Being a part of the healthcare information technology industry is a lot like working for the only coal mine in the valley, so the yearly Healthcare Information and Management Systems Society trade show is akin to the annual ice cream social at the only church in Coal Town.
A lot of the whoop-de-do is in seeing old friends again and simply catching up.
Sheldon Dorenfest has been a familiar face at the HIMSS shows for decades, going back to when the trade group was called the Hospital Management Systems Society and was still affiliated with the American Hospital Association. Dorenfest sold his healthcare IT marketing database business to HIMSS Analytics in 2004, but was in New Orleans for the HIMSS show again this year where he met for lunch and an interview.
"The first time I spoke at a HIMSS meeting it was in Atlanta in 1983 when there were 300 people at the whole meeting," Dorenfest recalled. HIMSS officials this year reported having nearly 25,000 attendees registered and almost 900 vendors with exhibits.
While the growth of HIMSS over the years has been astounding, within the IT industry, "I've seen several things that are cumulatively distressing to me," Dorenfest said.
Over those years, he said, he's seen four generations of technology applied to healthcare recordkeeping and transmissionfrom manual systems using pneumatic tubes, to the current enterprise IT systems. And during that time, he said, the adoption track has been littered with the wreckage of systems that were implemented too soon for the underlying technologysystems that only added to healthcare's complexity, not lessened or alleviated it.
"I've seen the industry spend so much money and not yet gain the efficiency that is to come from a good IT and work process improvement system," Dorenfest said. He lay most of the blame on vendors. "They're still overselling their systems and oversimplifying the implementations. I can't tell you how many million-dollar, $10 million-, $20-million (failure) stories I've seen."
"I call healthcare another 'Inconvenient Truth,' but there is nobody of the stature of Al Gore doing what he is trying to do with global warming for healthcare. We're still not dealing with it."
Dorenfest, who works out of an office in downtown Chicago, is looking east to the futureto China. Dorenfest said he has set up a healthcare IT consulting business in China and hired as his country manager Grace Yu, a native of China who is in the U.S. as a doctoral candidate in medical sociology at the University of Chicago, and is completing work on the firm's first IT management consulting assignment for a government-run healthcare district.
The ultimate vision, however, is to open a string of for-profit hospitals to serve the rising expectations of the Chinese middle class. Despite the country's Communist political leanings, China's healthcare is provided by a substantial mix of consumer-directed and self-pay systems.
"In terms of the funding of the healthcare industry, over 60% is out of pocket from the patients," Dorenfest said. It is not unusual for patients to pay in advance against an estimated bill. Waits are long, there is a fair amount of self-diagnosis, and while fees are low, "seeing the doc is a two- to four-minute experience," he said. "If you ask too many questions of a doctor, they'll tell you to go see another doctor."
Healthcare for the masses is provided by government-run systems, while for foreigners and the well-connected, it is provided by facilities set up for them. Dorenfest said he hopes to split the difference by tailoring his new hospitals to provide Western hospital care best practices and systems, including IT, in a Chinese healthcare environment.
"There is going to be something in the middle and that's the market I'm targeting," Dorenfest said. "A certain fraction of the population would be willing to pay more money for a better experience."
Dorenfest said he thinks he can get the financial backing for the hospital venture, but so far he and his fledgling organization need more time and experience in China.
"I don't think I'm going to be pouring concrete (on a first hospital) until the end of 2007," Dorenfest said, but, "China is going really well and I think the next trip will produce more (consulting) clients.
"I'm going back April 1," he said, for most of the month. "Basically, I've got a company. I've got two employees. We have one project going and another starting up. We have to assemble a team. Since this year is really my year of learning, I want to be involved in things I might not be involved in later. The experience of selling the assignments and negotiating the agreements is so exciting, I wouldn't want to miss it. That's why I'm going back."
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