It is quite natural that a system that is difficult for medical institutions to use has not become widespread. The government must listen to medical workers on the front line and do its best to reduce their burden.
In order to prevent the spread of the novel coronavirus, it is important to establish a system in which the central and local governments can quickly grasp the situation surrounding infections in an integrated manner. To this end, the central government introduced the Health Center Real-time information-sharing System on COVID-19 (HER-SYS).
Under the Infectious Diseases Control Law, medical institutions are obliged to submit a "notification of occurrence" that contains the name of a patient, symptoms such as fever and test results. In the past, the information was sent to public health centers by fax, and then each public health center compiled the information and reported it to the central government. The conventional system revealed a large delay in integrating information.
With HER-SYS, public health centers, the central government and local governments can instantly share notifications of occurrence that each medical institution has entered online. As it is also possible for public health centers to type into the system the behavior history of infected people and those with whom they have been in close contact, HER-SYS should have been a trump card for speeding up information sharing for that purpose.
However, since HER-SYS was introduced at the end of May, usage has not increased as expected. According to a survey by the Health, Labor and Welfare Ministry, only about 40% of the 318 medical institutions that responded to the survey said that they use the system, and about half of the respondents still use fax machies and other devices.
In 108 local governments, public health centers input data on notifications of occurrence received from medical institutions into HER-SYS on behalf of the medical institutions. Such circumstances have not helped reduce the burden on public health centers.
The reason for the low rate of utilization of HER-SYS is that there are as many as about 120 input items, increasing medical workers' workload. As expected, there has been a spate of complaints from medical workers on the front line saying that "data entry is too cumbersome when there are many patients."
The health ministry might have introduced the system too hastily to grasp the reality of front line medical workers. The ministry plans to designate about 30 priority input items, including patients' symptoms, infection routes and dates of onset, to encourage use of the system. Measures should be taken immediately to reduce the burden on medical workers on the front line.
Amid mounting concerns about a "twindemic" of influenza and coronavirus as the winter season approaches, the government is calling for the establishment of a system in which family doctors examine patients suspected of being infected with the coronavirus and test them. As a result, the number of medical institutions handling infection information will increase.
The health ministry must continue to improve the system to make it easier to handle.
Following the introduction of HER-SYS, if medical institutions and local governments review their distribution of personnel and their workflow, the central government will need to strengthen support such as through dispatching necessary personnel and providing advice.
Tokyo, Osaka and other large municipalities in urban areas have their own information-sharing systems. It is also important to establish a mechanism to avoid unnecessary duplication of effort entering data in HER-SYS and their own systems.
-- The original Japanese article appeared in The Yomiuri Shimbun on Oct. 8, 2020.
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