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Japan Update : Success Stories
Shinya Oku
IHE Japan Board Member
Presentation Outline
Characteristics of IHE Japan)
Introduction of Success Stories
Economical Consideration
Future Direction
- 8 Sites 120 profiles were implemented
-(21 in US, October 2007)
2 National University Hospitals
2 Private University Hospitals
3 Public or quasi-public Hospitals
1 Clinic (Imaging Centre)
IHE Japan
Activities initiated in 2001
Supported by METI and then MHWL
Established “IHE Japan Association” in March 2007
Success Stories: Comparison between Japan and US
Success Stories: Actors applied in SWF implementation
Three Stories en bref
Saitama Medical Centre 2003-2006
Okazaki City Hospital 2004-present
National Radiological Institute 2005-present
Case of Saitama Medical Centre
Saitama Medical Centre 2003-2006
Okazaki City Hospital 2004-present
National Radiological Institute 2005-present
“First-in-Japan” Showcase of the Radiology
Department System Using Integrating the
Healthcare Enterprise-Japan (IHE-J ) Guideline,
supported by the Ministry of Economy, Trade and
Industry (METI).
“First-in-Japan” Showcase of the Radiology
Department System Using Integrating the
Healthcare Enterprise-Japan (IHE-J ) Guideline,
supported by the Ministry of Economy, Trade and
Industry (METI).
Saitama Medical CenterSaitama Medical Center
IHE User Success StoryIHE User Success Story
SAITAMA MEDICAL CENTRE
Saitama MedicalUniversity Hospital【 1483 Beds 】
Saitama MedicalCenter【 913 Beds 】
Saitama InternationalMedical Center【 600 Beds 】
Server System(Web Type)Saitama Medical Center
initiatedHER in March, 2005.
IHE-J ・ Showcase
Implemented for Radiology Order Placer in EHR
Pharmacy Order
Blood test order
Food Supply Order
Laboratory Order
Radiology Order
powered by AMI
System(actor)System(actor)Order Placer
DSS/Order Filler
Image Manager/Image ArchiveImage Display/Portable Media Importer
Report Manager/Report RepositoryReport Creator/Report Reader
Acquisition Modality
Portable Media Creator
Applied Integration Profiles
○SWF Integration Profile ( JJ1017 )○PIR Integration Profile○CPI Integration Profile○PDI Integration Profile○WADO (Non XDS-I Integration Profile)
○SINR Integration Profile○RWF Integration Profile
Virtual Showcasehttp://www.saitama-ihe.jp/
IHE-J Official Site (including case presentation of SS)
Case of Hamamatsu University(Prof. Kimura)
Case of Okazaki City Hospital
Saitama Medical Centre 2003-2006
Okazaki City Hospital 2004-present
National Radiological Institute 2005-present
PIR
JJ1017 Ver.3
JJ1017 Ver.3
JLAC10
RIS/LIS
DSSDSS // Order Filler Order Filler JJ1017 Ver.3
Patient registration
ADT ADT
EMR
Order Placer Order Placer Order Placer Order Placer Order Placer Order Placer
Rad Phy Lab Order ResultOrder Result
TrackerTracker
electrocardiogram
Order Filler Order Filler
MFER
PACS
Image Archive Image Archive
Image Manager Image Manager
Print Server Print Server
IMAGER
Acquisition Modality Acquisition Modality
QA System of Modality
栄養指導
Eye Care
Dialysis
Prepare
Laboratory System
Order Filler Order Filler
AutomationAutomationManager Manager JLAC
10
ユヤマ
日機装
トプコン
グリーム
丸善
給食システム
CPI
LSWF , LIR
PIR
SWF
SWF , PIR , LIR SWF , PIR , LIR
SWF , PIR
SWF
SWF , PIR
Reservation System
PDI
ATNA
Cardiology
Image Archive Image Archive
Image Manager Image Manager
SWF , PIR , PDI PIR
PIR
PIR
Print Composer Print Composer
Media CreatorMedia Creator
Media ImporterMedia Importer
Secure NodeSecure Node
Audit RepositoryAudit Repository
Monitor :200 CPI
Media CreatorMedia Creator
Example of Okazaki(2008)
尾張
三河
Okazaki City Hospital
名古屋市
岡崎市
信長家康
秀吉
370 thousand habitants650 bedsRegional centre1,300 daily outpatients
Timeline of implementation・ FY 2005
Radiology SWF,PIR,CPILabo SWF,LIR
・ FY 2006Renewal of CT and US
・ FY 2007Radiology (Regional cooperation) PDIVirtual on-line reservation system ATNARenewal of intervention imaging systemCardioloy PIRIntegration of patient care monitors and nursing system
・ FY 2008Administrative management system
・ FY 2009 and later (planned)Extension of regional cooperation XDSRenewal of MR
Integration over 15 companies and 44 departments based on EHR<
Dialysis日機装(株)
Pharmacy(株)ユヤマ
Food Supply Nutrition System(株)グリーム
ADT
Nurse assistance
Nurses’ shift assistance
EHR system Radiology Laboratory
Ophtalmology(株)トプコン
SPD system京 丸善セラ
(株)システムインテグレーション
ECG System日本光電(株)
Test tube preparation
( 株 ) 日立情報制御ソリューションズDrug Information
(株)スズケン
Endoscpyオリンパス(株)
Lung Functionフクダ電子(株)
System Overview(as of January 2006)
MFER(ECG)
EHR Radiology/Physiology
PACS
Images WS
Image WS
Ordered Information
Images
情報連携の共通化(ワークフローの共通化)
モダリティ→モダリティ→ 仕様書の共通化 仕様書の共通化
MFER(ECG)
Arrival of unknown patient
EHR Radiology/Phisiology
Registered as Mr. Ambulance 1
PHILIPS
Reconcilliation after exam.
EHR
Radiology /Physiology
Immediate one-stop correction to the patient’s real
name
医事システム
Dept. of Nutrition
Ophtalmology
Dialysis
Food Supply
PharmacyEHR
PACS
Labo system
Radiology/ Physiology
Images(movies)
CommonCommon 仕様書仕様書 over depts.over depts.
○ オーダあり
◇ 実施済み
▲ 画像到着
● レポート到着
取得画像 表示プリント
画像提供: David Clunie
• GSPS– LUT,Shutter,Area,Annotation,Transformation
• GSDF ---JIRJESRA X-0093-2005
(http://www.jiranet.or.jp/commission/system/04_information/files/JESRAX-0093.pdf)
– Managed Monitors• 2 M- Colour LCD monitor 114 sets )• 2 M-Monocolour LCD monitor (49 sets )• 3 M-Monocolour LCDmonitor (33 sets )• 5 M-Monocolour LCDmonitor (2 sets )• 5M -Monocolour CRT monitor 2 sets )
total 200 sets
CPI( Consistent Presentation of Image )
Physicians in thec ity
Approx. 230 clinicsOur hospital
Off-line information sharingUsecase of PDI
(Portable Data for Imaging)
予約サーバ
VPN
EHRLAN
Our hospital
予約情報
Virtually on-line reservation Usecase of ATNA
(Audit Trail and Node Authentication)
Physicians in the city
Approx. 230 clinics
PIRのみ対応
JJ1017 Ver.3
JJ1017 Ver.3
JLAC10
RIS/ 生理検査システム
DSSDSS // Order Filler Order Filler JJ1017 Ver.3
Patient registration
ADT ADT
EHR
Order Placer Order Placer Order Placer Order Placer Order Placer Order Placer
画像検査 生理検査 検体検査
Order ResultOrder ResultTrackerTracker
心電図システム
Order Filler Order Filler
MFER 規格
PACS
Image Archive Image Archive
Image Manager Image Manager
Print Server Print Server
IMAGER
モダリティ群
Acquisition Modality Acquisition Modality
検像システム
栄養指導
眼科システム
透析システム
調剤支援
検体検査システム
Order Filler Order Filler
AutomationAutomationManager Manager JLAC
10
ユヤマ
日機装
トプコン
グリーム
丸善
給食システム
CPI
LSWF , LIR
PIR
SWF
SWF , PIR , LIR SWF , PIR , LIR
SWF , PIR
SWF
SWF , PIR
バーチャルオンライン予約
PDI
ATNA
循環器 ( 動画 ) システム
Image Archive Image Archive
Image Manager Image Manager
SWF , PIR , PDI PIR
PIR
PIR
Print Composer Print Composer
Media CreatorMedia Creator
Media ImporterMedia Importer
Secure NodeSecure Node
Audit RepositoryAudit Repository
CPI
Media CreatorMedia Creator
IHEImplemenation (as of April 2008)
Case of National Radiological Institute
Saitama Medical Centre 2003-2006
Okazaki City Hospital 2004-present
National Radiological Institute 2005-present
Economical Aspect
Case of HamamatsuSaved connection expenditure
From 1000USD to 120 USD
Future Direction
-Initial Implementations of IHE have been performed successfully.
- Information integration in regions (Japanese RHIO-like direction) is a part
of governmental policy to enhance national medical system reform initiated this year
Economical Aspect 2
Case of SaitamaSaved total system integration cost
for dept. of radiology
From 1,300,000 to 500, 000 USD*
(* contains some “first implementation” effect” and other effects)