CHINA HOSPITAL CEO ANNUAL CONFERENCE 2009 11 SHANGHAI

CHINA HOSPITAL CEO ANNUAL CONFERENCE 2009. 11 SHANGHAI, CHINA LESSONS LEARNED FROM 20 DIGITAL HOSPITAL GRACE YU 1 CHINA HOSPITAL CEO ANNUAL CONFERENCE 2009 DORENFEST CHINA HEALTHCARE GROUP

OUTLINE l THE CURRENT STATUS OF I. T. USE IN CHINESE HOSPITALS l LESSONS LEARNED FROM 20 DIGITAL HOSPITAL l CONCLUSION CHINA HOSPITAL CEO ANNUAL CONFERENCE 2 2009 DORENFEST CHINA HEALTHCARE GROUP

DORENFEST GROUP l 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. l 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 CHINA HOSPITAL CEO ANNUAL CONFERENCE 3 2009 DORENFEST CHINA HEALTHCARE GROUP

CHINA HOSPITAL CEO ANNUAL CONFERENCE 2009 THE CURRENT STATUS OF I. T. USE IN CHINESE HOSPITALS CHINA HOSPITAL CEO ANNUAL CONFERENCE 4 2009 DORENFEST CHINA HEALTHCARE GROUP

CHINA H. I. T. EXPENDITURE GROWTH 元（10亿） 6. 33 5. 29 4. 36 3. 5 26. 8% 26. 6% PUBLIC HEALTH HOSPITAL 26. 0% 25. 0% 74. 0% 73. 4% 73. 2% 75. 0% ANNUAL GROWTH RATE: 24. 6% 21. 3% 19. 7% Source: CCW CHINA HOSPITAL CEO ANNUAL CONFERENCE 5 2009 DORENFEST CHINA HEALTHCARE GROUP

ALLOCATION OF H. I. T. INVESTMENT AROUND THE WORLD SOURCE: CCW CHINA HOSPITAL CEO ANNUAL CONFERENCE 6 2009 DORENFEST CHINA HEALTHCARE GROUP

CURRENT STATUS OF H. I. T. IN CHINA 1. CHINA IS MAKING SIGNIFICANT HEALTHCARE REFORM 2. HEALTHCARE REFORM POLICY CLEARLY STATES THAT USE OF INFORMATION TECHNOLOGY CAN HELP IMPROVE THE HEALTH DELIVERY SYSTEM 3. 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 4. CHINA SHOULD LEARN FROM OTHER COUNTRIES TO ACHIEVE ‘LEAP-FROG’ IMPROVEMENT ON H. I. T. CHINA HOSPITAL CEO ANNUAL CONFERENCE 7 2009 DORENFEST CHINA HEALTHCARE GROUP

CHINA HOSPITAL CEO ANNUAL CONFERENCE 2009 LESSONS LEARNED FROM 20 DIGITAL HOSPITALS CHINA HOSPITAL CEO ANNUAL CONFERENCE 8 2009 DORENFEST CHINA HEALTHCARE GROUP

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. CHINA HOSPITAL CEO ANNUAL CONFERENCE 9 2009 1 BEIJING TIANTAN HOSPITAL 2 ZHEJIANG UNIV. AFFILIATED 1 ST 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 2 ND 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 DORENFEST CHINA HEALTHCARE GROUP

LESSON ONE: HOSPITAL EXECUTIVE SUPPORT IS CRITICAL TO HOSPITAL IT SUCCESS l 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. CHINA HOSPITAL CEO ANNUAL CONFERENCE 10 2009 DORENFEST CHINA HEALTHCARE GROUP

LESSON ONE: HOSPITAL EXECUTIVE SUPPORT IS CRITICAL TO HOSPITAL IT SUCCESS (CONTINUED) l 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” l 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. CHINA HOSPITAL CEO ANNUAL CONFERENCE 11 2009 DORENFEST CHINA HEALTHCARE GROUP

LESSON TWO: HOSPITAL IT SUCCESS CAN’T HAPPEN WITHOUT CLINICIAN PARTICIPATION l 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. CHINA HOSPITAL CEO ANNUAL CONFERENCE 12 2009 DORENFEST CHINA HEALTHCARE GROUP

LESSON THREE: POSITIONING IT DEPARTMENT AS THE BRIDGE OF FACILITATION BETWEEN HOSPITAL USERS AND VENDORS l 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. CHINA HOSPITAL CEO ANNUAL CONFERENCE 13 2009 DORENFEST CHINA HEALTHCARE GROUP

LESSON FOUR: BUILDING A WIN-WIN RELATIONSHIP WITH SOFTWARE VENDORS l LESSON FOUR: BUILDING A WIN-WIN RELATIONSHIP WITH SOFTWARE VENDORS – IT’S IMPORTANT FOR HOSPITAL TO BUILD A WINWIN PARTNERSHIP WITH 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. CHINA HOSPITAL CEO ANNUAL CONFERENCE 14 2009 DORENFEST CHINA HEALTHCARE GROUP

LESSON FIVE: HOSPITAL NEEDS TO TAKE MORE RESPONSIBILITY OF PROCESS IMPROVEMENT AND CHANGE MANAGEMENT DURING IMPLEMENTATION l 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. CHINA HOSPITAL CEO ANNUAL CONFERENCE 15 2009 DORENFEST CHINA HEALTHCARE GROUP

LESSON SIX: IT DEPARTMENT NEEDS TO TAKE MORE RESPONSIBILITY OF HELPING, FACILITATING AND COORDINATING CLINICIANS TO PARTICIPATE IN IT DEVELOPMENT l 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 TECHNOLOGYDRIVEN MANAGER TO BUSINESS-DRIVEN MANAGER. CHINA HOSPITAL CEO ANNUAL CONFERENCE 16 2009 DORENFEST CHINA HEALTHCARE GROUP

HOSPITAL IT PROJECT ROLES 阶段 Phases 领导层 Sr. Leaders 策略 Business and IT Strategi es 项目建 项目启动 议 Project Kickoff Proposal 需求制定 Requirements Definiti on 厂商选择 Vendor Selectio n 项目实施 Implemen -tation 主导 Lead 项目效益 实现 Benefits Realizat ion 加强及维 护 Enhancements and Maintena n-ce 督导 Oversee 科系 主管 Dept Head 主导 Lead 合导 Co-Lead 合导Co. Lead 信息 人员 IT 配合 Support 合导Co. Lead 配合 Support 配合 Support 厂商 Vendors CHINA HOSPITAL CEO ANNUAL CONFERENCE 17 2009 主导Lead DORENFEST CHINA HEALTHCARE GROUP

CHINA HOSPITAL CEO ANNUAL CONFERENCE 2009 CONCLUSION CHINA HOSPITAL CEO ANNUAL CONFERENCE 18 2009 DORENFEST CHINA HEALTHCARE GROUP

MISTAKES OF CHINA HOSPITAL IT INVESTMENT l MISTAKE #1: USER REQUIREMENTS CANNOT BE DEFINED. CLINICIANS DON’T KNOW WHAT FUNCTIONS THEY EXPECT FROM IT SYSTEMS. l MISTAKE #2: IT VENDORS WILL TELL THE HOSPITAL HOW TO IMPLEMENT THE SYSTEM. l MISTAKE #3: HOSPITAL IT DEVELOPMENT IS ONLY RESPONSIBLE BY IT DEPARTMENT. CLINICAL DEPARTMENTS HAVE NOTHING TO DO WITH IT. l MISTAKE #4: RETURN ON IT INVESTMENT IS NOT CALCULABLE. l MISTAKE #5: WHEN THE IT SYSTEM IS ADOPTED, EVERY PROBLEM WILL BE SOLVED. l MISTAKE #6: IF THE SOFTWARE IS RUNNING INTO A PROBLEM, ONLY THE VENDOR SHOULD BE HELD RESPONSIBLE. CHINA HOSPITAL CEO ANNUAL CONFERENCE 19 2009 DORENFEST CHINA HEALTHCARE GROUP

HOW CHINA HOSPITAL CAN IMPROVE THEIR INVESTMENT ON IT l BUILD BETTER IT PROJECT PLANNING METHODOLOGY TO BETTER SET IT PROJECT PRIORITY l CREATE BETTER USER REQUIREMENT DEFINITION METHODOLOGY l CREATE BETTER SOFTWARE PRODUCT ASSESSMENT METHODOLOGY l DEVELOP BETTER SYSTEM IMPLEMENTATION METHODOLOGY SO THAT NEW SYSTEM IMPLEMENTATION WON’T ADD WORK AND MAKE WORK PROCESS REDUNDANT. l DEVELOP BETTER COMMUNICATION METHODOLOGY WITH VENDORS TO FACILITATE SYSTEM IMPLEMENTATION AND SYSTEM MAINTENANCE. l DEVELOP BETTER USER TRAINING METHOD. l DEVELOP BETTER IT MANAGEMENT MECHANISM. l FOCUS MORE ON IMPROVING THE BENEFITS OUT OF IT INVESTMENT. CHINA HOSPITAL CEO ANNUAL CONFERENCE 20 2009 DORENFEST CHINA HEALTHCARE GROUP

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 CHINA HOSPITAL CEO ANNUAL CONFERENCE 21 2009 DORENFEST CHINA HEALTHCARE GROUP