Tokushukai Information System, Inc. is responsible for the information systems of Tokushukai, one of Japan's largest healthcare groups. It is developing hospital information systems across the Group in partnership with Dell, which provides flexible, cost-effective platforms based on open, standard technologies and products. Having developed BI tools for using management and clinical data, the company built a remote clinical data backup system for disaster preparedness using PowerEdge and PowerVault products running Windows Server 2012, soon after its release in autumn 2012.

Tokushukai Information System, Inc.: supporting information systems for one of Japan's largest healthcare groups

Guided by its principle that all lives are equally precious, Tokushukai operates more than 280 healthcare facilities, including 66 hospitals, from Hokkaido to Okinawa. In addition to large hospitals, it is expanding community clinics and establishing nursing care and social welfare facilities to meet the needs of an ageing society. Its medical, nursing care and welfare facilities extend to underserved areas, remote islands and rural communities throughout Japan.

Tokushukai Information System, Inc. supports the Group's use of information systems. It brings together work that was previously undertaken separately by individual facilities and drives the information strategy of this large healthcare group. The company was established to improve patient services and the quality of care by developing tools to use and analyse management and clinical data across the Group and by building unified information systems.

“To use data efficiently for Group management, we first needed to standardise the vendors of separately installed electronic medical record systems and unify the various coding schemes. Our main task at the outset was then to develop BI tools to analyse and use the consolidated data,” explains Katsuhiko Ozaki, Director and Senior Managing Executive Officer of Tokushukai Information System, Inc. Electronic medical record and order entry systems now operate at 47 of the 66 hospitals, all using Software Service systems. Around the time the company was established and the EMR integration programme began, Tokushukai also started developing its infrastructure with Dell as a strategic partner.

Choosing open, standard products and technologies

“Our healthcare IT strategy is based on open system specifications and de facto standards. We give top priority to cost performance when selecting systems and vendor partners,” says Ozaki. Software Service's EMR uses Microsoft products, including Windows Server, as its platform. “We value its use of widely adopted de facto standards, its clear focus on developing and supplying software, and its open approach to hospitals' use of their data.” He adds that Dell was chosen as a partner because “we believed it would provide a flexible, cost-effective platform based on open, standard technologies.”

Approximately 90% of the medical master codes across all hospitals have been standardised, creating an environment in which management data from all 66 hospitals can be centrally managed and analysed. Data on management indicators, clinical indicators, patient safety, patient satisfaction, departmental workloads and other statistical indicators can be classified, extracted, analysed and processed to support detailed management analysis, more efficient operations and better patient services. Analysis of statistics by medical procedure, drug composition and surgical costs has helped improve hospital management, while studies of the time patients spend in hospital have supported better patient services.

Another major strength of Tokushukai as one of Japan's largest healthcare groups is its ability to use clinical data on approximately seven million patients, supported by a unified coding system.

Examples include providing data for epidemiological studies and analysis under the medical information database infrastructure project promoted by the Ministry of Health, Labour and Welfare and the Pharmaceuticals and Medical Devices Agency (PMDA), and analysing chemotherapy data such as response rates among thousands of patients receiving anticancer drugs. The company has also developed and supplied remote SDV (Source Data Verification), which helps pharmaceutical company monitors compare medical records with case report forms. These activities enhance the value of Tokushukai's extensive clinical trial network and represent early steps in the use of medical big data.

Remote clinical data backups to sustain care during disasters

Using medical big data requires versatile, advanced IT. Dell's technology and expertise help provide this foundation. Tokushukai Information System, Inc. worked with Dell on remote EMR backups to support business continuity at each hospital during a disaster. Ozaki explains the decision to introduce the disaster recovery solution: “After seeing healthcare providers lose clinical information in the Great East Japan Earthquake, we felt that clinical data needed to be backed up at a remote location for large-scale disasters. We also needed a system that could be restored quickly so patients could continue receiving care.”

The data centre backup site introduced ten PowerEdge R720xd servers running the newly released Microsoft Windows Server 2012, together with PowerVault storage providing 301 TB of physical capacity and 150 TB of usable capacity. Microsoft SQL Server 2012 replication backs up data from all 47 hospitals with EMR systems in real time over Tokushukai's secure Group-VPN network. In addition to the servers used for ongoing storage, the data centre keeps two 5 TB servers for disaster response. When a disaster occurs, the affected hospital's EMR data is restored to these servers, which are then taken to the hospital for use, avoiding the need to restore data to servers on site.

The company plans to extend remote backups to diagnostic images as well as laboratory and prescription data.

Source: Dell