Perspective into Chinese Healthcare System
Sept 12th - Today, I was privileged to take part in a tour of a real Chinese Hospital System in operation with my Microsoft colleagues in China. Our host was Dr. Liu, CIO of Zhongshan City People's Hospital. James Chen, Microsoft Dir. of Strategic Investment and Business Development helped arranged the visit. This is a rare opportunity for us to spend an entire day with Dr. Liu to get an inside look of the complex processes and operations of one of the top 20 rated hospital in China. Dr. Liu is a really busy man and we appreciated his time spent hosting the Microsoft team.
In every Province of China there are three types of hospital services. City, Town, and Village (community).
City Level - Generally large hospital in a well populated city. Example: Zhongshan City Hospital has 1250 beds and expected to increase to 1500 beds by year end 2008 operated by 2000 professional staff. Well staffed with senior doctors and nurses. Facilitities and medical testing equipment are widely available such as onsite lab test analysis, Cat Scan, pharmacy, etc.
Town Level - Small town serving local populates. Staff and facilities are adequate but major complicated lab tests are sent to the City level hospital for analysis. Example: Sanjiao Township Hospital has 100 beds and 230 staff including doctors, nurses, etc.
Village Level - Small health clinic with basic facilities. Example: Suburb of Sanjiao township with 7 professional staff.
Each hospital has a rating system ranging from A (lowest) to AAA (highest). Within each rating class there are their tier level. Zhongshan City Hospital is rated at the top tier of AAA. AAA is a prestigious rating that is very difficult to achieve with clear criteria. Example are # of beds, # of in-patients and out-patients processed annually, organizational structure, # of specialty, information technology department, quality control, # of specialist certified, and years of operational services. For AAA rating a minimum of 10 years in service operation is required. Zhongshan City Hospital has been in operation for 50 years.
Village clinic medical service rate charges. All rates are quoted in Chinese RMB. As you can see rates for medical services and prescription drugs are really nominal. For residence of the village, the service are covered by government health insurance program. fro non-residence such as migrant workers who leave their home cities to work in larger cities, towns, and villages they are not covered. Thus for non-residence they either pay out of pocket or get coverage via commercial health insurance.
Due to the massive amount of population, hospital systems in China are focused more on outcome instead of quality. Quality do play an important role for AAA or AA rated hospitals BUT access to healthcare is a much higher priority.
Zhongshan City Hospital System headed by Dr. Wang is the poster child of a well run hospital system. Information Technology plays a key role in its efficiency. However, those efficiency could not be achieved without changes in operational processes. Dr. Wang was instrumental in eliminating outdated processes and adopting new ones since the introduction of an integrated Hospital Information System (HIS) that is now deployed to all three types of hospital in Zhongshan City Hospital System (City, Town, and Village as mentioned above).
Zhongshan City Hospital demonstrated the best of how information technology and streamlined process could achieve miraculous results in a city hospital that served over 2.17 million out-patients per year in 2007 with a professional staff of only 2000 people. In a country of 1.3 Billion people, such efficiency and scale is a matter of life and death. Operational processes used in this hospital are very similar to a good manufacturing process where everyone input and output are monitored and orchestrated to run in optimum efficiency. We can learn a lot from this way of thinking in applications to all that we do.