301 military hospital management seminar how hit can solve or cause quality problems beijing, china...

301 Military Hospital 301 Military Hospital Management SeminarManagement Seminar

How HIT Can Solve or How HIT Can Solve or Cause Quality ProblemsCause Quality Problems

Beijing, ChinaBeijing, China June 21, 2012June 21, 2012

301 MILITARY HOSPITAL MANAGEMENT SEMINAR301 MILITARY HOSPITAL MANAGEMENT SEMINAR DORENFEST CHINA HEALTHCARE GROUPDORENFEST CHINA HEALTHCARE GROUP22

Presentation AgendaPresentation Agenda

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About the Dorenfest GroupAbout the Dorenfest Group 33

The Original Vision and Reasons for HITThe Original Vision and Reasons for HIT 1111

Examples of How HIT Can Cause or Solve Quality ProblemsExamples of How HIT Can Cause or Solve Quality Problems 1717

HIT and Quality in ChinaHIT and Quality in China 2222

Clinical Decision Support and Data Analysis in China HospitalsClinical Decision Support and Data Analysis in China Hospitals 2828

How Can China “Leapfrog” in Using HIT for Quality Improvement?How Can China “Leapfrog” in Using HIT for Quality Improvement? 3333


The Dorenfest Group The Dorenfest Group

40 years experience in HIT40 years experience in HIT

Offer healthcare improvement services through a variety of businesses.Offer healthcare improvement services through a variety of businesses.

– SoftwareSoftware

– Hospital Operations Improvement for over 300 HospitalsHospital Operations Improvement for over 300 Hospitals

– Consultation with over 200 Technology and Software Vendors in HealthConsultation with over 200 Technology and Software Vendors in Health

– Created the Product That Became the HIMSS Analytics DatabaseCreated the Product That Became the HIMSS Analytics Database

Our work focuses on improving patient care and operational efficiency through Our work focuses on improving patient care and operational efficiency through better change management better change management

– Work process improvementWork process improvement

– Management systems improvementManagement systems improvement

– Improvement in services for patientsImprovement in services for patients

– Improvement in quality of patient care Improvement in quality of patient care


Dorenfest’s Investigation of China Healthcare in 2005-Dorenfest’s Investigation of China Healthcare in 2005-2006 2006

1.1. Dorenfest investigated China healthcare in 2005 and 2006 by visiting 17 Dorenfest investigated China healthcare in 2005 and 2006 by visiting 17 cities, meeting with healthcare leaders, and visiting over 100 hospitalscities, meeting with healthcare leaders, and visiting over 100 hospitals

2.2. We observed a major opportunity in China HIT to help Chinese hospitals We observed a major opportunity in China HIT to help Chinese hospitals and health bureaus to do better with their IT improvement effortsand health bureaus to do better with their IT improvement efforts

3.3. Chinese healthcare leaders wanted to “leapfrog” the world in IT use, and to Chinese healthcare leaders wanted to “leapfrog” the world in IT use, and to do that, they needed to make a number of changes in how IT was manageddo that, they needed to make a number of changes in how IT was managed

4.4. By learning from early adopters about what they did right and what they did By learning from early adopters about what they did right and what they did wrong, and doing more of what they did right and less of what they did wrong, and doing more of what they did right and less of what they did wrong, China can benefit from the experience of the world to do much better wrong, China can benefit from the experience of the world to do much better in HITin HIT

5.5. We created a consulting, education, and training company to bring the We created a consulting, education, and training company to bring the experience of the world to China to help the Chinese healthcare leaders to experience of the world to China to help the Chinese healthcare leaders to learn faster and accomplish their goals of “leapfrogging” the world in IT uselearn faster and accomplish their goals of “leapfrogging” the world in IT use


China Healthcare Leaders Want to “Leapfrog” the World China Healthcare Leaders Want to “Leapfrog” the World in IT Use in IT Use

Chinese hospitals and health bureaus are carefully considering how to be Chinese hospitals and health bureaus are carefully considering how to be more successful in taking next steps forward in IT usemore successful in taking next steps forward in IT use

There is a recognition that for China to accomplish its objectives in HIT There is a recognition that for China to accomplish its objectives in HIT requires the following: 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 what they Doing more of what the rest of the world did right and less of what they did wrong to avoid mistakes other countries have made and China is did wrong to avoid mistakes other countries have made and China is still makingstill making

– Developing more expertise in these areas of need quickly Developing more expertise in these areas of need quickly


The Dorenfest Group Is Bringing Needed New The Dorenfest Group Is Bringing Needed New Skills to China Skills to China

1.1. Hospital Operations Improvement and Change ManagementHospital Operations Improvement and Change Management

2.2. IT Program Improvement, Problem-solving, Strategy, and Planning IT Program Improvement, Problem-solving, Strategy, and Planning

3.3. New Approaches to Buying IT Systems in a Stronger Partnership with Users New Approaches to Buying IT Systems in a Stronger Partnership with Users

4.4. New Ways to implement IT Systems New Ways to implement IT Systems


Examples of Dorenfest Projects in ChinaExamples of Dorenfest Projects in China

The Dorenfest China Healthcare Group was formed in 2006 to offer The Dorenfest China Healthcare Group was formed in 2006 to offer consulting services to China Hospitals and Health Bureaus. We have consulting services to China Hospitals and Health Bureaus. We have worked with over 25 hospitals and health bureaus to help them use worked with over 25 hospitals and health bureaus to help them use information technology more effectively and have consulted with a variety of information technology more effectively and have consulted with a variety of Western companiesWestern companies

Some health bureau clients for RHN and digital hospital planning Some health bureau clients for RHN and digital hospital planning

– ShenzhenShenzhen

– ChongqingChongqing

Some hospital clients Some hospital clients

– Peking University Third HospitalPeking University Third Hospital

– Foshan City First People’s HospitalFoshan City First People’s Hospital

– Shanghai Changning Maternity & Infant Health InstituteShanghai Changning Maternity & Infant Health Institute

– Rizhao City People’s HospitalRizhao City People’s Hospital


Examples of Dorenfest Projects in China(Continued)Examples of Dorenfest Projects in China(Continued)

Helping clients from other locations bring their skills to Mainland China Helping clients from other locations bring their skills to Mainland China

– Hong Kong Hospital AuthorityHong Kong Hospital Authority

– IMS ChinaIMS China

– Microsoft ChinaMicrosoft China

– Philips Healthcare ChinaPhilips Healthcare China

Helping Chinese companies Helping Chinese companies

– Donglian – Hangzhou East AssociatesDonglian – Hangzhou East Associates

– Heren HealthHeren Health

– Simcere PharmaceuticalsSimcere Pharmaceuticals


Dorenfest Education in China – Tongren Hospital, Beijing Dorenfest Education in China – Tongren Hospital, Beijing 20052005


Dorenfest Education in China – Zhejiang Medical Dorenfest Education in China – Zhejiang Medical Association 2009Association 2009


The Original Vision and The Original Vision and Reasons for HITReasons for HIT

301 Military Hospital Management Seminar301 Military Hospital Management Seminar


The Situation in U.S. Hospitals in 1970 When Systems Were Still Manual

1.1. Many entries of similar data into different manual recordsMany entries of similar data into different manual records

2.2. Great redundancy of information and supporting workGreat redundancy of information and supporting work

3.3. Lack of timeliness in processing doctors’ orders and test results, etc.Lack of timeliness in processing doctors’ orders and test results, etc.

4.4. High error potentialHigh error potential

5.5. Multiple databases did not always contain the same informationMultiple databases did not always contain the same information

6.6. Very difficult to find data for analysisVery difficult to find data for analysis


This Led to the Original Vision for HIT

1.1. Enter information onceEnter information once

2.2. Communicate the information to those who need to knowCommunicate the information to those who need to know

3.3. Update all necessary files and databases Update all necessary files and databases

4.4. Create an electronic medical record (EMR)Create an electronic medical record (EMR)

5.5. Have the data available in automated form and organized so that it is easy to Have the data available in automated form and organized so that it is easy to retrieve and analyze the data to support good clinical decision makingretrieve and analyze the data to support good clinical decision making


U.S. Hospitals Have Sought the Original Vision Through U.S. Hospitals Have Sought the Original Vision Through 4 Generations of IT Software Systems 4 Generations of IT Software Systems

Finance Systems (1960s and 1970s) Finance Systems (1960s and 1970s)

Limited Clinical Systems (1970s and 1980s) Limited Clinical Systems (1970s and 1980s)

More Advanced Clinical Systems (Late 1980s and 1990s) More Advanced Clinical Systems (Late 1980s and 1990s)

Electronic Health Records (2000s)Electronic Health Records (2000s)


IT Caused Problems Because of Poorly IT Caused Problems Because of Poorly Implemented ChangeImplemented Change

Before IT=1x

2x

3x

4x

Growth in Growth in

RedundancyRedundancy

Total Hospital Work ProcessTotal Hospital Work Process


HIT Evolution in the Rest of the WorldHIT 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 than the Canada, France, Germany, England, and Australia all started later than the U.S., Invested less, and have made more progressU.S., Invested less, and have made more progress

Hong Kong started even later, invested less, and now is the state of the art in Hong Kong started even later, invested less, and now is the state of the art in HIT use in the world HIT use in the world

China HIT is now at an earlier stage of development. China has the goals and China HIT is now at an earlier stage of development. China has the goals and desire to “leapfrog” the rest of the world in HIT use in the next few years desire to “leapfrog” the rest of the world in HIT use in the next few years



Examples of How HIT Can Cause or Examples of How HIT Can Cause or Solve Quality Problems Solve Quality Problems


A Major Objective of the Original Vision of HIT Was to Do A Major Objective of the Original Vision of HIT Was to Do the Work Oncethe Work Once

1.1. But even today in most U.S. hospitals, similar data is entered many times, But even today in most U.S. hospitals, similar data is entered many times, creating the opportunity for many errorscreating the opportunity for many errors

2.2. So if the data was entered once, opportunities for error would be reduced, So if the data was entered once, opportunities for error would be reduced, making everything else work bettermaking everything else work better

3.3. For example, in a typical Chinese hospital, the clinician is entering outpatient For example, in a typical Chinese hospital, the clinician is entering outpatient orders through a physician workstation. Because systems are sometimes not orders through a physician workstation. Because systems are sometimes not very well designed, the physician may be filling out a number of paper order very well designed, the physician may be filling out a number of paper order forms to supplement what he has entered in the computer. Then he may enter forms to supplement what he has entered in the computer. Then he may enter the same information into the patient’s outpatient paper recordthe same information into the patient’s outpatient paper record

4.4. If that physician could enter the data once, the physician would have more time If that physician could enter the data once, the physician would have more time for taking care of his patients – the most valuable use of his timefor taking care of his patients – the most valuable use of his time

5.5. If physicians had more time for patient care, they will do a better job, and the If physicians had more time for patient care, they will do a better job, and the hospitals they work in will earn more revenuehospitals they work in will earn more revenue


How Can Well Conceived HIT Systems Help How Can Well Conceived HIT Systems Help the Physician?the Physician?

1.1. Well-designed computer systems can reduce physicians’ time on Well-designed computer systems can reduce physicians’ time on recordkeeping, permitting the physician to spend more time with patientsrecordkeeping, permitting the physician to spend more time with patients

2.2. A well-designed computer system can provide easy access to accurate data, A well-designed computer system can provide easy access to accurate data, giving physicians confidence that they know what they are looking at and can giving physicians confidence that they know what they are looking at and can rely on it in patient treatmentrely on it in patient treatment

3.3. A well-designed computer system can provide useful data for physician A well-designed computer system can provide useful data for physician decision making and hospital management of quality of caredecision making and hospital management of quality of care

4.4. While in China, physicians are in the early stages of using computerized data While in China, physicians are in the early stages of using computerized data to support clinical decision making, in the U.S. physicians do much data to support clinical decision making, in the U.S. physicians do much data analysis to support their clinical work and research activitiesanalysis to support their clinical work and research activities


How Can Well Conceived HIT Systems Help How Can Well Conceived HIT Systems Help the Physician? (Continued)the Physician? (Continued)

5.5. When patient data available in automated form is accurate, physicians will When patient data available in automated form is accurate, physicians will access it for clinical decision making support. Some examples of uses in the access it for clinical decision making support. Some examples of uses in the U.S. are:U.S. are:

A complex disease with unusual characteristicsA complex disease with unusual characteristics

Where familiarity with a certain disease is lackingWhere familiarity with a certain disease is lacking

To support better understanding of the frequency of different treatments for To support better understanding of the frequency of different treatments for a particular diagnosisa particular diagnosis

6.6. Some other simple automated activities can help the physician a lot:Some other simple automated activities can help the physician a lot:

Immediate availability of automated lab resultsImmediate availability of automated lab results

Immediate availability of current and old images from CT, MRI, ultrasound, Immediate availability of current and old images from CT, MRI, ultrasound, etc.etc.

Immediate availability of patient historyImmediate availability of patient history


Examples of How HIT Can Help Quality in Examples of How HIT Can Help Quality in Ancillary DepartmentsAncillary Departments

1.1. Laboratory systems where all testing is integrated with the LIS, so that the test Laboratory systems where all testing is integrated with the LIS, so that the test results are automatically passed to the LIS system, and then to the physician, results are automatically passed to the LIS system, and then to the physician, provides a great benefitprovides a great benefit

2.2. Radiology information systems with PACS components are able to distribute Radiology information systems with PACS components are able to distribute radiology results and images in a variety of ways, making the physician’s job radiology results and images in a variety of ways, making the physician’s job more effective and more timelymore effective and more timely



HIT and Quality in ChinaHIT and Quality in China


The Development of HIT in China The Development of HIT in China

1.1. Redundant, expensive, and error-prone hospital work processes led to the Redundant, expensive, and error-prone hospital work processes led to the initiation and development of HIT in China initiation and development of HIT in China

2.2. Chinese hospitals began to computerize in the late 1980s and early 1990s Chinese hospitals began to computerize in the late 1980s and early 1990s

3.3. The initial focus of computer efforts was on financial systems The initial focus of computer efforts was on financial systems

4.4. In the early 2000s, fueled by the Ministry of Health (MOH) guidelines for health In the early 2000s, fueled by the Ministry of Health (MOH) guidelines for health IT development issued in 2003, which called for all cities in China to implement IT development issued in 2003, which called for all cities in China to implement RHNs and digital hospitals by 2010, hospitals began to purchase clinical RHNs and digital hospitals by 2010, hospitals began to purchase clinical systems in a variety of areassystems in a variety of areas

5.5. HIT is one of the 8 pillars of China’s Healthcare Reform. Much new spending HIT is one of the 8 pillars of China’s Healthcare Reform. Much new spending is fueling a variety of new system purchases and developmentis fueling a variety of new system purchases and development


How Is IT Used in China Today?How Is IT Used in China Today?

1.1. Low investment in the 20-year period 1990 to 2010 caused slow progress in HITLow investment in the 20-year period 1990 to 2010 caused slow progress in HIT

2.2. Like other early adopter countries, China’s approach to IT systems buying and Like other early adopter countries, China’s approach to IT systems buying and implementation has created unnecessarily redundant and error-prone work implementation has created unnecessarily redundant and error-prone work processes, poorly integrated systems, and unhappy usersprocesses, poorly integrated systems, and unhappy users

3.3. At the current time, China HIT systems are primarily used for recordkeeping, and At the current time, China HIT systems are primarily used for recordkeeping, and have many characteristics in common with the poorly-working HIT systems of have many characteristics in common with the poorly-working HIT systems of other countries, particularly in their earlier yearsother countries, particularly in their earlier years

4.4. The current foundation of HIT efforts in China, including software and hardware The current foundation of HIT efforts in China, including software and hardware platforms, and integration tools, is in need of improvement to support the platforms, and integration tools, is in need of improvement to support the accomplishments of China’s vision for HIT improvementaccomplishments of China’s vision for HIT improvement

5.5. With much more money available today, China is at a crossroads. There is a With much more money available today, China is at a crossroads. There is a great opportunity to use that money wisely and produce many more great opportunity to use that money wisely and produce many more assisters to assisters to quality of care quality of care by paying much greater attention to what worked and did not by paying much greater attention to what worked and did not work in early adopter countries of the world. Using more of what worked and less work in early adopter countries of the world. Using more of what worked and less of what did not work, Chinese Hospitals and Health Bureau leaders will make of what did not work, Chinese Hospitals and Health Bureau leaders will make much greater progress toward their vision and “leapfrog” goalsmuch greater progress toward their vision and “leapfrog” goals


The Current Computing Environment in a Typical Large The Current Computing Environment in a Typical Large Complex Chinese Hospital Today Complex Chinese Hospital Today

Major Ancillary Systems

Note: Chart taken from a couple of real hospital situations with each vendor or product family shown in a different color

Sample Current Systems (High Level View)

Major FinancialSystemsMajor Clinic

OR/Anesthesia(Vendor 5)

R.I.S./PACS(Vendor 4)

L.I.S.(Vendor 3)

Blood Bank(Vendor 3)

Bar Code(Vendor 3)

Ultrasound(Vendor 6)

Stomatology (Vendor 7)

Financial(Vendor 2)

MD Workstation(Vendor 2)

Pharmacy(Vendor 2)

L.I.S.(Vendor 3)

Core Vendor(Vendor 1)

Inpatient EMR(Vendor 8)

Cashiering(Vendor 2)

General Accounting (Vendor 2)

Medical Records(Vendor 11)

Medical Ins(Vendor 9)

Medical Ins(Vendor 10)

Human Resources(Vendor 12)

Performance Assessment System

(Vendor 13)Policy Exchange

Platform (Vendor 13)

Webport System(Vendor 13)

Hospital Website (Vendor 13)

Office Automation

Systems

MajorAdmin Systems

Order Management

Inpatient Physician Workstation

Outpatient PhysicianWorkstation

Inpatient Pharmacy

Outpatient Pharmacy

Inpatient ADT and Billing

Outpatient and ER Registration

Outpatient Pricing and Charging

Material Supply

Smart Card

Patient ConsultationSurvey

Lab Price System

Instrument and Equipment

Management

InpatientInsurance Interface

RF Card Producing Sub-System

Many Other Niche andSpecialty Systems


Major Areas of Future Development and Opportunity in Major Areas of Future Development and Opportunity in the China HIT Marketthe China HIT Market

1.1. A new generation of HIT application software will become available in a more A new generation of HIT application software will become available in a more product-ized form, with greater tools to support proper use of the information in product-ized form, with greater tools to support proper use of the information in the IT systems the IT systems

2.2. New application software will emerge to serve the not yet automated areas of New application software will emerge to serve the not yet automated areas of clinical work processes clinical work processes

3.3. Integration tools to facilitate the development of an improved IT environment Integration tools to facilitate the development of an improved IT environment will emerge will emerge

4.4. Data analytics products and support tools to facilitate better data analysis, Data analytics products and support tools to facilitate better data analysis, reporting, and decision making will emerge as Chinese Hospital Managers reporting, and decision making will emerge as Chinese Hospital Managers grow in sophistication grow in sophistication

5.5. New service and implementation approaches are beginning to emerge New service and implementation approaches are beginning to emerge

1.1. General contracting for entire efforts with some company software and General contracting for entire efforts with some company software and some partner softwaresome partner software

2.2. Front end planning, buying, and implementation services purchased from Front end planning, buying, and implementation services purchased from independent third parties to help hospitals make better buying decisions independent third parties to help hospitals make better buying decisions and create more successful implementation of software and create more successful implementation of software


Today Chinese Hospital HIT Investment Is Spent Today Chinese Hospital HIT Investment Is Spent Differently Than the Rest of the World Differently Than the Rest of the World

SOURCE: CCW ResearchSOURCE: CCW Research


Clinical Decision Support and Data Clinical Decision Support and Data Analysis in China Hospitals Analysis in China Hospitals


301 MILITARY HOSPITAL MANAGEMENT SEMINAR301 MILITARY HOSPITAL MANAGEMENT SEMINAR DORENFEST CHINA HEALTHCARE GROUPDORENFEST CHINA HEALTHCARE GROUP

Background and Current Situation in Data Analytics in Background and Current Situation in Data Analytics in China HospitalsChina Hospitals

1. Until recently, there has been relatively little focus on the building of historic data in automated form in Chinese hospitals

2. Most automation in the outpatient area has been to support the ordering and collection of work done for patients in the outpatient setting. At the conclusion of an outpatient visit in most hospitals in China today, entries are made manually in an outpatient manual record that is returned to the patient at the conclusion of his/her visit. Today in some hospitals, some of the entries into the patient’s manual record are made from the automated systems through printouts

3. In most hospitals in China today, some outpatient data from previous visits is available in the automated revenue and ancillary service systems of these hospitals, but very little access is made of this information

4. On the inpatient side, hospitals began implementing various forms of EMRs in the past five years. Most of the EMRs in use today are at an early stage and require lots of typing from the physician. Often these EMRs create more work for the physicians than they used to do in the manual system, creating dissatisfaction in those situations

2929


Background and Current Situation in Data Analytics in Background and Current Situation in Data Analytics in China Hospitals (Continued)China Hospitals (Continued)

5. Until recently, the EMR data was not accessed for analytical purposes, and there was relatively little motivation to do that in Chinese hospitals

6. Healthcare reform in China, beginning in April of 2009, changed the demand and interest in building databases of historic data for various kinds of analytical purposes

7. As part of the healthcare reform package, the concept of having data available for analytical purposes from a national platform of EHRs and EMRs, which will be built at the city, provincial, and national levels, has emerged. While there is a great deal of unknown and undefined elements to the EHR/EMR program, much money is being invested in various kinds of efforts to implement new systems and databases

8. In spite of not knowing what they want to do with the data they will have, Chinese hospitals continue to buy products that would help them to access and analyze that data. The goals of healthcare reform are increasing the amount of data that will be available in health bureau and hospital databases and are further motivating hospital leaders to be interested in data analytics

3030


The Possible Future of Clinical Decision Support The Possible Future of Clinical Decision Support and Data Analysisand Data Analysis

1. Hospital leaders are more familiar with the management of their financial and business activities and often ask questions that cannot be answered through the data available in the hospital IT systems. This setting has caused some forward-thinking hospitals to buy business intelligence systems that provide data warehousing capability and analytical tools to analyze their business data

2. Opportunities are beginning to emerge in analytics of clinical and medical data. Hospitals that are early stage adopters are buying some kind of CDR data warehouse product to house all of their automated data, making it accessible for analysis, and providing tools to analyze and view the data. At the present time, the buyers are still diligently working to determine how to use the data that is contained in these systems

3131


The Possible Future of Clinical Decision Support The Possible Future of Clinical Decision Support and Data Analysis (Continued)and Data Analysis (Continued)

3. Another opportunity area in Chinese hospitals for data is for clinical research. Already leading Chinese medical universities and clinicians in the leading hospitals are doing some research and building data to support their research. There is a great deal of clinical trial work emerging in China. This is creating needs for clinical data that may or may not be available at the present time

4. These trends and conditions in the HIT market in China indicate that clinical decision support and data analysis will be a big opportunity in the future, developing faster as Chinese hospital leaders determine what to do with the data in their databases and how analysis can benefit them

3232


How Can China “Leapfrog” in Using How Can China “Leapfrog” in Using HIT for Quality Improvement?HIT for Quality Improvement?



China Has a Unique Opportunity China Has a Unique Opportunity

1.1. Approaching the national vision for HIT in China in a proper way will produce a Approaching the national vision for HIT in China in a proper way will produce a national database of patient information that could be accessed as the patient national database of patient information that could be accessed as the patient travels around the countrytravels around the country

2.2. This is not easy, but because of China’s individual identity cards, everybody in This is not easy, but because of China’s individual identity cards, everybody in China has a unique number that could be the starting point for this national China has a unique number that could be the starting point for this national databasedatabase

3.3. If the vision is thought through in a way that allows adequate integration and If the vision is thought through in a way that allows adequate integration and roll-up of the individual patient encounter to the national database, and access roll-up of the individual patient encounter to the national database, and access to the national database, wonderful things can be accomplishedto the national database, wonderful things can be accomplished

4.4. In the U.S., there is no such national I.D. number, and great argument about In the U.S., there is no such national I.D. number, and great argument about what I.D. number to usewhat I.D. number to use

5.5. To accomplish the opportunity that is available to China, a great deal more To accomplish the opportunity that is available to China, a great deal more thought is required related to how to build the foundation of the individual thought is required related to how to build the foundation of the individual entities to support accomplishing the national visionentities to support accomplishing the national vision

6.6. Until this happens, each individual hospital will need to continue to work with its Until this happens, each individual hospital will need to continue to work with its present foundation to build it into what would be an appropriate foundation to present foundation to build it into what would be an appropriate foundation to support its present and future needssupport its present and future needs


China Has Moved Too Fast in the Following Areas China Has Moved Too Fast in the Following Areas of HIT Developmentof HIT Development

1.1. Oversimplifying vision and ideas so that execution brought disappointment Oversimplifying vision and ideas so that execution brought disappointment

2.2. Buying HIT systems too quickly with too little front end planning and too little Buying HIT systems too quickly with too little front end planning and too little user involvement user involvement

3.3. Adopting best of breed software acquisition approaches without adequate Adopting best of breed software acquisition approaches without adequate attention to how these different software vendor products would fit together as attention to how these different software vendor products would fit together as a unit and work seamlessly in the hospital a unit and work seamlessly in the hospital


China Has Moved Too Slow in the Following Areas China Has Moved Too Slow in the Following Areas of HIT Developmentof HIT Development

1.1. To recognize the value and to invest in the methods to integrate a variety of To recognize the value and to invest in the methods to integrate a variety of different software vendors, and to not use too many software vendors if they different software vendors, and to not use too many software vendors if they cannot be integratedcannot be integrated

2.2. To address cultural impediments to good change management by involving To address cultural impediments to good change management by involving the users more and adopting processes that lead to good buying decisions the users more and adopting processes that lead to good buying decisions


Creating More Success in the Current China Healthcare Creating More Success in the Current China Healthcare EnvironmentEnvironment

1.1. There is much momentum for change. More money will be spent and better There is much momentum for change. More money will be spent and better results are mandatoryresults are mandatory

2.2. Because of limited investment for many years in China HIT, Chinese hospitals Because of limited investment for many years in China HIT, Chinese hospitals have created a poor foundation for implementing its HIT vision of the future, have created a poor foundation for implementing its HIT vision of the future, and have made many of the same mistakes that the U.S. made in its early and have made many of the same mistakes that the U.S. made in its early adoption of HIT adoption of HIT

3.3. Now China is at a crossroads. It is spending much money to accomplish a very Now China is at a crossroads. It is spending much money to accomplish a very grand HIT visiongrand HIT vision

4.4. But more careful front end planning at every level of the country – from the But more careful front end planning at every level of the country – from the hospital to the health bureau to the national level – must be done to support the hospital to the health bureau to the national level – must be done to support the execution of what could be a wonderful vision if successfully implementedexecution of what could be a wonderful vision if successfully implemented

5.5. By recognizing what the rest of the world learned from their successes and By recognizing what the rest of the world learned from their successes and failures, and doing more of what the rest of the world did right, and less of what failures, and doing more of what the rest of the world did right, and less of what the rest of the world did wrong, China will be able to make much faster and the rest of the world did wrong, China will be able to make much faster and better progress in the future of HIT implementation better progress in the future of HIT implementation


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

SHELDON I. DORENFEST OR XIAO LIUSHELDON I. DORENFEST OR XIAO LIU

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 HUAIHAI EAST ROAD NO. 45HUAIHAI EAST ROAD NO. 45CHICAGO, IL 60611-5555CHICAGO, IL 60611-5555 HUAIHAI PLAZAHUAIHAI PLAZAU.S. OF AMERICAU.S. OF AMERICA SUITE 908SUITE 908PHONE: 312-464-3000PHONE: 312-464-3000 SHANGHAI, CHINASHANGHAI, CHINAFAX: 312-467-0541FAX: 312-467-0541 PHONE: 021-51001821PHONE: 021-51001821

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]

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

301 military hospital management seminar how hit can solve or cause quality problems beijing, china...

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