SHELDON I. DORENFEST THE DORENFEST GROUP CEIBS Hospital Management Program CEIBS Hospital Management Program USING THE U.S. EXPERIENCE TO IMPROVE H.I.T. INVESTMENT RESULTS IN CHINA SHANGHAI, CHINA JANUARY 14, 2007

SHELDON I. DORENFEST THE DORENFEST GROUP 2 AGENDA SHELDON’S BACKGROUND AND CHINA BUSINESS APPROACH SHELDON’S BACKGROUND AND CHINA BUSINESS APPROACH THE U.S. HEALTHCARE INDUSTRY AND ITS USE OF INFORMATION TECHNOLOGY THE U.S. HEALTHCARE INDUSTRY AND ITS USE OF INFORMATION TECHNOLOGY OVERVIEW OF H.I.T. STATUS IN CHINA OVERVIEW OF H.I.T. STATUS IN CHINA A GOOD APPROACH TO SUCCESSFULLY IMPLEMENTING MAJOR I.T. SYSTEM UPGRADES A GOOD APPROACH TO SUCCESSFULLY IMPLEMENTING MAJOR I.T. SYSTEM UPGRADES DISCUSSION DISCUSSION

SHELDON I. DORENFEST THE DORENFEST GROUP 3 BRIEF SUMMARY OF SHELDON’S EXPERIENCE IN H.I.T. FORMED COMPUCARE 1969; CEO FORMED COMPUCARE 1969; CEO FORMED SHELDON I. DORENFEST & ASSOCIATES, LTD. IN 1976; CEO FORMED SHELDON I. DORENFEST & ASSOCIATES, LTD. IN 1976; CEO –LONG, RICH HISTORY OF MAJOR CONTRIBUTIONS TO HEALTHCARE I.T. UNDERSTANDING AND PROGRESS –WAS RECOGNIZED AS THE LEADING SOURCE OF INFORMATION ABOUT HEALTHCARE I.T. AND A LEADING HEALTHCARE CONSULTING FIRM –KEY BUSINESS UNITS INCLUDED THE DORENFEST INTEGRATED HEALTHCARE SYSTEM DATABASE™ AND HOSPITAL OPERATIONS IMPROVEMENT AND MEDICAL SUPPLIER CONSULTING SOLD THE DORENFEST INTEGRATED HEALTHCARE DELIVERY SYSTEM+ (IHDS+) DATABASE™ TO HIMSS ANALYTICS IN JULY, 2004 SOLD THE DORENFEST INTEGRATED HEALTHCARE DELIVERY SYSTEM+ (IHDS+) DATABASE™ TO HIMSS ANALYTICS IN JULY, 2004

SHELDON I. DORENFEST THE DORENFEST GROUP 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 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. 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: 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 WORLDWIDE EDUCATIONAL SERVICES

SHELDON I. DORENFEST THE DORENFEST GROUP 5 BRIEF SUMMARY OF SHELDON’S EXPERIENCE IN H.I.T. (CONTINUED) DONATED SHELDON I. DORENFEST & ASSOCIATES, LTD. TO THE HIMSS FOUNDATION TO FORM THE DORENFEST INSTITUTE FOR HEALTH INFORMATION TECHNOLOGY RESEARCH AND EDUCATION DONATED SHELDON I. DORENFEST & ASSOCIATES, LTD. TO THE HIMSS FOUNDATION TO FORM THE DORENFEST INSTITUTE FOR HEALTH INFORMATION TECHNOLOGY RESEARCH AND EDUCATION –CONTAINS A LIBRARY OF HISTORIC DATA (FROM 1986 THROUGH 2002 WITH HIMSS ANALYTICS DONATING THE NEXT CURRENT YEAR OF DATA ANNUALLY BEGINNING IN JULY 2005) AND PUBLICATIONS –PROVIDES FREE DATA FOR RESEARCH PURPOSES ELECTRONICALLY AND IN PRINT TO UNIVERSITIES, STUDENTS, FEDERAL, STATE, LOCAL GOVERNMENT AS WELL AS GOVERNMENTS OF OTHER COUNTRIES –WILL PROVIDE A VARIETY OF REPORTS ON TRENDS IN H.I.T. USE –WILL ENCOURAGE ONGOING RESEARCH INTO USING I.T. TO IMPROVE HEALTHCARE PRESENT ACTIVITIES PRESENT ACTIVITIES –HELPING HIMSS ANALYTICS IN TRANSITIONAL RELATIONSHIP –FORMED THE DORENFEST GROUP IN SEPTEMBER 2004 AS AN INVESTMENT AND CONSULTING BUSINESS –FOCUSING ON INVESTING IN CHINA IN HOSPITAL AND HEALTHCARE IMPROVEMENT BUSINESSES

SHELDON I. DORENFEST THE DORENFEST GROUP 6 DORENFEST INVESTIGATION OF HEALTHCARE IN CHINA 1.VISITED 17 CITIES IN CHINA 2.VISITED WITH HUNDREDS OF LEADERS IN THE HEALTHCARE INDUSTRY IN CHINA TO LEARN ABOUT HEALTHCARE REFORM IN CHINA – ITS PROGRESS, ITS PROBLEMS, AND ITS NEXT STEPS 3.VISITED WITH OVER 75 HOSPITALS TO GAIN AN UNDERSTANDING OF HOSPITAL OPERATIONS IN CHINA, THEIR CURRENT STATUS, AND OPPORTUNITIES FOR IMPROVEMENTS 4.VISITED WITH SEVERAL PROVINCIAL AND CITY HEALTH BUREAUS TO LEARN WHAT THEIR GOALS ARE FOR THEIR PROVINCIAL AND CITY HOSPITALS 5.VISITED SOME PRIVATE HOSPITALS TO OBSERVE THE RESULTS OF HEALTHCARE REFORM PRIVATIZATION EFFORTS IN CHINA 6.VISITED WITH COMPANIES SELLING PRODUCTS AND SERVICES TO THE HEALTHCARE INDUSTRY IN CHINA AND WHAT THEY BELIEVE ARE APPROPRIATE NEXT STEPS FOR REFORMING THE CHINESE HEALTHCARE SYSTEM 7.EVALUATED A GROUP OF HOSPITAL MANAGEMENT AND OWNERSHIP OPPORTUNITIES THAT WERE PRESENTED TO THE DORENFEST GROUP TO BECOME MORE FAMILIAR WITH THE ALTERNATIVE WAYS TO PROCEED IN BUILDING A “MODEL HOSPITAL” IN CHINA 8.DEVELOPED A STRATEGY FOR BRINGING DORENFEST SKILL AND EXPERIENCE TO CHINA

SHELDON I. DORENFEST THE DORENFEST GROUP 7 THE DORENFEST GROUP VISION FOR CREATING A MODEL HOSPITAL IN CHINA PROVIDES IMPROVED QUALITY OF CARE TO ITS PATIENTS PROVIDES IMPROVED QUALITY OF CARE TO ITS PATIENTS OPERATES AT A HIGHLY EFFICIENT LEVEL THROUGH EFFECTIVE USE OF SYSTEMS AND BETTER WORK PROCESSES OPERATES AT A HIGHLY EFFICIENT LEVEL THROUGH EFFECTIVE USE OF SYSTEMS AND BETTER WORK PROCESSES OFFERS ITS SERVICES TO PATIENTS AT AN AFFORDABLE COST OFFERS ITS SERVICES TO PATIENTS AT AN AFFORDABLE COST CREATES A HIGHLY SATISFIED PATIENT POPULATION WITH THE PATIENTS OBSERVING A NOTICEABLE IMPROVEMENT IN THE SERVICES AND TREATMENTS PROVIDED BY THE HOSPITAL CREATES A HIGHLY SATISFIED PATIENT POPULATION WITH THE PATIENTS OBSERVING A NOTICEABLE IMPROVEMENT IN THE SERVICES AND TREATMENTS PROVIDED BY THE HOSPITAL UTILIZES APPROPRIATE DIGITAL TECHNOLOGY TO CREATE A STATE OF THE ART “DIGITAL HOSPITAL” UTILIZES APPROPRIATE DIGITAL TECHNOLOGY TO CREATE A STATE OF THE ART “DIGITAL HOSPITAL”

SHELDON I. DORENFEST THE DORENFEST GROUP 8 CHINA BUSINESS OPERATIONS HOSPITAL MANAGEMENT CONSULTING 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 GENERAL MANAGEMENT CONSULTING FOR HEALTHCARE COMPANIES –MARKET ANALYSES –PRODUCT STRATEGIES –MARKET RESEARCH HOSPITAL CONTRACT MANAGEMENT HOSPITAL CONTRACT MANAGEMENT –WORK WITH HOSPITALS NEEDING NEW MANAGEMENT (INTERIM OR LONG TERM) –IMPLEMENT NECESSARY MANAGEMENT PERSONNEL AND SUPPORT SYSTEMS HOSPITAL OWNERSHIP AND IMPROVEMENT HOSPITAL OWNERSHIP AND IMPROVEMENT

SHELDON I. DORENFEST THE DORENFEST GROUP 9 CURRENT STATUS OF DORENFEST GROUP CHINA FORMED DE RUI YI LIAO ZI XUN, A WFOE BASED IN SHANGHAI FORMED DE RUI YI LIAO ZI XUN, A WFOE BASED IN SHANGHAI RECENTLY COMPLETED PHASE I PROJECT TO HELP SHENZHEN HEALTH BUREAU PLAN ITS REGIONAL HEALTH NETWORK AND DIGITAL HOSPITAL PROJECTS RECENTLY COMPLETED PHASE I PROJECT TO HELP SHENZHEN HEALTH BUREAU PLAN ITS REGIONAL HEALTH NETWORK AND DIGITAL HOSPITAL PROJECTS NOW BUILDING A MANAGEMENT TEAM NOW BUILDING A MANAGEMENT TEAM CREATING OTHER PROJECT ACTIVITIES CREATING OTHER PROJECT ACTIVITIES REVIEWING CANDIDATES TO IMPLEMENT MODEL HOSPITAL VISION REVIEWING CANDIDATES TO IMPLEMENT MODEL HOSPITAL VISION DEVELOPING PARTNERING RELATIONSHIPS TO DELIVER SERVICES DEVELOPING PARTNERING RELATIONSHIPS TO DELIVER SERVICES REVIEWING SOFTWARE SYSTEMS IN CHINA AND OTHER COUNTRIES TO DEFINE THE BEST SOFTWARE AVAILABLE FOR IMPLEMENTATION IN CHINA TO PARTNER ON I.T. PROJECTS FOR HOSPITAL CLIENTS REVIEWING SOFTWARE SYSTEMS IN CHINA AND OTHER COUNTRIES TO DEFINE THE BEST SOFTWARE AVAILABLE FOR IMPLEMENTATION IN CHINA TO PARTNER ON I.T. PROJECTS FOR HOSPITAL CLIENTS

SHELDON I. DORENFEST THE DORENFEST GROUP 10 CEIBS HOSPITAL MANAGEMENT PROGRAM THE U.S. HEALTHCARE INDUSTRY AND ITS USE OF INFORMATION TECHNOLOGY

SHELDON I. DORENFEST THE DORENFEST GROUP 11 HEALTHCARE COST AS A PERCENT OF GDP SOURCE: CENTERS FOR MEDICARE AND MEDICAID SERVICES GDP (not ‘75) $ ,299.51,877.6 $1,877.6 $75.1 $245.8 $426.8 $696.0 $990.3 $1, % 10% 5% 0% 20%

SHELDON I. DORENFEST THE DORENFEST GROUP 12 OPPORTUNITIES TO IMPROVE THE HEALTHCARE DELIVERY PROCESS HAVE BEEN PURSUED FOR MANY YEARS GREAT REDUNDANCY OF INFORMATION GREAT REDUNDANCY OF INFORMATION HIGH ERROR POTENTIAL HIGH ERROR POTENTIAL LACK OF TIMELINESS LACK OF TIMELINESS HIGH COST HIGH COST ORGANIZATION COMPLEXITY ORGANIZATION COMPLEXITY

SHELDON I. DORENFEST THE DORENFEST GROUP 13 4 GENERATIONS OF I.T. SYSTEMS IN U.S. HOSPITALS FINANCE SYSTEMS (1970s) FINANCE SYSTEMS (1970s) LIMITED CLINICAL SYSTEMS (LATE 1970s AND 1980s) LIMITED CLINICAL SYSTEMS (LATE 1970s AND 1980s) MORE ADVANCED CLINICAL SYSTEMS (1990s) MORE ADVANCED CLINICAL SYSTEMS (1990s) ELECTRONIC HEALTH RECORDS (2000s) ELECTRONIC HEALTH RECORDS (2000s)

SHELDON I. DORENFEST THE DORENFEST GROUP 14 $ in billions $16.0 $19.0 $21.6 $20.0 Actual $ %15.6%2.7% ANNUAL GROWTH RATE: 8.0%5.2% $23.6 $25.8 Forecast % $ % $ % H.I.T. MARKET TRENDS ($ IN BILLIONS) $ % $11.6 $10.0 $8.5 $ %17.6%13.3%6.7% SOURCE: SHELDON I. DORENFEST & ASSOCIATES, LTD.

SHELDON I. DORENFEST THE DORENFEST GROUP 15 HEALTHCARE REFORM BROUGHT INTEGRATED DELIVERY AND MANAGED CARE Hospital A Doctor’s Office Government Reimbursement Blood Bank Home Health Agency Hospital B Patient Data Doctor’s Office Insurance Payor Nursing Home Outpatient Clinic

SHELDON I. DORENFEST THE DORENFEST GROUP 16 HOW DID SOFTWARE SUPPLIERS DESCRIBE THEIR PRODUCTS IN THE 1990s? Application A Application B Application F Interface Engine LAN/ GUI Work- station User link to repositories Data Entry Data Access Local Analysis Other providers and companies Clinical Data Repository Rules Protocols Translating Formatting Other providers and companies

SHELDON I. DORENFEST THE DORENFEST GROUP 17 HOW DID SOFTWARE SUPPLIERS DESCRIBE THEIR PRODUCTS IN THE 1990s? Application A Application B Application C Application D Application E Application F Interface Engine LAN/ GUI Primary Vendor Other Vendors Work- station Work- station Work- station User link to repositories Data Entry Data Access Local Analysis Other providers and companies Other Data Repositories Clinical Data Repository Key: Rules Protocols Translating Formatting

SHELDON I. DORENFEST THE DORENFEST GROUP 18 WHAT IS TODAY’S TYPICAL SITUATION AT USER SITES? STILL MANY MANUAL RECORDS STILL MANY MANUAL RECORDS ERROR PRONE WORK PROCESSES ERROR PRONE WORK PROCESSES POOR IMPLEMENTATION AND USE OF I.T. HAS RESULTED IN A LARGE AMOUNT OF WORK PROCESS CONVOLUTIONS, TANGLES, REDUNDANCY, AND DUPLICATION POOR IMPLEMENTATION AND USE OF I.T. HAS RESULTED IN A LARGE AMOUNT OF WORK PROCESS CONVOLUTIONS, TANGLES, REDUNDANCY, AND DUPLICATION LEGACY SYSTEMS IN PLACE ARE VERY OLD LEGACY SYSTEMS IN PLACE ARE VERY OLD OVERSIMPLIFICATION OF AND MISUNDERSTANDING ABOUT WHAT TO DO NEXT OVERSIMPLIFICATION OF AND MISUNDERSTANDING ABOUT WHAT TO DO NEXT

SHELDON I. DORENFEST THE DORENFEST GROUP 19 U.S. HAS MADE MUCH PROGRESS TODAY OVER 100 HOSPITALS HAVE IMPLEMENTED CPR WITH CPOE TODAY OVER 100 HOSPITALS HAVE IMPLEMENTED CPR WITH CPOE MANY OTHERS ARE IMPLEMENTING CPR AND CPOE RIGHT NOW MANY OTHERS ARE IMPLEMENTING CPR AND CPOE RIGHT NOW I.T. IS A MAJOR TOOL FOR IMPROVING HOSPITAL PERFORMANCE I.T. IS A MAJOR TOOL FOR IMPROVING HOSPITAL PERFORMANCE

SHELDON I. DORENFEST THE DORENFEST GROUP 20 BUT U.S. HOSPITALS HAVE BEEN INEFFICIENT INVESTORS OVERSIMPLIFICATION OF I.T. INVESTMENT CONSIDERATIONS (I.E., DID NOT KNOW WHAT THEY DID NOT KNOW) OVERSIMPLIFICATION OF I.T. INVESTMENT CONSIDERATIONS (I.E., DID NOT KNOW WHAT THEY DID NOT KNOW) POOR PROJECT PLANNING POOR PROJECT PLANNING IMPROPER ASSESSMENT OF SOFTWARE PRODUCT CAPABILITIES IMPROPER ASSESSMENT OF SOFTWARE PRODUCT CAPABILITIES IMPLEMENTED A SERIES OF “1/2 SYSTEMS” WITHOUT PROPERLY REDESIGNING THE WORK PROCESS IMPLEMENTED A SERIES OF “1/2 SYSTEMS” WITHOUT PROPERLY REDESIGNING THE WORK PROCESS INDUSTRY MANAGEMENT DID NOT LEARN ENOUGH FROM PAST MISTAKES, AND THEREFORE, CONTINUED TO REPEAT THE SAME MISTAKES INDUSTRY MANAGEMENT DID NOT LEARN ENOUGH FROM PAST MISTAKES, AND THEREFORE, CONTINUED TO REPEAT THE SAME MISTAKES THIS LEFT THE NATION WITH REDUNDANT, CONVOLUTED, EXPENSIVE, ERROR PRONE WORK PROCESSES THAT PRESENTLY CRIPPLE THE COUNTRY’S HEALTHCARE SYSTEM THIS LEFT THE NATION WITH REDUNDANT, CONVOLUTED, EXPENSIVE, ERROR PRONE WORK PROCESSES THAT PRESENTLY CRIPPLE THE COUNTRY’S HEALTHCARE SYSTEM

SHELDON I. DORENFEST THE DORENFEST GROUP 21 THE KEY DRIVERS OF U.S. H.I.T. MARKET GROWTH IN COMPUTERIZED PATIENT RECORDS (CPR/EMR/EHR) COMPUTERIZED PATIENT RECORDS (CPR/EMR/EHR) COMPUTERIZED PHYSICIAN ORDER ENTRY (CPOE) COMPUTERIZED PHYSICIAN ORDER ENTRY (CPOE) MEDICATION MANAGEMENT SYSTEMS MEDICATION MANAGEMENT SYSTEMS PATIENT SAFETY IMPROVEMENTS PATIENT SAFETY IMPROVEMENTS –REDUCING MEDICAL ERRORS –IMPROVING CLINICAL WORK PROCESSES PICTURE ARCHIVING COMPUTER SYSTEMS (PACS) PICTURE ARCHIVING COMPUTER SYSTEMS (PACS) SPECIALTY DEPARTMENT INFORMATION SYSTEMS SPECIALTY DEPARTMENT INFORMATION SYSTEMS –EMERGENCY DEPARTMENT (EDIS)–SURGERY (SIS) –PHARMACY (PIS)–RADIOLOGY (RIS) –NUMEROUS OTHER CLINICAL AND FINANCIAL SYSTEMS PATIENT DATA SECURITY (HIPAA, ETC) PATIENT DATA SECURITY (HIPAA, ETC) RHIOs EMERGE TO SHARE ELECTRONIC PATIENT DATA RHIOs EMERGE TO SHARE ELECTRONIC PATIENT DATA

SHELDON I. DORENFEST THE DORENFEST GROUP 22 CEIBS HOSPITAL MANAGEMENT PROGRAM OVERVIEW OF H.I.T. STATUS IN CHINA

SHELDON I. DORENFEST THE DORENFEST GROUP 23 INTRODUCTION TO CHINA WHEN I FIRST CAME TO STUDY THE HEALTHCARE INDUSTRY IN CHINA IN LATE 2004, ATTITUDES TOWARD H.I.T. WERE VERY CONSERVATIVE: WHEN I FIRST CAME TO STUDY THE HEALTHCARE INDUSTRY IN CHINA IN LATE 2004, ATTITUDES TOWARD H.I.T. WERE VERY CONSERVATIVE: –HOSPITAL MANAGEMENT WAS NOT HAPPY WITH I.T. SYSTEMS IN USE –FUNCTIONALITY OF APPLICATION SOFTWARE AVAILABLE FOR PURCHASE IN CHINA WAS VERY LIMITED AND THE MOST FUNCTIONAL SYSTEMS WERE SELF-DEVELOPED –THE SKILLS TO MANAGE MAJOR I.T. UPGRADES WERE FELT TO BE IN SHORT SUPPLY –AS A RESULT, HOSPITAL MANAGEMENT WAS HESITANT TO MAKE MAJOR UPGRADES TO I.T. SYSTEMS –AT THAT TIME, THERE WAS VERY LIMITED BUYING OF MAJOR NEW I.T. SYSTEMS IN CHINESE HOSPITALS DURING THE PAST 2 YEARS, THE SITUATION HAS CHANGED DURING THE PAST 2 YEARS, THE SITUATION HAS CHANGED –MANY HOSPITALS ARE CONSIDERING MAJOR UPGRADES OF I.T. SYSTEMS –BIG BUDGETS ARE STARTING TO BECOME AVAILABLE TO MOVE TOWARD DIGITAL HOSPITALS WITH ELECTRONIC MEDICAL RECORDS, PACS AND OTHER SYSTEMS –BUT WEAK APPLICATION SOFTWARE AND IMPLEMENTATION SKILLS ARE DELAYING PROGRESS

SHELDON I. DORENFEST THE DORENFEST GROUP 24 CHINA HEALTHCARE AND I.T. USE HAS SIMILARITIES TO THE U.S. IN THE 1970s CHINA SPENDS 6.0% OF ITS GDP ON HEALTHCARE (800 BILLION RMB OR APPROXIMATELY $100 BILLION) COMPARED TO U.S. SPENDING ON HEALTHCARE IN 1970 OF 7% GDP ($75 BILLION) CHINA SPENDS 6.0% OF ITS GDP ON HEALTHCARE (800 BILLION RMB OR APPROXIMATELY $100 BILLION) COMPARED TO U.S. SPENDING ON HEALTHCARE IN 1970 OF 7% GDP ($75 BILLION) MOST HOSPITALS IN CHINA USE I.T. SOFTWARE FOR FINANCIAL SYSTEMS MOST HOSPITALS IN CHINA USE I.T. SOFTWARE FOR FINANCIAL SYSTEMS I.T. USE IN CLINICAL SYSTEMS HAS EMERGED ON A DEPARTMENTAL BASIS I.T. USE IN CLINICAL SYSTEMS HAS EMERGED ON A DEPARTMENTAL BASIS SOME HOSPITALS HAVE ACCOMPLISHED MORE ADVANCED SYSTEMS WITH MUCH CLINICAL FUNCTION AUTOMATED USUALLY THROUGH USE OF SELF- DEVELOPED SOFTWARE SOME HOSPITALS HAVE ACCOMPLISHED MORE ADVANCED SYSTEMS WITH MUCH CLINICAL FUNCTION AUTOMATED USUALLY THROUGH USE OF SELF- DEVELOPED SOFTWARE POOR INTEGRATION OF DIVERSE SOFTWARE SYSTEMS CREATES PROBLEMS AS I.T. USE EXPANDS POOR INTEGRATION OF DIVERSE SOFTWARE SYSTEMS CREATES PROBLEMS AS I.T. USE EXPANDS THE HARDWARE AND NETWORKING CAPABILITY AVAILABLE TO HOSPITALS IN 2005 IS MUCH BETTER THAN IT WAS IN 1970s IN THE U.S. BUT SOFTWARE AVAILABLE FOR CHINESE HOSPITALS TO AUTOMATE CLINICAL PROCESSES IS IN ITS INFANCY THE HARDWARE AND NETWORKING CAPABILITY AVAILABLE TO HOSPITALS IN 2005 IS MUCH BETTER THAN IT WAS IN 1970s IN THE U.S. BUT SOFTWARE AVAILABLE FOR CHINESE HOSPITALS TO AUTOMATE CLINICAL PROCESSES IS IN ITS INFANCY

SHELDON I. DORENFEST THE DORENFEST GROUP 25 CHINA HEALTHCARE AND I.T. USE HAS SIMILARITIES TO THE U.S. IN THE 1970s (Continued) CHINA HOSPITAL WORK PROCESSES ARE REDUNDANT AND ERROR PRONE WITH GREAT OPPORTUNITIES FOR IMPROVEMENT THROUGH APPROPRIATE USE OF I.T. CHINA HOSPITAL WORK PROCESSES ARE REDUNDANT AND ERROR PRONE WITH GREAT OPPORTUNITIES FOR IMPROVEMENT THROUGH APPROPRIATE USE OF I.T. CHINESE HOSPITALS WOULD LIKE TO TAKE A BIG LEAP FORWARD IN IMPROVING WORK PROCESSES AND IN DIGITIZING ITS HOSPITALS CHINESE HOSPITALS WOULD LIKE TO TAKE A BIG LEAP FORWARD IN IMPROVING WORK PROCESSES AND IN DIGITIZING ITS HOSPITALS THE MINISTRY OF HEALTH’S GUIDELINES FOR HEALTH I.T. DEVELOPMENT ( ) CALLS FOR ELECTRONIC MEDICAL RECORDS AND REGIONAL HEALTH NETWORKS TO BE IMPLEMENTED PROVIDING MUCH MOMENTUM FOR HOSPITALS AND HEALTH BUREAUS TO INVEST MORE IN I.T. NOW THE MINISTRY OF HEALTH’S GUIDELINES FOR HEALTH I.T. DEVELOPMENT ( ) CALLS FOR ELECTRONIC MEDICAL RECORDS AND REGIONAL HEALTH NETWORKS TO BE IMPLEMENTED PROVIDING MUCH MOMENTUM FOR HOSPITALS AND HEALTH BUREAUS TO INVEST MORE IN I.T. NOW CHINA HAS NOT INVESTED A LOT OF RESOURCES IN I.T. SYSTEMS AND INFRASTRUCTURE TO GET TO ITS PRESENT LEVEL OF I.T. USE. WHILE CHINA WOULD LIKE TO CONTINUE THIS APPROACH AS IT TAKES ITS NEXT STEPS FORWARD, CHINA’S I.T. GOALS WILL REQUIRE GREATER INVESTMENT CHINA HAS NOT INVESTED A LOT OF RESOURCES IN I.T. SYSTEMS AND INFRASTRUCTURE TO GET TO ITS PRESENT LEVEL OF I.T. USE. WHILE CHINA WOULD LIKE TO CONTINUE THIS APPROACH AS IT TAKES ITS NEXT STEPS FORWARD, CHINA’S I.T. GOALS WILL REQUIRE GREATER INVESTMENT

SHELDON I. DORENFEST THE DORENFEST GROUP 26 CHINA HEALTHCARE AND I.T. USE HAS SIMILARITIES TO THE U.S. IN THE 1970s (Continued) THERE IS CONCERN AMONG H.I.T. EXPERTS IN CHINA ABOUT THE READINESS OF H.I.T. SOFTWARE PRODUCTS, HARDWARE PLATFORMS, AND INTEGRATION TOOLS TO FACILITATE THE ACCOMPLISHMENT OF CHINA’S GOALS THERE IS CONCERN AMONG H.I.T. EXPERTS IN CHINA ABOUT THE READINESS OF H.I.T. SOFTWARE PRODUCTS, HARDWARE PLATFORMS, AND INTEGRATION TOOLS TO FACILITATE THE ACCOMPLISHMENT OF CHINA’S GOALS THERE IS ALSO DEVELOPING CONCERN AMONG H.I.T. EXPERTS IN CHINA ABOUT THE IMPLEMENTATION SKILL AND EXPERIENCE AVAILABLE IN CHINA TO TAKE THIS BIG LEAP FORWARD THAT IS NOW UNDERWAY THERE IS ALSO DEVELOPING CONCERN AMONG H.I.T. EXPERTS IN CHINA ABOUT THE IMPLEMENTATION SKILL AND EXPERIENCE AVAILABLE IN CHINA TO TAKE THIS BIG LEAP FORWARD THAT IS NOW UNDERWAY SO CHINESE HOSPITALS AND HEALTH BUREAUS ARE CAREFULLY CONSIDERING HOW TO TAKE THEIR NEXT STEPS SUCCESSFULLY SO CHINESE HOSPITALS AND HEALTH BUREAUS ARE CAREFULLY CONSIDERING HOW TO TAKE THEIR NEXT STEPS SUCCESSFULLY FOR CHINA TO ACCOMPLISH ITS OBJECTIVE SUCCESSFULLY REQUIRES THE FOLLOWING: FOR CHINA TO ACCOMPLISH ITS OBJECTIVE SUCCESSFULLY REQUIRES THE FOLLOWING: –OVERCOMING RESISTANCE TO CHANGE –KNOWING HOW TO MANAGE CHANGE –LEARNING FROM THE U.S. EXPERIENCE –DOING MORE OF WHAT THE U.S. DID RIGHT AND NOT MAKING U.S. MISTAKES –DEVELOPING EXPERTISE IN AREAS OF NEED

SHELDON I. DORENFEST THE DORENFEST GROUP 27 CEIBS HOSPITAL MANAGEMENT PROGRAM A GOOD APPROACH TO SUCCESSFULLY IMPLEMENTING MAJOR I.T. UPGRADES

SHELDON I. DORENFEST THE DORENFEST GROUP 28 THE PROJECT SHOULD BE DONE IN PHASES 1.STRATEGIC PLAN 2.SYSTEM SELECTION WITH FINAL IMPLEMENTATION PLAN 3.SYSTEM IMPLEMENTATION

SHELDON I. DORENFEST THE DORENFEST GROUP 29 STRATEGIC PLANNING PHASE 1.ESTABLISH A PLANNING COMMITTEE 2.GAIN THOROUGH UNDERSTANDING OF THE CURRENT OPERATIONS AND WORK FLOW OF THE HOSPITAL 3.IDENTIFY OPPORTUNITIES TO IMPROVE OPERATIONS AND WORK FLOW THROUGH NEW I.T. SYSTEMS 4.DEFINE THE VALUE OF THE OPPORTUNITIES FOR IMPROVEMENT IN TERMS OF THE FOLLOWING AREAS: −REVENUE IMPROVEMENT −TIME SAVINGS −OTHER COST REDUCTION −REDUCTION OF ERRORS −OTHER QUALITY OF CARE IMPROVEMENTS −RAISING LEVEL OF PATIENT SATISFACTION 5.SELECT THE HIGHEST PRIORITY IMPROVEMENTS FOR IMPLEMENTATION 6.DEFINE THE NEEDED I.T. SYSTEMS AND CHANGES IN WORK FLOW PROCESSES TO ACCOMPLISH THE IMPROVEMENTS 7.DEFINE USER ATTITUDES TOWARD AND TECHNICAL LIMITATIONS OF CURRENT I.T. SYSTEMS AND DETERMINE REPLACEMENT REQUIREMENTS

SHELDON I. DORENFEST THE DORENFEST GROUP 30 STRATEGIC PLANNING PHASE (CONTINUED) 8.DECIDE WHETHER TO BUY OR DEVELOP THE I.T. SYSTEM UPGRADE 9.PROVIDE THE NECESSARY EDUCATION TO HOSPITAL MANAGEMENT, PHYSICIANS, I.T. USERS, AND I.T. STAFF SO THAT THEY CAN BETTER UNDERSTAND THE REQUIREMENTS TO SUCCESSFULLY MANAGE THE CHANGE 10.CREATE AN ECONOMIC ANALYSIS SUMMARIZING EXPECTED COSTS AND BENEFITS OF THE CHANGE PROGRAM 11.GAIN GENERAL APPROVAL FROM HOSPITAL MANAGEMENT TEAM 12.FINALIZE A STRATEGIC PLAN TO IMPLEMENT THE OPERATIONS IMPROVEMENT PROGRAM

SHELDON I. DORENFEST THE DORENFEST GROUP 31 SYSTEM SELECTION AND IMPLEMENTATION PLAN PHASE 1.ESTABLISH A SELECTION COMMITTEE OF KEY USERS, I.T. PERSONNEL, AND MANAGEMENT 2.PREPARE A FUNCTIONAL REQUIREMENTS DOCUMENT DEFINING THE OBJECTIVES, FEATURES, TECHNICAL REQUIREMENTS, AND ANY OTHER KEY CHARACTERISTICS OF THE NEW SYSTEM 3.PREPARE A TENDER REQUEST (REQUEST FOR VENDOR PROPOSALS) 4.DEVELOP EVALUATION CRITERIA AND APPROACH 5.COMPARE AND EVALUATE PROPOSALS 6.FOR LEADING SUPPLIERS: – CONDUCT VENDOR SYSTEM DEMONSTRATIONS USING PREPARED SCRIPTS – CONDUCT TELEPHONE REFERENCE CHECKS – CONDUCT USER SITE VISITS

SHELDON I. DORENFEST THE DORENFEST GROUP 32 SYSTEM SELECTION AND IMPLEMENTATION PLAN PHASE (CONTINUED) 7.MAKE FINAL SELECTION 8.BEGIN NEGOTIATING CONTRACT 9.DEVELOP DETAILED IMPLEMENTATION PLAN WITH OVERALL GOALS, ORGANIZATIONAL REQUIREMENTS, SPECIFIC TASKS, TIMETABLE BY TASK, AND STAFFING RESPONSIBILITY FOR EACH TASK 10.DEVELOP MANAGEMENT PROCESS FOR OVERSEEING THE IMPLEMENTATION 11.FINALIZE THE CONTRACT

SHELDON I. DORENFEST THE DORENFEST GROUP 33 SYSTEM IMPLEMENTATION START IMPLEMENTING PLAN START IMPLEMENTING PLAN MONITOR RESULTS MONITOR RESULTS MAKE NECESSARY ADJUSTMENTS AND REVISIONS MAKE NECESSARY ADJUSTMENTS AND REVISIONS KEEP A CLOSE WATCH ON PROGRESS TO MAKE SURE YOU AVOID MAJOR PROBLEMS KEEP A CLOSE WATCH ON PROGRESS TO MAKE SURE YOU AVOID MAJOR PROBLEMS

SHELDON I. DORENFEST THE DORENFEST GROUP 34 THANK YOU. FOR MORE INFORMATION CONTACT: SHELDON I. DORENFEST SHELDON I. DORENFEST THE DORENFEST CHINA HEALTHCARE GROUP JINGHAI ROAD NO. 3288, BUILDING 4, SUITE 3302 PUDONG, SHANGHAI PHONE: WEB SITE ADDRESS: ADDRESS: SHELDON’S ADDRESS: