Impacts of the East Japan Earthquake and Tsunami towards Grand Design

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Prepared for Grand Design by Japan -The 2011 Quake and Tsunami Project- at Keio Business School

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Impacts of the East Japan Earthquake and Tsunami towards Grand Design

  1. 1. Impacts of the East Japan Earthquake and Tsunami towards Grand Design for ICT in Healthcare Prepared for Grand Design by Japan -The 2011 Quake and Tsunami Project- at Keio Business School February 19, 2012 Eiji Sasahara, Ph.D., MBA (C) 2012 Healthcare Cloud Initiative
  2. 2. AGENDA1.Introduction2.Cases of Ishinomaki City, Miyagi3.Discussion 2 (C) 2012 Healthcare Cloud Initiative
  3. 3. 1.Introduction• “Impacts of the East Japan Earthquake and Tsunami towards Governance, Risk and Compliance in Healthcare IT” Synthesis Journal 2011 IT Standards Committee (ITSC) Inforcomm Development Authority of Singapore (IDA) November 2011. http://www.itsc.org.sg/pdf/2011/Section4_Article1_021111.pdf •Focuses on Cases of Healthcare Providers in Ishinomaki City, Miyagi •Case-oriented Recommendation for Healthcare ICT Grand Design in Emerging Economies in Asia/Pacific 3 (C) 2012 Healthcare Cloud Initiative
  4. 4. 2.Cases of Ishinomaki City, Miyagi• 2.1 Landscape of Ishinomaki City(1) • Coastal city near the peninsula in the northeastern part of Miyagi Prefecture • Shrinking and ageing population affecting healthcare needs -Total Population: 152,775 (As of Jan.2012) Total Ratio of Year population Age 0-14 Age 15-64 Age 65- Age 65- 2005 170,630 23,131 106,904 40,595 23.8% 2006 169,147 22,564 105,217 41,366 24.5% 2007 167,474 22,002 103,203 42,269 25.2% 2008 165,894 21,538 101,401 42,955 25.9% 2009 164,433 21,025 99,756 43,652 26.5% 2010 163,216 20,459 98,902 43,855 26.9% 4 (C) 2012 Healthcare Cloud Initiative Source: City of Ishinomaki
  5. 5. 2.Cases of Ishinomaki City, Miyagi• 2.1 Landscape of Ishinomaki City(2) • Damages of the East Japan Earthquake and Tsunami in Ishinomaki • Death: 2,978. Missing: 669 (As of Oct.2011) • Damaged housing: 53,742 (About 70% of total) • Evacuating people: Max. 50,000 • Evacuating shelters: Max. 250 • 3 of 10 hospitals and 90 of 106 clinics damaged in Ishinmaki City. 5 (C) 2012 Healthcare Cloud Initiative
  6. 6. 2.Cases of Ishinomaki City, Miyagi • 2.2 Location of Healthcare InstitutionsIshinomaki Red Cross Hospital You Home Clinic Ishinomaki New Location for Ishinomaki Municipal Hospital (FY2015) Ishinomaki Municipal Hospital 6 Source of Map: Ishinomaki City Basic Plan for Urban Infrastructure Recovery (Draft) (C) 2012 Healthcare Cloud Initiative
  7. 7. 2.Cases of Ishinomaki City, Miyagi• 2.3 Case of Ishinomaki Red Cross Hospital(1) • #Bed = 402, #Total staff = 952 (#Physician = 113, #Nurse =514, #Other medical expert = 134, #Clerk = 191) (Numbers as of Jan. 2012) • Built in riverside area (Minato) of Ishinomaki in 1933 • Relocated in newly developed highland area (Hebita) since 2006. (6km from the sea) • Voluntarily developed "Ishinomaki Regional Network Council of Disaster Medicine Professionals" jointly with other healthcare institutions, regional medical associations, disaster prevention authorities and local governments. Business Continuity Planning (BCP) and Disaster Recovery Planning (DRP) 7 (C) 2012 Healthcare Cloud Initiative
  8. 8. 2.Cases of Ishinomaki City, Miyagi• 2.3 Case of Ishinomaki Red Cross Hospital(2) • Did not receive severe impacts from the tsunami directly. However, due to electricity blackout, had to continue operations with emergency electricity generators. (LANs were available) • Informed the local governments of its status via wireless disaster prevention communication network. • Before disaster: 60 patients/day, 1,800 patients/month. After disaster: 99 on 3/11, 779 on 3/12, 1,251 on 3/13. • IT operations as usual required even under an ad hoc system and hostile user environment with limited electricity and other resources. *Emergency = Peak time in capacity planning 8 (C) 2012 Healthcare Cloud Initiative
  9. 9. 2.Cases of Ishinomaki City, Miyagi• 2.4 Case of Ishinomaki Municipal Hospital(1) • #Bed = 206, #Total staff = 221 (#Physician = 24, #Nurse =150, #Other medical expert = 28, #Clerk = 19) (Numbers before the earthquake/tsunami) • Located in central downtown area near the sea since 1996 (0.3 km from the sea) • Severely damaged by the tsunami (maximum height of 5 m). Server room in the 1st floor and emergency electricity generators in the basement destroyed. • Both intra-hospital and external communications networks were not available due to electricity blackout, and the hospital could not inform emergency authorities about the status of its facilities. 9 (C) 2012 Healthcare Cloud Initiative
  10. 10. 2.Cases of Ishinomaki City, Miyagi• 2.4 Case of Ishinomaki Municipal Hospital(2) • In February 2011, Ishinomaki Municipal Hospital started to share data of electronic medical records (EMR) with Yamagata City Hospital SAISEIKAN for backup purposes. (SIer:Software Service, Inc.) • EMR data recovery works were conducted in Yamagata side. On April 7, Ishinomaki Municipal Hospital was able to open temporary clinic facilities in a safer area and to resume daily operations for outpatients. *Benefits of Remote Backup/Cloud Services 10 (C) 2012 Healthcare Cloud Initiative
  11. 11. 2.Cases of Ishinomaki City, Miyagi• 2.5 Case of You Home Clinic Ishinomaki(1) • Community-based home care delivery initiative to aging residents in damaged areas of Ishinomaki (Established after the disaster) • Initiative members include You Home Clinic, Kameda General Hospital, Hokkaido Center for Family Medicine, Nippon Foundation and Fujitsu. • Developing cloud-based home medical care systems, care team collaboration tools, telemedicine, etc. • Planning to add life support services to prevent aging residents from isolation. 11 (C) 2012 Healthcare Cloud Initiative
  12. 12. 2.Cases of Ishinomaki City, Miyagi • 2.5 Case of You Home Clinic Ishinomaki(2) • Total concepts (image) of community-based home care delivery initiative in Ishinomaki Source: “Social Business Case Book” by METI (Jan.13, 2012) Aging Residents Family Home Evacuation Households, in Damaged Areas Temporary Housing, etc. (Ishinimaki City)You Home Clinic (Tokyo) You Home Support Groups (e.g. NPOs)Kameda General Home-Visit Home-Visit Clinic Social Workers Hospital Pharmacies Stations Ishinomaki Mental Healthcare Team, etc. (Chiba) MedicalHokkaido Centre Consultation for Family Supports Medicine (Hokkaido) Home Medical/Nursing Care Information Exchange Systems 12 (C) 2012 Healthcare Cloud Initiative
  13. 13. 2.Cases of Ishinomaki City, Miyagi• 2.6 Miyagi Prefecture Regional Healthcare Recovery/Revitalization Plans (FY2011-2015) 宮城県、医療再生に 億円」 *Source: 「宮城県、医療再生に931億円」 by Kahoku Shimpo (Feb.8,2012) 億円 (http://www.kahoku.co.jp/news/2012/02/20120208t11017.htm) • Total Budget = JPY 93,100M • Enhancement in Emergency/Disaster Medicine at Ishinomaki Red Cross Hospital (JPY 10,700M) • Reconstruction of Ishinomaki Municipal Hospital(Completed by FY2015) (JPY 9,900M) • Development of Regional Health/Welfare Information Exchange Network Systems (JPY 4,100M) • Supports for General/Dental Clinics, Pharmacies, etc. (JPY 2,900M) • Supports for Home Health Care (JPY 400M) , etc. 13 (C) 2012 Healthcare Cloud Initiative
  14. 14. 2.Cases of Ishinomaki City, Miyagi• 2.7 Ishinomaki City Basic Plan for Disaster Revitalization (FY2011-2020)(1) 石巻市震災復興基本計画」 *Source: 「石巻市震災復興基本計画」 (Released in Dec. 2011, Japanese only) (http://www.city.ishinomaki.lg.jp/reconst/re_const.jsp) • Revitalization of regional healthcare delivery systems • Mainly supported by government funding • Hospitals as core infrastructure for “Smart City” • Suburbs area: To develop highway interchange near Ishinomaki Red Cross Hospital • Downtown area: To reconstruct Ishinomaki Municipal Hospital in front of JR East Ishinomaki Station (Supported by Ishinomaki Chamber of Commerce) 14 (C) 2012 Healthcare Cloud Initiative
  15. 15. 2.Cases of Ishinomaki City, Miyagi• 2.7 Ishinomaki City Basic Plan for Disaster Revitalization (FY2011-2020)(2) • Health promotion for disaster-damaged citizens • Supports for • Mental healthcare • Immunization/health check • Disease management • Prevention of lifestyle-related chronic diseases • Prevention of hypokinetic disease/disuse syndrome • Improvement in nutrition/food lifestyle • Oral care • Health promotion activities by health instructors • Relief/revitalization of health promotion facilities • The key is funding: “Public-Private Partnerships” or “Social” 15 (C) 2012 Healthcare Cloud Initiative
  16. 16. 3.Discussion• 3.1 Learning From Perspectives of Human 人 Resources (人) • Talent management for collaborative care team • Ishinomaki Red Cross Hospital case: -ICT Management and Facility Management • Ishinomaki Municipal Hospital case: -Ishinomaki ICT team and Yamagata ICT team • You Home Clinic Ishinomaki case: -Home-visit clinic/pharmacy/home nursing care via regional health/welfare information exchange 16 (C) 2012 Healthcare Cloud Initiative
  17. 17. 3.Discussion• 3.2 Learning From Perspectives of 物 Supplies/Product Resources (物) • Healthcare delivery as the center of social infrastructure/smart city value chains • Requirement for Just-In-Time (JIT) healthcare delivery in emergency • Business Continuity/Disaster Recovery by Design 17 (C) 2012 Healthcare Cloud Initiative
  18. 18. 3.Discussion • 3.3 Learning From Perspectives of Financial 金 Resources (金) • ICT = Enabler of “Social” funding methods e.g. PPP, Donor-assisted program, Crowd funding,etc.Welfare Wellness ServicesHome Home NursingCare Care Services Pharmacy GeneralOutpatient ClinicCare Non-profit HospitalInpatient PublicCare Hospital Public “Social” Private 18 (C) 2012 Healthcare Cloud Initiative Funding Funding Funding
  19. 19. 3.Discussion • 3.4 Learning From Perspectives of 情報) 情報 Information Resources (情報 (1) Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Basic HIS Advanced HIS Advanced   Digital Hospital      Digital Virtual      HIS/CIS Enterprise↑ Clinical Decision Support SystemsH Mobile Health EMR (ElectronicBenefits & Risks Medical Records)) PACS (Picture Archiving and Communication Systems) ) CIS (Clinical Information Systems) HIS (HospitalL ) Information Systems)↓ 19 19 (C) 2012 Healthcare Cloud Initiative
  20. 20. 3.Discussion • 3.4 Learning From Perspectives of 情報) 情報 Information Resources (情報 (2) • Healthcare as the enabler of “Big Data” innovation • Governance, Risk and Compliance (GRC) over “Big Data” will be a topic of debate • What is “Big Data”? (e.g.) "Technologies as a new generation of technologies and architectures designed to extract value economically from very large volumes of a wide variety of data by enabling high-velocity capture, discovery, and/or analysis."20 20 (C) 2012 Healthcare Cloud Initiative
  21. 21. 3.Discussion• 3.4 Learning From Perspectives of 情報) 情報 Information Resources (情報 (3) • Characteristics of “Big Data” Terabytes Data Volume Petabytes+ Size Is Not the Only Thing That Matters Structured Data Variety Unstructured Combination of Data Sources and Formats Is What Matters Batch Data Velocity Streaming Speed at Which Information Arrives and Is Analyzed and Delivered ¥ Value ¥¥¥¥¥¥ Capita, Operational, and Business Benefits All Matter 21 (C) 2012 Healthcare Cloud Initiative
  22. 22. 3.Discussion• 3.4 Learning From Perspectives of 情報) 情報 Information Resources (情報 (4) • Reference for “Big Data” • "Big data: The next frontier for innovation, competition, and productivity" by McKinsey Global Institute (May 2011) (http://www.mckinsey.com/Insights/MGI/Research/Technology_and_Innovation/Big_data_The_ next_frontier_for_innovation) • "Big Data, Big Impact: New Possibilities for International Development" by World Economic Forum (January, 2012) (http://www.weforum.org/reports/big-data-big-impact-new-possibilities-international- development) • "Health Care Is Next Frontier for Big Data" by The Wall Street Journal (January 19, 2012) (http://online.wsj.com/article/SB10001424052970204468004577169073508073892.html) • “Privacy in the Age of Big Data: A Time for Big Decisions” by Stanford Law Review (February 2, 2012) (http://www.stanfordlawreview.org/online/privacy-paradox/big-data) 22 (C) 2012 Healthcare Cloud Initiative
  23. 23. 3.Discussion• 3.5 Keywords for Recommendation on Healthcare ICT Grand Design in Emerging Economies • Real time • Preventive • Actionable • Transparency 23 (C) 2012 Healthcare Cloud Initiative
  24. 24. Question?Eiji Sasahara, Ph.D., MBAvyt04351@nifty.comhttp://jp.linkedin.com/in/esasaharahttp://www.facebook.com/esasaharahttp://twitter.com/esasahara 24 (C) 2012 Healthcare Cloud Initiative

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