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Telemedicine as a Tool in Japan Disaster Relief (Disaster Cardiovascular Prevention Network). Masatake Eto A&D Company Limited. ITU Workshop February 5, 2013. Company profile. DSP. Weighing.

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slide1

Telemedicine as a Tool

in Japan Disaster Relief

(Disaster Cardiovascular Prevention Network)

Masatake Eto

A&D Company Limited

ITU Workshop February 5, 2013

slide2

Company profile

DSP

Weighing

  • Founded in May 1977 with a vision of becoming a global measuring instrument company based on both Analog and Digital technologies.
  • Headquarters in Tokyo and Technical Center in Saitama with subsidiaries in 10 countries: USA, UK, Germany, Russia, China, Korea, Taiwan, India, Australia, Japan
  • Sales (FY2011): $400 Million(Consolidated)
  • Corporate culture: Technology driven, market and globally oriented

Striving for “Honmono” /…Clearly a Better Value

Medical/HHC

Testing

slide3

Accurate, Reliable

Measurement Technologies

Five businesses

Real-time, PC-basedMeasurement, Control, and Simulation Systems (Model Based Engineering)

Medical and Healthcare Instruments

Weighing and Analytical Instruments

Electron Beam and Focused Ion Beam Systems

Material Testing Instruments

slide4

Professional Medical Devices

Consumer Healthcare

Medical / Healthcare ICT Devices

Pioneering “Bridging home and hospital”

slide6

Minami Sanrikucho

Location for disaster medical support

Population; 17,400

Dead/missing: 845

Lost households: 3,300

Evacuees: 3,581 (as of 7/11)

Minami Sanrikucho is located in northeastern Miyagi Prefecture, north of the Oshika Peninsula. It is a resort town with numerous tourist attractions based on its natural beauty and the aquaculture industry is prevalent on the coastline.

It is in the middle of Minami Sanriku Kinkasan National Park and known for its beautiful ria coasts with wooded islands and mountainous inlets.

on going hardships of the survivors

1,500 evacuees stayed at Bay Side Arena at one time.

On-going hardships of the survivors
  • The magnitude of the disaster, which includes the total loss of communities on top of the loss of families and homes, can put a great number of survivors at risk leading to “Disaster-related death”.
  • In case of The Great Hanshin Earthquake of January 17, 1995 14% of the victims, 919 people, passed away after they survived the disaster out of the death toll was 6,402.
slide8

Cardiovascular diseases

Stress-induced cardiomyopathy

(takotsubo)

Acute myocardial infarction

Cerebrovascular accident (CVA) or stroke

Sudden death (SD)

Economy-class syndrome (ECS)

Cardiac failure

Right

after

Wounds

Fractures

Bleeding

Drowning

Cardiovascular diseases

Stress-induced cardiomyopathy

(takotsubo)

Acute myocardial infarction

Cerebrovascular accident (CVA) or stroke

Sudden death (SD)

Economy-class syndrome (ECS)

Cardiac failure

Infectious diseases

Skin infections

Infectious gastroenteritis

Urinary-tract infections

Pneumonia

A week

later

Mental disorders

Posttraumatic stress disorder (PTSD)

Depression

Several months

later

A few years later

Medical needs change as time passes

slide9

Blood pressure elevation Blood clotting

Cardiovascular risk after a disaster

  • Blood pressure as a sign of risks
  • Environmental changes after a disaster alter one’s lifestyle patterns immensely leading to stress and this stress causes the body to store more salt or become salt-sensitive.
  • The intake of salt increases due to the types of food eaten at evacuation sites.
  • Physical activity tends to decrease due to the loss of daily work and household activities.
  • The body tends to get dehydrated due to a reduced intake of water because of the colder or less convenient environment.
  • One tends to go to toilet less frequently and reduces water intake.
background of special medical activities
Background of special medical activities
  • Medical support must shift from emergency medical treatments to daily disease management immediately after a disaster due to the stress and risks the evacuees face.
  • Medical staff and doctors at disaster sites are occupied with the unpredictable medical matters, thus they cannot provide adequate medical support to the evacuees.
  • We received a request from the disaster medical support team of Jichi Medical University asking if we could organize a special medical support team for evacuees immediately.
  • We then created a special medical support team with the several key members of Continua. Thanks to the eagerness of the members and key products of modular concept already developed under Continua protocols, we had this team up and running within a week.
slide11

Dr. Kazuomi Kario, MD

Professor & Chairman

Division of Cardiovascular Medicine

School of Medicine

Jichi Medical University

Driving force of D-CAP Team

  • Disaster Cardiovascular Prevention Network
  • He lived through the Great Hanshin earthquake and experienced the hardships the survivors and medical staff went through. “How can we save lives of the people who survived the disaster?” was his main theme for medical support activities.
  • The mission of the D-CAP Team is to monitor the blood pressure of the evacuees remotely and provide timely advice to the medical staff at the disaster sites.
slide12

D-CAP process

Examination

Register for D-CAP ID card

Measure patient risk by Risk score card

Monitor blood pressure

Yes

Yes

BP over

180 mmHg

Irregularity

No

Doctor’s visit

Examination

No

No

BP over

160 mmHg

Individual advice and/or treatment

Routine check-up

Yes

slide13

D-CAP System for Evacuation Camp

Jichi Medical School

Evacuation camp

Vital signs sent with Patient ID via 3G

Data analysis, diagnostic support

Inform and communicate with doctors at the site.

Shizukawa Temporary Hospital

Face-to-face meeting with patient

Cloud / Data Center

Internet

3G

slide14

D-CAP System Configuration

Evacuation Camp

Cloud / Data Center

Internet

Blood Pressure Monitor with BT

Gateway

PC

Data Server System

3G Data Transmission Module

Patient ID card and ID card reader

Web application

Data viewer

slide15

D-CAP System for Home

Jichi Medical School

Temporary housing

Shizukawa Temporary Hospital

Patient measures BP with BPM at home

Patient vital sign data with patient ID uploaded to PC via BT

Patient visits hospital with BPM

Cloud / Data Center

Internet

3G

slide16

Medical staff meeting

Face-to-face meeting with evacuees

Medical examination

D-CAP systems

D-CAP Team at work

slide17

Dr. Kario and Dr. Nishizawa in front of the temporary clinic

Inside the temporary clinic

D-CAP Team at work

  • Dr. Nishizawa, who is in charge of ShizukawaHospital, said:
  • Very few of the evacuees have lost their lives thanks to the efforts of the medical staff and the support from all over the world.
  • D-CAP system gives us real time coordination with Dr. Kario’s medical staff, who monitor patients 200 km away from the evacuee camp.
  • It helps identify high risk evacuees in the early stages. Thus, we can respond to evacuees’ needs individually depending on their risks, which can be a pioneering effort for order-made medicine in a community.
  • It can eliminate unnecessary health exams and doctors’ visits, which is a great plus as there are shortages of medical staff.
slide18

Seven companies working together

  • Alive: Gateway AP3201(Bluegiga), its firmware development
  • Panasonic: PC
  • Toppan Forms: NFC ID cards and NFC card reader
  • Ryoyo Electro: Data center/server
  • Qute: Web application development
  • Intel: Project coordination
  • A&D: Fully automatic blood pressure monitor TM-2656PBT-C

Automatic blood pressure monitor UA-767PBT-C

slide19

From left,

Ohsako-san of Qute, Tagami-san of Intel, Hayashi-san of Toppan Forms,

Ozaki-san, Nozoe-san, and Yasui-san of A&D, and Yamamoto-san of Ryoyo.

D-CAP Team at work

Colleagues from different companies worked in collaboration under the Continua Alliance on the set-up of the D-CAP systems. They completed and installed the systems and had them up running in a week after we received a request from Dr. Kario.

slide20

Summary

  • For disaster health management, team work of all concerned and the coordination between the medical supporters and medical staff at disaster sites is so mportancet for successful implementation.
  • Timely response to local needs is not only important to reduce the health risks of the evacuees but also plays a critical role in motivating the evacuees into active participation.
  • Now that technologies are available, unforeseen difficulties can be overcome if the team has leadership and shares a clear vision.
  • Reliable instruments and a solid system integration concept must be deployed.
  • Compatibility and interoperability of instruments are of primary importance.
  • Continua has proved to be a great help not only for creating an eco systems but also for nurturing partnerships.
slide21

Summary

  • Disaster-related death toll as of March 31, 2012
    • Minamisanriku-cho: 20 or 2.3% of the total death/missing
    • Nation-wide: 1,632 or 7.9% of the total death/missing
  • D-CAP system, triggered by this tragedy, happens to be the one of the earliest realizations of the ehealth by ICT in a bottom up approach.
  • Not only can we support people to overcome the catastrophic disaster through D-CAP activities but also contribute to create cost-effective health care systems by ICT in a community.
slide22

With the people’s will and support, the beautiful nature and heart-warming scenery of Tohoku will return!

slide23

Thank you for your attention.

ITU Workshop February 5, 2013

Page 13

Confidential