CHINA COMPUTERWORLD RHN CONFERENCE

1. CHINA COMPUTERWORLD RHN CONFERENCE SEPTEMBER 12, 2009 BEIJING, CHINA EVOLUTION OF RHNs AROUND THE WORLD AND WHAT IT MEANS TO RHNs IN CHINA

2. PRESENTATION AGENDA • ABOUT THE DORENFEST GROUP AND ITS CHINA BUSINESS APPROACH • EVOLUTION OF RHNs AROUND THE WORLD • EVOLUTION OF RHNs IN CHINA

3. ABOUT THE DORENFEST GROUP • 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 BY THE END OF 2010 WHEN WE WILL BEGIN TO MAKE INVESTMENTS IN WELL-DEFINED, GOOD BUSINESS PROJECTS, IN PARTNERSHIP WITH CHINESE HEALTH BUREAUS AND HOSPITALS

4. DORENFEST ACTIVITIES IN OTHER COUNTRIES • CONDUCT MARKET STUDIES AND CONSULTING ASSIGNMENTS ON USE OF INFORMATION TECHNOLOGY IN HEALTH CARE IN A NUMBER OF COUNTRIES • CONDUCT WORLDWIDE STUDIES COMPARING THE STATE OF THE ART IN HEALTH CARE I.T. • CONTINUOUSLY MONITOR AND UPDATE OUR UNDERSTANDING OF WORLDWIDE HEALTH CARE I.T. THROUGH A VARIETY OF ONGOING ACTIVITIES: • IN-PERSON AND TELEPHONE DISCUSSIONS WITH NUMEROUS HOSPITAL EXECUTIVES AND I.T. SUPPLIER PERSONNEL • REVIEW OF I.T. IN USE AT HOSPITALS THROUGHOUT THE WORLD • WORLDWIDE EDUCATIONAL SERVICES

5. SOME RECENT CLIENT EXAMPLES IN CHINA • EXAMPLES OF HEALTH BUREAU CLIENTS RHN PLANNING CLIENTS • SHENZHEN • CHONGQING • EXAMPLES OF HOSPITAL CLIENTS • SHANGHAI CHANGNING MATERNITY AND INFANT HEALTH INSTITUTE • PEKING UNIVERSITY MEDICAL COLLEGE #3 HOSPITAL • RIZHAO CITY PEOPLE’S HOSPITAL • EXAMPLES OF HELPING CLIENTS FROM OTHER LOCATIONS TO BRING THEIR SKILLS TO MAINLAND CHINA • HONG KONG HOSPITAL AUTHORITY • MICROSOFT

6. CHINA COMPUTERWORLD EVOLUTION OF RHNs AROUND THE WORLD

7. Hospital B Nursing Home Doctor’s Office Patient Data Outpatient Clinic Outpatient Clinic GovernmentReimbursement Insurance Payor Doctor’s Office Doctor’s Office Hospital A Home Health Agency Blood Bank Outpatient Clinic RHNs WERE FIRST INTRODUCED AS CHINS IN THE U.S. IN THE EARLY 1990s

8. SUMMARY OF EVOLUTION OF RHNs IN THE U.S. • COMMUNITY HEALTH INFORMATION NETWORKS (CHINs) BEGAN IN 1990 AS THE FIRST GENERATION OF RHNs IN THE UNITED STATES • FORMED WITH A BROAD VISION OF SHARING INFORMATION AMONG HEALTH ORGANIZATIONS WITHIN A CITY OR STATE • UNCLEAR OBJECTIVES • LACK OF VALUE TO POTENTIAL PARTICIPANTS • MUCH MONEY INVESTED BY MANY CHIN PROJECTS • INTEGRATED DELIVERY OWNERSHIP MODELS EMERGED IN 1993 AS THE HOSPITAL ANSWER TO THE CLINTON HEALTHCARE REFORM PROPOSAL • BY THE MIDDLE 1990s, INTEGRATED DELIVERY SYSTEMS EMERGED IN EVERY CITY IN THE UNITED STATES, AND THE CHIN CONCEPT DISAPPEARED BY 1996

9. Hospital B Nursing Home Doctor’s Office Patient Data Outpatient Clinic Outpatient Clinic GovernmentReimbursement Insurance Payor Doctor’s Office Doctor’s Office Hospital A Home Health Agency Blood Bank Outpatient Clinic THE VISION OF INTEGRATED DELIVERY SYSTEM OWNERSHIP MODELS

10. RHIOs EMERGE IN THE DECADE OF THE 2000s • RHIOs WERE THE SECOND GENERATION OF RHNs IN THE U.S. • MANY DIFFERENT ORGANIZATIONS PROMOTED THEM IN THE EARLY 2000s • BY 2004, NATIONAL POLICY EMERGED THROUGH THE OFFICE OF THE NATIONAL COORDINATOR FOR HEALTH INFORMATION TECHNOLOGY (ONCHIT) • IN THE ENSUING SEVERAL YEARS BETWEEN 2004 AND NOW, ALMOST 100 OFFICIALLY DESIGNATED RHIOs EMERGED • HEAVY INVESTMENT IN THESE RHIOs WITH MOST FUNDS USED IN THEIR START-UP • MANY WERE UNABLE TO FIND A SUSTAINABLE OPERATING MODEL AND APPROACHED FINANCIAL COLLAPSE • SOME LONG TERM SUCCESSES EMERGED TO SHARE LIMITTED DATA

11. WHAT ARE THE LESSONS TO BE LEARNED? • BROAD VISIONS NEEDS DETAILED PLANS • OVERSIMPLIFIED IMPLEMENTATION APPROACHES CREATE FLAWED AND LIMITTED SUCCESS • LACK OF STAKEHOLDER COMMITMENT CREATED FAILED PROGRAMS • HEAVY INVESTMENT IN POORLY CONCEIVED IDEAS WASTED MONEY • SUCCESS ACCOMPLISHED THROUGH LIMMITTED, WELL THOUGHT THROUGH FIRST STEPS AND STRONG STAKEHOLDER PARTICIPATION AND SUPPORT

12. CHINA COMPUTERWORLD EVOLUTION OF RHNs IN CHINA

13. EVOLUTION OF RHNs IN CHINA • THE MINISTRY OF HEALTH (MOH) GUIDELINES FOR HEALTH I.T. DEVELOPMENT CALLED FOR REGIONAL HEALTH NETWORKS AND DIGITAL HOSPITALS TO BE IMPLEMENTED THROUGHOUT CHINA BETWEEN 2003 AND 2010 • THIS PROVIDED MUCH MOMENTUM AS MANY HEALTH BUREAUS UNDERTOOK REGIONAL HEALTH NETWORK AND DIGITAL HOSPITAL INVESTMENT • IN THE LAST FEW YEARS DATA SHARING HAS BEGUN TO EMERGE IN CHINA AS SOME RHNs SHARE LIMITED DATA SUCH AS TEST/DIAGNOSTIC RESULTS AND SOME PATIENT INFORMATION • HEALTHCARE REFORM CALLS FOR E-HEALTH RECORDS AND HAS PROVIDED SUBSTANTIAL ADDITIONAL FUNDING IN A VARIETY OF WAYS, SO IT IS EXPECTED THAT SUBSTANTIAL ADDITIONAL PROGRESS WILL BE MADE IN THE NEXT FEW YEARS • MUCH MORE ACTIVITY AND FUNDING IN MANY CITIES AND PROVINCES WITH EVEN U.S. FUNDING FOR ONE OR TWO MAJOR PLANNING PROJECTS

14. THE CURRENT SITUATION WITH RHN DEVELOPMENT AND ELECTRONIC HEALTH RECORDS IN CHINA RESEMBLES THE U.S. SITUATION OF PAST • BROAD VISION • MORE MONEY AVAILABLE • POOR DEFINITION OF FIRST STEPS • LACK OF STAKEHOLDER COMMITMENT TO SPECIFIC DATA SHARING

15. BUILDING SUCCESS THROUGH A STRONG FOUNDATION • CAREFULLY DEFINE FIRST STEPS • LIMITED DATA SETS WITH HIGH BENEFIT TO MANY STAKE HOLDERS WOULD BE ADVANTAGEOUS • WHEN FIRST STEPS PROVE BENEFICIAL, MORE AGGRESSIVE SECOND STEPS CAN BE TAKEN

16. THANK YOU. FOR MORE INFORMATION CONTACT: SHELDON I. DORENFEST OR 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