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2.3.2 Mobile communication as a service for
patients
The target university hospital permits the use of
cellular phones by outpatients, inpatients, and
visitors to unrestricted zones. In Japan, 85,500,000
or more cellular phones are now in use, with 75% or
more people having a cellular phone (TCA, 2004).
Many people have become so dependant on them
that a syndrome called "cellular-phone dependence"
has been coined for people who cannot live without
them. Also, the use of cellular phones in business is
widely promoted as they are now recognised as
being indispensable for doing business. Due partly
to the above factors, the demand for communication
using cellular phones by both outpatients and
inpatients is growing. Especially for inpatients, the
free use of a phone can decrease stress and the sense
of isolation caused by hospitalisation, thus raising
the Quality of Hospital Life (QOL). Other factors
may account for some of the increased demand for
cellular-phone use. For example, no reports of
malfunction of medical devices have been seen in
recent years. The third generation mobile phone
systems, which reduced the electric wave output
have become popular. Also, medical devices have
improved protection against electromagnetic waves.
The target university hospital defined criteria for
cellular phone use, with reference to experimental
results (EMCC, 1997, Hanada, 2000, MPHPT, 2002)
as shown in Table 2, and permitted the use of
cellular phones in limited areas from January, 2004.
Table 2: Conditions for cellular-phone use in the target
university hospital
• Cellular phones can be used only in a visitor lobby, a
single bed sickroom, and in dining rooms.
• The medical staff can use cellular phones at nurse
stations and in conference rooms
• Cellular phone use is not allowed within 50cm of
medical devices
• Patients connected to medical devices are prohibited
from using cellular phones
• After a set time for turning out sickroom lights, the use
of cellular phones is prohibited
• Staff members are not allowed to use a cellular phone
during rounds, while walking, or during explanations
to patients or their family.
In the target university hospital, these rules are
widely displayed and are specified in the hospital
guidelines. The co-operation of patients and staff
members has been requested, and no interference
with medical devices has been observed since these
rules were put in effect.
3 DISCUSSION
In Japan, other than the target university hospital
there are no hospitals with more than 600 beds using
wireless communications for both data and voice
communication. This is because restriction of
cellular phone use is economically cheaper and
responsibility can be avoided by hospital
administrators who fear EMI and who do not want to
take the measures necessary to mitigate against EMI.
However, by keeping cellular phones away from
medical devices and by using mobile phones or
wireless LAN apparatus with weak electromagnetic
wave output, it is possible to stop or minimise EMI
with medical devices, as shown by previous
experimental results (Hanada, 2000, Hanada, 2004).
In Japanese hospitals, long periods of time spent
in treatment as an outpatient has been a big problem.
Also, inpatients have, in many cases, been restricted
from communicating with persons outside the
hospital. The dissatisfaction of both groups has
grown. Recently, the Japan Council for Quality
Health Care (JCQHC) has been asked for a ruling
about cellular-phone use in hospitals. The JCQHC
has made standards and checks hospitals for
compliance. Japanese hospitals that have been
checked for evaluation of clinical function have felt
the evaluations were fair. The newest version of the
JCQHC standards require that a space be designated
in which cellular phone use is permitted or that an
alternative communication means be in place if the
institution wishes to meet the evaluation standards
(JCQHC, 2005). Such evaluation is not mandatory,
but permission for cellular-phone use taking into
account these factors has resulted in improvements
in service to patients.
Before mobile communications systems were
installed in Japanese hospitals, many telephone calls
searching for doctors were placed, which took quite
a lot of time. Because secretaries and office
personnel are seldom hired to work in wards in
Japanese hospitals, there are many cases in which
nurses receive calls that require administrative work,
reducing their ability to complete their nursing
responsibilities. For example, when a pharmacist in
the pharmacy has a question about a prescription, it
is necessary to contact the doctor concerned for
confirmation of the prescription and correction, if
necessary. However, in large hospitals, because the
pharmacists in many cases work in places distant
from doctors, the pharmacists do not have the means
to know the current location of each doctor.
Therefore, they had to call various wards or
consultation rooms.
A WIRELESS VOICE/DATA COMMUNICATION SYSTEM IN A LARGE HOSPITAL
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