FYI on Lesson Learned - Patient care at hospitals hit by loss of files in tsunami

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http://www.yomiuri.co.jp/dy/national/T110625003054.htm

Patient care at hospitals hit by loss of files in tsunami

The Yomiuri Shimbun

At least 14 hospitals in Iwate and Miyagi prefectures lost their medical records

in the March 11 tsunami, according to a Yomiuri Shimbun survey, making it

difficult to verify patients' medical histories and courses of medication.

Numerous records were washed away or rendered illegible by the water, the survey

found. However, Ishinomaki Municipal Hospital in Miyagi Prefecture suffered

minimal losses because it had digitized its data and kept backup copies at a

hospital in Yamagata.

The central government has began discussing the creation of a legal framework to

urge hospitals to back up their medical records. However, most of the nation's

facilities still keep only paper records, and the government expects

digitization to take a significant amount of time.

Dr. Takeshi Kanno, 31, recently responded to numerous telephone inquiries at a

temporary clinic established at an evacuation center in Minami-Sanrikucho,

Miyagi Prefecture. The questions were from hospitals that had taken in patients

previously treated at Shizugawa Hospital in the city, where Kanno used to work

and which was seriously damaged by the March 11 tsunami.

" Do you know what medicines your hospital prescribed to a patient who is now at

our facility? " one hospital staffer asked. Another wanted to know someone's case

history.

About 70,000 people were treated annually at Shizugawa Hospital before the

disaster. The tsunami reached the fourth floor of the five-story building,

washing away the paper records stored on the first and second floors.

Patients had to move to other hospitals, but the new facilities had difficulty

treating them with all the records lost. Many patients did not even remember the

names of medicines they were taking.

The Yomiuri Shimbun asked hospitals hit by tsunami in 27 municipalities in Iwate

and Miyagi prefectures whether their medical treatment records survived. At

least three in Iwate Prefecture and 11 in Miyagi Prefecture lost their records

when they were washed away by tsunami or when servers containing electronic

records were submerged in seawater and ruined. Many clinics also lost their

records.

According to the Miyagi Medical Association, 186 medical institutions, including

clinics, were destroyed or seriously damaged by the March 11 disaster. Of this

number, 163 said they lost all or some of their medical records, the association

said.

In contrast, Ishinomaki Municipal Hospital was able to quickly restore the

digitized records it lost after the tsunami.

The hospital had stored information on about 40,000 patients in a computer room

on its first floor. The room was submerged in the tsunami, but the hospital

retrieved the data from backup copies kept at Yamagata City Hospital Saiseikan

in Yamagata.

The two hospitals agreed in February to save each other's medical records.

" Examining patients without medical records is like examining them blindfolded, "

said Shu Matsukawa, vice director of Ishinomaki Municipal Hospital. The backup

data really saved us. "

After the disaster, the Cabinet Office's Information Technology Strategy Council

decided to urge hospitals to store copies of their medical records in far-off

locations.

The Health, Labor and Welfare Ministry has began discussing creating a legal

framework for this, but few hospitals possess the digitized records that would

make such backup copies possible.

According to the health ministry, only 14.2 percent had digitized their medical

records as of 2008. Only 10.2 percent of the hospitals in Iwate Prefecture have

finished digitizing their records, while the figure was 6.8 percent in Miyagi

Prefecture.

" If hospitals share digitized medical records with each other, they'll be able

to resume services soon after being hit by disasters, " said Tai Takahashi, a

professor at International University of Health and Welfare.

" Hospitals need to consider the risks of sharing information, including leaks,

as the data would be managed by outsiders, " Takahashi said. " However, hospitals

need to choose suitable information management systems after explaining the

risks and benefits to patients. "

(Jun. 26, 2011)