1. Japan Update : Success Stories Shinya Oku IHE Japan Board Member

2. Presentation Outline Characteristics of IHE Japan) Introduction of Success Stories Economical Consideration Future Direction

3. - 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)

4. IHE Japan Activities initiated in 2001 Supported by METI and then MHWL Established IHE Japan Association in March 2007

5. Success Stories: Comparison between Japan and US

6. Success Stories: Actors applied in SWF implementation

7. Three Stories en bref Saitama Medical Centre 2003-2006 Okazaki City Hospital 2004-present National Radiological Institute 2005-present

8. Case of Saitama Medical Centre Saitama Medical Centre 2003-2006 Okazaki City Hospital 2004-present National Radiological Institute 2005-present

10. 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 Center IHE User Success Story

11. SAITAMA MEDICAL CENTRE Saitama Medical University Hospital 1483 Beds Saitama Medical Center 913 Beds Saitama International Medical Center 600 Beds Server System (Web Type) Saitama Medical Center initiated HER in March, 2005.

12. IHE-J Showcase

13. Implemented for Radiology Order Placer in EHR Pharmacy Order Blood test order Food Supply Order Laboratory Order Radiology Order

14. powered by AMI System(actor) Order Placer DSS/Order Filler Image Manager/Image Archive Image Display/Portable Media Importer Report Manager/Report Repository Report Creator/Report Reader Acquisition Modality Portable Media Creator

15. 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

16. Virtual Showcase http://www.saitama-ihe.jp/

17. IHE-J Official Site (including case presentation of SS)

18. Case of Hamamatsu University (Prof. Kimura)

19. Case of Okazaki City Hospital Saitama Medical Centre 2003-2006 Okazaki City Hospital 2004-present National Radiological Institute 2005-present

20. JJ1017 Ver.3 JJ1017 Ver.3 JLAC 10 DSS Order Filler DSS Order Filler JJ1017 Ver.3 Patient registration ADT ADT EMR Order Placer Order Placer Rad Phy Lab Order Result Order ResultTracker electrocardiogram Order Filler MFER Image Archive Image Archive Image Manager Image Manager Print Server Print Server Acquisition Modality Acquisition Modality QA System of Modality Eye Care Dialysis Prepare Laboratory System Order Filler AutomationManager JLAC 10 CPI LSWF LIR PIR SWF 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 Print Composer Print Composer Media Creator Media Creator Media Importer Media Importer Secure Node Audit Repository Audit Repository Monitor CPI Media Creator Media Creator Example of Okazaki(2008)

21. Okazaki City Hospital 370 thousand habitants 650 beds Regional centre 1,300 daily outpatients

22. Timeline of implementation FY 2005 Radiology SWF,PIR,CPI Labo SWF,LIR FY 2006 Renewal of CT and US FY 2007 Radiology (Regional cooperation) PDI Virtual on-line reservation system ATNA Renewal of intervention imaging system Cardioloy PIR Integration of patient care monitors and nursing system FY 2008 Administrative management system FY 2009 and later (planned) Extension of regional cooperation XDS Renewal of MR

23. Integration over 15 companies and 44 departments based on EHR Dialysis Pharmacy Food Supply Nutrition System ADT Nurse assistance Nurses shift assistance EHR system Radiology Laboratory Ophtalmology SPD system ECG System Test tube preparation ( ) Drug Information Endoscpy Lung Function System Overview (as of January 2006)

24. MFER(ECG) EHRRadiology/ Physiology PACS Images WS Image WS Ordered Information Images

25. MFER(ECG) Arrival of unknown patient EHR Radiology/Phisiolo gy Registered as Mr. Ambulance 1 Registered as Mr. Ambulance 1 PHILIPS

26. Reconcilliation after exam. EHR Radiology /Physiology Immediate one- stop correction to the patients real name

27. Dept. of Nutrition Ophtalmolo gy Dialysis Food Supply Pharmacy EHR PACS Labo system Radiology/ Physiology Images (movies) Common over depts.

29. 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 M- Colour LCD monitor sets M-Monocolour LCD monitor sets -Monocolour monitor sets total sets CPI Consistent Presentation of Image

30. Physicians in thec ity Approx. 230 clinics Our hospital Off-line information sharing Usecase of PDI (Portable Data for Imaging)

31. VPN EHR Our hospital Virtually on-line reservation Usecase of ATNA (Audit Trail and Node Authentication) Physicians in the city Approx. 230 clinics

32. JJ1017 Ver.3 JJ1017 Ver.3 JLAC 10 DSS Order Filler DSS Order Filler JJ1017 Ver.3 Patient registration ADT ADT EHR Order Placer Order Placer Order Result Order ResultTracker Order Filler MFER Image Archive Image Archive Image Manager Image Manager Print Server Print Server Acquisition Modality Acquisition Modality Order Filler AutomationManager JLAC 10 CPI LSWF LIR PIR SWF SWF PIR LIR SWF PIR SWF SWF PIR PDI ATNA ( ) Image Archive Image Archive Image Manager Image Manager SWF PIR PDI PIR Print Composer Print Composer Media Creator Media Creator Media Importer Media Importer Secure Node Audit Repository Audit Repository CPI Media Creator Media Creator IHEImplemenation (as of April 2008)

33. Case of National Radiological Institute Saitama Medical Centre 2003-2006 Okazaki City Hospital 2004-present National Radiological Institute 2005-present

34. Economical Aspect Case of Hamamatsu Saved connection expenditure From 1000USD to 120 USD

35. 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

36. Economical Aspect 2 Case of Saitama Saved total system integration cost for dept. of radiology From 1,300,000 to 500, 000 USD* (* contains some first implementation effect and other effects)