Kai Ishida

Analysis of Medical Equipment Management in Relation to the Mandatory Medical Equipment Safety Manager (MESM) in Japan

Half a decade has passed since the fifth revision of the medical law and mandatory appointment of a medical equipment safety manager (MESM) in hospitals in Japan. During this period, circumstances have changed regarding maintenance of medical equipment (ME). We conducted a survey to examine these changes and the current situation in ME management. Maintenance of ME and related work were found to have increased in many hospitals, but the number of clinical engineering technologists (CETs) has only slightly increased. The appointed MESM was a CET or physician in most hospitals. In hospitals where physicians were appointed as the MESM, 81% had operation managers. Many respondents commented that it was difficult for one person to cover all the tasks required by the MESM, due to a lack of knowledge, too much work, or other reasons. This suggests the importance of an operation manager for ME to work under the MESM.

Study of electrical power facilities and measures for planned outages in Japanese hemodialysis clinics after the Great East Japan Earthquake.

The Great East Japan Earthquake on 11 March 2011 caused major damage in northeastern Japan. The Kanto region experienced a massive electrical power shortage in the summer of 2011. A questionnaire was submitted to 354 hemodialysis clinics in Kanagawa prefecture and the Tokyo metropolitan area, excluding isolated islands, and 176 responses were analyzed (49.7%). The questions included evaluation of the availability of a private electricity generator, countermeasures in case of a planned outage, awareness of saving electricity, and improvement of safety of medical devices or electrical facilities after the earthquake. Only 12% of the clinics had private electricity generators and many clinics had no plans to introduce this facility. However, 96% of the clinics had established countermeasures to deal with a planned outage. Many clinics planned to provide dialysis on a different day or at a different time. All clinics had tried hard to establish procedures to save electricity in the summer of 2011, and 84% of the clinics had reconsidered and improved the safety of medical devices or electricity facilities after the earthquake. These results show that the awareness of crisis management was greatly improved in the wake of the earthquake.

A Basic Study on the Measurement of Electromagnetic Fields in a New University Hospital Building Before and After the Hospital Opened

It is well-documented that establishing electromagnetic compatibility (EMC) is important for using medical equipment and communication devices in hospitals. To evaluate the basic electromagnetic environment, measurements should be conducted over 2 periods (before and after the opening of the hospital). We measured the electric field intensity induced by electromagnetic radiation in the broadcasting spectra coming from outside the hospital at 73 locations in our new hospital building in February 2014 (before any patients came into the hospital for the very first time) and August 2014 (6 months after the opening of the hospital). Frequency modulated radio signals, ultra-high frequency television signals, aeronautical radios, community wireless systems, and cellular phone system base stations were strongly detected at the windows of the upper floors. There was no great difference in measured levels between before and after the opening of the hospital. There were no cellular phone unit signals before the hospital opened its doors to patients, but were very strongly detected 6 months thereafter. In this study, the maximum electrical intensity was 0.28 V/m from cellular phone system base stations (2.1 GHz) observed on the south end of the 4th floor before the hospital first opened. This value was lower than the EMC marginal value of the general electronic medical equipment specified in IEC 60601-2-2 (3 V/m). Therefore, electromagnetic interference with medical equipment was extremely improbable in this situation. However, there were no cellular phone system base station signals in the elevator hall, in a portion of the corridor (located in the center of hospital), and in the hemodialysis unit. Measurements 6 months after the opening of the hospital revealed very strong cellular phone unit radio waves in the hospital. To promote greater EMC safety, the hospital should prepare countermeasures to improve these conditions, e.g., installing an interior cellular phone system base station.