Archive19:00, March 24, 2011
Remote Consultation
On March 23, the Ministry of Health, Labour and Welfare (MHLW) issued an administrative communication concerning medical care provided in relation to the current disaster emergency. With regard to the cases where a medical practitioner is unable to examine the patient or provide consultation face to face, it commented on its interpretation of Article 20 of the Medical Practitioners Act.
It states, "Methods such as verbal history taking, visual examination, palpation, and auscultation shall not be questioned when providing a consultation over an IT communication device (such as a telephone), as long as it is performed to the extent that a certain level of accuracy of diagnosis can be reached within the scope of modern medicine. In addition, though such practice may not be the same as a face-to-face consultation, if an equivalent level of useful information about the mental or physical state of the patient can be obtained, such practice may be acceptable as a remote consultation."
Drugs
As communicated previously, it is important to refrain from issuing long term prescriptions of drugs if your medical institution is not in the disaster-stricken zone and to give consideration to divided dispensing at your pharmacy, as a stable supply of drugs to the disaster area is the priority. Also the Federation of Japan Pharmaceutical Wholesalers Association has issued a communication asking for consideration to be given regarding the frequency of product deliveries, in order to reduce fuel consumption.
JMAT
We have seen a further elevated level of involvement in the JMATs. As of 15:00 today, 111 teams have been or are in action, and 88 teams are being prepared. Continuing assistance, as much as possible, by a team able to stay at one disaster area (while interchanging members) in April and beyond, is being requested.
Ibaraki Medical Association reported that Ibaraki Prefecture, though also struck by the disaster, suffered less severe damages compared to Iwate, Miyagi and Fukushima Prefectures and has sufficient resources for emergency medical aid, and therefore is asking for assistance intended for them to be diverted to other prefectures.
Scheduled Blackouts
The scheduled power outage by Tokyo Electric Power Company (TEPCO) is still ongoing. TEPCO makes the decision whether or not to go ahead with blackouts based on the electricity demand on the day. It is becoming clear how much trouble this has caused the medical institutions in the affected areas.
At first, after the statement by Prime Minster Kan on the night of March 13, the outage was supposed to start early the next morning. We were seriously concerned about the lack of the time to allow medical institutions get sufficiently prepared and the lack of measures to warn patients under home care receiving artificial ventilation and/or oxygenation therapies, and protested to the government. As a result, there were no blackouts on Monday, March 14.
Afterwards, TEPCO stated that larger regional base hospitals would be exempt from the planned outage. However, other medical institutions have been left to find their own solution when an outage takes place. Technically, it is said to be difficult to exclude every medical institution from an outage. Material assistance from medical associations such as lending of oxygen canisters and generators may be possible, but it is still under consideration.
When summer comes, the power demand will escalate, creating a serious situation. The headquarters will need to continue reviewing this issue. Note that Tohoku Electric Power Co. also announced possible planned rolling power outages depending on the demand, but has yet to implement any.