CHINA HOSPITAL CEO ANNUAL CONFERENCE 2009

1. CHINA HOSPITAL CEO ANNUAL CONFERENCE2009 2009.11 SHANGHAI, CHINA LESSONS LEARNED FROM 20 DIGITAL HOSPITAL GRACE YU

2. OUTLINE • THE CURRENT STATUS OF I.T. USE IN CHINESE HOSPITALS • LESSONS LEARNED FROM 20 DIGITAL HOSPITAL • CONCLUSION

3. DORENFEST GROUP • IN 2006 THE DORENFEST GROUP FORMED THE DORENFEST CHINA HEALTHCARE GROUP, BASED IN SHANGHAI. WE OFFER A VARIETY OF CONSULTING, TRAINING, AND EDUCATION SERVICES TO THE CHINA HEALTHCARE SYSTEM TO HELP THEM IMPROVEMENT IT MANAGEMENT, OPTIMIZE HOSPITAL WORKFLOW, IMPORVE QUALITY OF CARE AND REDUCE COST. • OUR CLIENTS INCLUDE: • SHANGHAI CHANGNING MATERNITY AND INFANT HEALTH INSTITUTE • PEKING UNIVERSITY MEDICAL COLLEGE #3 HOSPITAL • SHANDONG RIZHAO PEOPLE’S HOSPITAL • SHENZHEN CITY HEALTH BUREAU • CHONGQING CITY HEALTH BUREAU • HONGKONG HOSPITAL AUTHORITY • MICROSOFT

4. CHINA HOSPITAL CEO ANNUAL CONFERENCE2009 THE CURRENT STATUS OF I.T. USE IN CHINESE HOSPITALS

5. CHINA H.I.T. EXPENDITURE GROWTH 元（10亿） 6.33 5.29 26.8% 4.36 26.6% PUBLIC HEALTH HOSPITAL 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

6. ALLOCATION OF H.I.T. INVESTMENT AROUND THE WORLD SOURCE: CCW

7. CURRENT STATUS OF H.I.T. IN CHINA • CHINA IS MAKING SIGNIFICANT HEALTHCARE REFORM • HEALTHCARE REFORM POLICY CLEARLY STATES THAT USE OF INFORMATION TECHNOLOGY CAN HELP IMPROVE THE HEALTH DELIVERY SYSTEM • HOWEVER, SEVERAL FACTORS ARE IMPEDING THE SUCCESS IN CHINA H.I.T. INCLUDING LACK OF EXPERIENCE IN IT PLANNING, WEAK APPLICATION, AND LACK OF IMPLEMENTATION SKILL • CHINA SHOULD LEARN FROM OTHER COUNTRIES TO ACHIEVE ‘LEAP-FROG’ IMPROVEMENT ON H.I.T.

8. CHINA HOSPITAL CEO ANNUAL CONFERENCE2009 LESSONS LEARNED FROM 20 DIGITAL HOSPITALS

9. MOH APPOINTED THE FIRST GROUP OF 20 HOSPITALS AS DIGITAL HOSPITALS BASED ON “HOSPITAL IT SYSTEM BASIC FUNCTIONAL STANDARDS”, 20 HOSPITALS ARE SELECTED AS MOH DIGITAL MODEL HOSPITALS INCLUDING 13 GENERAL HOSPITALS,3 TCM HOSPITALS, 4 MILITARY HOSPITALS. 1   BEIJING TIANTAN HOSPITAL              2   ZHEJIANG UNIV. AFFILIATED 1ST HOSPITAL 3   SHANGHAI RUIJIN HOSPITAL  4   GUANGDONG JIANGMEN CENTRAL HOSPITAL                5   WUXI TCM HOSPITAL              6   SHANGHAI YUEYANG HOSPITAL 7   GUANGDONG FUOSHAN NANHAI DISTRICT TCM HOSPITAL            8   DONGNAN UNIVERSITY ZHONGDA HOSPITAL             9   DALIAN MEDICAL UNIVERSITY 2ND AFFILIATED HOSPITAL    10  SICHAN MEDICAL COLLEGE PEOPLE’S HOSPITAL      11  BEIJING TONGREN HOSPITAL        12  PKU SHENZHEN HOSPITAL       13  GUANGDONG ZHONGSHAN CITY PEOPLE’S HOSPITAL      14  SHANDONG QIANFUOSHAN HOSPITAL              15  CHINA MEDICAL UNIVERSITY SHENGJING HOSPITAL                 16 HUAZHONG SCIENCE AND TECH UNIV. TONGJI HOSPITAL 17 MILITARY GENERAL HOSPITAL 301 18 MILITARY 251 HOSPITAL 19 NANJING MILITARY GENERAL HOSPITAL 20 CHONGQING SOUTHWESTERN HOSPITAL

10. LESSON ONE: HOSPITAL EXECUTIVE SUPPORT IS CRITICAL TO HOSPITAL IT SUCCESS • LESSON ONE: HOSPITAL EXECUTIVE (ESPECIALLY PRESIDENT) IS CRITICAL TO HIT SUCCESS • THE PRESIDENTS OF THE 20 HOSPITALS GENERALLY HAVE SPENT A LOT OF TIME IN UNDERSTANDING HIT. IN STEAD OF AVOIDING IT, THEY MAKE EFFORT TO LEARN IT KNOWLEDGE AND HAVE BETTER UNDERSTANDING OF HOW IT SUPPORT THE HOSPITAL BUSINESS • THEY MAKE I.T. A PART OF THE HOSPITAL GROWTH PLAN AND REGULAR MEETING AGENDA. • THEY DEDICATE TIME TO IT MEETINGS AND DISCUSSIONS. THEY LEAD IT PLANNING AND CAREFULLY MONITOR IT PROJECT STATUS • THEY STIMULATE THINKING ON IT AMONG MID-LEVEL MANAGERS AND REGULARLY COMMUNICATE HOSPITAL’S IT VISTION WITH EMPLOYEES. THEY ENCOURAGE DEPARTMENT HEADS TO SUPPORT IT WORK AND PROMOTE THEIR ACCOUNTIBILITY AND PARTICIPATION. • THEY SUPPORT FOUNDATIONAL IT INFRASTRUCTURE AND IT ORGANIZATION DEVELOPMENT THOUGH ENOUGH IT INVESTMENT.

11. LESSON ONE: HOSPITAL EXECUTIVE SUPPORT IS CRITICAL TO HOSPITAL IT SUCCESS (CONTINUED) • DR. GUO QIYONG, PRESIDENT OF CHINA MEDICAL UNIV. AFFILICATED SHENGJING HOSPITAL IS CALLED “IT FAN” BY HOSPITAL EMPLOYEES. • HE PERSONALLY LEADS HOSPITAL IT STEERING COMMITTEE. • IN THE HOSPITAL, IT TOPICS ARE REGULAR DISCUSSION TOPIC IN THE EXECUTIVE MEETING. • HIS THEORY OF IT DEVELOPMENT IS “IT DEVELOPMENT IS NOT A ONE-TIME EVEN BUT A COMPLEX AND SYSTEMS PROJECT. IT IS ALSO A PRESIDENT-PROJECT” • DR. LI HONG, PRESIDENT OF SHANGHAI RUIJIN HOSPITAL HAS MERGED THE HOSPITAL’S IT STRATY WITH THE BUSINESS STRATEGY WHICH IS REGIONAL HEALTH CARE DELIVERY SERVICE MODEL. HE HAS MADE ADVANCED EXPERIMENT OF AUTOMATED REGIONAL HEALTH DELIVERY SERVICES.

12. LESSON TWO: HOSPITAL IT SUCCESS CAN’T HAPPEN WITHOUT CLINICIAN PARTICIPATION • LESSON TWO: HOSPITAL IT SUCCESS CAN’T HAPPEN WITHOUT CLINICIAN PARTICIPATION • CLINICIANS NEED TO ACTIVELY PARTICIPATE IN IT PLANNING, SYSTEM SELECTION, AND SYSTEM IMPLEMENTATION. THEIR ACCOUNTABILITY IS IMPORTANT TO IT SUCCESS. • FOR EXAMPLE, PKU SHENZHEN HOSPITAL HAS PERIODIC IT MEETING WHERE HOSPITAL EXECUTIVES, DEPARTMENT HEADS AND IT MANAGER OPENLY DISCUSS CLINICIAN’S FEEDBACKS ON IT SYSTEM.

13. LESSON THREE: POSITIONING IT DEPARTMENT AS THE BRIDGE OF FACILITATION BETWEEN HOSPITAL USERS AND VENDORS • LESSON THREE: POSITIONING IT DEPARTMENT AS THE BRIDGE OF FACILITATION BETWEEN HOSPITAL USERS AND VENDORS • MANY AWARD-WINNING CIO’S SAID THEIR SUCCESS EXPERIENCE IS POSITIONING IT DEPARTMENT TO SERVICE MANAGEMENT AND CLINICIANS. IT ONLY EXISTS BECAUSE IT RPOVIDES SERVICE TO IMPROVE THE EFFICIENCY OF OTHER DEPARTMENT. THE SUCCESS OF IT IS DEFINED AS HOW MUCH HELP IS CONSIDERED TO BE RECEIVED BY IT DEPARTMENT’S CUSTOMERS • FOR EXAMPLE, FUZHOU MILITARY GENERAL HOSPITAL CIO CHEN JINXIONG OFTEN WALK AROUND ALL THE CLINICIAL DEPARTMENTS AND OBSERVE SYSTEM IMPLEMENTATION AND PROCESS IMPROVEMENT SITUATION. HE COLLECTS CLINICAL FEEDBACKS AND IDENTIFIES OPPORTUNITIES FOR IMPORVEMENT. • PKU SHENZHEN HOSPITAL HAS ESTABLISHED A WEEKLY IT WARD-ROUNDING POLICY, I.E. CIO VISITS CLINICAL DEPARTMENT TO COLLECT CLINICIAN FEEDBACKS.THE CIO MR. LU HONG THINKS THAT A HOSPITAL CIO HAS TO HAVE A DEEP UNDERSTANDING OF HOW TO USE IT TO SUPPORT CLINICAL WORK IN ORDER TO MANAGE IT EFFECTIVELY.

14. LESSON FOUR: BUILDING A WIN-WIN RELATIONSHIP WITH SOFTWARE VENDORS • LESSON FOUR: BUILDING A WIN-WIN RELATIONSHIP WITH SOFTWARE VENDORS • IT’S IMPORTANT FOR HOSPITAL TO BUILD A WIN-WIN PARTNERSHIP WITH IT VENDORS. IT VENDORS ARE OFTEN NOT FAMILIAR WITH HOSPITAL’S BUSINESS PROCESSES WHILE USERS ARE NOT FAMILIAR WITH IT SYSTEMS. • THEREFORE, IT DEPARTMENT PLAYS A CRITICAL BRIDGING ROLE TO FACILIATE THE COMMUNICATION OF VENDORS AND USERS.

15. LESSON FIVE: HOSPITAL NEEDS TO TAKE MORE RESPONSIBILITY OF PROCESS IMPROVEMENT AND CHANGE MANAGEMENT DURING IMPLEMENTATION • LESSON FIVE: HOSPITAL NEEDS TO TAKE MORE RESPONSIBILITY OF PROCESS IMPROVEMENT AND CHANGE MANAGEMENT DURING IMPLEMENTATION • IT SYSTEM IMPLEMENTATION IS NOT ONLY SOFTWARE INSTALLATION BUT ALSO CHANGE OF WORKFLOWS AND ORGANIZATIONAL STRUCTURE. • BECAUSE OF INAPPROPRIATE SYSTEM IMPLEMENTATION, HOSPITALS FIND IT ENDS UP WITH REDUNDANT AND ERROR-PRONE WORKFLOW. • AS HOSPITAL IT SYSTEM BECOME MORE COMPLEX, THE REQUIREMENT OF HOSPITAL’S CAPABILITY IN SYSTEM IMPLEMENTATION AND IT LEADERSHIP AND USERS’ ROLE BECOME MORE IMPORTANT. • SUCCESSFUL SYSTEM IMPLEMENTATION REQUIRES GOOD PROJECT MANAGEMENT AND CHANGE MANAGEMENT CAPABILITY. GOOD UNDERSTANDING OF USER NEEDS AND HOSPITAL WORKFLOW IS CRITICAL.

16. LESSON SIX: IT DEPARTMENT NEEDS TO TAKE MORE RESPONSIBILITY OF HELPING, FACILITATING AND COORDINATING CLINICIANS TO PARTICIPATE IN IT DEVELOPMENT • LESSON SIX: IT DEPARTMENT NEEDS TO TAKE MORE RESPONSIBILITY OF HELPING, FACILITATING AND COORDINATING CLINICIANS TO PARTICIPATE IN IT DEVELOPMENT • CIO NEEDS TO TRANSFORM FROM TECHNOLOGY-DRIVEN MANAGER TO BUSINESS-DRIVEN MANAGER.

17. HOSPITAL IT PROJECT ROLES

18. CHINA HOSPITAL CEO ANNUAL CONFERENCE2009 CONCLUSION

19. MISTAKES OF CHINA HOSPITAL IT INVESTMENT • MISTAKE #1: USER REQUIREMENTS CANNOT BE DEFINED. CLINICIANS DON’T KNOW WHAT FUNCTIONS THEY EXPECT FROM IT SYSTEMS. • MISTAKE #2: IT VENDORS WILL TELL THE HOSPITAL HOW TO IMPLEMENT THE SYSTEM. • MISTAKE #3: HOSPITAL IT DEVELOPMENT IS ONLY RESPONSIBLE BY IT DEPARTMENT. CLINICAL DEPARTMENTS HAVE NOTHING TO DO WITH IT. • MISTAKE#4: RETURN ON IT INVESTMENT IS NOT CALCULABLE. • MISTAKE #5: WHEN THE IT SYSTEM IS ADOPTED, EVERY PROBLEM WILL BE SOLVED. • MISTAKE#6: IF THE SOFTWARE IS RUNNING INTO A PROBLEM, ONLY THE VENDOR SHOULD BE HELD RESPONSIBLE.

20. HOW CHINA HOSPITAL CAN IMPROVE THEIR INVESTMENT ON IT • BUILD BETTER IT PROJECT PLANNING METHODOLOGY TO BETTER SET IT PROJECT PRIORITY • CREATE BETTER USER REQUIREMENT DEFINITION METHODOLOGY • CREATE BETTER SOFTWARE PRODUCT ASSESSMENT METHODOLOGY • DEVELOP BETTER SYSTEM IMPLEMENTATION METHODOLOGY SO THAT NEW SYSTEM IMPLEMENTATION WON’T ADD WORK AND MAKE WORK PROCESS REDUNDANT. • DEVELOP BETTER COMMUNICATION METHODOLOGY WITH VENDORS TO FACILITATE SYSTEM IMPLEMENTATION AND SYSTEM MAINTENANCE. • DEVELOP BETTER USER TRAINING METHOD. • DEVELOP BETTER IT MANAGEMENT MECHANISM. • FOCUS MORE ON IMPROVING THE BENEFITS OUT OF IT INVESTMENT.

21. THANK YOU. FOR MORE INFORMATION CONTACT: YU ZHIYUAN (GRACE) THE DORENFEST CHINA HEALTHCARE GROUP SUITE 908, NO. 998 RENMIN ROAD, SHANGHAI PHONE: 021-63203522, 63269722 WEB SITE ADDRESS: www.dorenfest.com E-MAIL ADDRESS: info@dorenfest.com SHELDON’S E-MAIL ADDRESS: sheldon@dorenfest.com YU ZHIYUAN (GRACE) : yuz@dorenfest.com 21