Dr. Jilan Liu spearheads HIMSS Greater China

27th March 2014; CN-Healthcare.com

Healthcare Information and Management Systems Society (HIMSS), an internationally renowned healthcare IT (HIT) organization has set foot in Greater China, with JCI lead consultant Dr. Jilan Liu appointed as the HIMSS Vice President and Greater China Executive Director. This is an exclusive interview with Jilan by CN-Healthcare.

HIMSS, founded more than half a century ago, is a prominent entity in the international hospital and HIT landscape. It is, however, less well known in China. Today, HIMSS has set up a Greater China focus to serve Mainland China, Taiwan, Hong Kong and Macau.  This group will now repot directly to the HIMMS main office.  With this new milestone, Dr. Liu has expressed great confidence in and anticipation of the future of China’s development in healthcare informatics.

In China, Dr Liu is a familiar and well trusted figure in the healthcare industry as the Lead Consultant of Joint Commission International (JCI). She was involved in consulting for most of the 29 JCI-accredited hospitals and for many more seeking accreditation.  These institutions solicit her expertise in building better delivery systems, processes and mechanisms in order to improve patient-centered care and management services.

How does a hospital accreditation expert become linked up with healthcare informatics? How would the operations in the Greater China unfold? CN-Healthcare’s conversation with Dr. Liu will explore answers to these questions

“Interest dictates this choice,” states Dr. Liu as she maintains her usual immaculate style in responding to the questions. “I’ve been involved in consultations for JCI hospital accreditation for years and have seen how numerous hospitals around the world are building up their HIT capabilities. Hopefully, by leveling the playing field in HIT, I will be enabled to better help hospitals!” “I have spoken and moderated at the annual global and regional HIMSS conferences. As a result, when HIMSS approached me with the position, I didn’t hesitate to accept it.  My only condition was that I be able to continue consulting for JCI globally and in China. This is my passion and it helps me stay grounded.”

HIMSS (Healthcare Information and Management Systems Society) is a global, cause-based, not-for-profit organization focused on better health through information technology (IT). HIMSS leads efforts to optimize health engagements and care outcomes using information technology. Founded in 1961, HIMSS WorldWide encompasses more than 52,000 individuals.  More than two-thirds of these staff members work as healthcare providers in both governmental and not-for-profit organizations across the globe.  There are also over 600 corporations and 250 not-for-profit partner organizations that work with and share the goals of HIMSS.

While assisting hospitals in becoming better organized and safer by boosting quality and systematic operations, Dr. Liu also saw the challenges and opportunities in implementing hospital HIT. “JCI helps hospitals do the right things and do them well, while HIT provides effective tools.” Without advanced information technologies, modern standards of healthcare are unfeasible to uphold. However, Dr. Liu stressed that the hospitals must understand what they need. The implementation of HIT without a well structured design and plan may not deliver the promised clinical and operational excellence.

Disconnect in healthcare informatics: China’s HIT development hits bottleneck

During her JCI consultations, Dr. Liu has witnessed the torments of hospitals’ IT systems – “purchasing or developing a system to serve each of the single purposes cause multiple systems that are unable to interface with each other.  This in turn creates multiple information silos that are unable to interact”. Many hospitals have told her that their IT systems were not user-friendly and unable to integrate with each other, “So there was little interoperability among systems and so much wasted effort!”

Is it true that all the systems in China are unfriendly? From her perspective, some systems were truly not well built in functionality, but in many cases the hospitals were unable to fully understand and evaluate their own needs during system procurement or development. This lack of comprehension resulted in their inability to decide or build systems that best serve their purposes or to fully exploit the potential of their systems. “The journey from Boston to Beijing takes a plane flight and from Beijing to Tianjin a train ride. What is the better vehicle? Different starting points and destinations call for different vehicles. Therefore, it is imperative to understand what the destination is”. She also added, “like fighting a war – first make clear what to fight for and “how to” strategies on winning it, and then choose the weapons. There are times, however, that warfare is largely decided by weaponry. Breakthroughs in modem weaponry have been decisive for winning many wars and in affording us the effective strategies on how we fight some of the wars. The era of overcoming enemies with antiquated weapons is over”

In her JCI consultations, Dr. Liu witnessed hospitals craving robust information technologies.  Many of these organizations made breakthroughs by promoting the establishment of IT. However, she also noted that many IT staff in Chinese companies are very good at writing codes, but are not knowledgeable about how things operate in healthcare. Meanwhile, healthcare professionals are seldom part of the HIT research and development team. They often hold their physician and nurse identities in high regard and were not willing to work in IT companies. Dr. Liu notes that “this situation creates a downward spiral because without involving the healthcare professionals, the needs of hospitals can not be properly understood or addressed by the systems developed. The frequently seen disjointed systems cannot satisfy the hospitals needs. Therefore, they cannot get paid decent prices and HIT companies cannot afford to invest in more R&D with sufficient involvement of healthcare professionals.”

“The programmers nowadays are so good that they can write pretty much any codes you want, but they are not always well thought out,” Dr. Liu told CN-Healthcare. As she performs JCI evaluations globally, she has discovered that some good IT systems have robust functions to meet the needs of many similar organizations. Many Chinese HIT companies, however, tailor their systems for a particular hospital or individual, which may be unusable by others. If every deployment becomes a new development, it not only incurs higher costs but also compromises  the interoperability among hospitals in regional healthcare alliances.

Dr. Liu admitted that the key solution lies in the healthcare industry’s understanding of what the IT people are doing and what these new technologies are capable of.  They must also help IT companies understand the needs of the healthcare industry.

Bridging gaps in communication

HIMSS is best at engaging healthcare organizations and cutting edge HIT companies to co-develop the future of healthcare.

“My mission is to refine the regional platform for HIMSS in Greater China.” Dr. Liu admitted.  “Not only should we help to create a fairer dialog between the IT and healthcare industries, but  we need to reach out internationally.” In her opinion, the purposes of the regional platform are to foster communication between healthcare organizations and HIT enterprises in China and avoid potential pitfalls and meanders by learning from international experiences.

HIMSS’ professionalism and reputation are reported to garner international recognition. The annual HIMSS conference in United States is a grand gala of the international HIT industry and healthcare organizations. The recently concluded 2014 Conference attracted more than 1,200 vendors and close to 40,000 participants from all over the world.

“It was a pity that there were not many Chinese representatives among the 1,200 vendors,” commented Dr. Liu. “HIMSS members are found in many countries worldwide, which benefited from more convenient global communication and a greater reach in information channels. However, only a few HIMSS membership are found in China.”

“We have much to learn from others, but we also have products of our own to show the world. In terms of products with similar functionalities, we have the advantage of lower costs. However, we appear to keep all the good stuff to ourselves. That’s a pity.”

In response, as the Greater China Lead, Dr. Liu will first promote the HIT exchange amongst mainland China, Taiwan, Hong Kong and Macau.  She will then further facilitate international communication.  She told CN-Healthcare. “The HIT development in China has hit a bottleneck. To overcome this problem, we have to be both self-reliant and also be more open to international participation and exchange.” She is currently working on the MHealth Summit in mid-November this year  She says that “the preliminary decision is to have it in Beijing on the 18th and 19th , and hopefully, we will be able to attract the best crowd in this arena.”

For better communication and information, an official website for HIMSS Greater China is being planned, which is expected to play a pivotal role in staging HIT exchange. “There will be up-to-date news on the progress in HIT of the Greater China region and internationally, and off-line activities may be organized to promote exchanges.”

HIMSS EMR certification: Stage 6 to be tested for on-site validation in Greater China

‘HIMSS is looking at some process adjustments,” said Dr. Liu

Apparently, HIMSS evaluates electronic medical record systems in hospitals and ranks them from Stage 0 to 7. According to Dr. Liu, many Chinese hospitals are still unaware of HIMSS EMREM scores. This certification is the most widely recognized HIT certification program in the world. Stage 7 requires interoperability among systems, not only inside the organization but also connectivity with other organizations.  This interconnectivity requires a paperless care environment. Only 4 hospitals in China have been awarded the HIMSS Stage 6 certification, including the People’s Hospital of Peking University, Shengjing Hospital of China Medical University, Chang’an Hospital, and Yantai Niuhuangding Hospital.  As of today there are no Stage 7 hospitals in China. However, there are Chinese hospitals embarking on their HIMSS Stage 7 journeys and a breakthrough is expected within the year. “I feel full of hope and anticipation”, said Dr. Liu

The HIMSS EMR certification pushes the hospitals to advance their HIT advancement while driving HIMSS to continually evaluate and improve its own standards and processes. Dr.Liu told CN-Healthcare that an on-site validation survey has always been required for Stage 7. Stage 6 evaluations used to be conducted by phone interviews.  There have been recent discussions that Stage 6 may be better and more objectively served by an on-site survey as well.  This is particularly true, as requested by hospitals in China, to create a better opportunity for the hospitals to improve. Dr. Liu was very encouraged by Chinese hospitals’ desire to improve. As a result, she has offered to have Greater China to the pilot testing ground for the new process of Stage 6 on-site validation.

Promoting CPHIMS and pushing for training of world-class HIT pros

One way to best address the local needs is by getting into the international arena. In addition to the EMR certification for hospitals, HIT professionals may seek testing of their knowledge and be granted with CPHIMS (Certified Professional in Healthcare Information & Management Systems), which is another priority Dr. Liu is working on in the Greater China region.

CPHIMS certifies individual HIT professionals by testing their knowledge in three areas: general knowledge of HIT, theoretical understanding of IT systems, and operational/managerial knowledge in healthcare. This test includes questions on technology, information security, leadership/management as well as case analysis, graphic design, etc.

Only if we have a sufficient number of HIT professionals that can speak the same language with their international counterparts, can we level the playing field in international exchange, said Dr. Liu to CN-Healthcare. Some 30-40% of CIOs (clinical information officers???) in the US Hospitals are CPHIMS-certified in addition to those working in the HIT companies. This test makes sure that our HIT professionals know both how to write program codes and how to architect systems to reflect the authentic needs in healthcare environments. It is said that the test is available at all Chinese test centers, but most people are unaware and even fewer ever venture to take it. According to Dr. Liu, efforts may be needed to translate the training materials and launch some training programs to help Chinese HIT professionals in this regard.

When asked about her outlook into HIMSS’ future in Greater China, Dr. Liu said that she believes in doing the right things at the right time. HIMSS can bring clear value into China’s HIT right now. “I am not so ambitious as to try to change the world. But I want to do my best to help lay down a solid foundation, through the work of solid organizations such as JCI and HIMSS.  I believe that this will facilitate tangible and meaningful transformations in our healthcare delivery systems.”