Fuda Cancer Hospital is an early private entrant, specialized cancer hospital in China. Since its establishment 11 years ago, it has grown from a little-known private hospital to a well-known, specialized cancer hospital that has nearly 400 beds and attracts patients from more than 70 countries and regions. As China's healthcare care has long been dominated by public hospitals, Fuda Cancer Hospital was able to survive and grow by pursuing a differentiation-oriented strategy and a modern hospital management system. The hospital adheres to the strategy of "differentiated development" in the following aspects: Patient positioning - therapy of cancer in middle and advanced stage; Market positioning - Mainly overseas cancer patients in early stage Service; concept positioning - patient-centered, etc. To further expand operation, Fuda Cancer Hospital started to make preparations for IPO in 2011, planning to use the raised funds for hospital relocation and technical reform projects, scientific research and training center construction projects, and brand and market system restructuring projects. However, the hospital is faced with numerous setbacks in its endeavor to go public. From 2011 to 2013, the net revenue of the hospital has been declining, with a decrease of 47.80% in 2013. The cancer therapy, which the hospital is proud of, is challenged in the industry as it brings a negative impact on the IPO of the company. Moreover, since the national government has lifted policy restrictions on private capital in the medical market, many listed companies have invested in private hospitals, and Fuda Cancer Hospital will be confronted with fiercer competition. However, China's IPO market was frozen for nearly two years and Fuda experienced major roadblocks in its IPO journey.

Founded in 1892, Nanjing Gulou Hospital, is one of the earliest western medical hospitals in China. It was founded by Dr. William Edward Macklin, M.D., Disciples (Canada) Mission to China, with the assistance of Prof. Frank Eugene Meigs, the Curch of Christ (USA), and the local Nanjing community. At its early stage of establishment, the hospital took "Love, Kindness and Public Service" as its philosophy and "No prejudice to patients as the first priority", proposed by Macklin, as an aspiration. However, due to the uneven distribution of medical resources, neglect of humanities in China's medical education, among other reasons, Chinese public hospitals showed a lack of human concern over a long period of time. In 2004, the president of Gulou Hospital, Ding Yitao, took humanism as a breakthrough point, and first proposed the missing of honoring the hospital's heritage of humanism and building the best humanistic hospital. At a high level, the strategic transformation is implemented along three dimensions: building a memorial hall to honor the heritage of humanistic spirit of Gulou Hospital, launching an expansion project for the hospital that improves availability and quality of health care, as well as transforming hospital management, operation and performance evaluation that stimulate the cultural consciousness of all employees and create a humanistic hospital. Since Gulou Hospital embarked on the journal to build the best humanistic hospital in China, it has generated positive results in terms of patient attraction and satisfaction level. Gulou Hospital has become an exemplar of modern, humanistic hospital in China and received many awards. However, going forward, the hospital faces mounting challenges. How to further deepening the reform and engage all employees? Will Gulou Hospital's core competency sustain into the future and continues to enable the hospital to gain a strong foothold in the increasingly crowded healthcare market?

In 2006, Dr. WANG Shan was appointed as the president of Peking University People's Hospital (hereafter referred to as "PKUPH"), a large class 3A public hospital in China. Prior to his appointment, PKUPH had experienced three consecutive years of financial losses due to poor internal management. No standard operating procedure was established to prescribe the level of activity expected from each responsible person or decision units, and the amount of resources that a responsible party should use in achieving that level of activity. No formal management control systems were installed to collect, process, analyse accounting (particularly cost-related) information and provide timely feedback to the management. As a result, actual costs significantly exceeded budget. Loopholes in the system stemming from loose monitoring and control gave rise to severe agency problems. To turn the situation around, WANG Shan launched an IT-led management reform. By 2012, the reform has yielded significant and positive results. Annual revenues and profits increased significantly. Management and operational efficiency was also significantly enhanced. This case is intended to demonstrate how an institutionally complex organization (particularly hospitals) can overcome institutional challenges and upgrade management with an IT-oriented strategy.

Established in 1958, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (hereafter referred to as "Xinhua Hospital") is an integrated modern teaching and research hospital with a comprehensive set of disciplines and a specialization in paediatrics. Xinhua Hospital currently has 1,586 beds, 47 clinical departments and 66 specialties. It has three National Key Disciplines, one Shanghai Key Discipline, five Shanghai Jiao Tong University School of Medicine Key Disciplines, one Ministry of Education Key Laboratory (MOE-Shanghai Key Laboratory of Children's Environmental Health), and two of Shanghai clinical centres, respectively. In 2005, Xinhua Hospital co-founded Shanghai Xinhua Hospital Group with Shanghai Children's Medical Centre Affiliated to Shanghai Jiao Tong University School of Medicine, No.3 People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Chongmingbao Town People's Hospital, and Xinhua Hospital Chongming Branch. Under the arrangement, members remain as stand-alone legal entities, and are financially and operationally independent. Since 2007, Xinhua Hospital has been importing talent to lead its disciplinary development and enhancing its management through informatization development. In 2011, the hospital had 3,400 employees and its number of accident & emergency unit patients reached 3.3 million, the highest in Shanghai; it treated 69,000 inpatients and undertook 41,000 operations. Xinhua Hospital is a large Class 3A (the highest grade in China) public hospital. The focus of this case study is to understand how was it able to implement an EMR-centered (electronic medical records, also known as electronic patient records or electronic health records) information system within its complicated, traditional organizational structure.