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HIMSS ASIAPAC 2008

HIMSS ASIAPAC 2008. MAY 23, 2008. HONGKONG, CHINA. CHINA H.I.T. CASE STUDY. LEARNING OBJECTIVES. USE FOUR CASE STUDIES TO REVIEW THE CURRENT STATUS OF HOSPITAL I.T. DEVELOPMENT AND REGIONAL HEALTH NETWORK (RHN) PROJECT IN CHINA

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HIMSS ASIAPAC 2008

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  1. HIMSS ASIAPAC 2008 MAY 23, 2008 HONGKONG, CHINA CHINA H.I.T. CASE STUDY

  2. LEARNING OBJECTIVES • USE FOUR CASE STUDIES TO REVIEW THE CURRENT STATUS OF HOSPITAL I.T. DEVELOPMENT AND REGIONAL HEALTH NETWORK (RHN) PROJECT IN CHINA • DISCUSS SUCCESS FACTORS AND CHALLENGES FACED BY CHINESE HOSPITALS AND RHN PROJECTS • SUMMARIZE HOW CHINESE HOSPITALS ARE IMPROVING THEIR IT EFFORTS IN THE FUTURE

  3. AGENDA • ABOUT THE DORENFEST GROUP • OVERVIEW OF CHINA’S H.I.T. DEVELOPMENT • CASE STUDY: • SHENZHEN REGIONAL HEALTH NETWORK PROJECT • PEKING UNIVERSITY SHENZHEN HOSPITAL • SHANGHAI CHANGNING MATERNITY AND INFANT HOSPTIAL • A TYPICAL CHINESE HOSPITAL SYSTEM IMPLEMENTATION SITUATION • CONCLUSION AND FUTURE DEVELOPMENT • QUESTION AND ANSWER

  4. THE DORENFEST GROUP AND ITS CHINA BUSINESS APPROACH • HEALTHCARE CONSULTING AND INVESTMENT FOCUS • OFFER HEALTHCARE IMPROVEMENT SERVICES TO SUPPORT A MORE POSITIVE WORLD FUTURE • HELP HEALTHCARE ORGANIZATIONS TO IMPROVE HEALTHCARE SERVICES WHILE REDUCING COSTS BY IMPROVING WORK PROCESSES, MANAGEMENT SYSTEMS, SERVICES TO PATIENTS, AND QUALITY OF MEDICAL CARE • IN 2006 THE DORENFEST GROUP FORMED THE DORENFEST CHINA HEALTHCARE GROUP, BASED IN SHANGHAI, TO BRING OUR SKILL, TECHNOLOGY, AND CAPITAL TO CHINA IN A TWO-PHASE PROGRAM • WE ARE NOW OPERATING IN PHASE 1 OF THIS PROGRAM, OFFERING A VARIETY OF CONSULTING, TRAINING, AND EDUCATION SERVICES TO THE CHINA HEALTHCARE SYSTEM • WE EXPECT TO ENTER PHASE 2 OF OUR ACTIVITIES IN CHINA IN 2009 WHEN WE WILL BEGIN TO MAKE INVESTMENTS IN WELL-DEFINED, GOOD BUSINESS PROJECTS, IN PARTNERSHIP WITH CHINESE HEALTH BUREAUS AND HOSPITALS

  5. CHINA BUSINESS OPERATIONS • HOSPITAL MANAGEMENT CONSULTING • OPERATIONS IMPROVEMENT • STRATEGIC PLANNING FOR NEW I.T. SYSTEMS • I.T. SYSTEM SELECTION • I.T. SYSTEM IMPLEMENTATION • WORK PROCESS IMPROVEMENT • MANAGEMENT TRAINING • OTHER SERVICES • GENERAL MANAGEMENT CONSULTING FOR HEALTHCARE COMPANIES • MARKET ANALYSES • PRODUCT STRATEGIES • MARKET RESEARCH • HOSPITAL CONTRACT MANAGEMENT • HOSPITAL OWNERSHIP AND IMPROVEMENT

  6. HIMSS ASIAPAC 2008 OVERVIEW OF CHINA’S H.I.T. DEVELOPMENT

  7. HIT SPENDING IN CHINA RMB in billions 6.33 5.29 26.8% 4.36 26.6% 3.5 26.0% 25.0% 73.2% 73.4% 74.0% 75.0% 24.6% 21.3% 19.7% ANNUAL GROWTH RATE: SOURCE: CCW Research

  8. HIT SPENDING STRUCTURE IN CHINA SOURCE: CCW Research

  9. SUMMARY OF CHINA’S HIT STATUS • ON MAY 20, SHELDON DESCRIBED THE CURRENT STATUS AND FUTURE DIRECTION OF H.I.T. IN CHINA. HE REACHED CERTAIN CONCLUSIONS AS FOLLOWS: • CHINA IS TAKING MAJOR STEPS TO IMPROVE ITS HEALTHCARE SYSTEM. • IN THE NEW HEATLHCARE REFORM PLAN, BETTER I.T. USE IN THE HOSPITAL IS CONSIDERED AS ONE APPROACH TO IMPROVE THE HEALTHCARE SYSTEM. • HOWEVER, INEXPERIENCE IN I.T. PLANNING, WEAK APPLICATION SOFTWARE AND IMPLEMENTATION SKILL ARE DELAYING PROGRESS. • FOREIGN SKILL IS NEEDED TO HELP CHINA AVOID MISTAKES OF OTHER COUNTRIES AND AS A RESULT “LEAPFROG” THE REST OF THE WORLD

  10. HIMSS ASIAPAC 2008 CASE STUDY

  11. CASE 1. SHENZHEN REGIONAL HEALTH NETWORK PROJECT • SHENZHEN, A CITY OF 12 MILLION PEOPLE, HAS BEEN SELECTED BY THE MINISTRY OF HEALTH TO BE A PILOT SITE IN DEVELOPING REGIONAL HEALTH INFORMATION NETWORKS SUPPORTED BY DIGITAL HOSPITALS. • THE CURRENT PLAN IS TO DEVELOP AN INFORMATION NETWORK THAT CAN BE ACCESSED AND USED BY HEALTHCARE PROVIDERS THROUGHOUT THE CITY OF SHENZHEN • THE GOALS OF THE RHN ARE TO: • PROVIDING BETTER TOOLS AND INFORMATION TO IMPROVE HEALTH MANAGEMENT IN THE CITY • SHARING HEALTH INFORMATION THROUGHOUT THE CITY • ELIMINATING “ISLANDS OF INFORMATION” THROUGHOUT THE CITY • PROMOTING AND ADOPTING TECHNOLOGY STANDARDS THAT WILL FACILITATE INTEROPERABILITY OF HEALTH INFORMATION

  12. CASE 1. SHENZHEN REGIONAL HEALTH NETWORK PROJECT • THE RHN WILL BE MADE OF “ONE CENTER, THREE PLATFORMS, AND NINE SYSTEMS.” • ONE CENTER REFERS TO SHENZHEN HEALTHCARE DATA CENTER • THREE PLATFORMS REFERS TO: • DATA SHARING AND EXCHANGE PLATFORM • HEALTHCARE MACRO MANAGEMENT AND DECISION-MAKING SUPPORT PLATFORM • HEALTHCARE I.T. PUBLICATION AND VALUE-ADDED SERVICE PLATFORM • NINE SYSTEMS REFERS TO: • I.T. SYSTEM FOR HOSPITAL OPERATION • I.T. SYSTEM FOR PUBLIC HEALTH EMERGENCY RESPONSE • I.T. SYSTEM FOR DISEASE PREVENTION AND CONTROL • I.T. SYSTEM FOR HEALTHCARE SUPERVISION AND LAW ENFORCEMENT • I.T. SYSTEM FOR EMERGENCY CARE • I.T. SYSTEM FOR MATERNAL AND CHILD HEALTH • I.T. SYSTEM FOR COMMUNITY HEALTHCARE • I.T. SYSTEM FOR HEALTH EDUCATION • OTHER I.T. SYSTEMS FOR HEALTHCARE OPERATIONS

  13. CASE 1. SHENZHEN REGIONAL HEALTH NETWORK PROJECT CURRENT STATUS: • HEALTH DATA CENTER IS UNDER CONSTRUCTION • VPN (VIRTUAL PRIVATE NETWORK) SYSTEM IS BEING DEVELOPED. • BASIC STANDARDS FOR INFORMATION SYSTEMS ARE NOW UNDER DEVELOPMENT. • A EXCHANGE SERVER PLATFORM PROTOTYPE TO SHARE DATA AMONG HOSPITALS IS BEING DEVELOPED • A LOT OF PROGRESS HAS BEEN MADE FOR THE COMMUNITY HEALTH SERVICE INFORMATION SYSTEM. • A PILOT PROGRAM TO BUILD DIGITAL HOSPITAL IS BEING DEVELOPED.

  14. CASE 1. SHENZHEN REGIONAL HEALTH NETWORK PROJECT CHALLENGES AND PROBLEMS IN PLANNING AND IMPLEMENTING THE REGIONAL HEALTH NETWORK IN SHENZHEN: • A STRONG GOVERNANCE STRUCTURE NEEDS TO BE FURTHER DEVELOPED TO OVERSEE THE ENTIRE REGIONAL HEALTH NETWORK AND DIGITAL HOSPITAL PROJECT. THIS WILL INCLUDE A TOP MANAGEMENT TASK FORCE AND A SERIES OF ADVISORY COMMITTEES. • STAFF AND PERSONNEL NEEDS TO BE FURTHER TRAINED. THE PROJECT NEEDS BETTER I.T. PROJECT MANAGEMENT SKILLS, AS WELL AS CHANGE MANAGEMENT SKILL • GOOD SOFTWARE NEEDS TO BE DEVELOPED FOR THE DIGITAL HOSPITAL PROJECT AS WELL AS THE REGIONAL HEALTH NETWORK • STANDARDS NEEDS TO BE DEVELOPED • OVERCOME RESISTANCE AT THE HOSPITALS FOR PARTICIPATING IN THE REGIONAL HEALTH NETWORK

  15. CASE 2. PEKING UNIVERSITY SHENZHEN HOSPITAL • PEKING UNIVERSITY SHENZHEN HOSPTIAL WAS A RELATIVELY NEW HOSPITAL IN CHINA. IT WAS OPEN TO PUBLIC IN 1999. IT IS ONE OF THE LARGEST HOSPTIAL IN SHENZHEN, A CITY OF 12 MILLION PEOPLE IN SOUTH CHINA. • IT HAS 930 BEDS. ITS ANNUAL OUTPATIENT VISIT IS 1.8 MILLION AND ITS IMPATIENT VISIT IS 30,000. ITS DAILY OUTPATIENT VISIT IS AROUND 7000. • ITS MAJOR I.T. DEVELOPMENT STARTED IN 2003. IT HAS INVESTED OVER 42 MILLION YUAN IN HIT SINCE THEN. • DUE TO ITS ACCOMPLISH IN HOSPITAL I.T. DEVELOPMENT, IT IS SELECTED AS ONE OF THE 20 DIGITAL HOSPTIALS IN 2008.

  16. CASE 2. PEKING UNIVERSITY SHENZHEN HOSPITAL • CURRENTLY THE HOSPITAL HAS THE FOLLOWING I.T. SYSTEMS: • OUTPATIENT AND INPATIENT PHYSICIAN ORDER ENTRY SYSTEM • EMR • PACS • LIS • NURSING INFORMATION SYSTEM • PATHOLOGY INFORMATION SYSTEM, • ET AL. • ALL THE I.T. SYSTEMS ARE INTEGRATED AND PATIENT DATA CAN BE SHARED IN THE HOSPITAL. • CURRENTLY THE HOSPITAL IS DEVELOPING ITS WIRELESS ENVIRONMENT.

  17. CASE 2. PEKING UNIVERSITY SHENZHEN HOSPITAL CRITICAL FACTORS TO ITS SUCCESS: • I.T. DEVELOPMENT RECEIVES STRONG SUPPORTS FROM SENIOR HOSPTIAL MANAGEMENT TEAM • I.T. DEVELOPMENT IS DRIVEN BY CLINICIANS AND MANAGEMENT. • WEEKLY MEETING OF MANAGEMENT, DEPARTMENT HEADS AND I.T. DEPARTMENT TO COLLECT USER NEEDS. • IT DEPARTMENT IS POSITIONED AS THE “BRIDGE” BETWEEN HOSPITAL USERS AND VENDORS • I.T. STAFF REGULARLY VISIT AND TALK TO CLINICAL DEPARTMENTS TO COLLECT FEEDBACKS ABOUT HOW THE SYSTEM IS BEING USED. • CIO HAS A DEEP UNDERSTANDING OF HOW TO USE I.T. TO SUPPORT CLINICIANS’S WORK • DEVELOP A PARTNERSHIP WITH I.T. VENDORS

  18. CASE 3. SHANGHAI CHANGNING MATERNITY AND INFANT HOSPITAL • SCMI IS A CLASS 2 SPECIALTY HOSPITAL WITH 150 BEDS. SCMI IS ONE OF THE LARGEST BABY DELIVERY HOSPITALS AMONG ALL HOSPITALS IN SHANGHAI. • SCMI STARTED ITS BILLING SYSTEM IN 1996 AND INSTALLED A HIS SYSTEM IN 2003. IT HAS INVESTED OVER 6 MILLION YUAN IN H.I.T. UP TILL NOW. IN 2007 SCMI SPENTS ABOUT 1.5% OF ITS REVENUE ON I.T. • CURRENTLY SCMI HAS IMPLEMENTED HIS, LIS, RIS, PHARMACY MANAGEMENT, OUTPATIENT PHYSICIAN WORK STATION, INPATIENT PHYSICIAN WORK STATION (INCLUDING SOME ELECTRONIC MEDICAL RECORDS), ET AL.

  19. CASE 3. SHANGHAI CHANGNING MATERNITY AND INFANT HOSPITAL • DUE TO THE RAPID GROWTH OF BUSINESS OF SCMI, SCMI IS THINKING OF TAKING THE NEXT STEP IN I.T. DEVELOPMENT. • CREATE A FULLY DIGITIZED HOSPITAL WITH ELECTRONIC HEALTH RECORDS • IMPLEMENT ELECTRONIC SIGNATURE SYSTEM AND WORK PROCESS • HAVE MORE I.T. USE IN CLINICAL SERVICES. • ENHANCE THE I.T. FUNCTIONS IN HOSPITAL MANAGEMENT AND QUALITY CONTROL • STRENGTHEN THE NETWORK SAFETY • INTEGRATE THE HOSPITAL I.T. SYSTEM WITH THE CHANGNING DISTRICT COMMUNITY I.T. SYSTEM.

  20. CASE 3. SHANGHAI CHANGNING MATERNITY AND INFANT HOSPITAL • SINCE 2006 SCMI BECAME DISSATISFIED WITH THE SOFTWARE VENDOR’S PRODUCT AND THEIR SERVICES. • WE WERE ENGAGED TO MAKE AN ASSESSMENT OF THEIR CURRENT SYSTEMS AND DEVELOP A STRATEGY OF HOW TO MOVE FORWARD TO ACCOMPLISH THE IMPROVEMENTS SCMI DESIRES.

  21. CASE 3. SHANGHAI CHANGNING MATERNITY AND INFANT HOSPITAL • AFTER OUR INVESTIGATION, WE FOUND THAT THE MAJOR PROBLEMS THAT IMPEND SCMI’S IT IMPLEMENTATION ARE AS FOLLOWS: • LACK OF A FORMAL I.T. GOVERNANCE STRUCTURE • NOT TRAIN THE USERS RIGHT • THE SKILL OF STUDYING THE USER NEEDS STUDY IS WEAK • THE SKILL OF VENDOR MANAGEMENT IS WEAK • LACK OF A APPROACH OF SETTING I.T. PRIORITIES

  22. CASE 3. SHANGHAI CHANGNING MATERNITY AND INFANT HOSPITAL • NOW SCMI IS MAKING PROGRESS TO IMPROVE ITS IT IMPLEMENTATION: • DEVELOP A FORMAL I.T. GOVERNANCE STRUCTURE BY SETTING UP A I.T. TOP MANAGEMENT STEERING COMMITTEE AND A I.T. USER STEERING COMMITTEE • PROVIDE MORE USER TRAINING • DEVELOP A BETTER METHOD OF DEFINING USER NEEDS FOR SYSTEM THAT ARE BEING PURCHASED • DEVELOP A FORMAL APPROACH TO PROBLEM REPORTING BETWEEN I.T. MANAGEMENT AND USERS AND BETWEEN I.T. MANAGEMENT AND THE VENDOR • DEVELOP A BETTER APPROACH OF VENDOR MANAGEMENT

  23. CASE 4: A TYPICAL CHINESE HOSPITAL SYSTEM IMPLEMENTATION SITUATION • MORE AND MORE HOSPITALS IN CHINA ARE INCREASING THEIR SPENDING ON SOFTWARE PURCHASE. • HOWEVER, SYSTEM IMPLEMENTATION DOES NOT GO AS SMOOTHLY AS THEY WISHED. • HERE IS A TYPICAL HOSPITAL SITUATION I SEE MANY TIMES IN CHINA.

  24. CASE 4: A TYPICAL CHINESE HOSPITAL SYSTEM IMPLEMENTATION SITUATION • VENDORS WERE SELECTED BASED ON A RFP PROCESS. HOWEVER, USER NEEDS ARE NOT WELL-DEFINED IN THE TENDER DOCUMENT. • HOSPITALS IN CHINA SELECT VENDORS WITHOUT KNOWING WHAT THEY ARE BUYING. • THE SELECTED VENDORS WILL STUDY THE HOSPITAL’S USER NEEDS AFTER THEY SIGN THE CONTRACT. • LIKE OTHER COUNTRIES WHO ARE LONG TIME USERS OF HOSPITAL I.T. SYSTEM, CHINESE HOSPITALS WILL SOON MOVE TOWARD A MORE THOROUGH DEFINITION OF USER NEEDS BEFORE BUYING SOFTWARE SYSTEM. THEY WILL SELECT VENDORS BASED ON THE EVALUATION OF HOW WELL VENDOR PRODUCT MEET THE USER NEEDS.

  25. CASE 4: A TYPICAL CHINESE HOSPITAL SYSTEM IMPLEMENTATION SITUATION • LESSONS LEARNED IN SOFTWARE PURCHASE AND IMPLEMENTATION • DEFINE THE USER NEEDS BEFORE SELECTING THE VENDOR • ENGAGE USERS TO DEFINE THE USER NEEDS AND EVALUATE VENDOR PRODUCTS IN RELATION TO THOSE NEEDS. • TO HAVE THE I.T. SYSTEM BE SUCCESSFUL, HOSPITALS NEED TO TRAIN THEIR USERS IN HOW TO USE THE NEW SYSTEM • DURING SYSTEM IMPLEMENTATION, HOSPITALS NEED TO KNOW HOW THE SYSTEM WILL CHANGE THE WORK PROCESSES AND THUS GET THE BENEFITS OUT OF THE I.T. INVESTMENT.

  26. HIMSS ASIAPAC 2008 CONCLUSION AND FUTURE DIRECTION

  27. MYTHS AMONG CHINESE HOSPITALS REGARDING HOSPITAL IT INVESTMENT • MYTH #1: USER NEEDS ARE IMPOSSIBLE TO DEFINE. CLINICIANS DO NOT KNOW WHAT THEY WANT FROM THE IT SYSTEM. • MYTH #2: THE VENDOR WILL TELL US HOW TO IMPLEMENT THE SYSTEM • MYTH #3: HOSPTIAL IT DEVELOPMENT BELONGS TO THE IT DEPARTMENT, AND IT EFFORTS HAS NOTHING TO DO WITH CLINICAL DEPARTMENTS • MYTH #4: ROIS ARE IMPOSSIBLE TO MEASURE • MYTH #5: THE IT SYSTEM WILL SOLVE ALL OF OUR PROBLEMS • MYTH #6: IF THE SOFTWARE DOES NOT WORK VERY WELL, IT MUST BE THE PROBLEM OF THE VENDOR.

  28. NEXT STEPS TO IMPROVE I.T. INVESTMENT RESULTS IN CHINESE HOSPITALS • DEVELOP BETTER I.T. PLANNING AND PRIORITY SETTING • DEVELOP BETTER METHODS FOR DEFINING USER NEEDS FOR NEW I.T. SYSTEM • DEVELOP A BETTER I.T. GOVERNANCE STRUCTURES IN HOSPITALS • DEVELOP A BETTER APPROACH TO ASSESS SOFTWARE PRODUCT CAPABILITIES AND BUY SOFTWARE PRODUCTS • DEVELOP A BETTER APPROACH OF SYSTEM IMPLEMENTATION SO THAT IMPLEMENTATION OF NEW I.T. SYSTEMS WILL NOT ADD WORK AND CREATE UNNECESSARILY REDUNDANT WORK PROCESSES • DEVELOP A BETTER APPROACH TO MANAGE SOFTWARE IMPLEMENTATION AND ONGOING EFFORTS • DEVELOP A BETTER APPROACH OF USER TRAINING • FOCUS MORE ON HOW TO INPROVE H.I.T. INVESTMENT RESULTS

  29. THANK YOU. FOR MORE INFORMATION CONTACT: YU ZHIYUAN (GRACE) THE DORENFEST CHINA HEALTHCARE GROUP SUITE 908, NO. 998 RENMIN ROAD, SHANGHAI PHONE: 021-63203522, FAX: 021-63269722. WEB SITE ADDRESS: www.dorenfest.com E-MAIL ADDRESS: info@dorenfest.com YU ZHIYUAN (GRACE) : yuz@dorenfest.com

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