Abstracts of Magazine FUJITSU 2015-3 (Vol. 66, No. 2)

Special Issue: Healthcare Solutions for the Future

Overview

• Activity of Next-Generation Healthcare Innovation Center

Since the mid-1970s, Fujitsu has been the forerunner of information and communications technology (ICT) in the field of medical care. Being the first in Japan to develop and launch a package solution for medical care providers, we have always progressed with our customers. A major paradigm shift is taking place today in tandem with the remarkable advancement in medical technology and ICT, against the background of changing morbidity patterns and a rapidly aging population. As society is better connected through the ICT network and the scope of health information exchange systems are expanding, we are approaching the time when individuals are connected to the network through many channels in their lives, and information can be referenced and utilized in the area of self-management in healthcare. This paper describes the progress in, and present situations of, Fujitsu's efforts in the medical field, and it introduces some initiatives with facts in relation to the Next-Generation Healthcare Innovation Center, which has been established for the realization of a future society where people enjoy good health and longevity.

New Vision and Future Vision for Healthcare

• Trends of ICT in Healthcare Policy

Being a society of advanced aging, Japan is faced with the societal challenges of optimizing medical cost, which continues to increase by trillions of yen annually, and of sustaining the overstretched healthcare system. Thus, a fundamental reform is urgently required in healthcare and medical services. Given this situation, under the slogan of "prolonging the national health expectancy" in the country's growth strategy entitled "Japan Revitalization Strategy—JAPAN is BACK" (revised in June 2014) the Japanese government has set the goal of "prolonging the national health expectancy," and it aims to simultaneously ensure the sustainability of the social security system, provide high-quality healthcare services and activate the health industry. In addition, it has further developed the Act on Promoting the Healthcare Policy that has the basic philosophy of providing medicine using the highest level of technology in the world and contributing to economic growth, and formulated the Healthcare Policy (July 2014) that incorporates specific measures. This paper draws on the government's Healthcare Policy and describes the latest trends of ICT policies in the areas of healthcare, medicine and nursing care.

• Project on New Solution Utilizing Information & Communications Technology in Field of Clinical Trials and Clinical Research

Fujitsu has been offering electronic medical record solutions to medical practices for many years. As they become prevalent, there is an increasing demand to deploy the accumulated data in order to enhance diagnoses, or make the medical records accessible for the purpose of clinical trials and clinical research. On the research front, there are high expectations for the development of an IT-enabled environment that lets the users feed the knowledge they have acquired through such endeavors back to medical practices. For example, they may have acquired such knowledge from clinical trials and research at large university hospitals or from managing a volume of genetic data at medical school labs. Fujitsu is striving to realize a new solution that adapts medical data, accumulated via electronic medical records over an extended period of time, and develops a viable business model from it. This paper describes an ideal approach to the next-generation electronic medical record system, and it further explores the system's future potential from the perspectives of Personal Health Record (PHR) based on the current progress both in the coordination with research fields and in the application of IT to clinical trials and clinical research.

• Healthcare Study System Using Windows 8 Tablets: Case Study of Tohoku University Tohoku Medical Megabank Organization

Tohoku University Tohoku Medical Megabank Organization is developing a system to conduct a longitudinal health study project with participation by residents in the areas affected by the Great East Japan Earthquake. The project aims to support the reconstruction efforts and restore the community medical system. For this initiative, Fujitsu has developed a system for conducting various healthcare studies employing Windows 8 tablets, from a basic survey to an eye test, color vision test, intraoral check-up, medical interview for oral diseases, clinical psychology test, and cognitive psychology test. The system has adopted a web-application style, leveraging Fujitsu's know-how in web system development for better accessibility and usability, and it is used by installing on it applications from Windows Store that are dedicated for healthcare testing. The system enhances the study's implementation in various aspects, such as by improving the accuracy of the test results and ensuring a higher level of sophistication of the data to be collected, economizing the time to digitize the test results, and simplifying the process of test implementation. This means that human resources can be more efficiently deployed in comparison with conventional paper-based methodologies. This paper firstly describes the system structure, and then it explains the key features of the healthcare study system.

• Prospect of ICT Deployment at Major Clinical Research Hospitals

One of Fujitsu's endeavors in healthcare is to develop coordinated solutions for medicine and pharmaceuticals and have them deployed at medical institutions, and it is focusing on clinical trial research to enhance the development of drugs and medical equipment. Today, Fujitsu aims to develop a stronger system of medical cooperation by introducing the tsClinical DDworks21 series, developed for the pharmaceutical industry, into the existing healthcare product range including the Hope series. They will be used with electronic medical records and other medical information systems. It is also promoting the Fujitsu Healthcare Solution HOPE New Medical Good Clinical Practice (NMGCP), a clinical trial management solution to help trial implementations. Three systems are applied at medical establishments, namely the GCP Management System for managing clinical trials, the Electronic Data Capture (EDC) System for collecting case data, and a warning system for managing side-effect information. The coordinated solution for medicine and pharmaceuticals thus helps to improve the process efficiency in the development of drugs and medical equipment, and renders powerful support for quality management (validation), which is important and in fact essential in this field. This paper will describe the development of Fujitsu's coordinated solution that focuses on the clinical trial research at medical practices. It will describe its role, effects and future prospects, drawing on the social current in relation primarily to major projects for advancing clinical research.

• Project on Information-support Solution in Emergency Medical Service

Recent years have seen reports of incidents in which patients die before reaching hospital to be treated. This is becoming a social problem. Further, there are an increasing number of cases where emergency vehicles are on the road for longer than 30 minutes in search for a hospital with a capacity to receive patients, and this number is predicted to grow further. This paper explains the development of an emergency medical system in Japan and issues regarding the information system in emergency medical services. It also describes some of the projects at Fujitsu that address these issues, including the information-sharing system for an emergency medical service that allows for data-sharing between paramedics and hospital staff to minimize the patient transfer time. Another project at Fujitsu is a geriatric emergency medical service support system, which draws on regional healthcare networks to select an appropriate destination hospital and facilitate preparations for timely acceptance.

Set of Solutions to Realize Japan Revitalization Strategy—Japan is BACK—

• HumanBridge—Cloud Computing Solution for Regional Health Information Exchange: from Preventive Medicine to Regional Comprehensive Care

Launched in 2011 as a cloud-based service, the HumanBridge EHR Solution with features to share healthcare information has been introduced at nearly 400 hospitals (as of July 2014). Regional health information exchange is now considered to have moved on to the stage of proliferation. Against this background, the system's scope of application is expanding beyond conventional connections between hospitals and clinics, and Fujitsu has been developing various features and providing new solutions to accommodate such expansion. This paper describes HumanBridge features and services applied to various areas such as emergency medical care, remote medical care, home-care networks, networks of pharmacies and hospitals, wide-area health information exchange, and regional disease management, among others, with reports on cases of actual uses.

• Cloud-based Electronic Medical Record System for Medium-sized and Small Hospitals: HOPE Cloud Chart

An electronic medical record system allows physicians, nurses and other medical staff to share patient records with great efficiency, while at the same time enabling them to provide a patient-centered medical service with safety and security. By leveraging the electronic medical record system in regional medical networks, patient records can also be shared with other hospitals in the same region. In July 2014, Fujitsu launched an electronic medical record system, Fujitsu Healthcare Solution HOPE Cloud Chart, which can manage standard medical practices, and which was formulated on the basis of Fujitsu's management know-how gained through installing the system at more than 600 hospitals. Because HOPE Cloud Chart is a service based on cloud technology, it comes with the advantages of requiring less initial investment and imposing a lower burden in terms of its operation and maintenance, and it can be quickly installed. This paper describes HOPE Cloud Chart in terms of its features, system configuration, installation method and expected performance results.

• Nursing Care Cloud Computing Solution towards Construction of Community-based Integrated Care System

The population in Japan is aging at an alarming rate. According to the Annual Report on the Aging Society 2014 by the Cabinet Office of Japan, 31.9 million people were aged 65 or above as of October 2013, while the number of people in this age bracket is estimated to reach as high as 38.78 million in 2042. Given this situation, the Ministry of Health, Labour and Welfare aspires to establish a community-based integrated care system designed to allow elderly citizens to stay in the communities they are attached to and lead dignified, independent lives. An array of laws are in development, such as the Act for Securing Comprehensive Medical and Long-term Care in the Community that was passed in June 2014. The community-based integrated care system must address the increasing need for maintaining the quality of nursing care against the background of the growing elderly population requiring care at home. At the same time, it needs to establish a system to enhance efficiency in service provision and information-sharing among key players such as physicians and nursing care providers. This paper describes the efforts at Fujitsu to develop a community-based integrated care system that is built upon a Fujitsu's solution to assist care providers in their service provision and management.

• Developing Biological Simulations for Next-generation Healthcare

Supercomputers today are applied in ways that go beyond academic research and into diverse fields such as manufacturing and climate/meteorological predictions. Meanwhile, the use of information and communications technology (ICT) in medicine goes only as far as the latest medical equipment such as medical imaging diagnostic systems, or administrative support such as electronic medical record systems. Supercomputers, computer simulation in particular, have developed few practical applications in medical and surgical therapy and healthcare. We believe there is great potential for using computer simulations in this domain, and therefore we are pursuing research and development of several biomedical simulation systems. This paper describes one of our projects, a biomedical simulation system drawing on the heart simulator which has been under development since 2007 in joint collaboration with Profs. Toshiaki Hisada and Seiryo Sugiura from the Graduate School of the University of Tokyo and their research team. This paper presents an overview of the heart simulator, followed by descriptions of pre-processing and visualization in simulation with accounts of a case of application. The paper concludes with issues and future developments in order to realize practical application.

• Project on Bio-IT for Next-generation Healthcare

As part of its computing and simulation technologies in science, Fujitsu has been engaging in R&D of IT-based drug discovery that makes it possible to generate compound information and search for potentially efficacious materials. A joint research study started in FY2011, conducted with Research Center for Advanced Science and Technology, the University of Tokyo and some pharmaceutical manufacturers. It successfully composed a new compound with high avidity that held promise in terms of having possible medical potency. This development was made possible by the improvement of computing capacities such as Japan's supercomputer "K," together with enhanced computer simulation technology. New initiatives are already underway to realize the next-generation healthcare system. One such initiative is a project to develop a single-cell diagnostic system. It takes a minute sample of a single cell and manages to measure and analyze component materials, and it has potential to be applied to health check-ups and other areas. Another case is the development of analytical technology for genome data, which is expected to occupy a significant place in future personalized medicine. These projects aim to develop technologies by joint studies with academic and research institutes. In this paper, we introduce some initiatives at Fujitsu in relation to the development of bio-IT technology, and describe the potential to change future healthcare.

Trends of Overseas Markets and Cases of Activities

• Examination of Introducing Community Healthcare Information Network in Vietnam

In FY2013, Fujitsu, together with Fujitsu Research Institute and VNPT-FUJITSU Telecommunication System JSC, a group company in Vietnam, examined the feasibility of introducing a community healthcare information network in Vietnam, to leverage the endorsement of the Ministry of Economy, Trade and Industry. Vietnam faces an urgent task of improving community healthcare services to address the medical resource shortage. The Vietnamese Ministry of Health is highly interested in the community healthcare information network, which is designed for efficient deployment of medical resources through coordinating data between medical institutions within the country. Vietnamese medical facilities are equipped with IT infrastructure having a certain level of reliability thus providing the basis of the demand for such community healthcare information network. This paper describes the Vietnamese need for the information network, and presents an overview of the community healthcare information network and schematic steps necessary for introducing the network in this country.

• European Union's Growth Strategy in Healthcare

The European Union (EU) is investing extensively in healthcare-related research and engineering under its growth strategy Europe 2020, striving to address such long-term issues as advancing ageing and increasing unemployment. Research has been mainly conducted in the areas of chronic disorders—prevalent among people of advanced ages—and enhancement of medical system efficiency. There has also been research on the development of new drugs, enhancing healthcare systems, and developing methodologies and tools/technology to deliver healthcare adapted to individual needs such as personalized medicine and telemedicine. Horizon 2020, a new framework program that started in January 2014, builds on the previous research on advanced technology medicine, and includes many open projects related to information and communications technology (ICT) on self-reliance support for the elderly, patient self-management, integrative care systems, new diagnostic aids and other topics. These kinds of efforts are directed toward reducing healthcare costs through the enhancement of data-based medical technology, personalized medical care, and home care systems. In addition, they also expect to generate more employment by creating a new healthcare industry. In tandem with the EU's healthcare growth strategy, Fujitsu Laboratories is engaging in joint research in Ireland, together with Fujitsu Ireland, to leverage the data on daily health statuses to improve both disease prevention and illness recuperation. This paper presents a summary of research programs in relation to the EU healthcare growth strategy in terms of their structures and outlines, followed by accounts of the joint research project currently undertaken in Ireland by the authors.