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Voice of Users
Electronic Medical Record System
Customer : Tokai Municipal Hospital
With the goal of improving the quality of treatment, IT is being positively promoted
Mr. Atsuhito Yamada, Radiological Technologist and Health Information Technologist
Medical Professions Division, Head of IT Promotion Group Medical Information Section:
“Because it can be so easily disinfected, we chose the CF-H1 as the best terminal for use when dealing with super-flu outpatients.”
Tokai Municipal Hospital was established in 1974. Work to digitalize medical imaging information started after the hospital was relocated to greener surroundings on the edge of town in 1984. With this, the hospital started to deal with completely computerizing all its medical information.
When PACS (Picture Archiving and Communication System) was implemented in 2003, diagnosis became completely filmless. Now that nurses no longer had to deal with film records, they were better able to concentrate on caring for the patients.
“It was reckoned that the Nursing Division time spent about 30% of their working hours in bedside care. We have the figures to prove that it has been possible to increase this to 50%, and that savings of JPY 450,000 per bed per year have been made,” said Mr. Atsuhito Yamada, Radiological Technologist and Health Information Technologist of the Medical Professions Division, Head of the IT Promotion Group Medical Information Section.
The electronic medical record system came online in 2007. Aiming to conform with the Ministry of Health, Labour and Welfare “Guidelines for the security management of medical informatics systems”, the implementation is based on fault tolerant servers and completely redundant hardware, including the power supply infrastructure and two LANs to independently keep the medical information records. The system was particularly designed to ensure the quality and security of medical data centered on imaging: for example, the interface screens for textual and imaging information are completely separate. In addition, the data is stored in two remote locations, an eastern and a western data center and, regularly, on a daily basis, in an ongoing effort to create and maintain an institutional culture that has the proper attitude to the security of medical information, employees are trained in information literacy and other essentials. Systematization has been aggressively pursued with the aim of “Linking person to person” and “More complete patient care, while reducing costs incurred by more efficient use of funds.”
CF-H1 introduced in super-flu countermeasures
In 2009, a new virulent form of influenza swept the world, reaching Japan in the spring, and prompting the rapid formulation of emergency measures by the government. At Tokai Municipal Hospital, a means of coping with the anticipated pandemic while protecting the citizens from the virulence of super-flu infection, the super-flu Outpatients Clinic was set up. The CF-H1 was selected as the terminal for electronic medical record keeping.
As Mr. Yamada explained, the prime reason that the CF-H1 was considered suitable for the fight against the super-flu virus was, “It can easily be disinfected.”
He commented, “I first saw the Toughbook when I worked at the Emergency Critical Care Center of the Nagoya Ekisaikai Hospital. All my preconceptions about computers fell away when I saw the Toughbook being rinsed under a faucet to wash away blood that had spattered onto it.”
Initially, the hospital considered introducing a laptop model of the Toughbook but, as Mr. Yamada observed, there were serious concerns, to maintain the hygiene of the keyboard, “We would have had to wrap the PC in plastic film.” Then he saw the newly launched CF-H1 and he just knew it was right: “The body doesn’t have any projections or recesses; you can wipe it with alcohol. This is the one!”
In addition the toughness and multifunctionality of the CF-H1 also received attention. Mr. Yamada commented, “It doesn’t break easily, even if it gets dropped to the floor. And even though it’s compact, it has every feature we need. There’s a barcode reader, an RF–ID reader, a camera, and wireless LAN built in. Then, you can even change the batteries while it’s plugged in. I thought I’d really like to introduce it quickly to where we work.”
Set up especially for emergencies, the super-flu Outpatients Clinic. If disaster strikes, there are plans to use the CF-H1 here.
The handstrap makes it possible to operate the CF-H1 while standing.
From the Great Hanshin-Awaji Earthquake experience, decision to use CF-H1 during normal times
By the bedside, details of the patient status can be entered as an electronic medical record.
In the nurse station, connected via a cradle, the CF-H1 is operated by keyboard and mouse.
For hospitals, which everyone wants to continue to function even in disaster situations, it is particularly important to have a viable BCP (Business Continuity Plan). Mr. Yamada was passionately involved in implementing the hospital BCP because of his frustrating experience during the response to the Great Hanshin-Awaji Earthquake:
“Straight after it happened, the TV showed what it was like on the ground. Three days later, on January 20, even without equipment, I was rushed to duty at one of the sites. Not only were there not enough doctors and nurses at the facility, we lacked equipment and could not properly treat the injured. Straightaway, I flew back to Nagoya to arrange for a truck to be loaded with digital imaging equipment for delivery to our facility in the earthquake zone. At that time, however, there was no system in place for handling dispatch and receipt and, in the end, it was not possible to depart. I still cry when I think about the lung trauma patients and other people we could have saved if we could have taken X-rays in the disaster area.” (Mr. Yamada)
At that time, he strongly felt. “We need to be provided with the same equipment, both hardware and software, during normal circumstances,” and so the CF-H1 was first of all introduced to the wards.
Mr. Yamada commented, “If super-flu were strongly virulent, the outpatients clinic would be opened and the CF-H1 would be put to work. If the terminals were kept slumbering in a storeroom, I would be unsure of their practical usefulness in an emergency. By getting everyone used to using them in the wards, we can be confident of providing the same kind of treatment in emergencies as we do in ordinary practice. Of course, the computers are not treated like toys during normal use, they are tools that enable us to make more effective use of resources.”
Operability and reliability because it’s a computer
Ms. Aiko Aiba, Registered Nurse:
“I have a feeling that the built-in barcode reader and camera are going to completely transform the way we carry out nursing (Patient recognition (identity) traceability).”
Up to the changeover, the hospital had been using PDAs. Besides having small screens and tiny fonts, were sluggish and unreliable.
Looking back, Ms. Aiko Aiba, Registered Nurse, recalls, “I would often return to nurse station just to confirm that the data I entered by the bedside had been recorded in the system.”
When entering data while on the move, the connection with the server was likely to be interrupted, and it looks like the stress of things like the uncertainty and bother of having to re-enter the data caused a great deal of stress.
Ms. Aiba spoke of the improvement, “Thanks to the CF-H1, that annoyance has disappeared. And because it has a barcode reader and camera, it is can do more things. I think that we can soon put this extra potential to use.”
As applications are implemented the CF-H1 will extend it range of usefulness
He added, “Now, on the move in the wards, we can consult and use the electronic medical records on a computer.” (Mr. Yamada)
“In the near future, as a regional general hospital facility, we are going to merge operations with Chita Municipal Hospital in the neighboring city and there seems to be plans to build a new hospital. At that time, if something like the CF-H1 could be generally introduced as a special healthcare terminal, it would enable the best use of the new site, both the wards and the emergency outpatient clinic.” (Mr. Yamada)
The goal is to provide high-quality local medical care and to, furthermore, ensure the hospital continues to sustain medical operations well enough to cope during emergency situations. All the functions needed to support these goals have been squeezed into the compact body of the CF-H1. It will continue to provide reliable support in the forefront of medical treatment.
Communications are not disrupted, even en route to the ward, and the CF-H1 can be conveniently used at any time. Easy mobility is another plus as it can be lightly carried in one hand.
- Tokai Municipal Hospital
- 3-1-1 Naka-no-Ike, Tokai City, Aichi Prefecture
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