Better nursing care with networking: Fujisawa City, Kanagawa Prefecture 1

In Fujisawa City, Kanagawa Prefecture, a demonstration experiment called “e-Care Town Fujisawa”, is underway, with the aim to improve local nursing care. This project is run mainly by Fujisawa City, with the help from Fujisawa City Health Care Foundation, Faculty of Nursing and Medical Care as well as Faculty of Environmental Information at Fujisawa City, and the NTT East Japan. It aims to achieve detailed health care by using monitoring devices directly connected to the network to automatically collect information such as heart beat and pulse, and also tries to establish a system where elderly people not familiar with computers can easily obtain health information and send messages through the Internet. This project was supported by Ministry of Public Management, Home Affairs, Posts and Telecommunications as a part of 2002 fiscal year’s “e-project”, but it’s planned to continue into fiscal year 2003 and beyond.

One of the project leaders, Professor Kikuko Ota at Keio University’s Faculty of Nursing and Medical Care, explains the overall goal of the “e-Care Town Fujisawa”. “As the society becomes increasingly aged and the birthrate continues to decline, health care for the elderly becomes an important issue. The challenge is to come up with a system that enables the elderly to live a healthy and lively life. The need for nursing care for elderly shouldn’t disrupt the life of family members. We must find effective ways to incorporate the nursing care into the life of the whole family. The theme of this project is to study how the utilization of the next generation information technologies can help achieve these goals.”

Fujisawa City has already been running a health improvement project called “health-up project (Health Improvement Project)” with a support from Health, Labor, and Welfare Ministry of Japan. Furthermore, the city’s Health Care Center has all the function of hospital, visiting nurse station, gym, and nutrition management center concentrated in one facility, and it is providing a coordinated health and medical service. Help from Keio University regarding nursing care and networking technologies have also aided the progress of the project.

Eiko Uchiyama, a Special Research Assistant at Keio University’s Faculty of Nursing and Medical Care and a key member of the project, points out, “Fujisawa City is not a full-fledged industrial city but also a suburban commuter town, and therefore contains people that commute to Tokyo metropolitan area and those that are rooted to the local area. This makes Fujisawa City nicely balanced geographically.”


Seniors can use E-mail to notify their family members

In the project, there are three main demonstration experiment programs; “e-health-up” a program for maintaining and improving the health condition of middle-aged and elderly people, “e-family care” for healthy seniors and their family, and “e-nursing care” for the seniors who need nursing care, their family, and nursing care staff.

In “e-health up” program, specially designed exercise bikes were provided to ten participating members, and remote training was done using these bicycles. The bike itself is a normal home use exercise bike, but it allows the trainer to monitor the change in user’s heart beat from a remote location via IPv6 Internet and give professional advice to the user. Exercise programs and the load can also be remotely changed by trainer via IPv6. This program provides the advantage of being able to exercise according to the professional trainer’s instruction at the time of choice, without going to the fitness clubs.

“E-family care” project established a system that enables pedometer equipped with 802.11b Wireless LAN function to automatically transmit the number of steps taken by the user to the project center via Internet. Additionally, each participant’s house was installed with a illuminometer and a pad-type sensor that were placed over the bed or Futon. Illuminometers report the light level in the room that can be used to monitor the pattern of sleep-wake cycle, and pad-type sensors allow the monitoring of heart beat, breathing rate, and snoring.

Furthermore, a new device called “How-are-you Call” was developed. It is a small box equipped with a Wireless LAN. When the user presses one of the three buttons placed in front of the box, E-mail with a preset content and address assigned to that button will be sent semi-automatically. With this device, seniors can send E-mail messages such as “I’m fine”, “Call me”, or “Please drop by on the way back” to their kids or family members easily, even if they don’t know how to use PC nor keyboard.

Masaki Minami, a Assistant Professor at Keio University who oversees the IT involved in this project, explained us the motivation behind the development of the “How-are-you Call” device. “We wanted to find a way to extend the benefits of IT to people who doesn’t even know how to use cell phones. With this device, it is at least possible to tell your present condition to other people. Unlike phone calls, E-mails allow recipients to check messages later even if they are busy at the time. Seniors can feel secure by having sense of being taken care by someone, and family members who are out of the house can save worries if they can be told that the seniors are doing fine.”

”e-nursing care” program also uses illuminometer, pad-type sensor, and “How-are-you Call”. In addition, the program provides information such as how to exercise in order to maintain the leg strength and prevent falls, and examples of recipes for maintaining health, in an image rich format. Participants can browse these “e-Nursing Care Multimedia Information” using Web browsers. “People that are in need of nursing care can not move around much by themselves, and this increases their anxiety level. In order to resolve this anxiety, we need to provide more information. Accurate information by nursing care professionals has been scarce on the Internet until now.” says Uchiyama. “e-nursing care” has also introduced a system where health care professionals can provide an advice regarding nursing care to the person in need of the care and their family members, using PC-based video conferencing system that can transmit high resolution DV bi-directionally.

From left to right, Masaki Minami, Kikuko Ota, and Eiko Uchiyama