEST CHINA HEALTHCARE GROUPSUITE 908, NO. 998 RENMIN ROAD, SHANGHAISUITE 908, NO. 998 RENMIN ROAD, SHANGHAI

PHONE: 021-63203522, 63269722PHONE: 021-63203522, 63269722

WEB SITE ADDRESS: WEB SITE ADDRESS: www.dorenfest.com

E-MAIL ADDRESS: E-MAIL ADDRESS: [email protected]

SHELDON’S E-MAIL ADDRESS: SHELDON’S E-MAIL ADDRESS: [email protected]

YU ZHIYUAN (GRACE) YU ZHIYUAN (GRACE) : : [email protected]

THE 3 RD CHINA INTERNATIONAL EMR AND REGIONAL HEALTH CARE FAIR

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