This document discusses how information and communication technologies (ICT) can assist community healthcare and home medical care in Japan. It notes that Japan's population is aging rapidly and chronic diseases are becoming more common, increasing demand for home medical care. The document then introduces an ICT system called EIR that allows doctors, nurses, pharmacists, and other care providers to securely share patient information via smartphones to better coordinate care. A survey found that most medical professionals are interested in using such a system to improve communication and provide more efficient, team-based care for patients.

1. ISfTeH 18th
2013.10.19
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

2. Population Pyramid of Japan
2010
Aging rate (65y.o.-)
23%
2040
36%
65y.o
National Institute of Population and Social Security Research
India
2010
5%
14%
Canada
2010
United Nations, Department of Economic and Social Affairs, Population Division (2013)

3. Cause of death in Japan (2009)
Suicide
Others
Accidents
Old age
Cancer
pneumonia
cerebrovascular
disease
cardiac
disease

4. Place of Death
Nursing
Hospital Home
Home
Japan
U.S.A.
Netherlands
Where would
you like to die?
（survey in JPN）
８１％
１２％
４％
４１％
３１％
２２％
３５％
３１％
３３％
１５％
７３％

5. Goal of Medical Care is changing・・・
Cure ＱＯＬ
Health ＝ “Well-being Life”

6. 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.
Diseases of New
Patients at Homecare
2012.10～2013.9 (n=127）
Others
Respiratory
disease 5%
Cardiac disease
4%
5%
Orthopedics
disease
5%
Neurodegenerative
disease 1%
Cancer
39%
Old age
8%
Endocrine
disease
10%
Cerebrovasc
ular disease
10%
Dementia
13%

7. Visiting nurse
Care manager
Visiting
Rehab
Basic Condition for the
Patient
Comprehensive Community Care
House #2
Home care
System
doctor
Home
helper
１．Efficiency
Hospital
２．High level Cooperation
Patient
House #1
Visiting
pharmacist
Various specialists in the community support the
home medical care and nursing care as a team

8. Utilization of Smartphones in Home care
Schedule management
Prescription
GPS
FAX
Support everyday practice
Emergency call
Dictation
Patient Education

9. Allocation of time of a doctor has been drastically changed.
Temporary home visit
Documentation
Reporting to
related parties
3.1hr
5.7hr
Meetings
Preparation of
medical records
3.5hr
50% increase
of Consultation
time!
2.4hr
Travel time
Consultation time
4.4hr
2.9hr
Before
After
・Dicatation
・Utilizing IT for documentation and info sharing

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

11. Current Situation of Information Sharing
Communication notes
in patients homes
FAX
Paper
Information
•
•
•
•
Can only be seen in patient homes
Duplication of recording efforts
Lack of information consistency
Cannot be easily copied

12. EIR
cloud based information sharing system
Nurse：The pain is getting
worse. Morphine dosage needs
to be adjusted.
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.
the patient who has received home
palliative care in the cancer last stage.
Home helper：From when does
medicine change? What should
I be careful of?

13. Can be used both on the mobile and smart phones
www.eir-note.com
Can be used both on iPhone & Android

14. “EIR” users feel the positive change
in their operation
surveyed by questionnaire
Can understand MD’s
instruction easily.
Visiting
Nurse
Easy to communicate with DRs so
that I can understand disease
condition much better now!
pharmacist
Home care
doctor
Now I feel that I am part of
a team to treat a patient.
Ministry of
Would you like to use
ICT system for information sharing
Don’t know Already Using
26％
16％
Want to use
Don’t want
immediately
to use
1％
3％ If possible
54％
70% are interested
in the system

15. ICT ～powerful tool for home medical care～
• 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