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Medical professionals and local government officials on the frontlines of the fight against coronavirus (Part 2): The use of health monitoring chatbots increases among local governments and public health centers

Main visual : Medical professionals and local government officials on the frontlines of the fight against coronavirus (Part 2): The use of health monitoring chatbots increases among local governments and public health centers

(Continued from Part 1)
In an attempt to combat the global spread of the devastating COVID-19 virus, Fujitsu created and launched the “Special Task Force Team for Novel Coronavirus Disease Control” in late February, 2020.

As the situation continuously changed rapidly and multiple times over February and March, Fujitsu looked into every incident in order to create a health services chatbot. And as of May 11, that chatbot had been deployed in 20 local governments and 60 public health centers to support infectious disease control teams.

Continuing from Part 1, in this article we interview Shinji Narukawa. He’s leads the Novel Coronavirus Disease Control Special Task Force at Fujitsu and has been on the frontlines of this fight.

We also include comments from Professor Ken Osaka of Tohoku University, an expert in infectious disease control. The professor collaborated in the development of Fujitsu health monitoring chatbot service.

Contents


The importance of information management to prevent the spread of infections and the collapse of the medical care system, which Fujitsu has called for alongside Prof. Osaka of Tohoku University

―― Did the deployment of the chat service go smoothly?

People in the medical world have long wished to introduce a mechanism that allowed them to efficiently collect, share, and manage infectious disease data in real time. It would help them prevent medical systems from collapsing due to sudden clusters of cases. However, Japan’s Personal Information Protection Law was in the way.

However, under Infectious Diseases Control Law, there’s an understanding that personal information related to public health may be handled differently from the ways stipulated in the Personal Information Protection Law.

Nonetheless, the concept behind the “three-layer separation of networks” caused many local governments to regard the storing of personal data on their servers connected to the internet as problematic.

As such, despite the team’s initial efforts to explain the services’ benefits, they couldn’t move the project forward because the local government officials they spoke to had the view that they couldn’t deploy it because of the lack of precedent, even though they saw its merits and wanted to use it.

To address this problem, the team met with the Miyagi Prefectural Government on March 16, 2020. They were accompanied by Professor Osaka of Tohoku University, an expert in infectious disease control.

―― It must have been difficult to make such an unprecedented decision. So, why did you decide to visit the Miyagi Prefectural Government?

Even though only a limited number of people had been infected with the virus in Miyagi Prefecture at the time, the government had already begun looking into possible countermeasures. And because the prefectural government already trusted Professor Osaka as he’d been active on the frontlines of cluster response, it was just perfect timing.

In addition, I remembered that I’d seen the innovative spirit of the people of Miyagi Prefecture during the Great East Japan Earthquake. So, I was confident the people who had managed to overcome that disaster would have the courage to make this bold decision.

In Miyagi Prefecture, the burden placed on those on the frontlines of virus control operations and how personal data was being handled already had issues. So the team explained the benefits of the chatbot service to personnel in the information department, the deputy governor, and the members of the prefectural assembly, multiple times.

They requested that they collaboratively figure out how they could integrate security measures into the service that would allow them to respond rapidly in the field.

As a result, a consensus was reached as to how the service would function that would allow it to still adhere to prefectural ordinances. So they agreed to introduce our service.

What’s the mechanism behind the chatbot service deployed by Miyagi Prefecture?

―― Please tell us about the Infectious Disease Control Support Chat Service deployed by Miyagi Prefecture.

Miyagi Prefecture launched the chatbot service as a health monitoring system for the contact tracing of COVID-19 patients in April.

The service’s questions covered all items listed on the health monitoring slip specified by the national government under the supervision of Professor Osaka of Tohoku University. This included questions such as: “Have you coughed recently?”, “Do you have difficulty breathing?”, and “are you experiencing nausea?”

With this service, public health center staff could easily enter information from their mobile devices. The service also allowed users to enter their health conditions from their own mobile devices by answering simple questions asked by the chatbot app.

As a result, accurate information could be collected with certainty without having to place further burden on public health staff. Collecting the latest information this way gave departments involved in infectious disease control better understanding of the state of infection across the region, and the ability to utilize it for the future analysis of measures.

Figure : Image of the Health Monitoring System using a chatbot deployed by Miyagi Prefecture (developed in collaboration with Professor Osaka of Tohoku University and Fujitsu)

Image of the Health Monitoring System using a chatbot deployed by Miyagi Prefecture (developed in collaboration with Professor Osaka of Tohoku University and Fujitsu)

Figure : Image of the Health Monitoring Chat input screen. Close contacts report their health conditions daily from their smartphones, while public health centers manage the information in list format. In this way, it is possible to reduce the burden of interviewing for both close contacts and public health centers.

Image of the Health Monitoring Chat input screen. Close contacts report their health conditions daily from their smartphones, while public health centers manage the information in list format. In this way, it is possible to reduce the burden of interviewing for both close contacts and public health centers.

The chatbot was deployed to 20 local governments and 60 public health centers in 10 days, enabling them to gather the latest infection information across a wider range of people

―― After Miyagi Prefecture decided to introduce the chatbot, how did other local governments react?

It seems the decision made by the Miyagi Prefectural Government gave task forces in other local governments and public health centers across the country the courage they needed to also deploy the service. Miyagi Prefecture’s actions had established a precedent for deployment meaning other local governments had a basis for also introducing the service.

In just 10 days, 20 local governments and 60 public health centers followed Miyagi Prefecture’s lead and introduced the chatbot. What’s more, all these local governments made their decisions in between one to three days, a drastic reduction in the time needed for the decision-making process. It was at this moment that our team felt innovation had truly been embraced.

When more prefectures deploy the service, more data will be collected and used in future analysis. The service allows them to centrally manage the health monitoring apparatus in real time. The team also heard from the field that the service can be used for quick decision-making and information sharing between different local governments.

Figure : Image of the Health Monitoring Chat Administrator screen. Information entered by close contacts from smartphones is collected in real time and can be used for cluster response. * Personal information (name, physical address, phone number) is not included.

Image of the Health Monitoring Chat Administrator screen. Information entered by close contacts from smartphones is collected in real time and can be used for cluster response. * Personal information (name, physical address, phone number) is not included.

―― The fight against the novel coronavirus is on-going. How do you feel about it right now?

When it comes to the infectious disease control of COVID-19, the challenges, measures, and priorities of the field vary depending on a community’s medical care system and the current state of infection in that area.

In addition to health monitoring checks for close contacts, the team received many requests from various infectious disease control centers. Health checks for medical professionals and public health center staff; monitoring of the number of beds available for hospital admission; health checks for patients with mild symptoms who were staying at hotels and other such accommodations; and health checks for users at nursing care offices. Each day, the team is informed of the challenges happening in the field, analyzes all of it, and usually provide countermeasures within three days. It then feeds this newly obtained know-how to other locations.

The Special Task Force Team on Novel Coronavirus Disease Control will continue to take on the challenge of this prolonged fight against the virus by continuing to provide support for people on the frontlines of operations.

Figure : Members of the Special Task Force Team on Novel Coronavirus Disease Control who volunteered to fight this national crisis

Members of the Special Task Force Team on Novel Coronavirus Disease Control who volunteered to fight this national crisis

Comments from Dr. Ken Osaka, an infectious disease control expert and professor at Tohoku University

Figure : Dr. Ken Osaka Professor, Tohoku University

Dr. Ken Osaka
Professor, Tohoku University

Until recently, when an infected person was identified and surveys of their close contacts were carried out, public health staff met their close contacts in person to interview them directly. This presented a risk of infection for those staff members.

Further conversations with those close contacts would be conducted over the phone and recorded with pen and paper. These records would be manually entered into the system and distributed via fax.

When only a few people were infected with the virus, this was a manageable system. However, when the number of close contacts reached the several hundreds, they were no longer able to handle the situation in this manner – and centers became overwhelmed.

Fujitsu’s system will dramatically improve the efficiency of such work. It offers substantial benefits, such as eliminating the possibility of contact tracing staff becoming infected, reducing input errors, and speeding up the answering of questions that people may hesitate to answer face to face. It’s also great at analyzing databases in real time, identifying sources of infections and sharing information with other local governments.

Fujitsu’s Special Task Force Team is well organized and acts surprisingly quick by anticipating what we wanted them to do. Everyone involved has been amazed by their agile response. I believe that their swift responses we down to them listening to voices in the field, especially those with the added experience of the Great East Japan Earthquake.

What most want to praise is their readiness to do whatever it takes to help resolve this crisis to humanity. And I very much appreciate what they have done.