ICT ～Assisting Community Healthcare～

To Achieve efficiencｔ information sharing and effective education in home medical care

Junichiro Toya M.D. & Yuko Osuga RPh. Platanus Medical Corp. Sakura-shinmachi Urban Clinic

ISfTeH 18th 2013.10.19

Population Pyramid of Japan

India

2010

Canada

2010

36% 23%

5% 14%

Aging rate (65y.o.-)

United Nations, Department of Economic and Social Affairs, Population Division (2013)

National Institute of Population and Social Security Research

65y.o

2010 2040

Cause of death in Japan (2009)

Cancer

cardiac disease

cerebrovascular disease

pneumonia

Old age

Accidents

Suicide Others

Place of Death

Hospital Home Nursing

Home

Japan ８１％ １２％ ４％

U.S.A. ４１％ ３１％ ２２％

Netherlands ３５％ ３１％ ３３％

Where would you like to die? （survey in JPN）

１５％ ７３％

Goal of Medical Care is changing・・・

Cure ＱＯＬ

Health ＝ “Well-being Life”

Indication of Home medicinal care

• The patient who is difficult to go to hospital

regularly. Any diseases.

• Those who need a medical management of

urination, excretion, breathing, etc.

• Those who want to pass their later years at a

house.

• Those who want to have in-home hospice care.

Cancer 39%

Dementia 13%

Cerebrovascular disease

10%

Endocrine disease

10%

Old age 8%

Orthopedics disease

5%

Cardiac disease 5%

Respiratory disease

4%

Others 5%

Neuro-degenerative disease 1%

Diseases of New Patients at Homecare 2012.10～2013.9 (n=127）

Home helper

Care manager

Home care doctor

Visiting nurse

Visiting Rehab

Visiting pharmacist

Hospital

Patient House #2

Patient House #1

Various specialists in the community support the home medical care and nursing care as a team

Basic Condition for the Comprehensive Community Care

System

１．Efficiency

２．High level Cooperation

Schedule management

Utilization of Smartphones in Home care

GPS

Support everyday practice

Dictation

Prescription

FAX

Emergency call

Patient Education

・Dicatation ・Utilizing IT for documentation and info sharing

Consultation time

Travel time

Preparation of medical records

Meetings

Reporting to related parties

Documentation

Temporary home visit

5.7hr

2.4hr

2.9hr

Allocation of time of a doctor has been drastically changed.

3.1hr

3.5hr

4.4hr

Before After

50% increase

of Consultation time!

Cost for the set of applications ＝¥１，75０ ($20)

Current Situation of Information Sharing

Communication notes in patients homes

FAX

• Can only be seen in patient homes • Duplication of recording efforts • Lack of information consistency • Cannot be easily copied

Paper Information

Doctor：Let's change morphine from taking orally to injection then? We need the required equipment. How about the dosage?

Pharmacist：I understood. I’ll rent a continuous injection pump immediately. The dosage would be 20 mg/hr.

Nurse：The pain is getting

worse. Morphine dosage needs

to be adjusted.

Home helper：From when does medicine change? What should I be careful of?

cloud based information sharing system EIR

the patient who has received home palliative care in the cancer last stage.

www.eir-note.com

Can be used both on iPhone & Android

Can be used both on the mobile and smart phones

Now I feel that I am part of a team to treat a patient.

Easy to communicate with DRs so

that I can understand disease condition much better now!

“EIR” users feel the positive change in their operation

surveyed by questionnaire

Visiting Nurse

pharmacist

Home care doctor

Can understand MD’s instruction easily.

Already Using 16％

Want to use immediately

1％ If possible

54％

Don’t know 26％

Don’t want to use

3％

70% are interested

in the system

Ministry of

Would you like to use ICT system for information sharing

• Home medical care = medical treatment under mobile environment + cooperation with various partners

• New way of information usage comes to reality with smart phones and cloud systems

• Information sharing, Consultation, Administration

ICT ～powerful tool for home medical care～