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High-tech    hospital

Amenities for 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 tells.

 "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 effectively."

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.

 

Outpatient Efficiency
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.

 

Inpatient Amenities
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 payment data.

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 system.

 

University Training
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 textbooks.

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."


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