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Healthcare Solutions

2011-1 (Vol.47, No.1)

This special issue presents Fujitsu's activities in the healthcare field in Japan and several other countries.

2011-1 (Vol.47, No.1) Contents

1. Preface (510 KB): In Japan, Fujitsu has been active in the healthcare field from early on. It was the first to adopt a strategy of packaging integrated medical information systems, and it has contributed to the adoption of information technology in medical institutions by providing one-stop electronic medical record (EMR) solutions covering implementation, operation, and maintenance. Looking forward, Fujitsu is dealing with the following two issues in an era of change. First, the need is felt for more sophisticated EMR systems that can provide functions for genuinely supporting medical care and enabling advanced use of medical data and that can enhance networks. Second, to support an advanced, human-centric information society, Fujitsu is pursuing the health information business to provide an individual-oriented information platform that merges medical, nursing, and health information. ---[Hirofumi Gouda, Corporate Vice President, Executive Vice President of REGIONAL BUSINESS GROUP, President of HEALTHCARE SOLUTIONS UNIT]

2. Fujitsu's Ongoing Activities in Healthcare Field (747 KB): As a pioneer in the application of information technology (IT) in the healthcare field, Fujitsu was the first company in Japan to develop a software suite for medical institutions. Ever since, it has advanced together with its customers. At first, it was engaged in introducing IT to departments involved in work such as insurance claims and accounting and clinical laboratory examinations. As IT use in individual departments progressed, it moved toward overall integration and developed a computerized physician order entry system. Now, it is digitizing patient medical records that were originally handwritten on paper by doctors, leading to the development of electronic medical records. During all this progress, target markets expanded from the medical field to include health, nursing, and the healthcare industry. Today, as it strives to address the familiar concerns of public safety and security, Fujitsu is playing the role of a social infrastructure provider. This article outlines this history and discusses today's healthcare solutions and future ones. ---[Takemi Kida]

3. Trends in National Information Technology Strategy for Healthcare (1.68 MB ): The crisis facing Japanese medical care is becoming more evident with the rapid aging of society and the accompanying issues of rising public health expenditures, lack of and uneven distribution of doctors, collapse of regional medical care, and overworking of healthcare personnel. It threatens the security of Japanese citizens in their daily lives. In light of these social issues, the Japanese government views the medical/health field as a growth industry. While laying out an economic growth scenario, it is emphasizing the healthcare field in its national information technology (IT) strategy and engaging in proactive use of IT as an effective solution. IT strategy has been restarted under the new Democratic Party of Japan (DPJ) administration: in May 2010, a new IT strategy was approved by the Cabinet. Efforts in the healthcare field continue to play an important role. This article looks at trends in the national IT strategy for healthcare, focusing on the government's new growth and new technology strategies. ---[Takeshi Onaya, Nobuhide Kaneda, Hiroki Fujii]

4. Evolution of Electronic Medical Record Solutions (1.11 MB ): This paper introduces Fujitsu's efforts in the area of electronic medical record (EMR) solutions. EMRs play a central role in promoting information technology in the medical arena, which is a priority measure of the Japanese government. Through the evolution of EMR solutions, we have designed and provided solutions that meet the unique characteristics of medical institutions according to their size while also strengthening partnerships with customers through user association activities. The initial task was to achieve uniform management of information within medical institutions, but recently, due to the promotion of regional medical cooperation, it has become necessary to unify medical information in a way that focuses on individual patients. This paper reaffirms the future role that EMR solutions will play in personal health records, a system that we must move toward as record use evolves from an approach based on an individual's illnesses to one based on his or her total well-being. ---[Takeharu Sonoda]

5. Revolutionizing System Support in the Age of Electronic Medical Records (833 KB): To allow its customers to use electronic medical record (EMR) systems with peace of mind, Fujitsu began providing a One-Stop Medical Support Center service in May 2009 in Japan. Although an EMR system can be complicated, it must be accessible at any time (24 hours a day, 7 days a week), and system maintenance requires broad product knowledge and a significant amount of labor. Designed to reduce the burden on customers, this service shook up the traditional per-product support system and the traditional support scheme centered on on-site systems engineers. As part of this service, a round-the-clock specialized staff was created for handling and responding to questions and problems related to all Fujitsu healthcare products (from hardware to application packages): an industry first. This made it possible to prevent problems by monitoring customers' systems through a secure line and achieve speedy problem resolution through remote maintenance. This paper introduces the One-Stop Medical Support Center service, which robustly supports customers in using their systems safely and securely. ---[Toshihiro Sakurai]

6. Human Centric Care (922 KB): With populations ageing and chronic disease increasing, the cost of healthcare will continue to rise. The challenge for societies is to improve existing healthcare services with less money. While it is true that information technology (IT) promises to help solve this problem, the IT industry has been slow to deliver the types of benefits seen in other industries. How to best utilise IT in supporting healthcare systems depends on how we choose to view those systems. There are many different perspectives. This paper outlines the most common ones: clinician centric, government centric, and patient centric before describing a new holistic view, which we call Human Centric Care. By understanding the goals common to every healthcare system and the human relationships within them, we believe that we can create new flexible IT systems, around both people and processes, that can unlock the full potential of IT healthcare. ---[Joel Ratnasothy, Makiko Hisatomi, Paul Blackburn, Ali Anjomshoaa, Kenichi Fukuda, Adel Rouz, Lester Russell]

7. Fujitsu's Lean Solutions Group—Lean Healthcare in Canada— (921 KB): For many years, public healthcare delivery has been in crisis mode for various reasons such as increased demand for services, demographics, waiting time concerns, rising cost of service delivery, government funding constraints, quality concerns, lack of qualified personnel, and productivity and morale issues. This situation will only get worse in the coming years. Most healthcare sectors around the globe are facing similar challenges. It is therefore only a matter of time until public healthcare sectors have to tackle these challenges with a front-line, operational approach that delivers real, short-term results to patients, clinicians, and stakeholders. This paper introduces an example of consulting based on the Lean Healthcare practiced by the Fujitsu Lean Solutions Group with Fujitsu Consulting (Canada). ---[Camil Villeneuve]

8. Finnish National Archive of Health Information (KanTa): General Concepts and Information Model (726 KB): The need for semantically interoperable health information systems is an eminent principle in health informatics. The Service Orientated Architecture (SOA) together with a standardised structured information model based on the extensible markup language (XML) like HL7 CDA R2 is a recognised tool for storing and sharing medical information in a semantically uniform way (HL7: health level 7, CDA: clinical document architecture, R2: release 2). In Finland, the Ministry of Social Affairs and Health initiated an implementation project to build a national, centralised health information archive based on HL7 v3 CDA R2 in 2007 (v3: version 3). The Finnish model using the SOA architecture and a highly structured implementation of CDA R2 provides a solid infrastructure for gathering nationwide health information in the centralised archive. In Finland, these architectural foundations are applied to implement a national health record archive, a national electronic prescription system, and a Web portal for citizen access to personal health information. Together, these three applications form the foundation of the Finnish national archive of health information known as KanTa. Fujitsu Services Oy in Finland is the prime contractor and has overall project responsibility for delivering the KanTa system. ---[Teemu Suna]

9. Industrial-Strength Interoperability Platform for Health (IOP-H) (892 KB): To sustain the evolution toward pan-Canadian electronic health records, Fujitsu was mandated to develop the InterOperability Platform for Health (IOP-H), which can be viewed as a robust, flexible, and high-performance integration platform that ensures the reliable, secure, and traceable flow of patients' clinical information between applications located in technically diversified and physically or organizationally distributed environments. This flow is controlled by rules governing the access rights and the logical sequence of events and conforms to pan-Canadian standards for the health sector. This paper outlines IOP-H by introducing its architecture, services, and implementation. ---[Pierre Coderre]

10. Growth of Biometric Technology in Self-Service Situations (731 KB): While the healthcare industry has made great strides in ensuring patient safety, challenges still remain with medical identity theft and insurance fraud continuing to make headlines, leaving hospitals responsible and exposed. In recent years, new procedures and technologies have emerged to address these challenges and help healthcare facilities protect their patients' privacy and well-being. This paper introduces activities that utilize biometric technology to address issues such as medical identity theft and identity verification in the USA. ---[Josh Napua]

11. Initiatives in Prospective Payment Systems Based on Diagnosis Procedure Combination (877 KB): The Prospective Payment System (PPS) based on a patient's diagnosis procedure combination (DPC) was introduced in 82 technologically advanced hospitals nationwide in Japan in April 2003. This system was later expanded to private general hospitals that offer acute care, bringing the number of participating institutions to 1557 in fiscal year 2009. As a top vendor in the healthcare system market, Fujitsu has participated in the study and operation of PPS from the beginning and supported the smooth introduction of DPC. We have developed a DPC analysis system that organizes and compiles the necessary information from a large amount of DPC data into databases. This allows hospital management to easily retrieve useful statistical data. This tool helps medical institutions in their efforts to make full use of DPC data and to improve medical service quality and service efficiency. This paper provides an overview of PPS and how to use the DPC analysis system for administrative improvement. It also mentions how Fujitsu has worked on benchmarking between hospitals. ---[Kazuhiro Takei, Hirokazu Ito]

12. Region-based Total Medical Care and Inter-Regional Solutions (1.12 MB ): The regional medical network run by "HOPE/Regional Cooperation V1" went live in April 2008 at Asahikawa Red Cross Hospital and in May 2008 at the National Hospital Organization Kanazawa Medical Center, in Japan. This product was recognized by the Japan Industrial Design Promotion Organization as a solution concept for "medical care that integrates the region, thereby providing the patient and family with peace of mind" and won the 2009 Good Design Award. After first touching on the effects of inter-regional solutions on region-based total medical care through the introduction of the HOPE/Regional Cooperation V1 network, this paper describes what is involved in the spread of regional medical networks. Next, it describes the features of the new product HOPE/Regional Cooperation V3 and explains how it addresses a growing need for multiple-access linkage capability. It also mentions the issue of standardization, which is necessary for the spread of multiple-access linkages. Finally, it examines how multiple access linkages will affect regional medical care. ---[Yoshiki Tanaka]

13. Medical Image Information Solution and Laboratory Test Information Solution for Improvement of Diagnostic Accuracy (1.01 MB ): A wave of medical record computerization is sweeping through the medical field, starting with individual hospitals and extending to regional cooperation. Medical records include images obtained by computed tomography (CT) and magnetic resonance imaging (MRI) and numerical measurements of specimens such as blood and urine. Systems for managing image and numerical information have become widespread as departmental business systems, and they are now evolving into decision-making support systems and systems for improving diagnostic accuracy. This is because they transmit and process exponentially increasing amounts of image information for each patient and because they provide easy access to the electronic medical records. In this paper, we introduce Fujitsu's solutions related to medical images and laboratory tests and describe our activities for making systems better able to support improvements in diagnostic accuracy. ---[Yasuharu Ogino, Fumio Fukushige, Kohei Murao]

14. Fujitsu's Approach to Online Medical Billing Mechanism (816 KB): Japanese ministerial reforms of 2006 called for an online medical billing system that would use secure network lines to claim remuneration for medical care rendered. Moreover, electronic billing (online billing or billing using optical disks) is to become mandatory in principle by fiscal 2015 as a matter of government policy. Sending bills over the Internet requires the use of a service provider abiding by the "Guideline for Security Management of Medical Information Systems." Fujitsu currently provides the FENICS Medical Group Net Service, which has conformed to this guideline from the start, and is also developing new online support services that use network connections for online billing. This paper outlines the online billing process, introduces Fujitsu's approach to online medical billing, and describes new services for small and medium-sized hospitals that use an online billing network. ---[Koji Nishida]

15. Fujitsu's Approach to Healthcare Information Systems (742 KB): The institutionalization of health promotion issues is proceeding in Japan, as can be seen from Industrial Safety and Health Law revisions in 2006 that lay out the obligations of entrepreneurs towards employees and the enforcement in April 2008 of systems for specific medical examinations and specific health guidance resulting from regulations ensuring medical care for the elderly. With these developments, the public's awareness of health issues is also changing. Fujitsu has been providing health checkup assistance systems to hospitals and health centers with the aim of enabling early detection of diseases. However, to cope with the developments in the market and the heightening of public awareness of health issues, Fujitsu has developed HOPE/webH@ins-GX, a healthcare information system. It also strengthens features such as providing medical advice seekers with the ability to promote their own health, as exemplified by the health guidance feature, and allowing entrepreneurs to manage and direct the health of their employees more effectively. In this paper, we describe this new system's development background and its characteristics from the various viewpoints of system users and describe prospects for the human-centric health information business, which will support health promotion for everyone. ---[Hiroshi Kogawa, Takashi Ito]

16. Care Solution That Benefits Aging Society (1,000 KB): In response to the rapid aging of society and the diversification of user needs, the Japanese nursing-care insurance system and the care service industries have been undergoing continuous transformation. Likewise, the demands of the care service providers for their business support systems are also changing. When Japan's first nursing-care insurance system went into effect in April 2000, Fujitsu began offering care service providers the business support package HOPE/WINCARE. Ever responsive to the needs of the time, we have provided new functionality such as reliable billing, improved efficiency in billing paperwork, care record sharing and data editing, and form creation through processing. We have helped to increase work productivity and have continuously striven to improve functionality. Moreover, in February 2010, we released HOPE/WINCARE-ES as a new product in the HOPE/WINCARE series. The concept was twofold: to provide more comfortable operation and to utilize records to achieve quality improvements in care service. This paper describes Fujitsu's care solutions based on the HOPE/WINCARE series. ---[Hitoshi Hatakeyama]

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