| Project/Area Number |
19K15236
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 25010:Social systems engineering-related
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| Research Institution | Tokyo Institute of Technology |
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Principal Investigator |
顧 秀珠 東京工業大学, 工学院, 准教授 (20632615)
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| Project Period (FY) |
2019-04-01 – 2024-03-31
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| Project Status |
Granted (Fiscal Year 2022)
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| Budget Amount *help |
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2021: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
Fiscal Year 2020: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
Fiscal Year 2019: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000)
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| Keywords | Patient safety / Incident / EMR system / Taxonomy |
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| Outline of Research at the Start |
本研究では電子カルテシステムに起因する新たな患者安全問題に焦点をあて、これらの事象の報告・分析・対策・評価を含む「電子カルテシステム適応型インシデント管理システム」の構築を目指す。まず文献調査と専門家にインタビューを実施し、適応する「インシデント分類法」を開発する。これを利用し、インシデント・事故事例の分析の結果から、現状での問題点と特徴を解明する。これらの分析結果に加え、さらに電子カルテシステム先進国の安全管理経験をもとに、インシデント報告・分析・対策・評価を含む「電子カルテシステム適応型インシデント管理システム」を構築する。構築したシステムの有効性を病院でのケーススタディにより評価する。
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| Outline of Annual Research Achievements |
A draft of the EMR-related incident management system has been developed. It includes not only a common format for EMR-related incident reporting, but also includes how to make analysis of incidents; corresponding to the analysis results, what kind of measures could be taken and how; and how to make evaluations after taking measures. The draft of the developed EMR-related incident management system has been discussed with the healthcare management personnel in several hospitals. Improvements were suggested and most of the points have been revised but not all finished.
A new study unincluded in the original project was also planned last year. The objective of this new study is to investigate whether EMR system really has positive effects on safety, productivity and healthcare quality. A literature survey was conducted and research design was all prepared. However, as the information about the EMR system implementation period of all the Japanese public hospitals is needed, such information is not open to the public. Although efforts were also made to inquire the relevant government ministry, it was not provided even for research. Therefore, the new planned study could not continue anymore and was terminated.
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| Current Status of Research Progress |
Current Status of Research Progress
3: Progress in research has been slightly delayed.
Reason
The progress of the project was delayed because of the COVID-19 in the last three years. However, the progress becomes better and better. Due to the COVID-19, many plans had to cancelled or changed, e.g., the observation experiment was cancelled considering the risks; the questionnaire survey to healthcare staff was conducted although the scale was much smaller than the original plan. Still, based on all the findings as well as learning from EMR advanced countries’ experience, an EMR-related incident management system was developed although it was still a draft. However, because of the big delay in the last three years and more improvements were suggested for the draft system than expected, the plan of implementing the EMR-related incident management system and validating its effectiveness was not met.
Another reason for the delay in last year was because of the new planned study of investigating whether EMR system really has positive effects on safety, productivity and healthcare quality. A lot of time and efforts were spent on the literature review, research design and data collection. However, because the government does not provide the information that we thought it was open to the public, the study was terminated. Therefore, the extension of this project for another year was applied and approved.
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| Strategy for Future Research Activity |
First, the draft of the developed EMR-related incident management system will be improved continuously. Then, according to the plan, this system will be implemented and validated its effectiveness. The developed system will be implemented after adaptation to the current hospital systems. Effectiveness of the system will be verified after implementation, using indicators such as change of EMR-related incident reporting rate, appropriateness of the proposed measures, and healthcare staff and risk managers’ satisfaction. In addition to the quantitative and qualitative effectiveness measurement, usability of the system is also planned to be investigated. Interviews or the System Usability Scale (SUS) could be used to patient safety managers and healthcare providers as the users. This is very important as although the system is effective, if the usability is poor, then the system will not be used in the future as many existing systems. Based on the results and suggestions, improvement of the system’s usability and utility will be conducted.
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