Abstracts of Magazine FUJITSU 2010-7 (VOL. 61, NO. 4)

Special Issue: Healthcare Solution

• History of Fujitsu's Activities in Healthcare Field

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, we have advanced together with our customers. At first, we were engaged in introducing IT to departments involved in work such as insurance claim and account system and clinical laboratory examinations. As IT use in individual departments progressed, we moved toward overall integration and developed a computerized physician order entry system. Now, we are digitizing patient medical records that were originally handwritten on paper by medical 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 health care industry. Today, as we strive to address the familiar concerns of residents' safety and security, Fujitsu is playing the role of a social infrastructure provider. This article reflects on this history and discusses today's healthcare solutions and future ones.

• Trends in National Information Technology Strategy for Healthcare

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. This situation 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. The government is engaging in proactive use of IT as an effective solution. IT strategy has been restarted under the new Democratic Party of Japan (DPJ) administration, and in May 2010, a new information and communications technology 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 strategy and new technology strategy.

• Evolution of Electronic Medical Record Solution

This paper introduces Fujitsu's efforts in the area of electronic medical record solutions. Electronic medical records play a central role in promoting information technology in the medical arena, a priority measure of the Japanese government. Through the evolution of the electronic medical record solution, we have designed and provided solutions that meet the unique characteristics of medical institutions according to their size while also deepening 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 the electronic medical record solution will play in personal health records, a system we must move toward as record use evolves from an approach based on an individual's illnesses to one based on an individual's total well-being.

• Revolutionizing System Support Scheme in the Age of Electronic Medical Records

To allow our customers to use electronic health records system with peace of mind, Fujitsu began providing a one-stop medical support center service in May 2009. While electronic medical records system comprise a complicated system, they must be accessible at any time (24/7 availability), 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 around on-site system engineers. As part of this service, as an industry-first, 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). This made it possible to prevent both problems by monitoring customers' systems through a secure line and speedy trouble 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.

• Initiatives in Prospective Payment Systems Based on Diagnosis Procedure Combination

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 medical 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 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 care quality and service efficiency. This article provides an overview of PPS and how to use the DPC analysis system for administrative improvement. It also mentions how Fujitsu has worked to meet hospital benchmarks.

• Region-based Total Medical Care and Inter-Regional Solutions

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. 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.

• Image Information Solution and Laboratory Test Information Solution for Improvement of Diagnostic Accuracy

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 because they transmit and process exponentially increasing 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.

• Fujitsu's Approach to Receipt Online Claim System

Japanese ministerial reforms of 2006 called for a "receipt online claim system" that would use secure network lines for claiming remuneration for medical care rendered. Moreover, electronic receipt claims (online claims or claims using optical disks) are to become mandatory in principle by fiscal year 2015 as a matter of government policy. Making online claims 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 claims. This paper outlines the online claim process, introduces Fujitsu's approach to online claims, and describes new services for small- and medium-sized hospitals that use an online claim network.

• Fujitsu's Approach to Healthcare Information Systems

The institutionalization of health promotion issues is proceeding, as can be seen from the Occupational Health and Safety 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 that 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 human-centric health information business, which will support health promotion for everyone.

• Care Solution That Benefits an Aging Society

In response to the rapid aging of society and the diversification of user needs, the 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, 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.

• Human Centric Care

With ageing populations and increasing chronic disease, 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 the deliver the type of benefits seen in other industries. How to best utilise IT in supporting healthcare systems, depends on how we choose to view them. There are many different perspectives. This paper outlines the most common: Clinician centric, Government centric and Patient centric, before describing a new holistic view, one we call Human Centric Care. By understanding the goals common to every healthcare system and the human relationships within them, we believe we can create new flexible IT systems, around both people and process, that can unlock the full potential of IT healthcare.

• Fujitsu's Lean Healthcare Solution's Success Story

For many years, the public healthcare delivery has been in "Crisis mode". Many reasons may explain that situation: increased demand for services, demography, wait time concerns, rising cost of service delivery, government funding constraints, quality concerns, lack of qualified personnel, productivity and morale issues, etc. 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 will 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 Lean Healthcare practiced by Fujitsu Consulting, in Quebec, Canada.

• Finnish National Archive of Health Information (KanTa):General Concepts and Information Model

The need for semantically interoperable health information systems is an eminent principle in health informatics. The Service Orientated Architecture (SOA) together with an XML based standardised structured information model like HL7 CDA R2 are recognised tools to store and share medical information in a semantically uniform way. In Finland, the Ministry of Social Affairs and Health initiated an implementation project to build a national, centralised HL7 V3 CDA R2 based health information archive in 2007. The Finnish model to use SOA and highly structured implementation of CDA R2 provides a solid infrastructure to gather nationwide health information to the centralised archive. In Finland these architectural foundations are applied to implement a national health records archive, a national electronic prescriptions system and a web portal for citizens' 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 Finland is the prime contractor and has the overall project responsibility in delivering the KanTa system.

• Industrial strength InterOperability Platform for Health (IOP-H)

In order to sustain the evolution toward a pan-Canadian Electronic Health Record (EHR), 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 is abiding by pan-Canadian standards for the Health sector.

• Growth of Biometric Technology in Self-Service

While the healthcare industry has made great strides to ensure patient safety, challenges still remain as cases of medical identity theft and insurance fraud continue 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.