Cleveland native Dr. Randy Jernejcic first realized his love for China in medical school at Ohio State University. He spent the summer of 1994 working at a hospital in Wuhan, a city that at the time had few foreigners coming through.
"It started off my real long history of going back to China and taking part in different aspects of healthcare in China," Jernejcic said.
Jernejcic will soon return to the county of more than 1.4 billion people as CEO of Chengdu Wanda UPMC International Hospital, China's first hospital run by an American academic medical center. The 500-bed hospital still under construction is slated to open in March 2023. It's the first of five hospitals UPMC plans to develop with Wanda Group, a multinational conglomerate based in Beijing that specializes in film and real estate.
There was a relatively small pool of people qualified for the top job at UPMC's Chengdu hospital, and Jernejcic fits the bill. He's an American trained physician who has held leadership roles at hospitals both in the U.S. and China. He comes from University Hospitals of Cleveland, where he started in 2017 and was most recently vice president of ambulatory quality and clinical transformation.
From 2010 to 2012, Jernejcic was chief medical officer of the Beijing market for United Family Hospital, a privately owned system with hospitals in six major cities in China. His role included oversight of the Beijing hospital, ambulatory clinics and rehabilitation hospitals. The hospital served mostly expatriates—patients came from 90 other countries—which Jernejcic said informs the model for the Chengdu hospital.
Jernejcic's ties to China are personal as well. His wife of 25 years is from there and he adopted his daughter from China as well.
The healthcare systems in China and the U.S. have similar challenges: ballooning costs and rising chronic disease rates. Those are particularly difficult issues in China because of its much larger population and the fact that primary care is virtually nonexistent, Jernejcic said.
"So that large population tends to go to the hospitals for much of their care, which really puts that burden on the hospitals as opposed to how we spread it out with primary care," he said. "That was one of the big differences I saw early on, and it continues to be one of the large differences."
Promoting and delivering primary care will be a big focus for UPMC's Chengdu hospital, in addition to the obvious specialties like oncology, cardiology and orthopedics. It's one thing to fix a patient's hip, it's another to provide a broad continuum of care for that patient and their family, Jernejcic said.
"The traditional specialties are important, but we really have to be that differentiator with primary care and how they connect," he said.
During his time in Beijing, Jernejcic said Chinese doctors regarded him skeptically, assuming he would try to make them into American doctors. When he returns to China, Jernejcic said he'll promote a culture of harnessing the best aspects of both medical systems and not trying to change one into the other.
"A lot of folks have a tendency to go in and say: 'Let me show you how we do this,'" he said. "I wanted to change that around because I think we're so much better if we build upon each other, not just on one side. That's the frame of reference I want to take going into this."
Jernejcic said he tries to imagine if a Chinese company opened a hospital in Pittsburgh run by Chinese providers. Americans would be similarly skeptical. "In some ways, it's not too different," he said.
Jernejcic officially takes the helm Feb. 1. He'll spend the first six months of his tenure in Pittsburgh planning the hospital's opening. The hospital was originally slated to open in mid-2022 but that was delayed because Wanda increased its investment to upgrade the hospital design and equipment.
The biggest task ahead is hiring. UPMC has a staff of about 20 people in China plus an even bigger team in Pittsburgh, but they'll need many more to staff a 500-bed facility. Much of the recruitment will be in Chengdu and elsewhere in China, but Jernejcic said he's also looking for people trained in the U.S. and Europe.
"We believe having that diversity in the medical staff and administrative staff will only make us better," he said.
Being able to speak Chinese is not a requirement, even for some caregiver roles, since many Chinese speak English fluently, Jernejcic said.
Wanda's operations were heavily impacted by the COVID-19 pandemic, but UPMC said that hasn't derailed their venture, first announced in October 2019. Wanda is funding the hospitals' construction and operating costs, while UPMC will manage the facilities under an agreement with Wanda.
China's public hospitals are struggling to keep up with demand, and the country's government has encouraged the development of private hospitals. To that end, the government has since 2014 allowed hospitals to be wholly foreign-owned, up from the 70% cap that had existed previously.
Jernejcic said it's unclear what proportion of the hospital's patients will rely on government insurance versus private insurance, which has become increasingly common in China. Chengdu has a sizable expatriate population as well, so UPMC will need to figure out how to serve patients with health insurance from their home countries.
The COVID-19 pandemic has complicated the hospital's planning in that it's limited the ability to travel between the countries, Jernejcic said. That said, key leaders will travel from Pittsburgh to Chengdu to get things up and running.
"There's going to be a lot of timing of folks going back and forth," Jernejcic said. "While that adds to the cost of the project, we believe it's so critical to that interconnectivity between Pittsburgh and Chengdu."