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Telemedicine in Geriatric 　　　　　　　　 Care in Japan

Sep.5, 2014

Jitsuzo Katsumata, Ph.D.

SDM Research Institute, Graduate School of System Design and Management, Keio University

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Content1 Introduction 1.1 Trend of elderly people in Japan 1.2 Trends in the population of major age group 2 Characteristics of Japanese Aging Society 3 Health Measures for the Elderly 4 Local Medical Cooperation 5 Proposal for Solution 5.1 Proposal for Mobile Clinics 5.2 Virtual remote chat conference 5.3 Results of Experiment 6 Mind of elderly people ・ Mental disease in an elderly people ・ Questionnaires ・ Results of Experiment 7 Conclusion

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1 Introduction 1.1Trend of elderly people in Japan

January 17, 2014　 FT Magazine

Figure 1-1

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1.2 Trends in the population of major age group

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2. Characteristics of Japanese Aging Society

• Under social security system in 2030, 5 working people must support 1 elderly person aged older than 75.

• Population aging changes and the highest aging proportion will come in 2055 (proportion of the aged older than 65 ).

• In 2055 the aging society will come when 1 in 4 will be older than 75.

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3.Health Measures for the Elderly• Current three major illnesses are • “Cancer (malignant neoplasm)”, • “Acute myocardial infarction”, and• “Stroke”, and

preventive diagnosis visualizing

mental illness through referral system is needed to cope with increasing number of elderly.

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4 Local Medical Cooperation

⇒ 　 Linkage between acute phase medical institution and healthcare institution 　 ⇒

　　　　　　

　 ⇒　 Sharing medical data between medical institutions

⇒ 　

Ad

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Utilization of ICT

Visualization of Mental Problem

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5 Proposal for Solution• Cooperation between urban area and rural area

　 ⇒ Smaller distance through usage of ICT technology

⇒Usage of telemedicine such as Introduction of efficient mobile clinics for using

ICT Introduction of remote chat conference

　 Idea of establishment of local medical center　

Increasing of elderly people in Japan 　 ⇒ Development of health and medical

system

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5.1 Proposal for Mobile Clinics

M.G. Hospital, Jaipur

Nurse INTERNET

Rural Village

iPad

Image send to general hospital in Jaipur by iPad

(Size-20inch,better14inch,good :4-Gigabyte)

1 GB download 255 INR

Vertical Medicine management System

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SONY Confidential

3D-MonitorLMD-4251TD

doremi LabsDimension-3D

HD-SDI x 2

Comm-Box

HD-SDI x 2

Comm-Box

3D-MonitorLMD-2451TD

HD-SDI x 2HDMI

GbE-SW

GbE-SW

GI-POF Network

Patient

Medical Doctors

Digital HandycamHDR-TD10

Chat PC & Diagnosis

5.2 Virtual remote chat conference

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　 Image Diagnosis

Doctor’s Specialty

Accuracy Speed Trouble Chat Type

Judge

Internal medicine good good even good even

Surgery good good good good good

Dermatology good good good good good

Otolaryngology good good even even bad

Virtual remote chat conference was a practical system concerning new medical devices.

Neurology good good even even even

5.3 Results of Experiment

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6 Mind of elderly people

(1) Confirmation of life spent(2) Contact with others(3) Journey to transcendence(4) Search for self(5) Mental preparedness for the future

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Confirmation of life spent

Contact with others

Search for self

Mental preparedness for the future

Journey to transcendence

Active life style

⇒⇒

⇒

⇒

⇒The concept of life style can be divided into five factors.

Souce：MicroAVS

Mental disease in an elderly people

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Questionnaires1　 Confirmation of life spent

1-1Sense of gratitude for parents (Do you think your life was affected by your parents' way of life?)

1-2 Purpose of life (Do you think you grew up by crossing over many hurdles?)

1-3 Hope for life (Do you think it worthwhile to overcome hurdles?)2　 Contact with others2-1 Feeling of acceptance (Do you think you respect others and others respect you?)2-2 Your feeling deep inside (Do you think you accept anybody without prejudice?)2-3 Purpose of life (Do you think you forgive people you meet or around you?)3 Journey to transcendence3-1 Your ancestors (Do you think your ancestors and descendants are firmly bonded?3-2 Invisible force (Do you think you live your life by strong invisible force?)3-3 Lost family (Do you think you feel relieved and comfortable through prayer?)

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4 Search for self4-1 Friendly relationships (Do you think you live asking yourself the meaning of life?)4-2 Consideration to others (Do you think your life is meaningful?)4-3 Bond with valuable person (Do you think your life is becoming more meaningful?)

5 Mental preparedness for future5-1 End of life (Do you think you wish to transmit what you have acquired to people around you?)5-2 About death (Do you think you wish to have good relationship with people around you in your life?)5-3 Organizing your mind (Do you think you are prepared to the end of life?)

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Questionnaire Analysis

• 88 senior high school students in Japan, 19 university students in Chengdu, China

• They are neutral about a spirituality to people.

• The participants consisted of 20 men (23%) and 68 women (77%).

• The response rate was 84% (1093 of 1307 people approached)

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Visualization of Mental Problem of the Elderly

Doctor

NurseChaplainCare aid Psychologist

Social worker

Rehabilitation Staff

Dietitian

Conference

Spirituality

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7 Conclusion

(1) This system can be promising as the healthcare service quality in elderly people should be improved.

(2) We confirmed the effectiveness of the mobile clinic system in which chat virtual conference including a second opinion.

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Reference[1]Misawa H., Nojiri M., Niino N. (2010),

Spiritually Rating Scale for the Elderly in Community-A study of validity and reliability- Japan Health medicine Association 18(4) 170-180 (in Japanese)

[2] Katsumata J., Toma T., Ogi T.(2012), Introduction of doctor’s second opinion and preventive critical path based on remote chat conference, Japanese Journal of telemedicine and telecare Vol.8.pp2-7 (in Japanese)

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Reference (Continued)[3] Takeda K. et al. (2007), Development of a

spirituality rating scale related to health in the elderly-A study of the validity and reliability- J Japan Health Society No2, 63-72 (in Japanese)

[4] Matsuoka Y. (2011), “Medical Philosophy and Ethics,” Substitute/Supplemental Medical Service and Perspective to Discussing Spirituality, 9.

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Thank you! If you have any questions concerned, could please send me an e-mail at ktboy@chime.ocn.ne.jp

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Score Dis tr ibut ion and Rel iabi l i ty

　 Score Analys i s Rel iab i l i ty

　 Average Score

Standard Devia t ion

αcoe f f i c i en t

１ Confirmation of life spent 11.36 2.6 0.67

２ Contact with others 11.07 2.5 0.76

３ Journey to transcendence 14.16 4.0 0.83

４ Search for self 10.37 2.9 0.80

５ Mental preparedness for the future

10.16 2.7 0.69

Tota l 57.66 11.8 0.91

Appendix: Example of Analysis of Visualizing Mental Problem