Healthcare ICT in Japan—A view from the top
There are some 8500 hospitals in Japan; a number that is surprising when you consider that the population of this country is approximately 120 million people. That adds up to a lot of hospital beds per capita! Ten percent of the population of Japan lives in Tokyo. And it is here it Tokyo that I had an opportunity to visit one of Japan’s most technologically advanced hospitals, the National Center for Child Health and Development (NCCHD).
As is customary when I visit other countries, my hosts often default toward showing me their most modern facilities. The good part is that I get a fairly accurate snapshot of the level of ICT sophistication on the high end of the scale. The bad part is that I don’t get to see as much of the “real world” situation as might be desirable. After all, part of my job is helping customers achieve high levels of efficiency, productivity, and safety in patient care in all facilities. I know what I saw today at NCCHD isn’t typical of the Japanese healthcare system. In fact it is surprising in this land of sophisticated consumer electronics, robotics and other technologies that healthcare is so far behind other sectors in the use of ICT . Then again, I guess I shouldn’t be too shocked since parallels could be drawn to American hospitals as well.
NCCHD would likely qualify as a HIMSS level 7 organization. CPOE is fully implemented. The organization is pretty much paperless. There are electronic kiosks for patient check-in. There are a different set of kiosks at check-out (please insert your favorite credit care here). It is customary in Japan for patients to pay deductibles and co-pays immediately upon discharge. I think there’s something American hospitals could learn from this.
Up on the patient floors, there isn’t much, if any, paper laying around. A fully integrated HIS system from Fujitsu handles just about everything. That includes bedside monitors that provide access to the EMR as well as access to a variety of patient services from ordering meals to patient education videos. What isn’t handled by Fujitsu is managed by other systems that control everything from those patient-friendly kiosks at registration to a robotic medication inventory, dispensing, and distribution system in the basement.
Unlike most American hospitals, ICT staff in Japan is pretty thin. In Japanese hospitals, even the CIO is a rare commodity. That isn’t the case at NCCHD which may explain why it is one of Japan’s showcases. Not only do they have a CIO, the CIO is a physician. I met Dr. Yuji Yamanobe during my first visit to Japan about 3 years ago. I was immediately impressed by his intellect and enthusiasm. He has managed to accomplish a lot at NCCHD and he’s not done yet. In addition to what I’ve already mentioned, he is championing the use of Microsoft Unified Communications at the hospital. Staff are aggressive in their use of Office Communicator for managerial and administrative communication and collaboration. This includes full integration of VOIP. He has also masterfully integrated Microsoft SharePoint with the Fujitsu HIS to provide enterprise document management and information access. His next project is an enterprise clinical data repository/unified intelligence solution, a perfect job for Microsoft Amalga UIS should it become available in Japan.
All in all, this facility compares with some of the best I’ve seen anywhere in the world--not in every way, but they are well ahead of the pack. Unfortunately, the same cannot be said about the majority of hospitals in Japan (or even America). So there’s much more work to be done, and many more miles to keep before I sleep.
Bill Crounse, MD Senior Director, Worldwide Health Microsoft