1.Introduction of District Health Management Information Software System Version 2: a literature review
Kazuki MIYAZAKI ; Ikuma NOZAKI
Journal of International Health 2019;34(2):93-98
Introduction Electronic health information systems (HISs) are believed to improve access to health information. The District Health Information System Version 2 (DHIS2) is used widely in developing countries. While numerous successful cases highlighting the introduction of DHIS in facility-based settings have been reported, it remains unclear how similarly effective results can be obtained in developing countries. Methods We conducted a literature review to clarify the achievements and challenges regarding the use of DHIS2, and extracted 62 papers from PubMed and Google Scholar using the search term ‘District Health Information Software System’. Eleven papers that described the process of introducing DHIS2 were selected for analysis.Results We categorized the achievements into two groups: ‘Improvement of the reporting system’ and ‘Human resources development’. The challenges were categorized into eight groups, of which most commonly reported were human resources-related issues, followed by system complexity and data collection inadequacy. Conclusions The introduction of DHIS2 contributed to the improvement of the timeliness and completeness of data reporting, as well as human resources development, while utilization of data should be further strengthened. The most common challenges reported consisted of human resources-related issues. The HISs should be simple and easy to understand, even for individuals with low computer literacy.
2.Establishing a System for Providing Heart Failure Palliative Care in the Acute Care Hospital
Takashi OHMORI ; Hideyuki KASHIWAGI ; Shujiro INOUE ; Shoichiro FURUKAWA ; Michiko SHIMOMI ; Mayuko MIYAZAKI ; Emi HARADA ; Kiko HIROKI ; Yoshiko OKA ; Kazuki TSUTSUMI ; Kiyofumi OYA
Palliative Care Research 2022;17(4):165-170
The need for palliative care for heart failure patients has been attracting attention, but the system for providing such care is not yet fully established in Japan. Iizuka Hospital is a 1048-bed acute care hospital located in Fukuoka, Japan. The Heart Support Team (HST) was established to provide palliative care for heart failure at the hospital. After the HST was launched in May 2017, 168 referrals for palliative care intervention for heart failure patients by March 2022. Twenty-five (14.8%) met the intervention cases’ additional palliative care treatment criteria. The Integrated Palliative Outcome Scale was administered to 11 consecutive patients from April 1 to 30, 2021. In establishing and operating the HST, the challenge was recruiting, training, and creating a system to sustain the system. Creating the HST in collaboration with staff specializing in palliative care, psychiatric care, and cardiovascular specialists was the first step in establishing a method for palliative care to heart failure patients in an acute care hospital.
3.Reference Data, Characteristics and Related Factors of Quality of Life Assessed by a Questionnaire of Patient’s Behavior Survey in the General Population in Japan
Satoko ITO ; Megumi SHIMIZU ; Kazuki SATO ; Masashi KATO ; Daisuke FUJISAWA ; Akemi NAITO ; Tatsuya MORITA ; Mitsunori MIYASHITA
Palliative Care Research 2020;15(2):135-146
To decide the policy to promote palliative care properly, a new questionnaire has been added to Patient’s behavior survey to assess Quality of Life (QOL) of inpatients and outpatients in Japan. The aim of this study was to survey QOL score of general population in Japan by using a questionnaire of patient’s behavior survey. A large nationwide postal survey was conducted from January through February 2013 in Japan. A total of 2400 subjects were selected randomly from among members of the general population who were 20 to 79 years of age and lived in Japan. A total of 978 (41.1%) questionnaires were analyzed, and reference data of QOL score weighted by the national standard value of sex-age group population were calculated. Correlation coefficients were calculated between QOL score and SF-8TM, Patient Health Questionnaire-9 (PHQ-9), Eastern Cooperative Oncology Group Performance Status (ECOG), Memorial Symptom Assessment Scale (MSAS) score. In addition, sociodemographic factors related to QOL score were evaluated. From the perspectives of public health and administrative policy, the results of this survey will provide important basic data to evaluate patient’s behavior survey broadly and continuously with the goal of establishing a palliative care system in Japan.
4.Report on the Implementation of an Interactive Online Hands-on Seminar for Making Rehabilitation Orthosis with Vietnam in the Period of Travel Restriction
Kazuki MIYAZAKI ; Ayumi MIYAGI ; Hitomi KARAKI ; Ayumi MORIYAMA ; Masashi FUJIMOTO ; Yuriko EGAMI ; Junko FUJITANI ; Tetsuo HARA
Journal of International Health 2023;38(4):193-201
Background and Objective The Projects of Global Growth of Medical Technologies, implemented by NCGM since 2015, have contributed to human resource development through on-site training in partner countries and training in Japan. However, since 2020, online training has become mainstream due to the travel restrictions by COVID-19 impact. As one of the projects, the NCGM and Bach Mai Hospital rehabilitation departments in Vietnam held an interactive online hands-on seminar in FY2022 for Vietnamese occupational therapists and others to provide technical guidance for making splint orthoses to rehabilitate patients with hand dysfunction. This paper aims to report on the preparation and implementation process of the seminar and its results.Preparation and Implementation of the Seminar NCGM (the instructor) and Bach Mai Hospital (the site of the hands-on training) prepared the seminar through regular online meetings, fostering ownership and collaborative planning on the Vietnamese side, and discussed the program development, necessary materials, participant selection, and obtaining authorization from the Vietnamese Ministry of Health. To ensure the quality of the technical instruction, the seminar was connected via Zoom to both NCGM and Bach Mai Hospital, where the live video of the splinting technique was conducted, along with explanations and Q&A sessions. The post-training evaluation was carried out through a questionnaire with self-assessment of the participants about the knowledge and skills they obtained. Outcome and Discussion As a result, 96% (27/28) of the participants answered that the seminar was “useful for clinical practice,” suggesting that the interactive online hands-on seminar regarding technical instruction in making splint orthosis was as good as or better than the face-to-face training. We found that the Vietnamese side took ownership from the preparatory stage by establishing a regular online meeting system; the quality of the training was assured by live video by both sides, which enabled detailed technical instruction; the training provider’s skills were improved by more detailed preparation; training was cost-effective compared to on-site training or training in Japan; and the materials used and the training videos can be used as teaching materials, which is expected local benefits and sustainability. These findings can be applied to face-to-face training to make the training more effective and extended as a useful method when similar activities are developed in other countries.
5.Development of a Patient Registry System for Specialized Palliative Care Quality Assessment Using Patient-reported Outcomes: A Multicenter Pilot Study
Hideyuki HIRAYAMA ; Eriko SATOMI ; Yoshiyuki KIZAWA ; Mayuko MIYAZAKI ; Keita TAGAMI ; Ryuichi SEKINE ; Kozue SUZUKI ; Nobuyuki YOTANI ; Koji SUGANO ; Hirofumi ABO ; Meidai SAKASHITA ; Kazuki SATO ; Sari NAKAGAWA ; Yoko NAKAZAWA ; Jun HAMANO ; Mitsunori MIYASHITA
Palliative Care Research 2022;17(4):171-180
Objective: This study aimed to investigate the feasibility of a patient registry system for assessing PCT (palliative care team) by PRO (Patient-reported outcome) in Japan. Methods: We operated a patient registry system with electronic data collection at eight hospitals in 2021 in Japan. We consecutively included newly referred patients for a month and followed up with them for a month. IPOS or ESAS obtained as PRO at the start of the intervention, three days later, and every week after. The primary endpoint was the response rate to the symptom rating scale by patients and providers. Results: 318 patients were enrolled. The patient response rate was 59.1% at intervention and 37.0% after intervention, and the medical provider response rate was 98.4% at intervention and 70.3% after intervention. Interviews with PCT members indicated that participants required support to input PRO responses required support and paper questionnaire was better and that managing the survey date and overall management was burdensome. Discussion: Although only about half of the patients were able to respond to the PRO, this was the same level as in previous studies. The system and its operation method have many problems. We found that improvements such as reducing items and making the patient interviews paper-based are necessary to expand the system nationwide.