Dispatch from China

This week I'm in Shanghai meeting with government, academic, and industry experts to discuss the implementation of electronic health records, healthcare information exchange, and business intelligence applications supporting the care of 23 million people.

Our team of 4 (Dr. Mitch Rabkin, Mt. Auburn hospital CEO Jeanette Clough, Architect Martha Rothman and I) flew to China February 12-13, losing 24 hours because of the international date line and 18 hours of flying.   We're staying in the eastern area of Shanghai, called Pudong, home to the economic miracle of the past 20 years - more skyscrapers than any other municipality in the world.

On February 14, we visited Huashan Hospital, a major teaching affiliate of Fudan University Medical School.  We learned a great deal about leading practices in China, specifically in the areas of neurology, neurosurgery, and infectious disease.    Huashan leads the country in many ways, but not in IT, since it only invests .8% of its operating budget in clinical applications and infrastructure supporting the healthcare process.   It's at a HIMSS Level 1 adoption level, but very committed to accelerating its progress.   In the afternoon, we keynoted a conference of all the hospital CEOs in Shanghai at the International Convention Center, Yellow River Hall. We were introduced by Dr. Chen, former director, Shanghai Municipal Health Bureau, now head of the Shanghai Hospital Association and  Dr. Jianguang Xu, Director General of the Shanghai Municipal Health Bureau.  The audience was very receptive to our comments about process improvement, patient centered care, accountable care organizations, LEAN improvement projects, and the importance of IT as a tool to facilitate these activities.

On February 15, we visited clinics and hospitals to better understand the emerging plans and infrastructure supporting healthcare in Shanghai.

On February 16, we've traveling to Hangzhou to offer advice to a team building a new hospital.

On Friday and Saturday we're advising healthcare leaders from Hong Kong before flying back to the US.

Every country, culture, and society has its own approach to healthcare.  China currently spends 5% of its gross domestic product on healthcare compared to 17% in the US.   In some ways China has fewer policy and technology barriers than the US because there are no state laws - just a single set of federal guidelines covering privacy, healthcare delivery, and IT.   Shanghai mandated the use of a single electronic record across its public hospitals.   It has mandated common standards and processes for medication exchange across the community.  If Dr. Xu develops a strategy, all hospital CEOs will follow it.

I look forward to our continued work with Chinese healthcare leaders.  The quality, safety, and efficiency challenges in China are similar all over the world and the lessons learned from Meaningful Use and Healthcare Reform will assist China while also ensuring they avoid our mistakes.