inpatients include Internet access, TV and a call button that works
via PHS phones
Photos by Kristen McQuillin
Web surfing from your hospital bed? Thatís just one
perk at the new University of Tokyo Hospital. Kristen McQuillin tours and
"Medicine is quickly changing, and it needs more high
technology," says Tetsuya Igarashi, chief of Hospital Planning and
Development at University of Tokyo Hospital. "But what we need is not
technology itself, but knowledge. Knowledge of how to organize our resources
and to organize information for people in the hospital to use
To manage 1200 beds in the new inpatient building and 3000
outpatient visits every day, technology is the key to organizing this busy
system. In fact, technology underlies everything happening at the University
of Tokyo Hospital.
From the moment a patient arrives at the outpatient clinic,
first opened in 1994, itís obvious that this hospital is on the cutting
edge. A patient uses her hospital ID card to receive a pager along with an
appointment time . She can roam the corridors or have a snack in the
restaurant until sheís paged to the examination room.
Each examination room includes a computer workstation that
allows doctors to view the list of scheduled patients and to call up details
including a patientís previous visits, test results, examination notes and
other particulars. He can schedule tests or appointments with specialists by
clicking on the appropriate icon and requesting a date.
When the patient arrives at the lab, she swipes her ID card
at the reception desk and is sent in for the test. Test results are fed back
into the database of patient records so that the referring doctor can see
them as soon as they arrive. Thereís no more need to phone labs to find
out where a result is.
Despite the use of computers in the exam rooms, patient
records on paper havenít gone away. One hundred thousand active medical
records pass through the hospital daily. Each file is barcoded to allow a
robotic system to manage the records in a series of 15-meter long file
cabinets. The barcodes are scanned and the robot quickly locates and
retrieves the correct folder.
If the doctor needs to refresh his knowledge on a
condition, he can call up an online textbook or manual right in the exam
room. Patients can learn more in the patient learning center equipped with
Internet access, online texts, and CD-ROMs of medical information.
For patients staying in the newest building, opened on Sept
22, an "iBox" at every bedside provides television and Internet. In the
future, patients may have access to their own clinical records via this
system, but security issues must be worked out carefully before it will
become a reality.
The patientís bedside buzzer calls the nurse via her PHS
phone assuring that she arrives in a timely way. Additionally, the call
system is displayed on a large kiosk at the nursesí station and vital
signs are displayed on flat panel monitors.
What Lies Beneath
Behind the scenes, the hospitalís technology really
shines. A gigabit Ethernet routes information around the buildings as
doctors access patient records and labs log test results. Two Fujitsu
mainframes do the administrative work, handling all of the billing and
Tucked into the second sub-basement, a computer room houses
the dozens of servers running Linux & Windows NT that serve the
individual labs and exam rooms. 500 client workstations throughout the
hospital run Unix and 700 run Windows NT.
The hospitalís just-in-time Supply Processing and
Delivery system transports medical provisions to every nursesí station.
Cargo boxes travel from the control center to the wards via an intricate
system of tunnels hidden in the walls. A computerized tracking system
displays a real-time map depicting each box and automatically routes
supplies around congestion in the system. Over 1500 boxes are delivered on a
typical day and all of the data is stored for analysis to improve the
Medical informatics, the science of organizing and
delivering information, keeps all the data flowing smoothly. The University
of Tokyoís Department of Medical Informatics works closely with the
hospitalís computer center. Students in the program contribute to the
systems that are used in the hospital including the computerized patient
records, bilingual databases of standard medical terminology, and electronic
Technology is also devoted to the student education at the
hospital. An 80-seat multimedia lecture room is equipped with a modern
teaching podium that includes a computer embedded in the console and a
variety of audio and video inputs.
In another area of the hospital, a Hi-Vision video
conferencing system broadcasts surgeries to all the national university
hospitals in Japan via the University Medical Information Network "The
resolution of the broadcast allows even a single surgical thread to be
seen," explains Yuzo Onogi, who works in the computing center. "Almost
all of the procedures in our special operating theaters are recorded and
stored in our library."