Challenges upon ICT Implementation in hospitals demystified -- ICT in Healthcare Market Report

In this pandemic era, led by notable enterprises, many companies have leveraged their ICT and network enhancement -- while it is not the case in the frontline of healthcare services in Japan.
Nikkei Research conducted an online survey in March 2021, investigating the installed health information systems and the challenges toward installing them in facilities where doctors service. A total of 4,508 physicians throughout nationwide Japan responded. Nikkei BPs’ “Nikkei Medical Online Panel” were used for the sampling source.

The result at a glance

The “Electronic medical records” was the most installed reaching nearly 80%. Followed by “Medical billing computer” and “PACS (Picture archiving and communication system)”, both over 40%, and “Medical appointment register system”, slightly above 30%. Cloud-based systems and online patient care system (telehealth) were both below 10%, indicating that those implementations are not successfully proceeding.
Looking at the result by facility type, health information systems are more widely adopted in hospitals rather than in clinics, particularly “Electronic medical records”, “PACS”, and “Medical appointment register system” have relatively large difference in the installation rate. In contrast, “Medical billing computer” are more commonly used in clinics. The installed rate of “Cloud-based electronic medical records”, “Online patient care system (Telehealth)”, and “Home-visit medical care support system” are low in both hospitals and clinics.

What doctors are saying (from the open-ends)

Advantages of ICT and network enhancements are “Sharing information and data management becomes easier” and “Work efficiency”

• “By sharing information promptly between staff, I am expecting the useless order authentications to be eliminated.” -- Director of a private general hospital (100-199 beds)
• “The management of medical records will be easier. I would not be annoyed with the non-readable hand-written records or referral letters.” -- Physician of a private general hospital (200-399 beds)
• “Leads to productivity through work style reform and work efficiency (Although, the users need to make the best from it and change their mindset).” -- Physician of a public hospital (400+ beds)
• “I think the work efficiency will be improved because the electronic medical records enable us to store the various past examinations and records where we can retrieve those patient data instantly.” -- Director of a private clinic (No beds)

The expectation toward “remote patient care (telehealth)” is high.

• “If telehealth becomes possible, the medical system of remoted areas would be reinforced.” -- Board member of a private clinic (No beds)
• “With remote patient care, we can reduce the risk of COVID-19.” -- Physician of a public hospital (200-399 beds)

The challenge of installation is the “cost”. Not only the fees of the system itself but also considering “time for getting used to the new system” impacting the labor costs.

• “We cannot afford the cost of that amount of infrastructure investment.” -- Director of a private clinic (No beds)
• “People who have been used to work with paper records would rather need extra time (if changed to electronic records).” -- Director of a private clinic (No beds)
• “Staff would need a certain time to get used to it. And we need money to install the machines.” -- Board member of a private general hospital (200-399 beds)

“Security risks over data management” and “Digital literacy of both doctors and patients” are also barriers.

• “We have to protect personal information and each medical institute has its own policies. It is disturbing if we get to inspecting each other.” -- Director of a public hospital (200-399 beds)
• “The digital literacy of doctors, the gap between generations.” -- Assistant professor of a public hospital (400+ beds)
• “For example, telehealth would be difficult for elderly patients. I don’t think it would be easy for them to prepare their internet environment.” -- Physician of a private clinic (No beds)

Although the enhancement of ICT and networks in the healthcare sector is concerned as a national issue, in reality, there are many challenges to overcome for making progress. Not to mention the effort of each hospital and institution, but the support of the government and good follow-up scrum from the device/service provider is necessary.

Curious to know more about how we approached the doctors and directors of the hospitals?
You can download the panel book from below.