IT Applications for Medical Services in Japan

The Information Technology (IT) application for medical services has developed in line with two major national level factors. One was the “E-Japan Project” which was proposed and implemented to revitalise the Japanese economy by introducing IT to a wide range of industries and sectors of the society and by promoting establishment of so-called IT infrastructure. The other was serious concern over the fast rising healthcare expenses in the country in the face of the coming aging society. First, the major efforts were, therefore, made for productivity improvement and const reduction in the health insurance bill claiming procedure and other related fields. These initiatives were followed by construction of medical information sharing and processing system first, and then developed further for regional collaborations among medical institutions. Other examples of the IT applications in the medical services can be found telemedicine to cope with the serious shortage of medical doctors.

Development of an Online Sleep Diary

Sleep disorders causing excessive daytime sleepiness are estimated to affect six percent of the population and has traditionally been under diagnosed. Sleep disorders symptoms may lead to an increased likelihood of suffering work and vehicle related accidents as well as affecting the physical and mental well being of the sufferer. A sleep diary documenting sleep hygiene habits over a period of time is an important tool in the diagnoses of sleep disorders. This project was to develop an online sleep diary, bringing benefits of presenting the information earlier to the physician in a format which allows the quick assimilation of information from the diary. The information is also in an electronic format facilitating the transmission to an electronic health record and the building of a database of sleep patterns. An online sleep diary allows a patient to self-monitor their condition allowing them to assess treatment and lifestyle changes on sleep patterns.

The Use of Laboratory Test Results in Health Care Management

Laboratory test results used in health care management can be qualitative or quantitative. These cover several disciplines, the four major disciplines being histopathology, haematology, medical microbiology and chemical pathology. Histopathology and medical microbiology are mainly qualitative assessments, while chemical pathology is predominantly based on quantitative analysis of chemical constituents in blood or other body fluids. Haematology encompasses both quantitative and qualitative assessments, the blood cell parameters being quantitative while blood film reports and bone marrow reports are qualitative. The application of such results to healthcare management includes screening for disease as well as in making a diagnosis and for monitoring response to treatment of a known disease. This necessitates the availability of normal ranges to compare with and decide whether the results are normal or not. Normal means the individual is in a state of good health and a deviation from normal is interpreted as implying ill-health. Data used in these tests are taken from previous studies of Sri Lankan Adults carried out from May 2005 to July 2006.

Data-Mining Techniques for an Analysis Of Non-Conventional Methodologies

Some common methodologies in our everyday life are not based on modern scientific knowledge but rather a set of experiences that have established themselves through years of practice. As a good example, there are many forms of alternative medicine, quite popular, however difficult to comprehend by conventional western medicine. The diagnostic and therapeutic methodologies are very different and sometimes unique, compared to that of western medicine. How can we verify and analyze such methodologies through modern scientific methods? We present a case study where data-mining was able to fill this gap and provide us with many tools for investigation. Osteopathy is a popular alternative medicine methodology to treat musculoskeletal complaints in Japan. Using data-mining methodologies, we could overcome some of the analytical problems in an investigation. We studied diagnostic records from a very popular osteopathy clinic in Osaka, Japan that included over 30,000 patient visits over 6 years of practice. The data consists of some careful measurements of tissue electro-conductivity differences at 5 anatomical positions. Data mining and knowledge discovery algorithms were applied to search for meaningful associations within the patient data elements recorded. This study helped us scientifically investigate the diagnostic methodology adopted by the osteopath.

Digitizing Healthcare

Proliferation of the Internet and Information Technology (IT) has led to many innovations in the healthcare industry. Among such innovations are the Electronic Medication Administration Record (eMAR) and the Bedside Medication Verification (BMV), both of which have been widely implemented by hospitals around the world. In this regard, the goal of this chapter is three-fold. It first describes the underlying work-flow utilized in these systems by comparing it with traditional methods of medication administration. Then it investigates the adoption and implementation of eMAR and BMV in hospitals in the United States, the conversion from traditional medication administration to eMAR documentation, and how utilization of eMAR and BMV can promote patient safety. The chapter concludes with the exploration of future trends in medication administration through the utilization of eMAR and BMV, and highlights future research directions in the field.

TACMIS

TACMIS is an inclusive solution to the management of health care and medical information and its design is based on a detailed process analysis of patient journeys and the pathways of clinical care of stroke patients as they progress from acute care, through rehabilitation to discharge and independent living, often with a residual disability. The findings are the work of a team based in the Discovery Research Laboratory at Ritsumeikan University in Japan. The clinical analysis was conducted at King’s College Hospital in London and in several care institutions for the disabled and the aged in Japan.

The Role of Wireless Technology in Addressing Sleeping Disorders in Aged Care

Sleep problems are frequently witnessed in aged care facilities with a large proportion going undetected. Multiple factors are known to contribute many abnormal sleep/wake patterns for residents. A systematic review conducted by Haesler (2004) provided a guide to the direction of future research into sleep in older adults residing in care facilities. This chapter evaluates the effectiveness of implementing the following evidence based recommendation from Haesler (2004): Wrist actigraphy currently represents the most accurate objective sleep assessment tool for use in the population of interest. Factor analysis was utilized to study the patterns of relationship among many dependent variables, with the goal of discovering something about the nature of the independent variables that affect them. Wrist actigraphy showed a disparity between the actual bed time and wake time. One clear difference detected using the device was the increased detection of sleep during the day.

User-Centric and Inclusive Design Methods

This chapter discusses the role of user-centric and inclusive design methods in healthcare pathways. The rapid uptake of e-health technologies by clinicians and healthcare managers to administer, for example, patient records, has meant that user-centered e-health tools and processes should be adopted to enable those receiving healthcare to become more involved, more proactive in, and more responsible for their own healthcare and its planning. An argument for a user-centered approach as good business practice can also be made. The three case studies described in this chapter are united by a concern for the individual, the end-user, at the heart of healthcare processes, and how design methods, which have a strong emphasis on the consumer or user perspective, can assist the changing requirements for healthcare delivery through an improved, earlier and ongoing engagement with the recipients of health care.

Incorporating Radiological Patient Data Acquired at Other Hospitals into the Local Workflow

Patient data are increasingly distributed between hospitals using CDs instead of physical films. This introduces problems because different viewers from different vendors are provided, and sometimes viewers are unusable because local software installation is not allowed. In 2004, we started to facilitate the incorporation of image data from CDs into the normal workflow of the hospital by using commercially available software to perform patient reconciliation based on the DICOM modality work list. In the years after the first introduction, a more comprehensive software system was developed which allows for the fast upload of large amounts of patient image data into the normal workflow. Although direct network connection between institutions is currently being developed and deployed, in the next decade CDs will remain to be used and the integration of the data into the normal workflow is a must. Literature shows that other institutions also started to handle the CDs similarly.

Doctors Using Patient Feedback to Establish Professional Learning Goals

There is growing interest in the way that communication between doctors and patients affects important aspects of patient care and health outcomes. However, there is not much research on quantifying the effect of specific training programmes in communication skills for doctors. The aim of this chapter is to describe a research project that addresses this issue by first asking patients to provide feedback to doctors on their interpersonal skills. A set of training objectives is then discussed with individual doctors based on patient feedback. A training programme is subsequently undertaken by doctors, who are re-assessed by patients to determine the effectiveness of the feedback and training. The results indicate significant improvement on re-measurement. The chapter discusses the reasons for this improvement and the implications for providing personalised interpersonal skills training programs that target those skills that have been specifically identified by patients.