Information System. in JAPAN (esp.traceability for patient safety)

Transcription

1 Information System for Health Promotion in JAPAN (esp.traceability for patient safety) Takashi Taniguchi MD, PhD, Ministry of Health, Labour and Welfare(MHLW) Japanse Gov. GS1 Healthcare Conference, Tokyo, Japan 28 October 2008

2 Health Care System in JAPAN 1. Health Promotion Program (1) Nationwide Regulation Training for Profession & Construction Standard of Hospital (2) Local Government Appropriate Distribution of Medical Fascilities & Human Resources 2. Health Insurance System All the country is coverd by the system since 1961

3 Today s Serious Subject 1. Structual Changes of Target Disease Drop in the Birth Rate Acceleration of Agi ing Society 2. Increased Need for Advanced Medical Services Dynamic Progress in Medical Science Popularization of Informed Consent

4 Solution of the Difficulty Reconstruction of Medical Infrastructure/System High Quality Patient Safety Improvement of Efficiency

5 IT as a Useful Meaesures for Improvement of Health Care System Grand Design for Computerization in Health Syst tem (MHLW 2001) Standardization of Medical Terminology/Code Promotion of EHR/Telemedicine Health Service IT Network in Each Area

6 e-japan Strategy : Advanced Plan ( MHLW 2005) Further Promotion of Computerization in Adoption of EHR Reimbursement System Telemedicine Sharing of Medical Data through IT Network

7 Patient Safety Program throug gh IT in National Hospital

8 How can we manage patient safety? We need the Real-time Consumption Data Capturing System Collects, manages, and uses consumption data at the point of consumptio on (e.g. Hospital bedside) In the form of When, Where, Who, to Whom, Why, What, How (6W s, 1H) The first application is hospital International Medical Center of Japan (since 2002) Current technology is PDA/bar code, but RFID technologies are in process for the future Single item management with unique serialized number

9 What can IT do? By collecting data from wireless PDAs, examination room terminals, and laboratory equipment, Single item management (ex: POAS) can: Record medical actions in detail, everywhere Assist practicing medical treatment to patients Monitor patient symptoms continuously Comprehend logistical data by the minimum unit In real-time.

10 RISK MANGEMENT What can IT improve? Prevent medication errors patient safety HOSPITAL MANAGEMENT Cost saving because waste is decreased Optimize inventory level of Medicine) DATA MANAGEMENT Re-engineering by simulation with system dynamics Accumulate accurate data for clinical research and clinical tri als Allows for more accurate cost analysis DISTRIBUTION MANAGEMENT Material (Medical Materials and

11 Background on POAS (Point of Act System) When Who When Who MD, POAS Data (6W s, 1H) Nurse, etc. To Whom Where Why What How To Whom Patient Where Why - Disease What Drugs and Medicines How Medical Acts

12 How is this different from conventional systems? Conventional systems Enter schedule For Patient safety Enter action Granularity of Invoice slip = by one day Granularity of single item = real time Nurse station/out Patient dep. Bedside Medical affairs section

13 What can IT improve? RISK MANGEMENT Prevent medication errors patient safety HOSPITAL MANAGEMENT Cost saving because waste is decreased Optimize inventory level of Material (Medical Materials and Medicine) DATA MANAGEMENT Re-engineering by simulation with system dynamics Accumulate accurate data for clinical research and clinical trials Allows for more accurate cost analysis DISTRIBUTION MANAGEMENT Optimize supply chain management (SCM) in the medical/pharmaceutical industry

14 Alarm status according to different time segments Time segments with higher alarm rates become even clearer when seen in 30-minute increments. 時間帯別エラー発発生率 ( 年間 ) Number of errors for different time segments (30-minute increments) and error rates Hand-over time (0:30-1:00) =Before hand-over time =Hand-over time =After hand-over time Hand-over time (16:30-17:00 17:00) 6.0 1,200 1,000 Error rate (%) 5.0 (%) 率生発 4.0 ーラエ Hand-over time (8:30-9:00) : 0 0 : : 0 1 : : 0 2 : : 0 3 : 0 4 : 0 4 : : 0 5 : : 0 6 : : 0 7 : : 0 8 : : 0 9 : : 0 1 0: : 0 1 1: : 0 1 2: : 0 1 3: : 0 1 4: : 0 1 5: : 0 1 6: : 0 1 7: : 0 1 8: : 0 1 9: : 0 2 0: : 0 2 1: : 0 2 2: : 0 2 3: 3 0 エラー件数エラー発生率 (%) Number of errors(% %) 数件ーラエ

15 What can IT improve? RISK MANGEMENT Prevent medication errors patient safety HOSPITAL MANAGEMENT Cost saving because waste is decreased Optimize inventory level of Material (Medical devices and Medicine) DATA MANAGEMENT Re-engineering by simulation with system dynamics Accumulate accurate data for clinical research and clinical trials Allows for more accurate cost analysiss DISTRIBUTION MANAGEMENT Optimize supply chain management (SCM) in the medical/pharmaceutical industry

16 Automatically acquired information : Digitize arehouse Injection order Pharmacy Change order ward 発 ng 注 Accountin Injection / Shot Mixing Audit Picking Rp Print ting Inventor ry Purchas se Order Consumption point of c onventional electronic m edical charts most dangerous. unnecessary costs. Consumption point of co nventional systems used by the Pharmaceutical Division Return Waste POAS consumption point Optimize

17 IT can be improved hospital management. Prevent medical accidents. Thorough inventory management Keywords are real-time ngle item management. The accurate acquisition of information on bedside actio ns is crucial. Acquire cancellation and Only about 60% can be acquired in conventional systems. POAS gives an overall picture. POAS can save 1 million dollar per yea ar. entry and serialization for si change data. This improves medical sa afety and management efficie

18 What can IT improve? RISK MANGEMENT Prevent medication errors patient safety HOSPITAL MANAGEMENT Cost saving because waste is decreased Optimize inventory level of Material (Medical Materials and Medicine) DATA MANAGEMENT Re-engineering by simulation with system dynamics Accumulate accurate data for clinical research and clinical trials Allows for more accurate cost analysis DISTRIBUTION MANAGEMENT Optimize supply chain management (SCM) in the medical/pharmaceutical industry

19 Revenue by physician experience rends in 医師 研修医 average revenue ( 経年 職種別 (operations ) 平均収益 (/ 手術 処置補正 treatment corrections) ) 推移 for physicians and interns (years / description) \3,500,000 研修医 Interns (1 (first 年目 year G eneralist) / generalist) 研修医 Interns (1 (first 年目 year G eneralist / other 以外 than ) generalist) 研修医 Interns (2 (second 年目 G eneralist) year / generalist) 研修医 Interns (2 (second 年目 G eneralist year / 以外 other ) than generalist) 医師 Physicians \3,000,000 \2,500,000 \2,000,000 \1,500,000 \1,000,000 \500,000 \0 6 月 7 月 8 月 9 月 10 月 11 月 12 月 1 月 2 月 3 月平均

20 What can IT improve? RISK MANGEMENT Prevent medication errors patient safety HOSPITAL MANAGEMENT Cost saving because waste is decreased Optimize inventory level of Material (Medical Materials and Medicine) DATA MANAGEMENT Re-engineering by simulation with system dynamics Accumulate accurate data for clinicall research and clinical trials Allows for more accurate cost analysis DISTRIBUTION MANAGEMENT Optimize supply chain management (SCM) in the medical/pharmaceutical industry

21 Standardizationn - ISO/TC 215 the International Organizationn for Standardization s (ISO) Technical Committee (TC) on health informatics. TC 215 works on the standardization of Health Information and Communications Technology (ICT), to allow for compatibility and interoperability between independent systems. WG 1: Data structure WG 2: Messaging and communications WG 3: Health Concept Representation WG 4: Security WG 5: Health Cards WG 6: Pharmacy and Medication WG 7: Devices WG 8: Business requirements for Electronic Health Records

22 Thank you for your attention. Have A Nice Day In Japan!