Continuous Care and Cure Network Project: Doctors to Patients telemedicine service for Tohoku Earthquake/Tsunami victims

Continuous Care and Cure Network Project: Doctors to Patients telemedicine service for Tohoku Earthquake/Tsunami victims

Japan
Organization type: 
nonprofit/ngo/citizen sector
Budget: 
$50,000 - $100,000
Project Summary
Elevator Pitch

Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

The earthquake/tsunami hit the Tohoku area (eastern part) of Japan on March 11, 2011. After 3 months, there are more than 88 thousand refugees. One of the most serious problems faced by the quake/tsunami victims is the severe shortage of medical/health service as many of the hospitals and facilities either were destroyed or became inoperative.
C3NP supports the victims of the 3.11 quake/tsunami by providing medical and health assistants through a telemedicine system. By using telemedicine, we will be able to deliver medical/health service quickly without waiting for reconstruction of hospitals; we can also utilize help from many volunteer doctors and other specialists all over Japan, in an effective way. We started our activities in Minami Soma city in Fukushima near nuclear power plant

About Project

Solution: What is the proposed solution? Please be specific!

Telemedicine, particularly what is known in Japan as the “D to P” telemedicine, i.e., a practice of medical support or treatment via internet and other telecommunication methods from doctors (and other medical staff) to patients, was almost non-existent several years ago. One of the major reasons is that the law (giving restrictions to doctors’ activities) has been interpreted as suggesting that the basic form of medical practice has to be face to face. Professor Kaneko considers that since the medical resources are always limited as compared to the needs, it is important for the sake of patients to employ any available methods to maximize the utilities of the limited resources. Telemedicine is one very effective method. Kaneko was appointed Chairperson for the Roundtable Board of Advisors to reconsider national policies of telemedicine 4 years ago and the interim report for the round table published 3 years ago opened a gate to the practice of D to P telemedicine. Kaneko and his team started experimental practice of D to P telemedicine in several localities in Japan and it gave an example for many other research groups and local municipalities to start similar experiments. It is said that many of the 80 or so projects sponsored by the central and local governments launched in the past three years or so adopt at least partially a telemedicine approach. C3NP is one approach to innovate the situation so that the telemedicine will be fully recognized so that more people will be able to receive necessary medical assistance.
Impact: How does it Work

Example: Walk us through a specific example(s) of how this solution makes a difference; include its primary activities.

The majority of the people in the stricken areas have large sense of loss and insecurity. C3NP will offer care and cure, i.e., consultations and medical advices for those in need of such service, for a sustained period of time, so that it will be easier for these people to recover from the loss and fear and to regain health in body and mind. We aim at providing services outlined below to 500 or more people for at least one year starting July, 2011. These services are given free of charge. (a) By utilizing a telecommunication system, people in the stricken area can talk “directly” to doctors, mental care professionals, radiation specialists and other staff people in Tokyo to feel safe and obtain relief, without moving long distance to go to hospitals and other institutions. In the case of The Great Kobe Earthquake , it is known that a long stay at a shelter and prolonged period of loneliness causes so called “loneliness death” to many older people. (b) In particular, there is a strong needs to know about effects of radiation emitted from Fukushima nuclear power plant accident. There are radiation specialists among the professional staff members to give consultation and advice. (c) Right after the disaster occurred, many teams of doctors were sent by various organizations to the stricken areas. After a month or more, most of these teams left the scenes, creating a serious shortage of doctors and other specialists on site. We will try to be in touch with local officials and local medical institutions and hope that by offering the professional helps through a telecommunication networks, we will be able to relieve some of the burdens to be born by local doctors, nurses, and health related personnel. (d) When and if needed, we may be able to connect local medical authorities with specialty hospitals in Tokyo thus patients with acute and severe diseases may be transported to Tokyo hospitals.
About You
Organization:
Continuous Care & Cure Network Project (C3NP)
About You
First Name

Ikuyo

Last Name

Kaneko

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About Your Organization
Organization Name

Continuous Care & Cure Network Project (C3NP)

Organization Phone

81-3-6300-0569

Organization Address

Sakakibara Heart Institute, 2-5-4 Yoyogi, Shibuya-ku, Tokyo 151-0053

Organization Country

, 3

Country where this project is creating social impact
How long has your organization been operating?

Please select

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Innovation
What stage is your project in?

Operating for less than a year

Tell us about the community that you engage? eg. economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts.

Minami Soma City, Fukushima prefecture is located just north of the troubled nuclear power plant. This is the area hit by “double calamities” by both tsunami and the nuclear plant accident. A large part of the city is the area of mandatory evacuation, while another part is under the government control where people's life is severely restricted. As many medical facilities were closed and as the functions of hospitals are under restrictions, the supply of medical service is well short of the needs. There are some 23 temporary housing facilities for the capacity of some 1500 families as of now, and more are being built for additional 500 families. C3NP stated a telemedicine assistance to three of the facilities where respectively 81, 40, 127 families reside.
Kesennuma City, Miyagi pref. was the place with one of the most famous and largest fishing and fishery food-processing industries. Most of the ships and facilities were destroyed by the quake/tsunami. The total capacity of the temporary housing facilities is as of now some 3500. C3NP will start the support several of the facilities as soon as the reconstruction of internet is completed in a month or so.
Kamaishi City, Iwate pref. is also a city of fishermen and food-processing industry, where a large part of the fishery industry area was devastated. The total capacity of the temporary housing facilities is planned to be some 3000 families. C3NP started to talk with the city officials to support some of the temporary housing facilities.
Starting with these areas, C3NP will expand the activities to cover temporary housing facilities in other areas of the 3 devastated prefectures as we will obtain funds.
Tohoku district, which include these three prefectures has always been one of the areas with severe shortage of doctors and medical resources. Average number of doctors per 100 thousand residents in Japan is 132. Of the 23 medical districts for Tohoku area, the number of districts with above average per capita doctors is two and for 16 districts, the number is below 100. The situation was bad for the disaster stricken areas, and now it is said to be at the state of crisis.

Share the story of the founder and what inspired the founder to start this project

Ikuyo Kaneko (Deputy Representative of C3NP) graduated from a graduate school in the area of applied mathematics at Stanford University has been teaching and doing research in the fields of computer networks and mathematical optimization theory, teaching at University of Wisconsin-Madison and Hitotsubashi University. When the Great Kobe Quake occurred, he started Inver-V-net which is an information sharing network on the internet to connect quake victims and volunteers. Inter-V-net was then the network with the largest number of accessible users in Japan, and was the recipient of several awards. As Kaneko experienced that the information network and optimization theory actually help people in severe needs at the time of disaster, he changed his research fields from theory to practice. As Kaneko got involved with the Roundtable Board of Advisors to propose reforms of telemedicine, he and Kyoko Shibuya (Chief of Staff of C3NP) stared experimental projects of using telemedicine in several cities in Japan. One of the interesting effects is that the telemedicine project had an effect to forming intimate and active communities among the participants of the projects. It is estimated that a good part of the improvements is a result of participants help one another and get more interested in their health. As the 3.11 quake/tsunami hit Tohoku area, Kaneko and Shibuyaimmediately thought of utilizing the telemedicine to the victims of the disaster. Many doctors, nurses, and other health specialists, several telecommunication and medical supply companies offered cooperation.

Social Impact
Please describe how your project has been successful and how that success is measured

C3NP is at a very early stage of its activities, but have already achieved the following.
・a ‘test-run’ of mental care remote session done for few refugees at a shelter, and mental care consultations
for 30 or so employees at a company whose factory was half destroyed, both in City of Kurihara, Miyagi prefecrue.
・start-up sessions on 12th-13th of August at three temporary housing facilities at City of Minami Soma, Fukushima prefecture. Some 40 or so residents participated in total. We will offer similar session at each of the three sites once in every week. Since there are some 250 families residing in the three facilities, there will probably be more participants as sessions continue. Among the participants, there was an elderly woman who claimed that her husband is getting frail but refused to go to a hospital. Our staff talked with both and found that the husband probably experienced a minor case of heart attack. Upton the consultation, the man agreed to be hospitalized. Many of the participants of the sessions voluntarily wanted a blood test using a do-it-yourself kit. They will be able to consult with doctors about the physical conditions in future sessions based on the numerical test results.
Indices for success of C3NP activities: (1) the number of temporary housing facilities C3NP covers and the number of participants, (2) improvements (measured by numerical values of health indices and self perception of the participants), (3) community building in temporary housing facilities at which elderly residents are prone to be isolated (measured by frequency of gathering at Community Space unit, the number of residents regularly converse with one another etc.)

How many people have been impacted by your project?

101-1,000

How many people could be impacted by your project in the next three years?

1,001-10,000

Winning entries present a strong plan for how they will achieve growth. Identify your six-month milestone for growing your impact

Next step will be a combination of constant review of existing service and an expansion of our service to more locations. C3NP have recently been receiving many requests from local governments.

Task 1

We will expand our service locations to Kesennnuma and possibly to Kamaicshi. At this early stage, though, we will be paying close attention to service at existing locations rather than expansion.

Task 2

At this stage, we will be placing more emphasis on increasing the locations to which we provide C3NP service as well as exercise a review of the quality and results of our service.

Task 3

Toward the end of the 1st half year of activities, we shall do a comprehensive review and evaluation of our service. Also we shall review the needs of residents to find if there are unexpected needs.

Identify your 12-month impact milestone

In the 2nd half, in order to run our service in more locations, we should obtain funds/cash contributions. With the review process, we shall find some new directions to add to our existing services.

Task 1

Review and expand strategy : It is important for C3NP to try to provide our svcs to as many people. Yet, our priority is to keep the quality of the svc. We review balance betn quality and expansion

Task 2

Promotion of collaboration with local hospitals : In the 1st year local hospitals can do no more than coping with incoming patients.After a year they could discuss an effective relationship with C3NP.

Task 3

Delegation of functions to local NPOs : C3NP is committed to our support to the refugees. Yet it is important to delegate functions of C3NP to local NPOs so that the services may be provided locally.

How will your project evolve over the next three years?

C3NP considers its activities in 2 phases. 1) a direct assistance to refugees residing in temporary housing. We estimate the 1st phase will end in 2 years or so. 2) (presumably starting in 2nd and 3rd years) is to contribute to the rebuilding of medical/healthcare systems in the disaster stricken districts. Due to the quake/tsunami, 6 of the 19 hospitals and 52 of the 218 clinic were closed in Iwate. In Miyagi, total of some 1100 beds at the hospitals/clinics were destroyed. Doctors are not coming back to hospitals.Based on the practice, C3NP will make a proposal to create an efficient and effective medical and health care system utilizing telemedicine to Tohoku district. We are making a proposal for the Comprehensive Special Area Plan of the government.

Sustainability
What barriers might hinder the success of your project and how do you plan to overcome them?

(1) Delay of instalment of internet connections: Since the activities of C3NP depend upon the remote communication, it is imperative that the disaster areas and C3NP sites (Tokyo and Yokohama) are connected via telecommunication network. Coastal parts of Tohoku district was devastated by tsunami, and so there are many areas where the reconstruction of internet requires a long waiting time. As a solution we shall use a satellite communication as needed and if we can obtain cooperation from companies having the satellite communication resources.
(2) Most of doctors, nurses and other professional staff people offer volunteer help for C3NP. Many companies provide C3NP with in-kind donations of network use, office space, medical devices etc. However, to expand our activities, we will need cash to pay for call center staff people, to cover travelling and other necessary expenditure. As a solution, we will seek cash donations from individuals and organizations, and will propose joint projects with the central or local governments.

Tell us about your partnerships

NPOs: C3NP seeks cooperation from local NPOs in Fukushima, Miyagi, and Iwate, so that the local NPOs deal with setting up remote sessions at temporary housing facilities, while C3NP provides medical and health consultation via network.
Local governments and local hospitals and other medical/healthcare facilities: C3NP work closely with these offices so that more effective assistance could be provided for residents. Local governments, especially city governments are particularly concerned with the mental as well as physical health conditions of residents, particularly those of elderly persons, in temporary housing facilities. However, severe shortage of medical and healthcare resources prevents them from giving good service. This is the situation where C3NP has been receiving requests from cities and prefectures to provide telemedicine assistance at many temporary housing facilities.
Companies: C3NP are receiving various in-kind donations from companies. Companies work with C3NP because they consider C3NP to be a worthy partner to promote their CSR. Details are explained below.

Explain your selections

A personal, international web site for social innovation activities: C3NP contacts this web site through a personal communication. C3NP is to receive cash donation.
An intermediary NPO:C3NP was offered an opportunity to receive case donation from one of the major intermediary NPOs in Japan. We are in the process of application.
Foundations to assist relief activities by non-profit organizations: We are in the process of application to a few public foundations offering cash donations to non-profits engaging in quake/tsunami relief operations.
Companies: NTT East provides with C3NP free instalment of optic fiber network, free TV conference devices, and free communication through the network (for two years). Sakakibara Heart Hospital offers us free use of the C3NP headquarter office space. Other companies provide with C3NP, self blood test kits, blood pressure measuring devices, cloud service, satellite communication channels etc. These are companies interested in CSR activities and find C3NP worthy partners.

How do you plan to strengthen your project in the next three years?

C3NP consider its activities in two phases.
Phase I : direct assistance to refugees residing in temporary housing facilities
Our basic strategy in Phase II will be “review and expand,” i.e., we will expand our service in more locations, but we shall make sure that we would maintain the quality of the service and would try to alter services as necessity changes over time.
Phase II: policy implications                                  The second phase in the second to third year would coinside with the rebuilding stage of medical and other healthcare systems in the disaster stricken districts as a whole. As time goes by, the immediate needs for healthcare diminishes but the shortage of doctors and other healthcare professionals as well as that of hospitals/clinics will surely remain to be a very serious problem for Tohoku. C3NP’s principal goal in Phase II would be concerned to national and prefectural policies on rebuilding medical structure in the area. C3NP will act to provide a proposal and concrete plans to create an efficient and effective medical and health care system utilizing telemedicine to Tohoku district. To realize this goal, we shall be able to work closely with the central government and prefectures to plan and start the new medical system. We have already started such an effort in order to make a proposal for the Comprehensive Special Area Plan (“tokku”) of the government.

Challenges
Which barriers to health and well-being does your innovation address?
Please select up to three in order of relevancy to your project.

PRIMARY

Limited human capital (trained physicians, nurses, etc.)

SECONDARY

Lack of physical access to care/lack of facilities

TERTIARY

Limited access to preventative tools or resources

Please describe how your innovation specifically tackles the barriers listed above.

(1) C3NP’s most salient innovation is that (i) it will be using telemedicine (under the limit of the current law) in practice to show that it is in fact effective and that (ii) based on the practice C3NP will appeal to the government the need of change the medical law situation so that telemedicine can be utilized fully.
(2) Another innovation of C3NP is that it emphasizes a “community approach” to promote spontaneous participation of patients rather than patents are always subjective and waiting for directions by doctors.

How are you growing the impact of your organization or initiative?
Please select up to three potential pathways in order of relevancy to you.

PRIMARY

Influenced other organizations and institutions through the spread of best practices

SECONDARY

Repurposed your model for other sectors/development needs

TERTIARY

Grown geographic reach: Multi-country

Please describe which of your growth activities are current or planned for the immediate future.

C3NP's activities will be adopted in the Iwate Prefecture wide reconstruction of the medical system. Iwate Prefecture, one of the 3 prefectures receiving the heaviest damage from the 3.11 announced the official Basic Plan for reconstructing the social system. By recognizing the importance and effectiveness of the activities of C3NP, they include the employment of telemedicine.
Our mission is to give a direct service to residents of facilities, but it is also important to make sure that our service will be replicated by many other NPOs and municipalities so that service expands in total. We want to do our best to help the disaster victims in a way we have some successful experience, and by doing so we’d like to disseminate our experiences to NPOs, municipalities, and to the world.

Do you collaborate with any of the following: (Check all that apply)

Government, Technology providers, For profit companies, Academia/universities.

If yes, how have these collaborations helped your innovation to succeed?

Government: Prof. Kaneko is the Chairperson for the Roundtable Advisory Board for Telemedicine to promote policy innovation. He is also a chairperson for New Public Commons Conference to promote social innovation including telemedicine. Kaneko also leads a group applying for Comprehensive Special Area Plan (Tokku) to carry out rebuilding of medical system of Tohoku with innovative methods including telemedicine.
Companies and technology specialist: Companies such as NTT, Intel, NEC are working closely with C3NP to promote new approaches of telemedicine.
Universities: Keio University is one of the key organizations supporting C3NP’s social and technical innovation.