Since the system for the national and local governments to grasp the patient information of the new corona did not function sufficiently at the beginning, the Ministry of Health, Labor and Welfare decided to introduce a new system from October.

Currently, medical institutions and health centers are manually inputting each case, which is a burden on the business, and since the input was delayed and it led to a delay in grasping, we are considering automatically reading handwritten faxes. increase.

In order to utilize it for infection control of the new corona, the national government introduced a system called "HER-SYS" in May, when it was in the early stages of infection, and collects information such as the patient's name, age, onset date, and symptoms. ..



However, at medical institutions and health centers, it was initially necessary to manually enter about 120 items for each patient, which was a heavy work burden, and the input was delayed, leading to a delay in grasping the infection status. I was there.

The government's Council of Experts, which examines the measures against the new corona, also points out that the delay in digital reform is serious because the basic information for the measures is not provided to the government and experts.



In response to this, the Ministry of Health, Labor and Welfare has decided to introduce a new system for the next infectious disease to local governments nationwide from October.

In order to reduce the input burden in the new system, we are also considering the introduction of a technology called OCR, in which some information can be input by the patient himself / herself on a smartphone and the handwritten fax that reports the infection is automatically read.



The Ministry of Health, Labor and Welfare has introduced the system after the spread of the infection in the new corona, and said that it did not function sufficiently, and wants to respond to the next infectious disease by introducing it in advance.

Current system Infection cannot be grasped in real time, and work is tight

"HER-SYS" is a system that centrally manages information on infected people of the new corona, and was newly developed by the Ministry of Health, Labor and Welfare over a period of about two months in response to the spread of infection in Japan. I proceeded with the introduction.



One of the purposes of the introduction was to "understand the infection status in real time" nationwide by the Ministry of Health, Labor and Welfare.



However, as the introduction to local governments progressed, problems with the aggregation function and errors in the input data were found one after another, and the state of being unable to accurately analyze the infection status nationwide continued for more than half a year.



In addition, it was said that the burden on the health center could be reduced because medical institutions could directly enter data, but initially there were about 120 input items.



After that, the number of items required for input was reduced in response to the voices of the field, but there were a number of cases where the health center was forced to input the fax information sent from the medical institution, which was a major factor that put pressure on the work. ..

Tokyo Kita Ward Public Health Center One after another cases where input cannot keep up

Of these, the "outbreak report" sent by fax is stored at the Kita-ku Health Center in Tokyo, and there are dozens of cardboard boxes.



When "HER-SYS" was first introduced, there were many omissions and mistakes in the input of medical institutions, so the staff of the health center corrected it based on the "report of occurrence" that was sent by fax separately, or heard from the patient again. It means that I had no choice but to enter it.



However, at the beginning, there are very many items that are required to be entered, about 120 items, and it takes about 30 minutes for one person to enter all the items, so it is a task such as patient health observation and hospitalization adjustment. It was very burdensome to do it in parallel.



As the number of infected people increased, the work became tight and there were a number of cases where the input work could not keep up, but at the beginning there was no instruction from the government etc. on which information should be prioritized for input, so it is possible. It means that I had no choice but to continue typing.



According to this health center, the number of input items for "HER-SYS" has decreased, and most of them are input at each medical institution.



Hideo Maeda, director of the Kita Ward Health Center, said, "There was no communication between the government and the health center about what kind of information the country wants to know and what data needs to be entered at a minimum. Isn't it part of the problem of not being prepared for infectious diseases? It is natural that adjustments are necessary because it is a new disease, but we have to discuss and judge in advance that "this item is necessary for infectious disease control". I should have kept it. "

National research group No other system development was introduced before the spread of infection

Based on the lessons learned from past infectious diseases such as the new influenza, the national research group has been developing a system different from HER-SYS since 2013, seven years before the spread of the new corona in Japan.

That is the "Case Information Rapid Accumulation System = FFHS".



The basic idea of ​​development is to collect necessary information accurately and efficiently while minimizing the burden on the site.



For example, in the conventional method, when an infected person appears, the health center received a notification of the outbreak of infection by fax from a medical institution and had to input it to a personal computer, but in this system, the handwritten characters of the fax are called OCR. It can be automatically registered as read data by technology.



In addition, HER-SYS required the input of about 120 items for infected persons, but after repeated discussions with local governments regarding what information is required for this system, the minimum of the patient's age, gender, onset date, symptoms, etc. We have narrowed down to 18 items.



This information can be viewed in real time by each local government, and it was expected that the burden of work required for information sharing would be reduced.



Furthermore, the research group has been conducting exercises with multiple local governments every year, assuming the occurrence of a pandemic by actually operating this system since 2013.

According to the research group, in February, when the spread of the new corona started, the Ministry of Health, Labor and Welfare instructed us to repair the system for the new corona by e-mail, but since then, there has been no contact and the system has been introduced. It was never done.



Takashi Okumura, a former technical officer of the Ministry of Health, Labor and Welfare who was in charge of system development in the research group, said, "Based on the lessons of the past, we have prepared for the solution of problems that occur in the field, so if it is introduced. For example, I think that it was possible to reduce the burden on the site and efficiently collect patient information nationwide from the first infected person in Japan to the end of the pandemic. One of the reasons why we couldn't do this is that the organization has lost the ability to inherit experiences. "

Research group system Introduced in Hokkaido and results

The system developed by the research group has been introduced in Hokkaido as a system compatible with the new corona and has been successful.



Since Hokkaido participated in exercise training at the time of development, a research group system was introduced in August last year and operated as a database for sharing patient information between the prefectural government office and the 26 health centers under the jurisdiction of the prefectural government. doing.



According to the road, HER-SYS cannot share patient information efficiently, so it was managed by inputting it into spreadsheet software, but it was necessary to check frequently with the health center, and the burden on the site was heavy. That is.



In addition to basic information, the research group's system

can also confirm information necessary for local governments to consider infection control, such as


▽ patient status,


▽ vaccination history,


▽ infection route , and type of mutant strain.


I can do it.



In addition, since the entered contents are immediately reflected in the database, information can be shared quickly, and it is now an indispensable system for deciding the policy of the road.



Yoshitetsu Hitomi, director of the Hokkaido Health and Welfare Department, said, "Because HER-SYS has comprehensive items, we could not share information with the health center or think about infection control based on the contents. Number of patients. However, the research group's system has been able to reduce the burden on the site, and the situation is as different as heaven and earth. It is an important basis for tackling infection control. " I'm talking.

Without grasping the system of the Ministry of Health, Labor and Welfare research group

Several executives from the Ministry of Health, Labor and Welfare, who were involved in the introduction of HER-SYS, told NHK that they "did not know about the research group's system because they had not received a report."



On top of that, the Tuberculosis Infectious Diseases Division of the Ministry of Health, Labor and Welfare, which was in charge of the research, said, "Whether or not the research team's system was shared with the department in charge of HER-SYS has not been recorded because it was chased by unprecedented corona response. I can't explain it clearly. However, if I couldn't confirm that the research group's system could be operated nationwide without any problems, it would have been difficult to introduce it as it was. "

Committee member of the expert meeting "should be prepared in advance"

Mr. Tetsushu Kusaba, Chairman of the Japan Primary Care Association, who served as a member of the government's expert meeting to verify measures against the new corona, said, "It is of course important to respond after a crisis occurs, but it is important to prepare for it from normal times and the crisis will occur. It is very important to create a system that allows immediate transition when it happens. It is a major premise that we should prepare an input system for infected person information in advance. "



In addition, the national research group had been developing another system since 2013, but this time, the reason why it was not fully utilized was "Why from the department in charge of the Ministry of Health, Labor and Welfare when the new corona actually spreads? Couldn't you make a proposal? It means that what was prepared over a long period of time was not used as a result, so I think it is necessary to verify whether it can be used. " I am.