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

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

CHINA COMPUTERWORLD THE DORENFEST GROUP 3 ABOUT THE DORENFEST GROUP HEALTHCARE CONSULTING AND INVESTMENT FOCUS HEALTHCARE CONSULTING AND INVESTMENT FOCUS OFFER HEALTHCARE IMPROVEMENT SERVICES TO SUPPORT A MORE POSITIVE WORLD FUTURE 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 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 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 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 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

CHINA COMPUTERWORLD THE DORENFEST GROUP 4 DORENFEST ACTIVITIES IN OTHER COUNTRIES 1.CONDUCT MARKET STUDIES AND CONSULTING ASSIGNMENTS ON USE OF INFORMATION TECHNOLOGY IN HEALTH CARE IN A NUMBER OF COUNTRIES 2.CONDUCT WORLDWIDE STUDIES COMPARING THE STATE OF THE ART IN HEALTH CARE I.T. 3.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 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 REVIEW OF I.T. IN USE AT HOSPITALS THROUGHOUT THE WORLD 4.WORLDWIDE EDUCATIONAL SERVICES

CHINA COMPUTERWORLD THE DORENFEST GROUP 5 SOME RECENT CLIENT EXAMPLES IN CHINA 1.EXAMPLES OF HEALTH BUREAU CLIENTS RHN PLANNING CLIENTS SHENZHEN SHENZHEN CHONGQING CHONGQING 2.EXAMPLES OF HOSPITAL CLIENTS SHANGHAI CHANGNING MATERNITY AND INFANT HEALTH INSTITUTE SHANGHAI CHANGNING MATERNITY AND INFANT HEALTH INSTITUTE PEKING UNIVERSITY MEDICAL COLLEGE #3 HOSPITAL PEKING UNIVERSITY MEDICAL COLLEGE #3 HOSPITAL RIZHAO CITY PEOPLE’S HOSPITAL RIZHAO CITY PEOPLE’S HOSPITAL 3.EXAMPLES OF HELPING CLIENTS FROM OTHER LOCATIONS TO BRING THEIR SKILLS TO MAINLAND CHINA HONG KONG HOSPITAL AUTHORITY HONG KONG HOSPITAL AUTHORITY MICROSOFT MICROSOFT

CHINA COMPUTERWORLD THE DORENFEST GROUP 6 CHINA COMPUTERWORLD EVOLUTION OF RHNs AROUND THE WORLD

CHINA COMPUTERWORLD THE DORENFEST GROUP 7 RHNs WERE FIRST INTRODUCED AS CHINS IN THE U.S. IN THE EARLY 1990s 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

CHINA COMPUTERWORLD THE DORENFEST GROUP 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 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 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 BY THE MIDDLE 1990s, INTEGRATED DELIVERY SYSTEMS EMERGED IN EVERY CITY IN THE UNITED STATES, AND THE CHIN CONCEPT DISAPPEARED BY 1996

CHINA COMPUTERWORLD THE DORENFEST GROUP 9 THE VISION OF INTEGRATED DELIVERY SYSTEM OWNERSHIP MODELS 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

CHINA COMPUTERWORLD THE DORENFEST GROUP 10 RHIOs EMERGE IN THE DECADE OF THE 2000s RHIOs WERE THE SECOND GENERATION OF RHNs IN THE U.S. 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 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

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

CHINA COMPUTERWORLD THE DORENFEST GROUP 12 CHINA COMPUTERWORLD EVOLUTION OF RHNs IN CHINA

CHINA COMPUTERWORLD THE DORENFEST GROUP 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 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 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 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 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 MUCH MORE ACTIVITY AND FUNDING IN MANY CITIES AND PROVINCES WITH EVEN U.S. FUNDING FOR ONE OR TWO MAJOR PLANNING PROJECTS

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

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

CHINA COMPUTERWORLD THE DORENFEST GROUP 16 THANK YOU. FOR MORE INFORMATION CONTACT: SHELDON I. DORENFEST OR YU ZHIYUAN (GRACE) SHELDON I. DORENFEST OR YU ZHIYUAN (GRACE) THE DORENFEST CHINA HEALTHCARE GROUP SUITE 908, NO. 998 RENMIN ROAD, SHANGHAI PHONE: , WEB SITE ADDRESS: ADDRESS: SHELDON’S ADDRESS: YU ZHIYUAN (GRACE) :