2020 Application of Smart Medical Technology

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● Established by the Joint Commission of Taiwan, where Health Smart Taiwan (HST) is a premium platform for Taiwan smart healthcare solutions. ● Offers integrated information for healthcare institutions implementing information technology. ● Provides cross inter-professional integration and matchmaking.

Product and solution search

Success cases

Latest smart health trend

Matchmaking

HST, your answer to Smart healthcare and cross-industry cooperation

hst@jct.org.tw https://www.hst.org.tw/en/


Introduction The Joint Commission of Taiwan (JCT) is a government funded and nonprofit organization. JCT has committed to promoting healthcare quality and patient safety, as well as the use of quality management tools and training, in order to help health administrators to enhance the healthcare quality in the past 2 decades. To improve quality and mutual learning, JCT started to call for successful projects of using information technology in healthcare services since 2013. It has officially become the “Smart Healthcare” campaign of National Healthcare Quality Awards (NHQA) which is held by JCT annually. Based on the solution, service and institution-wide level, the evaluation criteria of the campaign are safety, digitalization, automation, serializability, connectivity, interoperability, mobility, computation, and artificial intelligence.

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A total of 728 solutions and 22 services were collected during the past 7 years. Through the campaigns, JCT has introduced the best and practical applications in the smart healthcare and provided the benchmarking opportunities. This also increased the visibility of Taiwan’s outstanding achievements to the world. This is the fifth volume of “The Application of Smart Medical Technology” series. In addition to the new 35 awarded projects in 2019 NHQA, the rest from the previous volumes in which a total of 100 awarded solutions can be found in this brochure. JCT hopes this brochure may facilitate the cooperation between IT and healthcare industry, and to increase the efficiency, quality and value in healthcare.


National Healthcare Quality Award In 2000, the Joint Commission of Taiwan (JCT) held the first nationwide Healthcare Quality Improvement Campaign (HQIC). Initially, the campaign focused on “Healthcare Quality Improvement Circle” and selected institutions, organizations, or teams with excellent performance in quality improvement to facilitate stimulation and benchmark learning. For the past 2 decades, HQIC has focused on improving Taiwan’s overall healthcare quality, with the competition items being diverse and advancing with the times to cover a multitude of important issues promoted by the government’s policies. As of this year, there were a total of 5,114 participating teams, 3,631 healthcare quality improvement projects. Supported by the Ministry of Health and Welfare, HQIC was officially re-named the

“National Healthcare Quality Award” in 2018, and has become the leading brand of healthcare quality competition in Taiwan. The “National Healthcare Quality Award” is also the epitome of Taiwan’s smart healthcare. By calling for outstanding smart healthcare solutions/ services, the “National Healthcare Quality Award” acts as a platform for outstanding hospitals and industrial teams to present their prowess. The degree of application for solutions/services participating in the competition as well as their effectiveness has been highly praised. Through inter-hospital exchanges and learning, we can unravel the key to refined quality and pursue excellence in the medical field.

Joint Commission of Taiwan

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Contents

Contents

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About HST

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Introduction

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National Healthcare Quality Award

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Take it right! Smart Homecare Pharmacist doing pill recognition, reconciliation, education, the best companion of homecare Taipei Veterans General Hospital

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From BI to AI prediction: the distance between influenza and death Chi Mei Hospital

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Smart infection control navigation– clinical microbiological surveillance system, healthcare-associated infection surveillance system National Taiwan University Hospital

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Intelligent Information System for the Emergency Patient MacKay Memorial Hospital

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Medical Image AI Determination Analysis System Tri-Service General Hospital

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"Healthcare e-Line" Personalized medical secretary of mobile device Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation

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Introducing ADC (automated dispensing cabinet) to innovate the inpatient medication management in hospital National Taiwan University Hospital


Innovative XR (Extended Reality) Training System for DecisionMaking and Health Education Tools – Training through Interactive Games, Removing Doctor-Patient Communication Barriers Taipei Veterans General Hospital

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System for Classification and Diagnosis Assistance of

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Diabetic Retinopathy China Medical University Hospital

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Smart Physical Examination AI Distribution China Medical University Hospital

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Smart Dialysis Scheduling Management System through Electronic Whiteboard – Visualized Management, Stay Informed Smartly Taipei Veterans General Hospital

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Patient Referral Information Management System – Stayed Informed, Instant Referral Taipei Veterans General Hospital

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To establish the information system to optimize ACLS performing Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation

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Smart Home Dialysis App Tri-Service General Hospital

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Full speed ahead : using clinical decision-making support system to enhance the medical quality of cerebral and cardiovascular diseases National Cheng Kung University Hospital

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Development of an real-time and automated ventilatorassociated event intelligent surveillance system MacKay Memorial Hospital

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Smart Medicine Pneumatic System Tri-Service General Hospital

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3A Early Warning Broadcasting System for the Sudden Cardiac Arrest (Automation, Alarm, AI) Chi Mei Hospital

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Integrated nursing information platform Nursing information Map-- Medical record navigation, hand over, interdisciplinary team communication strategies Ditmanson Medical Foundation Chia-Yi Christian Hospital

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15 seconds real-time update ~ Implement the real-time database to develop the Early Warning System (EWS) to reduce the unexpected cardiac arrest event Far Eastern Memorial Hospital

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Effectiveness of Improving Integrated Post-Acute Care for Heart Failure through Cloud Management Taichung Veterans General Hospital

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Protect the health of mothers and infants throughout the whole process - eBaby maternal and child health management platform Chang Bing Show Chwan Memorial Hospital

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Improving the health service efficiency for elderly people who live alone in communities with a smart telecare system Feng Yuan Hospital, Ministry of Health and Welfare

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Integrated Service of Medical Big Data and High-Performance Computing Support National Taiwan University Hospital

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Construction of Smart Medical Textile Supply Mechanism through Technology Applications Chang Gung Medical Hospital


A Fantastic Helper for the Safe Hospital Environment – Smart Monitoring Management System Changhua Christian Hospital

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Smart Environmental Management

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China Medical University Hospital

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Smart medical waste management system Tri-Service General Hospital

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The smart IoT creates the new value for the hospital equipment management security Taichung Veterans General Hospital

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Holistic Physician Smart Shift System Cathay General Hospital

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Instrument Management Re-Innovation. The cloud data supports the decision-making management Far Eastern Memorial Hospital

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aHOP UDI Smart Set - Transform CINDERELLA into DIANA

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Virtual Educational System for Clinical Decision Making

aHOP Co., Ltd

INNOVA Medical Technology

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Comprehensive yet Simplified-Controlled Drug Smart Management System Changhua Christian Hospital

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GaitBest LongGood

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2020 Application of Smart Medical Technology

Taipei Veterans General Hospital

Take it right! Smart Homecare Pharmacist doing pill recognition, reconciliation, education, the best companion of homecare OVERVIEW The "AiGiA-Smart Pharmacist APP" was jointly developed by the AiGiA Lab for Smart Care in collaboration with the Family Medicine Department and the Department of Pharmacy of Taipei Veterans General Hospital to use artificial intelligence and natural language to integrate the domestic Taiwan Food and Drug Administration, the National Health Insurance Administration and Taipei Veterans General Hospital to establish a high-definition drug identification database. AiGiA Lab for Smart Care developed an image recognition device for medical drugs to help people avoid taking the wrong medication. Professor Chen is a general physician at Taipei Veterans General Hospital. He said that he has seen patients suffer from taking the wrong medicine, as some pills and capsules look very similar and are hard to tell apart, especially for the elderly. The development of the image recognition system and device took about three years. The team has also created an app called AiGiA, which is integrated with the system. Users, patients and doctors alike, can use the camera on their mobile phones to recognize what the medicine is. All they have to do is connect the device to their phones, but the drug into the device, and turn on the app. Upon recognition, information such as the active ingredient, application, and warnings about the drug will be displayed. The system incorporates about 18,000 drugs and supports multiple language settings, including Chinese, English, Vietnamese, Indonesian and Malay.

BENEFIT Introduction AiGiA-Smart Pharmacist is more than APP, five key components make it useful. 1.Drug information integrator: aggregated, standardized and quality controlled drug information. 2.Drug Recognition Engine: recognizes medication according to its appearance

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with high accuracy. 3.MedVision: Simple design and multilingual interface. 4.MedBox: transforms low-profile phonecamera for high-quality pictures. 5.Drug management platform: drug identification, drug inquiry, and user records providing customized demand. AIGIA-Smart Pharmacist is a novel solution empowers clinical doctors and


nurse to identify medicines based on their appearance. Upon recognition, information such as the active ingredient, application, and warnings about the drug will be displayed in multiple languages. Designed for clinical professionals, AiGiA-Smart Pharmacist system incorporates about 18,000 drugs can recognize around 400 commonly used drugs. AiGiA-Smart Pharmacist had been used in the home care unit of the Taipei Veterans General Hospital. The new application successfully recognized medication of home care patients at high accuracy. The home care team showed a 3.5 fold increase in medication recognition and the correctness of use of medication doubled with the aid of AIGIA-Smart Homecare Pharmacist. Literacy of drug is the key to safety. AIGIA-Smart Pharmacist empowers clinical doctors to deliver complete and comprehensive medication at the right time and right place.

Progress in commercialization 1.2016 Concept Development

●Analysis of user drug identification problems ●Situational Analysis of Home Medical Applications ●Prototype system design 2.2017 Prototype Optimization ●User trial interviews ●Situational Analysis of Home Medical Applications ●Prototype system design 3.2018 System Verification ●Patent Number: M572562(Taiwan) ●On-site test of home care at Taipei Veterans General Hospital ●System development with strategic partners 4.2019 Market Applications ●Download app from Google Play Store and Apple app store ●Medication reconciliation in Taipei Veterans General Hospital

Future development

●Continuously optimize the app function of the AiGiA-Smart Homecare Pharmacist. ●Expanded market includes outlying islands and rural areas.

Fig 1.App Function

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2020 Application of Smart Medical Technology

Fig 2.App Easy Scan

Fig 3.Chibi Product Promotion

ABOUT THE HOSPITAL Taipei Veterans General Hospital has a great vision to become the first preferred hospital for the general public and the world-class medical center. Since the establishment for 60 years, the hospital is committed to providing the medical service with top quality, upholding the “customer-oriented” service concept to engage in the medical technology innovation and service quality enhancement. Furthermore, the hospital aims to provide the patient with holistic medical care, convenient medical environment and humanized medical service. In the future, the hospital will continue to uphold the service concept of “Treating patients with sincerity and pursuing excellence”, to develop and improve the medical service, education training and medical research.

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Moreover, the hospital maintains two core values, “Quality” and “Efficiency”, to seek the human health and welfare, striving to become the first preferred hospital for the general public as well as the world-class medical center.

Keywords Artificial Intelligence、Natural Language Processing、 Cloud Computing、the high-definition drug identification database、video camera “MedBox”

Contact details Department of Family Medicine, Taipei Veterans General Hospital

Cooperated partners Nation Yang-Ming University AiGiA


Chi Mei Hospital

From BI to AI prediction: the distance between influenza and death OVERVIEW In recent years, the rise of AI (artificial intelligence) has contributed to explosive progress into data analysis. The hospital upgraded BI (business intelligence) to AI, and established an effective disease prediction system in the emergency department to assist physicians in predicting the development and prognosis of influenza for the reference of clinical decision. Influenza is a common seasonal disease in older adults. In addition, the older patients have more complicated and rapid changes in their conditions. Those with severe conditions must be hospitalized, and they are more likely to have sepsis or even death. Therefore, it is very important to predict the prognosis of this disease as early as possible. In the past, we published the paper “Geriatric Influenza Death score” calculated by BI in 2018. Now, based on this BI paper, we adopted supervised machine learning “random forest” algorithm with ten candidate predictors (so-called features) to analyze the medical records of Chi Mei system from 2009 to 2018 and established five AI prediction models for influenza. We also integrated the AI prediction model into the emergency hospital information system (HIS, hospital information system) with Web Service. This system can promptly and automatically predict the prognosis of the older patients when they visit the emergency physicians, including the probability of hospitalization, pneumonia, sepsis or shock, ICU (intensive care unit) admission, and death. It provides an important assistance for physician’s decision and reference for patients and their families.

BENEFIT The hospital was established in 1968 and the original name was “Fengjia Hospital”. In November 2010, the hospital was then changed to “Chi Mei Medical Center”. Presently, the hospital has 883 emergency hospital beds, and the total number of hospital beds is 1,278. The hospital includes a total of 37 departments, such as Department of Medical Science, Healthcare Center, Nursing Department,

Medical Technology and Teaching Research Departments, a total of 13 administrative departments and a total of 45 medical and hospital affair related committees. Currently, there are 3,800 employees in the hospital. The core value of the hospital is “Care, Professional, Efficiency”. The hospital also upholds the patient-based spirit along with the goals of “develop quality characteristic healthcare”, “research with innovation, cultivate quality talents”, “improve process,

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2020 Application of Smart Medical Technology increase service quality” and “flexible management, sustainable operation” in order to construct the organization culture of excellent healthcare quality, guarantee patient safety and protect the benefits of

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patients, thereby promoting the health of the public and employees and becoming a healthcare system trusted by the public the most.


ABOUT THE HOSPITAL The hospital was established in 1968 and the original name was “Fengjia Hospital”. In November 2010, the hospital was then changed to “Chi Mei Medical Center”. Presently, the hospital has 883 emergency hospital beds, and the total number of hospital beds is 1,278. The hospital includes a total of 37 departments, such as Department of Medical Science, Healthcare Center, Nursing Department, Medical Technology and Teaching Research Departments, a total of 13 administrative departments and a total of 45 medical and hospital affair related committees. Currently, there are 3,800 employees in the hospital. The core value of the hospital is “Care, Professional, Efficiency”. The hospital also upholds the patient-based spirit along with the goals of “develop quality characteristic healthcare”, “research with

innovation, cultivate quality talents”, “improve process, increase service quality” and “flexible management, sustainable operation” in order to construct the organization culture of excellent healthcare quality, guarantee patient safety and protect the benefits of patients, thereby promoting the health of the public and employees and becoming a healthcare system trusted by the public the most.

Keywords Business intelligence, artificial intelligence, machine learning, older, influenza, disease prediction, geriatric influenza disease prediction system, hospital information systems

Contact details Center for Quality Management, Chi Mei Medical Center

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2020 Application of Smart Medical Technology

National Taiwan University Hospital

Smart infection control navigation– clinical microbiological surveillance system, healthcare-associated infection surveillance system OVERVIEW Surveillance is the cornerstone of infection control. Large-scale hospitals all depend on the experience and vigilance of the Infection Control Officers. However, the conventional infection surveillance frequently consumes a tremendous amount of manpower and generates a vast volume of paperwork with an effectiveness that remains to be improved. Setting proactive continuous surveillance as the focus, the National Taiwan University Hospital (NTUH) designed, developed, and constructed a series of automatic, full-spectrum, hospital-wide real time surveillance and alerting system through the integration of the existing information systems, including “clinical microbiological surveillance and alerting system” and “healthcare-related infection surveillance system”. The “clinical microbiological surveillance and alerting system” can not only automatically identify drug-resistant micro-organisms by the program, but also features data analysis methods including “time-space trends”, “statistical settings for abnormal alert”, “ cluster analysis of antimicrobial agent resistance test data”. The “healthcare-associated infection surveillance system” establishes the operational definitions and the logical rules converted from the healthcare-related infection surveillance definitions; the system is able to automatically identify the infected case on a real time basis.

BENEFIT In terms of program performance and reliability: 1.Clinical Microbial Monitoring System: The system approximately saves 8 man-hour/ day of the infection control practitioner to detect multidrug resistance inspection reports, and also improves the detection accuracy rate from 63% to 100%. 2.Medical Care-Related Infection Control System: The urinary tract infection (UTI) sensitivity rate is 94% and the specificity rate is 100%. The enrollment is closed 51 days in advance. The bloodstream infection sensitivity rate is 98% and the

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specificity rate is 100%. The enrollment is closed 29 days in advance. As for the economic benefits: From the monitoring strengthening to the decision timeliness, the hospital has optimized the human resource allocation and time management. Furthermore, the business focus has been shifted from monitoringoriented to quality-oriented. We devoted ourselves to the quality improvement promotion and various rooted businesses, including the reduction of medical carerelated infections, the elimination of drug-resistant bacterial strains, the strict


monitoring of environmental quality, the prevention and responding preparation of emerging infectious diseases, infection prevention education, etc. Based on the results over the years with 2008 as the base value, the total number of the infection in 2018 decreased by 38%, reducing the additional medical expenses, family burdens and disability situations.

Fig 1.Operational Definition

Fig 2.Infection Control Monitoring and Warning System – introducing the information technology to establish the smart management system

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2020 Application of Smart Medical Technology

Fig 3.Statistical Chart of Clinical Microbial Real-Time Warning System

ABOUT THE HOSPITAL Founded in 1895, the hospital is a large medical center that importantly offers teaching, research and clinical services in northern Taiwan. It is also a supporting hospital in the Taipei pandemic prevention system. The hospital has been appointed to integrate the ministry hospitals and establish a NTU medical system that includes regional hospitals and medical centers with different medical tasks. After the serious SARS pandemic in 2003, the hospital started to promote the importance of hand hygiene campaigns annually before the WHO. Through the efforts of our colleagues over many years, not only did the care-related infection rate go down, but multidrug resistant bacterial infections have also been reduced.

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Furthermore, the medical costs have been significantly saved. The hospital has won various domestic and international awards, such as the “2011 Asia Pacific Hand Hygiene Excellence Award” and the “2015 National Quality Award, Silver Medal”.

Keywords Infection prevention and control, autonomic surveillance, electronic detection, outbreak detection, multidrug resistant organisms, healthcare-associated infection

Contact details Center for Infection Control, National Taiwan University Hospital


MacKay Memorial Hospital

Intelligent Information System for the Emergency Patient OVERVIEW The emergency patients are divided into three categories according to their technology stickiness. The emergency patients of the first category have a higher level of technology stickiness and are able to use the mobile phone App; the emergency patients of the second category have a lower level of technology stickiness and are unable to use the mobile phone App; and the emergency patients of the third category are able to use the National Health Insurance (NHI) card for information inquiry (might overlap with the first and second category). Targeting at the groups with different levels of technology stickiness, two brand-new software programs were developed to be applied in the information digital signage and mobile phone Apps. The Apps were also developed on both Apple iOS and Google Android platforms simultaneously. The information digital signage are divided into two different models: one model is dedicated to the information carousel, which is provided for the on-site patients to review the relevant information; the other model supports the NHI card reader function. In addition to the routine information carousel, the system also provides further relevant emergency treatment information of the NHI cardholder while inserting the NHI card. The software developed by the project does not operate as an independent program and requires to be connected to the hospital HIS database and the physician orders for the clinical use by the medical personnel, in order to conduct the one-stop information transfer mode. Moreover, the software will be able to provide information to the corresponding equipment end for the patient and the family members to check and review.

BENEFIT As of March 31, 2020, the system on the Apple iOS platform has been downloaded for more than 5,600 times, the system, on the Google Android platform, more than 5,800 times. The system on the Apple iOS platform received an extreme high rating of 4.4 stars, the system on the Google Android platform, 3.5 stars. The result showed that the overall planning and design of the App, including the interface, function and user experience, all met the expectation and needs of the patients. A built-in satisfaction survey function is available in the mobile phone App. As of March 31, 2020, according to the responses of 176 satisfaction surveys that were received, the overall rating of the App was 4.3 (5 as the full

mark), which was almost equivalent to those of external ones on the Apple iOS platform. Overall, the App received highly recognition and affirmation from various users. Furthermore, according to an indicator in the satisfaction survey, the top 3 functions of the App that are the easiest to use are “My Status”, “Result Progress”, and “PreRegistration”. The unit effectiveness evaluation found that, for each consultation by the patient’s family to the medical personnel being reduced, 30 seconds were saved. A reduction of 169 minutes was achieved based on the calculation of an average of 338 registered patients per day. With the same token, if the patient reduce 3 times of consultation, a total of 507 minutes can be saved, which was equivalent to the manpower cost of an 8-hour shift nurse.

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2020 Application of Smart Medical Technology

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ABOUT THE HOSPITAL Recently, the medical environment has become increasingly complicated. The resources are insufficient while the demands are increasing. Furthermore, Taiwan is gradually entering the aging society. Thanks to the technology advancement, the information communication technology is applied in the hospitals to increase the patient safety, improve the healthcare quality, and promote the operation efficiency. MacKay Memorial Hospital aims to transform from the conventional hospital to the smart hospital, creating the brand-new value of the medical service. MacKay Memorial Hospital offers the Holistic Health Care that attends to the body, soul, and spirit through its multiple programs of professional care quality involving interprofessional practices. The hospital is dedicated to all details of the healthcare quality and patient safety, upholding the ultimate goal of pursuing excellent healthcare. Moreover, MacKay Memorial Hospital integrates all resources and expands its services within the hospitals toward the

community, rural countryside, offshore islands, even to the global. With the highend healthcare and lean management being implemented along with the combination of cloud-based information, MacKay Memorial Hospital enhances the hospital effectiveness and momentum, further transforming its medical service to another brand-new era which has been highly complimented. won various domestic and international awards, such as the “2011 Asia Pacific Hand Hygiene Excellence Award” and the “2015 National Quality Award, Silver Medal”.

Keywords Emergency room, Real-time information, Management, Pre-registration, App

Contact details Emergency Medicine Department, MacKay Memorial Hospital

Cooperated partners VIA Technologies, Inc.

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2020 Application of Smart Medical Technology

Tri-Service General Hospital

Medical Image AI Determination Analysis System OVERVIEW According to clinical experience, patients with high or low potassium levels have significantly increased mortality. Therefore, the Institute developed its own AI image analysis system. This system can use the function of AI, and it only takes 10 seconds to predict the blood potassium concentration using the electrocardiogram image, as an auxiliary decision-making information in emergency medical treatment. This function uses R language to write related machine learning programs based on the concept of Convolutional Neural Networks (CNN). From September 2016, after 6 months of research and implementation and verification, and successfully interfaced with the hospital system The function is online, and the accuracy rate of AI interpretation is over 90%. Supports immediate upload of ECG and AI real-time calculation. It can send a blood potassium abnormality newsletter within 15 seconds to notify the attending physician and the physician who prescribes the prescription.

BENEFIT In the introduction of sharing experience, in the initial period, the ECG data center data was used as the data source to transpose and clean the relevant data such as the ECG file. A total of 66,321 ECG map files and blood potassium (K +) test data corresponding to the same visit were used. Data range: May 11, 2011-Dec 31, 2016. In addition, through the Internet service program, the blood potassium ion test data of the data center is accessed, the electrocardiogram of the same visit is matched with the blood potassium ion test report, and the invalid data is removed for data preprocessing. This data is then connected to an AI deep learning machine through a web service. It also uses artificial intelligence algorithms based on convolutional neural networks (CNN) to perform machine deep learning. The learning results of each stage are measured in batches with application

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accuracy. After completion, the clinical staff will actually test the relevant functions and verify the accuracy of the AI. Through 2 years experience, 4 years experience, 13 years experience of emergency physicians and 1 year experience, 2 years experience, 9 years experience of cardiology attending physicians to interpret the electrocardiogram image with AI, calculate the relevant sensitivity and specificity results. After the accuracy of AI interpretation exceeded that of the clinician, he set out to interface HIS data for function development, private cloud deployment, and connection to related medical systems. Finally, the whole hospital was tested online to collect user feedback and monitor service usage.

Efficiency

1. Reduce decision-making time for medical operations. (It takes 40 minutes to perform a blood test urgently, and the AI reading is only 10 seconds.)


2. Assist in an emergency medical condition. 3. Improve the quality of medical services. After feedback from clinicians, patients with acute serum potassium abnormalities will be processed immediately through AI interpretation and reported and processed 30 minutes later through the blood laboratory.

Those who have advanced treatment on the patient's recovery will have better recovery results. Although the difference is only 30 minutes, it is very likely that the patient will be admitted to the hospital on the day of recovery or in poor condition. This is a very helpful tool in emergency medical treatment.

Fig 1.AI Data Integration Combined with Deployment Application

Fig 2.ECG AI Interpretation UI

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2020 Application of Smart Medical Technology

Fig 3.Critical Value Message Notification

ABOUT THE HOSPITAL Tri-Service General Hospital (TSGH) was established in 1946. To serve the public, we are committed to continuous advanced diagnostic skills, and constant investment in procurement of edgy equipment and instruments, and provision of holistic medical care settings (ex: AIoT center). It is our anticipation to gradually improve the quality of medical services and the operating capacities provided to the army, the dependents and the public with software and hardware updated constantly. With Care, Quality, Discipline and Innovation as our core values for constant provision of prime instructions, studies and services as our goals, the TSGH hopefully is one of the top medical institutions in Taiwan. As it comes to medical services, TSGH cooperates with foreign and domestic

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medical and research facilities and faculties. With a new look and edgy healthcare dedicated to the armed forces and the public as a paradigm of all military hospitals, it is our vision to be the top hospital nationwide, healthcare guardian in the community and international medical center worldwide.

Keywords ECG, EKG, Artificial Intelligence, Postadmission, Convolutional Neural Networks, AI Predication

Contact details Medical Artificial Intelligence and Internet of Things Development Center, Tri-Service General Hospital


Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation

"Healthcare e-Line" Personalized medical secretary of mobile device OVERVIEW In order to solve the common “three longs and two shorts” problems in Taiwan – long registration time, long outpatient clinic waiting time, long medication pickup time, and short doctor interaction time in clinic & short communication with the doctor, Dalin Tzu Chi Hospital has independently developed the “Healthcare e-Line” integrated intelligent medical service to provide the most caring, intelligent, safe, and fast” LINE App. Dalin Tzu Chi Hospital’s “Healthcare e-Line” App provides integrated and smart health care services including reminders, healthcare tips, quick registration, personal health information management and varieties of value added services. 1.Intelligence (AI, artificial intelligence): The AI artificial intelligence interactive robot "Xiaoci" is available 24 hours a day on line and provides medical guidance and illness inquiries in real time. It also provides the most relevant health education videos or other materials. 2.Considerate: Provide nine active and intimate reminders for the public: registered appointments, clinic progress, medication pickup progress, examination schedule, surgery status, health education information, prescription and medication, four cancer screening qualifications, and event-related information reminders . 3.Security: Rigorous information encryption and verification procedures are designed to ensure personal privacy. 4.Fast: Provide 32 commonly used fast service functions, and provide personalized one-click login operation service, so that customers’ medical needs can be fully met.

BENEFIT 1.Utilize API to integrate medical consultation and create "AI Health Secretary". LINE friends reached 11,981 in 12 months. Compared with the mobile registration system APP, which has only been used by more than 10,000 people for many years. And the Dalin Tzu Chi LINE system/service/ information quality satisfaction rate is as high as 96.5%! 2.Outpatient satisfaction improved! Annual Satisfaction with waiting time for doctors (shortened) increased by 2.36%; satisfaction with waiting time for medication (shortened) increased by 3.45%. 3.Among the LINE registered personalization

service users, with 44% LINE outpatient clinic registration use rate, and the on-time rate for seeing a doctor in outpatient clinic increased significantly by 11.7%. 4.The "LINE Personalized Action Screening" function, which has won the National Gold Award, provides enquiry and reminders of cancer screening eligibility. Among LINE registered users, the number of screenings has increased by 20% compared to the previous two years before the introduction. 5.Make full use of the characteristics of LINE's easy-to-connect services to provide diversified and integrated services, such as quick inquiries, medical applications and inquiries, etc., with an annual usage of

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2020 Application of Smart Medical Technology 10,000 plus times. 6.Get closer to the doctor! Improve the communication between doctors and patients and improve the writing of medical records. Outpatient patients use the LINE "Question before Clinic function" to list medical conditions or questions that they want to ask. More than 30 people use it in two months. 7.Optimize your health records! This design is combined with the in-hospital medical information system, and the blood glucose, blood pressure, and body mass data input is designed in the "Health Management function". The LINE Q&A function is convenient and easy to use, which increases the willingness of the public to fill in, and improves the accuracy and completeness of the medical record information. For statistics, it has been used more than 5,000 times in six months. 8.Refined LINE referral medical information feedback system. Referral patient information is instantly broadcast to the original referral clinic physicians, which can improve the work efficiency and time

Fig 1.Function Interface

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of medical staff, and improve the hospital service quality. It is used by more than 20 physicians. 9.LINE intelligent medical services have been introduced to Taichung Tzu Chi Hospital. Award Records . Poster “Gold Award� for the "Excellent Creative Screening Campaign for Cancer Screening and Seminar" held by the National Health Administration, Ministry of Health and Welfare . The 20th National Medical Quality Award Smart Solution Group-National Masterpiece, Special-Potential Award . The 2019 Taiwan Continuous Improvement Activity Special Group Intelligence Application Category-National Bronze Tower Award, Southern District President Award . Became one of the successful representative cases of the LINE Corporation (headquarter)

Fig 2.Service Poster


Fig 3.Development Team

ABOUT THE HOSPITAL The medical resources in Yunlin, Chiayi, & Tainan were scarce; with only 2 beds & 1.7 physicians per 10,000 people. In response to the public's medical needs, Chiayi Dalin Tzu Chi Hospital, covering an area of 19 hectares, was inaugurated in Aug. 13, 2000. With the tenets of “Saving Lives, Safeguarding Health, Upholding the Spirit of Love�, Dalin Tzu Chi Hospital devotes itself to creating high-tech, high-quality, high human-touch medical care. The hospital provides 1,200 beds medical center level service, and with a modern luxury postnatal care facility, and a long-term nursing home. In order to implement the instructions given by Dharma Master Cheng Yen to relieve sufferings, the hospital actively participates in the community to promote preventive health care, cancer screening, elderly health promotion, elderly friendly medical care, community epidemic

prevention promotion, and remote areas m e d i c a l servi ces. A l so, the hospi tal combines the resources of the Tzu Chi International Medical Association Yun-ChiaNan Branch to provide home visits and other medical outreaches to the poor and needy. From the four perspectives of staff, patients, environment, and the community for health promotion, Dalin Tzu Chi Hospital is now highly recognized internationally and has become one of the role model hospitals in Taiwan.

Keywords Line, intelligent(wise/smart), health(y), health care, medical service

Contact details Division of Public Communication, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation

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2020 Application of Smart Medical Technology

National Taiwan University Hospital

Introducing ADC (automated dispensing cabinet) to innovate the inpatient medication management in hospital OVERVIEW Automated Dispensing Cabinets (ADC) are the computerized medication storage devices placed in the wards, in which each medication is stored in separated cubies. The nurses can assess the cabinet to remove the right medication, previously verified by the pharmacists, at the time need to administer. Utilizing this medication delivery and management system, the nurse can get the medication immediately with personnel identification, and the pharmaceutical manpower and time can be reduced. The goal of this project is to introduce this new delivery system to the wards over the whole hospital. Through the cooperation of multidisciplinary team, using artificial intelligence to enhance the quality of healthcare system.

BENEFIT Through the successes of information interface with the ADC and the hospital’s medical information systems, the medications needed are stored in the ADC, and can be removed by the nurse at the right time to be administered. It is a closedloop medication management system to achieve the point of care. This is a multidisciplinary teamwork project, with members including pharmacist, nurse and information technology experts. After more than 15 meetings, finally the information interface had be established, which is the first case in Taiwan, that all types of the orders were included. In this system, more than 80% of the medication needed were stored in the ADC and could be used immediately. The key points

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of success were integrated information interface, process renewing, and comprehensive training program. The four main effectiveness of the project are (1) enhancing work efficiency with optimizing nursing work flow; (2) dramatically decreasing the amount of the medication returned from the wards results in pharmaceutical manpower rearrangement; (3) enhancing the effectiveness of medication management; (4) increasing nursing satisfaction. The ADC system is a more effective and safer medication delivery model for inpatient, which can successfully replace the traditional unit-dose -delivery system with trolley models.


Fig 1. Automated dispensing cabinet

Fig 2. Fingerprint settings

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2020 Application of Smart Medical Technology

Fig 3. Nurse operation

ABOUT THE HOSPITAL Established in 1895, the National Taiwan University Hospital was the largest and most modern hospital in Southeast Asia at that time. Since its establishment for over hundred years, it has cultivated countless well-known experts in the medical field. The clinical healthcare quality is world-famous and trusted by the general public. The National Taiwan University Hospital is generally acknowledged to be the leader and the model of the medical profession in Taiwan. As a national-level teaching hospital, NTUH is responsible for three major medical tasks: teaching, research and service. For teaching, it coordinates with the medical schools to serve as a continuation of the curriculum design to cultivate medical and various specialist experts; for research, it integrates the research resources to set up a core research institution, providing colleagues with the best research equipment

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and environment; it also combines the advantages offered by the National Taiwan University and its College of Medicine to develop AI innovative teaching and research to maximize the synergy of the industryacademia cooperation; for service, the patient safety-centered orientation service, emphasizing humanized care and focusing on medical quality as well as patient safety management to provide high-quality and sophisticated medical services.

Keywords automated dispensing cabinet (ADC), inpatient medication delivery system

Contact details Pharmacy Department, National Taiwan University Hospital


Taipei Veterans General Hospital

Innovative XR (Extended Reality) Training System for DecisionMaking and Health Education Tools – Training through Interactive Games, Removing Doctor-Patient Communication Barriers OVERVIEW In the past, health education had been conducted through paper-based materials or videos. However, the patient and the family members are often anxious about the decision before the major disease treatment and follow-up medical treatment. Afterwards, they may face some further problems such as inability to make the decision and fear due to lack of understanding the disease and the patient condition. To implement the principle of shared decision making, the hospital has developed the smart system by using XR for tools that aid in the shared decision making process and medical education. The smart system allows the patient, family members and medical personnel to experience the condition in the virtual world personally. By embedding the related surveys in the teaching materials and collecting the feedback list through the VR experience, the medical personnel can focus on the point that the patient doesn’t understand and provide appropriate assistance to enhance the doctor-patient communication. In terms of education training, the system can add some interesting and lively VR educational training content to make the teaching materials more fascinating, further enhancing the learning motivation of trainees to learn actively.

BENEFIT After many consultations with the manufacturers and visits to relevant information industries, the executive team and the hospital have jointly proposed 8 sets of teaching materials after 15 meetings. Furthermore, the hospital has also constructed relevant hardware equipment and established the “Innovative XR Simulation Education Zone” in the Division of Clinical Skills Training Center, providing the excellent environment for experience and development space of the teaching materials in the future. After completing the teaching material

establishment, the hospital held 2 press conferences in the training center. Moreover, there have been 12 experience events in the training center, clinical unit, general unit, cancer treatment center, intensive care unit and cardiology unit, with over 250 user experiences and feedback collected. Lots of experiencers have expressed p o s i t i v e a ff i r m a t i o n o f t h e t e a c h i n g material set. After the promotion, the set has benefited lots of people, including the patients, family members, doctors, nurses, medical technologists, respiratory therapists, pharmacists, interns, non-medical personnel, non-institutional personnel and

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2020 Application of Smart Medical Technology the general public. The teaching material set has been technology transferred, published and relevant institutions are willing to purchase it. In the future, more and more domestic medical institutions and units will be benefited. In terms of backend maintenance and management, the hospital has established the “XR Interactive Management Platform� to conduct the system maintenance and teaching material usage management. Furthermore, the platform is able to collect all experience results in the backend database,

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providing reference for future development of the teaching materials. The medical personnel can focus on solving the related problems that the patient and family members do not understand. The teaching materials have been continuously promoted and implemented in multiple clinical units and training courses. They will be implemented to provide more medical services for the patient and family members, as well as train more medical personnel in the future.


ABOUT THE HOSPITAL Taipei Veterans General Hospital has a great vision to become the first preferred hospital for the general public and the world-class medical center. Since the establishment for 60 years, the hospital is committed to providing the medical service with top quality, upholding the “customer-oriented” service concept to engage in the medical technology innovation and service quality enhancement. Furthermore, the hospital aims to provide the patient with holistic medical care, convenient medical environment and humanized medical service. In the future, the hospital will continue to uphold the service concept of “Treating patients with sincerity and pursuing excellence”, to develop and improve the medical service, education training and medical research.

Moreover, the hospital maintains two core values, “Quality” and “Efficiency”, to seek the human health and welfare, striving to become the first preferred hospital for the general public as well as the world-class medical center.

Keywords Extended reality, smart aid system, shared decision making, clinical and medical education, virtual reality

Contact details Division of Clinical Skill Training Center, Department of Medical Education, Taipei Veterans General Hospital

Cooperated partners Harvest Culture Communication LTD.

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2020 Application of Smart Medical Technology

China Medical University Hospital

System for Classification and Diagnosis Assistance of Diabetic Retinopathy OVERVIEW Retinopathy is an important complication of diabetes. At present, domestic first-line care division for diabetic patients are family medicine or metabolism clinics. Fundus photography must be arranged for diabetic patients to screen symptoms of retinopathy. The image interpretation is extremely dependent on the experience of ophthalmologists. In response to the lack of experience of frontline physicians in most hospitals, this system provides relevant auxiliary decision-making information to assist physicians in subsequent processing. This system is assisted by a team of professional ophthalmologists to label a large number of normal and diabetic retinopathy images as a training data set to develop a deep neural network structure. Machines learn the characteristic patterns of normal images and abnormal images caused by lesions to assist in diagnosis and classification. It also communicates closely with clinicians to verify, increase training data and improve accuracy rate through instant feedback from physicians, which achieve a smart medical ecological cycle.

BENEFIT In the process of introducing into clinics, image labeling and deep learning neural network training need to master the quality and quantity of the training data. This system will utilize more than 40,000 images labelled from ophthalmologists’ team and use the NIVIDIA supercomputer DGX2 for data training to verify the risk level by retina division. Engineers took part in building the image labelling platform, developing AI algorithms, data training, data optimizing, and clinical validating. Currently, AI’s precision rate is 0.86, sensitivity is 0.94, with 0.90 f1-score, which shows an outstanding result. In order to maintain high accuracy rate, the cross-validation between physicians and this system is very important. The development of algorithms mainly

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utilizes supervised learning to determine the state of retinal pathology (4 risk levels), predict the risk levels and generate a graded report. Except for diabetic retinopathy diagnosis, the training of age-related macular degeneration and glaucoma are also ongoing. The benefits can be divided into five major categories 1.Assist in first-line physicians in family medicine, metabolism, and internal medicine to diagnose diabetic retinopathy and reduce the burden on ophthalmologists 2.Educational training for inexperienced physicians 3.Improve clinician's efficiency of image interpretation


Figure 1. Ophthalmologist AI Clinical Application

Figure 2. Page for Predicted Classification and Physician Feedback

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2020 Application of Smart Medical Technology

Figure 3. System for Classification and Diagnosis Assistance of Diabetic Retinopathy

ABOUT THE HOSPITAL Founded in 1980, China Medical University Hospital has for long stuck to the principles of “taking pride in our hospital and viewing the patients and staff as top priorities”. We have made a committed effort to improving medical services and exterior environment, hoping to create the best medical institution in Taiwan. China Medical University hospital contain 7 medical buildings, 2,135 beds, and 6,000 staff . On average, we have more than 190,000 outpatients, 14,000 patients admitted to emergencies, and 7,500 hospitalized patients (4,900 patients receiving surgeries) every month. CMU Healthcare System has sixteen hospitals, which include CMU Hospital,

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CMU Beigang Hospital, Tainan Municipal An-Nan Hospital, Children’s Hospital, and CMU Hsinchu Hospital, etc.,We are indeed a responsible medical center and fortress of public health in central Taiwan.

Keywords Retinopathy image,Deep Learning,Computer-aided diagnosis system,Picture archiving and communication system,Diabetes

Contact details AI Center for Medical Diagnosis, China Medical University Hospital


China Medical University Hospital

Smart Physical Examination AI Distribution OVERVIEW We summarize the “Physical examination smart navigation principle”, organize each examination and waiting time, design the “AI-Based Smart Examination Scheduling System” and provide the smart watch for patient to wear in order to communicate with nursing personnel in a real time on the two-way communication basis. Furthermore, we use the “AI-Based Smart Scheduling System” operation to automatically schedule the physical examination and notify the nursing personnel via their tablet computers of the most optimized schedule. Afterwards, the system will notify the patient via the smart watch. At the same time, we develop the “Patient Positioning and Navigation System” through inter-industry cooperation so that the patient may select a navigation systemguided route to go to the examination room. Examination time would be recorded to shorten the waiting time and reduce the chance of having examination room from idling. The system is a pioneering invention with 8 major features, including: 1. AI-Based Smart Scheduling System, 2. Patient Positioning and Navigation System, 3. Online device connection and data upload, 4. Smart watch applications: real-time message notification, real-time conversation, two-way communication, 5. Smart watch applications: recognize VIP patient, 6. Smart watch applications: inquire the physical examination scheduling status, 7. Smart watch applications: record the physical examination checkpoints and 8. Smart watch applications in combination with NFC TAG applications: inductive locker, enhance the teamwork effectiveness and service quality.

BENEFIT 1.Save manpower: The introduction of AI-Based Smart Scheduling System, in cooperation with the Patient Positioning and Navigation System, can save the manpower of nursing personnel on supervising the patient during physical examination up to 1-2 personnel/ day, and further save the shift manpower up to 7-14%/day. 2.Increase space usage rate and physical examination quantity: The space usage rate increased 20%/day and the overall performance gradually rose up. Furthermore, the on-site personnel can proactively inquire the current status of the examination room to reduce the time spent on making calls or physically making a trip to the examination room for

current status. 3.Reduce the waiting time for the examination room: Solve the past conditions while nursing personnel awaited in the examination room for the patient, which prolonged the working hours. Up to now, the physical examination is completed within the examination check time without any delay. 4.Shorten the patient waiting time for the examination room and the time for completing the physical examination: The average patient waiting time for the examination room is reduced from 30 minutes to 15 minutes, with an improvement rate of 50%. The time for completing the physical examination is reduced from 5 hours to 4.5 hours, with an improvement rate of 10%.

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2020 Application of Smart Medical Technology

Fig. 1 AI-Based Smart Scheduling System on the tablet computer.

Fig. 2 Smart watch application in combination with a inductive locker

Fig. 3. Nursing personnel demonstrate how to use a smart watch to a patient

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Fig. 4 A patient is using a smart watch


Fig. 5 Review committee members are commenting on the on-site evaluation.

Fig. 6 The award ceremony in Taipei

ABOUT THE HOSPITAL Founded in 1980, China Medical University Hospital has for long stuck to the principles of “taking pride in our hospital and viewing the patients and staff as top priorities”. We have made a committed effort to improving medical services and exterior environment, hoping to create the best medical institution in Taiwan. China Medical University hospital contain 7 medical buildings, 2,135 beds, and 6,000 staff. On average, we have more than 190,000 outpatients, 14,000 patients admitted to emergencies, and 7,500 hospitalized patients (4,900 patients receiving surgeries) every month. CMU Healthcare System has sixteen hospitals, which include CMU Hospital,

CMU Beigang Hospital, Tainan Municipal An-Nan Hospital, Children’s Hospital, and CMU Hsinchu Hospital, etc.,We are indeed a responsible medical center and fortress of public health in central Taiwan.

Keywords Smart physical examination, Smart scheduling, Smart watch application, Patient Positioning and Navigation System, Data connection

Contact details Center of Health Evaluation and Promotion, China Medical University Hospital

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2020 Application of Smart Medical Technology

Taipei Veterans General Hospital

Smart Dialysis Scheduling Management System through Electronic Whiteboard – Visualized Management, Stay Informed Smartly OVERVIEW Recently, the kidney disease has become an important issue in Taiwan with its increasing impact on citizens’ health, causing the medical expense and cost to raise up significantly. In the past, the dialysis scheduling management was conducted by informing the patient through the phone manually. Afterwards, the dialysis instructions and information of the patient would be recorded on the scheduling card. However, the manual operation sometimes would lead to several scheduling errors or the information on the scheduling card is insufficient. As a result, the hospital is unable to fully control the patient status and the medical requirements. What’s worse, serious medical errors or insufficient preparations may also occurred. The hospital tries to implement the information system to conduct the smart hospital scheduling management, using the computer information system to directly schedule the blood dialysis of the patient, ensuring the accuracy and completeness of the dialysis scheduling. The hospital aims to enhance the satisfaction and cooperation of the patient and family members, achieving the positive communication between the doctor, medical personnel and patient. Therefore, the best dialysis care quality can be created.

BENEFIT The team initiates the “Smart Dialysis Scheduling Management System through Electronic Whiteboard”. When the dialysis patient is admitted, the nephrologist issues the relevant instructions or annotates items for handover or shifts with special demands. The computer information system will automatically conduct the scheduling based on the available beds and display the relevant information through the interactive screen of the electronic whiteboard, including the dialysis instructions, isolation information and oxygen requirements, so as to reduce manual operation errors. If the medical personnel want to adjust the shift, they can conduct the scheduling change directly on the screen. The smart

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management is able to control the patient status and improve the dialysis treatment safety. Furthermore, the work efficiency, accuracy and medical care quality will be significantly enhanced. After the implementation of the system, the medical team’s ability to control the current dialysis bed management has been improved obviously, with statistics showing that the smart dialysis scheduling management system can even reduce the labor cost time for scheduling changes, lower the scheduling miss rate and incomplete rate. In addition, the system can also display the bacteria that the patient needs to be isolated from, as well as whether the patient is hepatitis B or C carrier who needs isolation action, allowing the medical team to


arrange the isolation beds and improve the unit infection control ability. The real-time display of the patient dialysis prescription as well as the oxygen usage can also allow the medical team to prepare materials and other related tasks before the dialysis. The project integrates the interactive electronic whiteboard and smart scheduling management system to connect the clinical data of the patient and display the latest

scheduling status on the screen. In addition to simplifying the change and addition process of the dialysis scheduling on a real-time basis, the system also improves the scheduling problems and eliminates the scheduling errors, allowing the medical personnel to rapidly control the dialysis prescription and data related to the patient. With the system, the work efficiency, accuracy and medical care quality will be significantly enhanced.

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2020 Application of Smart Medical Technology

ABOUT THE HOSPITAL Taipei Veterans General Hospital, established in 1958, is a national level medical center in Beitou District, Taipei City. The hospital upholds the concept of “Treating patients with sincerity and pursuing excellence” as the top service standard to develop and improve the medical service, education training and medical research. The hospital is committed to providing the medical service with top quality, upholding the “customer-oriented” service concept to engage in the medical technology innovation and service quality enhancement. Furthermore, the hospital aims to provide the patient with holistic medical care, convenient medical environment and humanized medical service. In the future, the hospital will continue to uphold the service concept of “Treating patients with sincerity and pursuing excellence”, to develop and improve the

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medical service, education training and medical research. Moreover, the hospital maintains two core values, “Quality” and “Efficiency”, to seek the human health and welfare, striving to become the first preferred hospital for the general public as well as the world-class medical center.

Keywords Blood dialysis, electronic whiteboard, smart dialysis scheduling management system, visualized management, medical care quality

Contact details Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital

Cooperated partners JAGUAR TECHNOLOGY INC.


Taipei Veterans General Hospital

Patient Referral Information Management System – Stayed Informed, Instant Referral OVERVIEW To implement the two-way referral process between Taipei Veterans General Hospital and other hospitals, as well as transmit the patient data such as medical treatment, examination and medication through the “NHIA E-Referral Platform”, Taipei Veterans General Hospital has established the “Patient Referral Information Management System”. The system integrates the database and the “E-Referral Platform” to effectively simplify the patient referral process, enhance the medial service quality and improve the administrative efficiency, further achieving the purpose of “Stayed Informed, Instant Referral”.

BENEFIT 1.The hospital connects the information management system to the “NHIA E-Referral Platform” to regularly download the referral data. By doing so, the patient can wait for the consultation directly without registering at the front counter, simplifying the medical process and saving huge amount of time effectively. 2.The patient referral database is connected to the medical system so as to simplify various administrative tasks, such as importing the medical institution code. The efficiency of referral issuance is significantly enhanced by importing the data automatically. 3.The system is able to directly integrate relevant data, including medical records

and “NHIA E-Referral Platform”, thereby effectively enhancing the data accuracy, data quality and administrative efficiency of the referral center personnel. 4.The system will immediately transmit the patient data to other contracted hospitals via e-mail after successfully archiving the patient data, allowing them to search for the patient data such as medical treatment records, medication records or surgical records through the “Taipei Veteran General Hospital Patient Referral Information Platform”. 5.For the E-referral patient, the system can upload the data to the “NHIA E-Referral Platform” on a real-time basis. In 2019, the response rate of the E-referral form is 100%.

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2020 Application of Smart Medical Technology

Fig 1. Patient Referral Information Management System-Core Value

Fig 2. Patient Referral Information Management System – PatientCentered Database Integration

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Fig 3. Automatic referral form archiving to compare with the E-referral form and medical treatment data

ABOUT THE HOSPITAL Taipei Veterans General Hospital has a great vision to become the first preferred hospital for the general public and the worldclass medical center. Since the establishment for 60 years, the hospital is committed to providing the medical service with top quality, upholding the “customer-oriented” service concept to engage in the medical technology innovation and service quality enhancement. Furthermore, the hospital aims to provide the patient with holistic medical care, convenient medical environment and humanized medical service. In the future, the hospital will continue to uphold the service concept of “Treating patients with sincerity and pursuing excellence”, to develop and improve the medical service, education training and

medical research. Moreover, the hospital maintains two core values, “Quality” and “Efficiency”, to seek the human health and welfare, striving to become the first preferred hospital for the general public as well as the world-class medical center.

Keywords Hierarchy of medical care,Two-way referral E-referral platform,Database integration Patient Referral Information Management System

Contact details Department of Medical Affairs and Planning, Taipei Veterans General Hospital

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2020 Application of Smart Medical Technology

Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation

To establish the information system to optimize ACLS performing OVERVIEW ACLS guidelines emphasize the concept of teamwork in resuscitation. Not only should members perform standard actions, but they should also be familiar with different roles in the emergent situation and cooperate. Therefore, we want to use the information system to assist the medical team in implementing the ACLS process fully. Under the information system assistance, the medical team can perform the resuscitation actions precisely, and it will not be affected by memory errors. The medical and nursing team can complete a perfect resuscitation with the help of information technology. The information system performs timing, prompting, and guidance according to the ACLS process. It records the procedures to be used in emergency treatment (chest compression frequency, the establishment of the intravenous route, placement of endotracheal tubes, electric shock, drug type, and dose) by clicking. After the file is uploaded, the medical records are complete at the same time. By in-hospital Wi-Fi, all hospital staff can use this information system correctly to assist in the implementation of advanced CPR. It does improve the quality of saving lives and reduce the burden on clinical and writing medical records of medical staff.

BENEFIT 1. The cloud database can analyze every CPR data of the hospital. It makes the analysis process more quality, faster, and more accurate. We are easier to catch the deficiencies in the ACLS process and can improve medical members' performance through education training. 2. Analysis of the System Usability Scale: to survey eight aspects of the user satisfaction, and four elements of the execution effectiveness. The satisfaction of operating the ACLS optimization system reached 80.3%, and the execution effectiveness reached 84.2%. 3. Comparing the ACLS results between the

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paper-dependent group (from October to December 2017) and the information assistant system group (from January to March 2018). The use of the ACLS information system increased the ROSC (recover spontaneous circulation) rate by 31%, the rate of surviving more than 24 hours increased by 14%, and the proportion of discharged patients without neurological sequels increased by 5.8%. 4. In 2019, we conducted 18 times of the ACLS training programs and simulation exercises with the ACLS information assistant system, with a 90% satisfaction rate.


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2020 Application of Smart Medical Technology

ABOUT THE HOSPITAL Philosophy Purpose: People-oriented medical treatment, respect for life Mission: guard life, health, and love Vision: To develop into a model of an international hospital patientcentered Long-term goals: Goal 1: Sustained developing and to become the benchmark of smart hospitals Goal 2: To nurture talent in medicine and various specialties actively, implement medical humanities and become an international medical education training center Goal 3:To provide services centering on patient safety Goal 4:To establish a high-quality research environment and to enhance innovative study capabilities Goal 5: To take care of vulnerable groups and fulfill social responsibilities

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Emergency Department Hualien Tzu Chi hospital is the only tertial health-care institute in eastern Taiwan, and responses for the emergency medical rescue (EMS) system training, and the base "referral hospital," which bears most of the emergency and critically ill patients. Not only all medical services are oriented towards and centered on patient safety, with a focus on medical quality and patient safety management to provide high quality and refined medical assistance, but also, we take the responsibility of social health and emergency response. Keywords cardiac arrest, ACLS: Advanced Cardiac Life Support, information system, resuscitation quality

Contact details Medical Department, Hualien Tzu Chi Hospital


Tri-Service General Hospital

Smart Home Dialysis App OVERVIEW The "Home Dialysis Central Mobile APP" is a cross-disciplinary collaboration in which the nephrology medical team, the information room, and the internet manufacturers jointly discuss innovative and intelligent development. This APP covers 10 functional features: "Team introduction"; "Medical consultation information"; "Medical calendar" is intelligent to remind the doctors of the unique and innovative design; "Message management" can leave messages online and have dedicated feedback to promote two-way medical treatment interaction and communication without distance; "Message push function" medical staff take proactive care and warm reminders to increase patient behavior compliance; "Home record" can continuously record data such as heartbeat, blood pressure, weight, water consumption, etc., and can also upload diet and anomalous photos provide more complete records of dietary content and servings; "Data Statistics" presents the trend of inspection values in a variety of charts; 3 major features of "Examination Report" are automatic uploading of real-time updates, outlier warning reminders, and intelligent connection to the health education list; The video animation of "Video Guardianship" is a vivid video guardianship that can be watched repeatedly to enhance the patient's willingness to learn. TSGH has more innovatively developed the "quiz in video guardianship" which could be completed after watching the video To let doctors and nurses understand the patient's absorption of health education and provide individual guidance so that health education will not missed; Kidney Kaleidoscope "will share the department organized activities, so that the patient who could not go to the scene also understand the relevant information.

BENEFIT The intelligent home dialysis central mobile APP has many functions first created by TSGH. It is innovative and unique. With the practical application of the APP, it has achieved good results. It not only improves the patient's diet control and behavior compliance, but also the patient's selfefficacy and life satisfaction. The degree has also been greatly improved, improving the quality of medical care. In terms of disease control self-efficacy: -Confidence in disease control (34.2% improvement rate)

-Medication compliance (43.2% improvement rate) In terms of life satisfaction: -Satisfaction with disease management (27% improvement rate) -Satisfaction with physical health (progress rate 27.8%) -Satisfaction with resources (26.3% improvement rate) All have improved significantly. On the other hand, tangible benefits can reduce the cost of paper by 3,840 (sheets / year) and the cost of photocopying by about 11,520 (yuan / year) after the introduction of the APP. Together with energy conservation

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2020 Application of Smart Medical Technology and carbon reduction, we can contribute to environmental protection and love the planet. In addition, the nursing manpower has reduced the time spent on manual transcription by about 320 hours equal to 13 (days / year), which can make better planning and use of manpower in the clinic

and improve medical quality. In terms of intangible benefits, the five major features of smart medical care have been incorporated into clinical care after the introduction of the APP, and increased interaction between patients and family members can help family support and improve self-care capabilities.

Fig 1.Smart Home Dialysis App

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Fig 2.Smart Home Dialysis App-Patient usage

ABOUT THE HOSPITAL Tri-Service General Hospital (TSGH) was established in 1946. To serve the public, we are committed to continuous advanced diagnostic skills, and constant investment in procurement of edgy equipment and instruments, and provision of holistic medical care settings (ex: AIoT center). It is our anticipation to gradually improve the quality of medical services and the operating capacities provided to the army, the dependents and the public with software and hardware updated constantly. With Care, Quality, Discipline and Innovation as our core values for constant provision of prime instructions, studies and services as our goals, the TSGH hopefully is one of the top medical institutions in Taiwan. As it comes to medical services,

TSGH cooperates with foreign and domestic medical and research facilities and faculties. With a new look and edgy healthcare dedicated to the armed forces and the public as a paradigm of all military hospitals, it is our vision to be the top hospital nationwide, healthcare guardian in the community and international medical center worldwide. Keywords Hemodialysis, Mobile Technology, Home Dialysis Central Mobile App, Smart Medical, App Management

Contact details Nephrology, Tri-Service General Hospital

Cooperated partners ST.BEAR INCORPORATED

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2020 Application of Smart Medical Technology

National Cheng Kung University Hospital

Full speed ahead : using clinical decision-making support system to enhance the medical quality of cerebral and cardiovascular diseases OVERVIEW After we joined in Taiwan Clinical Performance Indicator, we monitored the indicators about acute stroke and acute myocardial infraction (AMI). The Quality Center had leaded our members to other medical center to learn about the working in clinical decision support system (CDSS). The reminding window designed by our team member would show on the screen each time when physicians completed their prescription for atrial fibrillation (Af), AMI, and chronic heart failure (CHF). The CDSS is used to link clinical decision making with best guidance and empirical medical knowledge to assist in managing data and supporting physicians' decision making.

BENEFIT The CDSS was set-up in 2015 and can produce reports to analyze the medication status of patients. The prescription rates of dual antiplatelet therapy in patients with Af was up to 68% in 2018 and the rate of 1-year re-stroke was decreasing. In patients with AMI, the prescription rates of β-blocker and Angiotensin-convertingenzyme inhibitor (ACEI) or Angiotensin II receptor antagonist or angiotensin receptor blockers (ARB) was 98% and 99%, respectively. On the other hand, there

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was increasing in the CHF prescription rates after CDSS installation: ACEI/ ARB/ Angiotensin receptor-neprilysin inhibitor was 93.2%; β-blocker/Ivabradine was 93.4%; Mineralocorticoid receptor antagonist was 83.7%. The readmission rates in CHF patients before and after system installation were 17.4% and 13.3%, respectively, and the mortality rates before and after system installation were 9.2% and 4.5%, respectively.


Fig 1.Clinical Decision Support System

Fig 2.Admission Notification System

Fig 3.Discharge Prescription Inspection System

Fig 4.Real-Time Monitoring System

Fig 5.Clinic Atrial Fibrillation System

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2020 Application of Smart Medical Technology

ABOUT THE HOSPITAL National Cheng Kung University Hospital is the only national university hospital medical center and teaching hospital in the southern Taiwan, and it includes a total of 29 clinical medical departments, 3 departments of allied health and 18 administrative units. Since the establishment in 1988, we are devoted to our mission to protect the health of the people of southern Taiwan, heading to be the international clinical research and medical education main association. In addition, the hospital is positioned as a support and leader in the medical treatment of emergency, critical, difficult and rare diseases. National Cheng Kung University Hospital shapes the culture based on the core value of �Life, Love, Excellence, Creativity�. The hospital aims to be the best medical care center for the general public and the best teaching, research, and work environment f o r m e d i c a l p r o f e s s i o n a l s . We l o o k forward to providing a high-quality medical environment for people in South Taiwan.

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Keywords Clinical Decision Support System, Atrial Fibrillation, Stroke, Acute Myocardial Infraction, Chronic Heart Failure

Contact details Quality Center, National Cheng Kung University Hospital


MacKay Memorial Hospital

Development of an real-time and automated ventilatorassociated event intelligent surveillance system OVERVIEW MacKay Memorial Hospital adopts the Microsoft Visual Studio2015 VB.NEt as its development tool and the ORACLE 11, as the database. The system integrates the Physician Order System, Laboratory Information System, HIS System, Respiratory Therapy System, and filters the patient list based on the definition of the ventilator-associated event and the conditions of the standard workflows through the powerful computing capability. The Function planning of the system is listed as follows: 1. Inquiry Function: The function can specify the time interval and ward to not only inquire the patient information with a forward-looking method about the current condition but also search for the historical data. 2. Export Function: The patient data retrieved through the Inquiry Function can be exported as a batch into an Excel report. 3. Prompt Function: When a doctor logs in the system, the system will search for the responsible patient of the doctor and prompt the information whether the patient was marked as “VAC� the previous calendar day.

BENEFIT 1.The system can provide complete automatic, real-time VAE monitoring, transmit the setting of the ventilator and physiological parameters on a real-time basis according to the data of the connected ventilator. Furthermore, the system combines the electronic medical record system which can provide the clinical medical data to auto-matically conduct the case determination. The result is better than that of manual monitoring by the experienced infection control practitioner(ICP). 2.The automated monitoring system has an excellent sensitivity of 100% and a specific-ity of 100%. 3.The time spent by a respiratory therapy case manager to sort the data is saved at least 18.75 working days per month. 4.Ninety percent of doctors agree that re-altime notification is beneficial to the clini-cal

medical operation. 5.The time spent by an infection control prac-titioner(ICP) to determine the case infection time is saved at least 12.5 working days per month. 6.The traditional manual monitoring relies on the automatic monitoring through the retrospective data. The notification is usually issued after the patient has left the intensive care unit (ICU) while the doctor originally of the ICU no longer provides medical care for the patient. The automatic monitoring can change to send out the VAE warning to the frontline clinical doctors in order to provide the opportunity to improve the care service. 7.For users, the automatic system can reduce the data errors of human factor. 8.The automatic electronic monitoring system provides monitoring function with excellent quality and reduces the burden of the infection control personnel (ICP).

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2020 Application of Smart Medical Technology

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VAE System

Hospitalization order ●Ventilator order ●Bacteriological examination order ●Antibiotic order ●Pathology report ●Temperature measurement

Respiratory therapy ●Ventilator connection ●Ventilator data ●Ventilator care record (parameter) (PEEP, FiO2)

Manual verification

Bacteria report

System integration

Real-time monitoring and bidirectional feedback

●Endotracheal suctioning ●Broncho alveolar lavage ●Purulent respiratory tract secretion

●Use the ventilator≥4 days ●Daily lowest PEEP ●Daily lowest FiO2 ●Temperature>38°C ●Bacteria positive report ●WBC ≧ 12,000

●Comply with the VAC condition ●The system will remind the doctor automatically. ●VAC case determination ●The supervisor can monitor each doctor’s VAE result.

Case Statistics Report VAC, IVAC, PVAP

ABOUT THE HOSPITAL Recently, the medical environment has become increasingly complicated. The resources are insufficient while the demands are increasing. Furthermore, Taiwan is gradually entering the aging society. Thanks to the technology advancement, the information communication technology is applied in the hospitals to increase the patient safety, improve the healthcare quality, and promote the operation efficiency. MacKay Memorial Hospital aims to transform from the conventional hospital to the smart hospital, creating the brand-new value of the medical service. MacKay Memorial Hospital offers the Holistic Health Care that attends to the body, soul, and spirit through its multiple programs of professional care quality involving interprofessional practices. The hospital is dedicated to all details of the healthcare quality and patient safety, upholding

the ultimate goal of pursuing excellent healthcare. Moreover, MacKay Memorial Hospital integrates all resources and expands its services within the hospitals toward the community, rural countryside, offshore islands, even to the global. With the highend healthcare and lean management being implemented along with the combination of cloud-based information, MacKay Memorial Hospital enhances the hospital effectiveness and momentum, further transforming its medical service to another brand-new era which has been highly complimented. Keywords Ventilator-associated event(VAE), Infection control, Respiratory therapy, Real-time, Smart, Electronic automatic monitoring

Contact details Emergency Medicine Department, MacKay Memorial Hospital

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2020 Application of Smart Medical Technology

Tri-Service General Hospital

Smart Medicine Pneumatic System OVERVIEW Timely administration of medicines in hospital is essential, but it becomes urgent when patient’s condition progresses or medical intervention, like surgery, implements. However, it always takes a lot of time and employs a tremendous amount of manpower to deliver the medication from central pharmacy to wards. In order to solve this problems, pneumatic tube delivery system, to transport medication (First Day Doses of Prescriptions) between pharmacy and wards or departments, was upgraded by combining RFID and bar code tracking systems. This intellectualized pneumatic tube delivery system has replaced most of manual transportation of medication. Medication delivery currently becomes quick, accurate and cost saving.

BENEFIT Through the combined cooperation with pharmacy, nursing, information, biomedical engineering systems and other systems, the intellectualization of medication delivery was accomplished as followings: 1.Simplified the process of medication delivery: Processes are simplified from 6 steps to 3 steps. 2.Increasing the efficiency of drugs delivery: A.The waiting time for orderlies receiving drugs has reduced 63%. B.The time drugs delivered to wards from pharmacy has reduced 60%. 3.Due to the convenience of practicing system, about 75% of drugs delivery

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through pneumatic tube can be done, improving the efficacy of system use grows up to 37 times higher than before. 4.The comprehensive drug delivery can reduce about 6.5 labor cost, keeping the cost down and save about 2.34 millions NTD per year. 5.The delivery of medicine is trackable, reducing the frequency of following up for medicine from crew in wards. 6.This system can be remote controlled to get rid of errors and reduce the repairing calls. 7 . S t a ff s S a t i s f i c a t i o n : N u r s e : 8 0 % , Orderlies : 92%.


Fig 1.RFID Carrier

Fig 2.Pneumatic Station Transportation

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2020 Application of Smart Medical Technology

Fig 3.Barcode scanning for identification and transportation

ABOUT THE HOSPITAL Tri-Service General Hospital (TSGH) was established in 1946. To serve the public, we are committed to continuous advanced diagnostic skills, and constant investment in procurement of edgy equipment and instruments, and provision of holistic medical care settings (ex: AIoT center). It is our anticipation to gradually improve the quality of medical services and the operating capacities provided to the army, the dependents and the public with software and hardware updated constantly. With Care, Quality, Discipline and Innovation as our core values for constant provision of prime instructions, studies and services as our goals, the TSGH hopefully is one of the top medical institutions in Taiwan. As it comes to medical services, TSGH cooperates with foreign and domestic

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medical and research facilities and faculties. With a new look and edgy healthcare dedicated to the armed forces and the public as a paradigm of all military hospitals, it is our vision to be the top hospital nationwide, healthcare guardian in the community and international medical center worldwide.

Keywords Pneumatic tube delivery system, RFID, bar code tracking system

Contact details Department of pharmacy practice, Tri-Service General Hospital

Cooperated partners Yiwei Electronics International Ltd


Chi Mei Hospital

3A Early Warning Broadcasting System for the Sudden Cardiac Arrest (AutomationďźŒAlarmďźŒAI) OVERVIEW For clinical healthcare professionals, vital signs are the most crucial information. Accordingly, we designed our vital-sign warning system and utilized a vital-sign database to integrate all vital signs of patients based on the concept of "IoT." The database, which is based on patient-centered, presented each vital-sign value with a visualized panel. This visualized management can benefit the determination of vital-sign changes, disease progression, and predict the possibility of emergency events. By doing so, healthcare professionals can provide timely medical treatments and enhance healthcare quality.

BENEFIT The vital-sign warning system of the Chi Mei Medical Center is developed based on the "3A" concept, including "Automation," "Alarm," and "AI." Four major features of the system are listed as follows: 1. Integrate the requirements through the IoT framework and establish the patient information network: Construct the "Physiological Parameter Database" by collecting physiological parameters of all systems, integrate the "Blood Pressure Transaction" operation, cooperate with patients' "Examination and Inspection Data," "Scheduling Calendar," "Team Communication Message" and "Work Schedule" to provide complete information before the medical treatment is implemented. The other healthcare staff will be able to search for the care team and notify them on a real-time basis. Furthermore, the system not only provides sufficient information but also creates a convenient team communication. 2.Optimize mobilization: With establishing the vital sign database and implementing

the mobile devices under safe management, the database can not only shorten the inquiry time (all the inquiry requirements are integrated into a single page and the retrieval time is only 3~5 seconds), but timely obtain the complete information of patient's condition (the mobile phone version includes team communication about the patient's conditions, shift handover messages, examination, and inspection reports). 3. Medical professional supporting system: We convert the physiological parameters into an objective determination value according to the "NHS Early Warning Score." The value is no longer an individual data, but a clinical warning through the calculation by the "BI Rule." The score will be displayed on the patient list. Furthermore, the system determines the possible emergency cases and forecasts the value of the emergency probability by the AI-assisted system. 4. The visualized management panel can support the managers on decision-making:

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2020 Application of Smart Medical Technology there were 160 text messages transmitted per day previously. With the NEWS data computing, we filter the text messages and help the medical professionals to comprehensively detect the unstable patients' conditions in the hospital. As a result, they will be able to provide timely medical care and treatment. Chi Mei Medical Center connects the IoT, BI computing, concise signs, NEWS

platform, and visualized management panel, and introduces AI to solve the problems encountered during the daily practice. Meanwhile, a smart healthcare system is tailored for the Chi Mei Medical Center by a multidisciplinary medical team for collaboration. This system can improve patient safety and reduce the clinicians' workload and help Chi Mei Medical Center move forward to an AI medical institution.

Fig. 1 Sources of the Vital-sign Input Parameters

圖很糊,原始檔沒 有那麼糊,請協助 調整

Fig. 2 Vital-sign Warning System Screenshot

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Fig. 3 Visualized Management Panel

ABOUT THE HOSPITAL The hospital was established in 1968, and the original name was "Fengjia Hospital". In November 2010, the hospital was then changed to "Chi Mei Medical Center". Presently, the hospital has 883 emergency hospital beds, and the total number of hospital beds is 1,278. The hospital includes 37 departments, such as the Department of Medical Science, Healthcare Center, Nursing Department, Medical Technology and Teaching Research Departments, a total of 13 administrative departments, and 45 medical and hospital affair-related committees. Currently, there are 3,800 employees in the hospital. The core value of the hospital is "Care, Professional, Efficiency". The hospital also upholds the patient-based spirit along with the goals of "develop quality characteristic healthcare", "research with innovation, cultivate quality talents", "improve the process, increase

service quality" and "flexible management, sustainable operation" in order to construct the organization culture of excellent healthcare quality, guarantee patient safety and protect the benefits of patients, thereby promoting the health of the public and employees and becoming a healthcare system trusted by the public the most.

Keywords Vital signs, NEWS, Automation, Alarm, AI, Vital-sign warning system

Contact details Center for Quality Management, Chi Mei Medical Center

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2020 Application of Smart Medical Technology

Ditmanson Medical Foundation Chia-Yi Christian Hospital

Integrated nursing information platform Nursing information Map-- Medical record navigation, hand over, interdisciplinary team communication strategies OVERVIEW Nursing medical records navigation map system, to build nursing staff medical records reading guidelines and handover tools. The system introduction is based on the patient focused method (PFM) and shift trajectory. It connects each system to a single interface and becomes a nursing medical record map. The interface is simple and presents the patient's problems and current processing status. Use multiple links to query detailed information, edit shifts and notes. The introduction of the nursing medical record navigation map system is to reduce the learning curve of nursing staff to understand the patient through the medical record, and shorten the search path, standardize the shift procedure, and reduce the shift time. The purpose of the import is: (1) The center's map-based nursing staff read medical records to simplify the search process. (2) Collect the information about the shift to establish a standard format to shorten the shift time. (3) Improve the communication distance between teams, and the information is not missed.

BENEFIT The nursing medical record navigation map system promotes the use of sophisticated techniques, the use of Lockamy and Smith's strategy-based system reconstruction steps, and the planning, status analysis, visualization, design and execution of five-stage steps for the process of information reconstruction. System construction content: According to the ISBAR (Introduction Situation–Background– Assessment– Recommendation) transfer concept, the design concept is divided into six major functional items, patient basic information, nursing problems, inspection and inspection, wound piping, nursing process, team information connection area And team handover, and there is a record of the handover time selection, as the basis for

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handover management. Color management: Use colors to distinguish the forms that have been used, and present cross-team cooperation and high-risk screening. There are two parts to the evaluation of system effectiveness. (1) Shorten the delivery time. The completion rate of the first delivery within 30 minutes has increased from 32.3% to 72.8%, effectively saving the delay of the first delivery due to unfamiliar patients. (2) System Satisfaction Evaluation: Satisfaction evaluation is collected by Likers 4-point method, and the two aspects of evaluation are (1) Elements of system success (including system quality and information quality) (2) System use experience (including cognition Ease of use, cognitive usefulness and system use


attitude), of which the system use attitude is 3.05, the highest average information quality score is 3.01, the system quality is 3.11, cognitive ease of use is 3.03, and cognitive usefulness is 3.04. Nursing staff's

attitude towards the use of the integrated platform system was significantly correlated with system quality, information quality, cognitive ease of use, and cognitive usefulness (p <0.000)

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2020 Application of Smart Medical Technology

ABOUT THE HOSPITAL Ditmanson Medical Foundation ChiaYi Christian Hospital was founded in 1985 and is located in Chiayi city. It is a regional teaching hospital in the southern region. It has 1,077 beds and approximately 3,183 employees. The average number of outpatient clinics exceeds 4,110 persontimes per day, providing more than 40 specialist services. Emergency volume: On average about 250 person-times per day. It is an important emergency and severe evacuation hospital in Chiayi and people's preferred hospital. It is ChiaYi Christian Hospital mission to share Jeaus’s prosperous blessings to everyone, and devote to Healthcare, Evangelism, Education, and Solicitude, based on the core values, Faith, Hope and Love.

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Keywords 1.Integrated nursing information platform 2.Nursing information map 3.Patient focused method;PFM 4.Medical record navigation 5.Introduction Situation–Background– Assessment– Recommendation;ISBAR

Contact details Department of Nursing, Ditmanson Medical Foundation Chia-Yi Christian Hospital


Far Eastern Memorial Hospital

15 seconds real-time update ~ Implement the real-time database to develop the Early Warning System (EWS) to reduce the unexpected cardiac arrest event OVERVIEW The clinical patient care requires the continuous vital sign data recording to assess the patient condition so that the proper medical diagnosis and treatment can be delivered. However, it is extremely difficult to predict the sudden condition of the patient. Therefore, how to monitor on a real-time basis and prevent such condition from happening in advance, so that the medical team can immediately intervene to reduce the critical illness risk has become the major challenge of the project. Through the implementation of the EWS system, the hospital has successfully reduced the number of the unexpected cardiac arrest event. The medical team can immediately handle and transfer the patient to the ICU, which also increases the survival to discharge rate. It is worth mentioning that the informatization significantly reduces the time for the nursing personnel to manually transcribe the data and also improves the job satisfaction. In the future, the Multiple Database Analysis can be implemented and the Machine Learning Optimization System can be established in order to achieve the AI application and expand the disease prediction. For example, combine with the clinical test database to enhance the early warning of various diseases and shock risks, further effectively designing the system for actual clinical needs.

BENEFIT The project integrated the Nursing Department, Information Department and Critical Disease Intensive Care Unit(ICU) to jointly establish the Early Warning System (EWS). The system allows the vital sign data to be automatically uploaded and combined with the early warning assessment table score to update the patient vital sign database in 15 seconds on a real-time basis.

Therefore, it can quickly determine the inpatient risk level (use red, yellow, and green block to classify the clinical risk) and display the information on the electronic whiteboard of the department. The Rapid Response Team (RRT) record can also be transacted to the physician record, so that the team communication can be achieved seamlessly.

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2020 Application of Smart Medical Technology

Fig 1.The electronic whiteboard displays the patient alerted by the early warning assessment.

Fig 2.Early Warning System

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Fig 3.The Rapid Response Team (RRT) record transacted to the physician’s Progress Note.

ABOUT THE HOSPITAL Far Eastern Memorial Hospital is the only hospital accredited as the medical center in the New Taipei City, undertaking the responsibility of caring the patient with acute and critical disease. Currently, Far Eastern Memorial Hospital has a total of 64 specialties and 2 medical centers, including the Cardiovascular Medical Center, Department of Internal Medicine, Department of Surgery, Department of Obstetrics and Gynecology, Department of Pediatrics, and other medical specialties, with a total of 1,408 hospital beds. The hospital has over 6,500 outpatient visits and approximately 400 emergency cases per day, ranking the fourth largest hospital in Taiwan by volume with over 85% occupancy rate. Every medical operation has its own SOP. Furthermore, the ISO9001 quality system has been implemented and taken root through internalization in 2004. The hospital establishes the quality

objective every year. It also obtained 5 Disease-specific Care Certifications (DSC), being the hospital with the most certifications in northern Taiwan. In addition to providing the medical service, Far Eastern Memorial Hospital strongly encourages the personnel to conduct academic research. There are 3 joint laboratories, 1 animal laboratory, and 24-hour e-service electronic library. The hospital approximately published 150 journal articles, including 120 SCI publications at least every year.

Keywords Early Warning System,Unexpected Cardiac Arrest Rapid Response Team

Contact details strategy planning department, Far Eastern Memorial Hospital

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2020 Application of Smart Medical Technology

Taichung Veterans General Hospital

Effectiveness of Improving Integrated Post-Acute Care for Heart Failure through Cloud Management OVERVIEW In 2013, Taichung Veterans General Hospital established the “Heart Failure Care Team” which emphasized the Holistic Health Care of the interprofessional team. The “Heart Failure Care Team” includes the physician, case manager, specialist nurse, pharmacist, physical therapist, nutritionist, social worker, etc., providing the comprehensive interprofessional care and case tracking. By utilizing digitized management and cloud telecare mode, the hospital established the “Patient-Specific Healthcare Record Platform”. Taichung Veterans General Hospital is the medical center in central Taiwan equipped with the highest number of the Cardiac Resynchronization Therapy Pacemaker for the patient with medium to severe level of heart failure; regarding the patient implanted with the Cardiac Resynchronization Therapy Pacemaker, Implantable Cardioverter Defibrillator (ICD) and Permanent Pacemaker (PPM), the hospital has launched the “Heart Implantable Electronic Device Telecare Project”, providing the patient with the promptest and personalized healthcare and securing the patient safety by using the cloud management to monitor the heart rhythm. In January 2018, the hospital completed the “Heart Failure Health Management Application System”. The patient only had to use the smartphone to manage the home status and deliver immediate feedback, thereby reducing the readmission and mortality rate. Furthermore, the application could also be used to increase the life quality for the patient with heart failure, raise the patient self-care capacity, and promote the medical compliance and family support while reducing the care-related stress and financial burden.

BENEFIT Implementation effectiveness: Six Minute Walk Test 213.5±6.4 (p<.001) Nutritional assessment 11.00±2.2 (p<.000) Healthy life quality 5.3±1.6 (p<.003) LVEF 37.0±8.4 (p<.000) All items indicated significant differences. Using the 50% reduction in the 30-day readmission rate for calculation, the hospital can predict the reduction from 200 heart failure patients to 100 patients in a year. Assuming the cost of each emergency case to be 1,200 NTD, the hospital can save the NHI expense up to 120,000 NTD every year. The weight control rate of the heart failure patient (weight after discharge for 30 days ≦ weight at discharge + 2 kg) has been improved from

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39.3% to 90.3%. The life quality has been improved by 82.4%. The daily care capability completion rate has been improved from 0% to 76.9%. The discharge satisfaction score has been raised from 92 to 96. The 90-day readmission rate is 3.23%, which is 60% lower compared to 2016. The 6-month readmission rate has been decreased down to 4.26%. Annually, around 78 readmission cases have been prevented, saving the NHI expense up to 6,864,000 NTD. The healthcare period of the project is 6 months, with the hospital providing the patient with personalized heart failurerelated knowledge and self-care execution education, further assisting the patient in completing the self-care and relevant training


(such as weight monitoring, medication knowledge, deterioration detection, etc.). Furthermore, the cardiologist would provide the patient with the comprehensive medical treatment project. Through the data integration and care provided by the case manager, the patient would receive the complete care and reduce the 30-day

readmission rate as well as the mortality rate of the patient with heart disease. The Ministry of Health and Welfare hopes to promote the project to all hospitals in Taiwan, thereby allowing the patient to receive the care with the highest quality. Moreover, Taiwan’s medical system can be comprehensively improved.

Fig 1.Application System Implemented in the Hospital

新增基本資料

Fig 2.Health Management Interface

確定新增

進人 HF 管理系統

Fig 3.After binding with the authentication code, the data is saved in the mobile phone with an encrypted mode and the user data is transmitted through the HTTPS encrypted channel

Fig 4.Provide Self Vital Sign Monitoring and Input

Fig 5.The system will automatically conduct the data calculation assessment and provide the health-related warning

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2020 Application of Smart Medical Technology

Fig 7.Physiological Data of the Closed Case Fig 6.Knowledge Platform: Daily precautions for the control of medication, diet and water

Fig 8.System Automatic Red/Green Light Warning

ABOUT THE HOSPITAL Taichung Veterans General Hospital is located in central Taiwan. It started medical services on September 16, 1982. Since 1991 it has been accredited “Medical Center and First Class Teaching Hospital� by the governmental Department of Health. This is a 1,500-bed hospital with around 3,900 employees. It is able to handle about 7,000 outpatients and 190 patients in the emergency room daily. As a public medical center, it provides safe, high-quality medical services with advanced facilities and training programs as well as outstanding research and development programs.

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Keywords HF, Post-Acute Care, IT, Cardiac resynchronization therapy

Contact details Quality Management Center, Taichung Veterans general hospital


Chang Bing Show Chwan Memorial Hospital

Protect the health of mothers and infants throughout the whole process - eBaby maternal and child health management platform OVERVIEW The hospital combines medical care, nursing, and information teams to develop an "eBaby maternal and child health management platform" that includes the health management system and the eBaby APP. This APP connects the hospital's medical and imaging system to establish a complete personal medical record for mothers and infants. From pregnancy, postpartum to mother and infant's health, this APP can monitor their exam data and provide consultation service. Also, by strengthening the guidance of prenatal women, fetal health promotion, childcare, and health education, this app can improve the health consciousness of mothers and babies, and create a supportive environment for maternal and infant health. We hope that the eBaby maternal and child health management team will accompany and take care of babies as they grow up in order to achieve the goal of “welcoming a new life and creating a good family�.

BENEFIT Experience The eBaby maternal and child health management team uses this platform to effectively improve " the efficiency care" and reports in the "quality index", including monitoring of pregnant and postpartum women's check-up schedules, and neonatal vaccination schedules. Quality management can improve care, health service, and patient safety. The eBaby provides " warm service" on the member side, strengthens participation in health education activities, and parenting guidance to improve caring skills, positive care services, automatic notifications, and complete medical records of mothers and infants. This APP connects the hospital's medical care information system to establish mother and infant

medical treatment and health records in different stages. Strengthen the prevention of maternal and child diseases during pregnancy, and the prenatal ultrasound examination. "Postpartum, Infant and Toddler Stages": Newborn screening and vaccination monitoring, case referral and follow-up, health promotion and care of pregnant and fetal health, childcare education and guidance. The hospital actively creates the supportive environment for maternal and child health,and provides the continuous, holistic and individual professional maternal and child health management service and the good medical care quality. Cost-effectiveness It includes reducing the cost of human

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2020 Application of Smart Medical Technology resources by using the informatization operation, reducing the cost of development by using a sharing platform, reducing the cost of education by using a standard operating procedure, and increasing hospital operational efficiency.

Cross-district services The development of smart medical service is a trend. This platform has been used in Show Chwan Memorial Hospital and Tainan Municipal Hospital to fulfill resource integration and innovative service.

Fig 1.eBaby platform

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Fig 2.eBaby platform: vaccination schedule synchronized with mobile APP

Fig 3.Vaccination reminders and alerts

ABOUT THE HOSPITAL Show Chwan medical system takes care of people's health in the remote area. The founder, Dr. Minho Huang, follows the Mayo Clinic's philosophy, and the spirit of "care for the benefit of patients, the needs of patients are given priority, and treat employees like family". Chang Bing Show Chwan Memorial Hospital(CBSCMH) is a regional hospital located in the coastal area in Changhua. The hospital's patient-centered, highquality medical culture is integrated into the community. The hospital combines the community resources and provides humanized medical service by high-quality medical service and administrative systems. All full-time and part-time physicians had received complete physician training, implemented medical quality and patient

safety management, and improved medical quality. The four goals of "the holistic health care, the whole family, the whole team, and the whole process" have been extended from serving the group of adults to the group of women and children. We hope to protect the health of mothers and infants throughout the whole process.

Keywords eBaby, pregnancy, infant, toddler, mother and infant health, health prevention, health management

Contact details Superintendent Office, Chang Bing Show Chwan Memorial Hospital

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2020 Application of Smart Medical Technology

Feng Yuan Hospital, Ministry of Health and Welfare

Improving the health service efficiency for elderly people who live alone in communities with a smart telecare system OVERVIEW Feng Yuan Hospital established inter-departmental professional teams to participate in the cross-industry cooperation. Together with the TSMC Charity Foundation, Feng Yuan Hospital constructed the telecare system and the healthcare management cloud platform for elderly people living alone in the community. The distance equipment of the telecare system includes the video conference system server, sphygmomanometer, forehead thermometer, smart wristband, indoor positioning device and smart pillbox. The senior-friendly equipment features simple operation steps and display screens with large-size fonts. The functions of the healthcare cloud platform include the case distribution map, telecare panel, physiological measurement record, medication record, step counting, revisit/ inspection reminder, care record, to-do list, nutrition assessment and case management. In addition, the platform has the function of LINE@ instant notification and unusual warning to provide the health service, health education, and care for the elderly people.

BENEFIT With the rapid growth of the long-term care demand, the project introduced the telecare system and investigated how to utilize the technology auxiliary equipment to enhance the service momentum without increasing the manpower. The implementation stage can be divided into several periods, including the development period, pre-installation period, construction period, testing period, optimization period, and stabilization period. After the case service proceeded for 5-6 months, the practice outcomes are listed as follows: 1.After 6 months of implementation, the blood pressure measurement rate per day reached 72.8% and the hospital revisit rate was 100%. 2.If the pharmacist proactively persuaded the elderly to use the smart pillbox, the medication compliance rate was effectively increased by more than 80%.

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3.After 5 months of implementation, the intake amount of the daily protein was greatly improved. Among all elderly people, 50% of them achieved 1.0-1.2 g per kg; the Sarcopenia related indicators at least remained the same or slightly improved. 4.The average walking steps per month increased by 5.39% with the implementation of the rewarding system. 5.The average score of ADL was 96 without the deterioration of 10 elderly people. The average score of IADL was improved from 6.8 to 7.2. To sum up, all effectiveness assessments indicated significant improvements. With the implementation of the technology equipment, the social participation and the sense of achievement of the elderly people living alone can be greatly improved. Meanwhile, the recognition of self-health management and the compliance were enhanced, resulting in positive impact on promoting the health and postponing the


disability diseases from happening. In terms of step counting rewarding system, healthy seniors were encouraged to walk further (5000 steps or more) and the compliance rate was even better. However, for the elderly people with moderate health condition (1,000-5,000 steps) and the less healthy elderly people (< 1,000 steps), the result showed that only the deterioration rate was deferred. The hospital can continuously improve the healthcare effectiveness of the elderly people living alone without increasing the manpower. The service items increased from the aforementioned 4 items to 16 items; the

care frequency increases from once every 2 months of the home visit to at least once video conference care service per week, the care efficiency is increased by 8 times. The senior-friendly design can promote the learning and utilization motivation. The system construction must take into account of the living environment, weather, and other factors that affect the network speed. In the future, if the system will be applied for the elderly people with moderate health condition, it can also detect and intervene the unusual conditions, further reducing the long-term care demand of the manpower.

Fig. 1 Features of the Telecare Service

Fig. 2 Case Selection, Distance Equipment, and Implemented Item

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2020 Application of Smart Medical Technology

Fig. 3 Platform Function Framework

Fig. 4 Infrared Indoor Positioning Warning System

ABOUT THE HOSPITAL Feng Yuan Hospital, Ministry of Health and Welfare, was established on April 30, 1983. Currently, there is a total of 712 beds and 1,100 employees. Feng Yuan Hospital is accredited as the regional teaching hospital with the vision of becoming the “most trustworthy medical and healthcare center to the general public in Taichung�. Feng Yuan Hospital upholds the patientcentered principle to provide healthcare services that meet the needs of the community residents. Moreover, Feng Yuan Hospital proactively

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develops the featured health care, expands the care momentum and long-term care service, enhances the acute and critical care quality, and strengthens the community connection, being a good neighbor who protects the health of the community residents. Keywords smart healthcare, telecare, the elderly who live alone, health promotion, long term care

Contact details Social Work Division, Feng Yuan Hospital


National Taiwan University Hospital

Integrated Service of Medical Big Data and HighPerformance Computing Support OVERVIEW Currently, the world has paid much attention to the application and development of the big data. Furthermore, the development of the high-performance hardware resources has been popularized and the computing technology has been advanced as well. Coupled with the accumulation of a large number of long-term data, the research has been tended to use AI-based solutions. A great difficulty arises for the researcher in providing sufficient big data computing resources and effectively calculating huge amounts of data under the medical privacy and security environment. Therefore, by establishing the medical integrated database and data analysis zone, the researcher only needs to deal with one single terminal for the clinical data application. Furthermore, the AI computing platform for big data analysis can be established according to various needs.

BENEFIT A medical integrated database covering all information systems of the main hospital and branch hospitals has been established. The time interval is from the hospital digitization to the present. A “Searching Platform for the Statistical Data in the Medical Research� has also been established on this database which includes statistical query functions such as diagnosis and treatment. Coupled with the query conditions such as the patient source, hospital branch, gender, etc., the researcher can easily preview the summary statistics of the required data in advance in order to integrate the complete clinical electronic data in the hospital and speed up the application process. In order to maintain the patient data safety, a large quantity of clinical data applied by the researcher can be computed in the data analysis zone. This zone has been constructed in the equipment isolation area for jump server and virtual environment and it only allows the relevant software provided through the jump server to operate. Moreover, it also monitors and records its operating behavior, and features

data management and control mechanism with information security protection. The zone contains high-performance computing resources and provides the AI computing platform in combination with the operating environment of the Docker container. At the same time, it can provide different AI computing platforms for multiple users. Therefore, this service, from the data application of the medical integrated database to the establishment of the computing platform, can enhance the clinical data value-added application and the research capacity, further making the hospital become more efficient and convenient in the teaching and research field. There are currently more than 100 research projects applied through the medical integrated database. Compared to the previous method of multi-terminal data application, the hospital has effectively achieved the integrated singleterminal service. For applications that are required to be restricted to use within the hospital due to data information security regulations, after the data analysis zone has provided its services, the researcher can save time on collecting data and searching for the

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2020 Application of Smart Medical Technology secure computing environment. Therefore, the researcher is able to speed up the application processing time, and use the database contents to publish academic papers, while also reducing the disturbance to information personnel focused on the system development and maintenance.

The researcher can also focus on the teaching and research aspects such as the research and development of algorithms, thereby reducing the trouble caused by the information security management and computing resources.

Integrated Service of Medical Big Data and AI Computing Support PResearch publication

Researcher

Searching System for the Statistical IRB〠Hospital-signed approval RDB Data Application Data in the Medical Research Entity analysis Medical research department

zone

Research results GPU computing resource

Information Office

Data acquisition

Computation analysis

Data production requires signed approval from the Data Medical Research Migration department Research integrated Clinical medical database database De-identified RDB HIS LIS MIS DW

Fig 1. Integrated Service of Medical Big Data and High-Performance Computing Support

Fig 2.Medical Data Analysis Zone

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Fig 3.Results of the medical integrated database project

ABOUT THE HOSPITAL Established in 1895, the National Taiwan University Hospital was the largest and most modern hospital in Southeast Asia at that time. Since its establishment for over hundred years, it has cultivated countless well-known experts in the medical field. The clinical healthcare quality is world-famous and trusted by the general public. The National Taiwan University Hospital is generally acknowledged to be the leader and the model of the medical profession in Taiwan. As a national-level teaching hospital, NTUH is responsible for three major medical tasks: teaching, research and service. For teaching, it coordinates with the medical schools to serve as a continuation of the curriculum design to cultivate medical and various specialist experts; for research, it integrates the research resources to set up a core research institution,

providing colleagues with the best research equipment and environment; it also combines the advantages offered by the National Taiwan University and its College of Medicine to develop AI innovative teaching and research to maximize the synergy of the industryacademia cooperation; for service, the patient safety-centered orientation service, emphasizing humanized care and focusing on medical quality as well as patient safety management to provide high-quality and sophisticated medical services. Keywords NTUH Integrated Medical Database,Healthcare Big Data,Searching for the Statistical Data in the Medical Research,Artificial Intelligence Computing,Medical Data Analysis Area

Contact details Information Technology Office, National Taiwan University Hospital

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2020 Application of Smart Medical Technology

Chiayi Chang Gung Memorial Hospital

Construction of Smart Medical Textile Supply Mechanism through Technology Applications OVERVIEW This project is to build benchmark medical cloth supply management model by using intellectual technology tool, its focal point: 1.Importing intelligent tunnel washing and drying cloth equipment: a.conforming one-way moving line. b.Central computer is more smart to choose washing and drying sequence by presetting schedule. c.More comprehensive judging about cloth drying situation. d.More saving water. e.Multilevel cottonwool filter system. 2.Promoting the intellectual operation and Monitoring mechanism by using Information Technology: a.The monitoring mechanism about supply cycle of bed curtains. b.The Monitoring mechanism about abnormal using cloth quantity by user. c.By linking dryer signal and ventilator, the ventilator Revolutions is controled more smart. And we can observe its operation from monitoring screen. 3. The application of other technology tools: Importing PDA bar code system to monitor operator that surely take back the dirty medical cloth on time.

BENEFIT This project main benefit: 1.Promoting the ratio about washing bed curtains on time from 87% to 100%. 2.Promoting the efficiency of using water, electricity, steam about 47% to68%.Its benefit is equal to reduce 597 Ton CO2 emissions, and save water about fulling 11 standard swimming pool. 3.Compared to traditional washing machine, the intelligent tunnel washing and drying cloth equipment can reduce the frequency of operator moving cloth from 6 times to 1 time during the washing cloth process, and reduce the occupational injury. 4.Promoting the efficiency of filtering cotton wool after drying cloth about 96%.

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5.Reducing 7 operator who operating washing machines. 6.Reducing the frequency of abnormal washing operation From8% to1.9%. 7.Reducing the frequency of hoarding cloth by user department .The missing is discovery by Auditor from12 times reducing to1times every year. After building the washing medical cloth firm, we tried our best on saving energy, automated and intellectual management. Last year, we produced steam by natural gas instead of fuel. In the future, we will evaluate to import the dryer heat recovery device. We hope that we can defend the earth by actual action.


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2020 Application of Smart Medical Technology

ABOUT THE HOSPITAL "Chiayi Chang Gung Memorial Hospital" obtained the opening license in December 2001, providing a medical center level service, and high-quality outpatient, inpatient and emergency medical services for 2 million people in Yunlin/Chiayi/Tainan. During the ten-year period of the hospital, more than 1,300-bed medical center-level hospitals and nursing homes have been built in this medical special area. Including nursing schools that accommodate more than 6,000 students have been built here, too. We have successfully integrated acute and chronic medical care, long-term care, and medical and nursing education into a complete system. The district strives for all public facilities, convenient transportation and beautiful environment. We not only improve the standard of service for people with acute and chronic diseases in Chiayi, and improve the quality of life

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for senior citizens, but also increase the opportunities for young people to study and find employment. Besides, we expand to promote medical services in remote areas. In the future, we will continue to benefit the people in Chiayi to fulfill our social responsibilities.

Keywords Medical cloth,Washing and drying cloth equipment ,Washing bed curtains,Cotton wool filter,Energy Monitoring

Contact details Laundry Section, Chiayi Chang Gung Memorial Hospital

Cooperated partners The eslite corporation


Changhua Christian Hospital

A Fantastic Helper for the Safe Hospital Environment – Smart Monitoring Management System OVERVIEW The interruption of the supply of water, electricity, medical gas and other infrastructure will cause patient panic, emergency referral, patient injury and even death. How to provide a stable supply of life support system is the top priority for the logistics management department of the hospital. The Smart Central Monitoring Warning Platform features various functions, including the personnel recognition, monitoring point information, each monitoring panel and point status, warning issuance and push notification, abnormality processing description and report statistics. The project vertically integrates the basic system, individual equipment monitoring system and integrated warning platform to construct the comprehensive defense network.

BENEFIT Implementation status and effectiveness 1.Central Monitoring Warning Platform: ● After the platform was launched, a total of 1,523 incidents were reported in 2018, with a processing and response rate of 100%. The equipment failure accounted for 27% and the rest were early warnings. ● Equipment abnormality reports were reduced from 272 to 133, with a total reduction of 51%. The abnormality processing time was reduced by 28 hours per month on average, which also reduced the medical interruption possibility caused by the system failure. ● The platform allowed multiple people to receive the abnormality warning text message and voice message at the same time. Maintenance personnel can immediately leave for the incident site to troubleshoot. At present, the shortest time from receiving the warning to the incident site is 0 minute and the longest,

5 minutes (from B6 to 17F). 2.Water supply: The stability of water supply from 2014 to 2018 is 100%. 3.Electricity supply ● The Active Abnormality Report can enhance the personnel response and maintenance efficiency: During 20142018, there were 8 UPS failures, which actually affected the on-site power supply for 1 hour and the stability was 99.998%. ● Summarize the load records to adjust the UPS supply according to the actual power supply requirements: The total capacity of the UPS has been reduced by 40 KVA compared to 2015, saving 400,000 NTD in the system construction cost and 55,000 NTD every year in annual maintenance and battery replacement cost. 4.Central medical gas: ● From 2014 to 2018, there were 5 failures related to the oxygen and compressed

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2020 Application of Smart Medical Technology air machine, which actually affected the on-site power supply for 35 minutes and the stability was 99.999%. Innovativeness 1. The Central Monitoring Warning Platform adopts the centralization and private cloud system setting. It centralizes the information system management of each hospital, reducing the cost of each setting and taking the information confidentiality issue into consideration as well. Furthermore, it adopts the whip mode for the problem tracking and review.

Fig 1.Stay informed –Receive the abnormality warning text message on a real-time basis

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2. Flywheel UPS system: It is the first full-unit UPS system built in the largescale invasive inspection and treatment instrument which can ensure that the patient under treatment will not be affected during power failure. Reduce resource waste and consumption Due to the early warnings such as the high water level in storage tank notification, the overflow of the tank is prevented. Furthermore, the maintenance cost of water resource waste and building water damage will also be reduced.

Fig 2.Constantly reminded – Report the processing status after the warning


Fig 3.Smart Central Monitoring Warning Platform

ABOUT THE HOSPITAL Changhua Christian Hospital is the oldest medical center in central Taiwan. The hospital has been established for more than 100 years and upheld the spirit of salvation and love of Jesus Christ. The hospital provides high-quality medical services based on the complete medical system. Changhua Christian Hospital and its affiliated hospitals cover multiple counties, including Changhua, Yunlin, Taichung and Nantou, with 8,900 employees and over 3,700 hospital beds. In recent years, it has been actively developing its overseas medical services and medical diplomacy by sending medical teams to friendly nations to provide medical services and personnel training in cooperation with the New Southbound Policy.

Keywords Central Monitoring Warning Platform, warning, flywheel UPS, early warning

Contact details Dept.of Engineering & Construction, CHANGHUA CHRISTIAN HOSPITAL

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2020 Application of Smart Medical Technology

China Medical University Hospital

Smart Environmental Management OVERVIEW The project introduces various smart monitoring systems. For instance, the “Smart Grid Energy Management System” conducts the current direction analysis through the electric meter at the terminal to improve the electrical efficiency and reduce the energy consumption. The equipment can determine whether the equipment efficiency is decreasing through the long-term analysis of operating time and power consumption, so as to perform appropriate maintenance or replacement. The “Remote Air Conditioning Monitoring System” mainly integrates the frontend/backend equipment of the air conditioning system to inspect the equipment status and operation abnormality alarm on a real-time basis. Through the indoor/outdoor sensors, the system is able to automatically adjust the load of various equipment, so as to strike a balance between energy saving and comfort level. The “Internet-Connected Temperature Controller System” integrates the blower with the temperature control to remotely monitor the on-site temperature, as well as automatically adjusts the cold water valve, preventing the temperature difference due to the crowd in the public area. Additionally, the system regularly turns on/off the equipment to prevent unnecessary energy consumption. The “Indoor Air Quality Monitoring System” primarily monitors the CO2 concentration level in the indoor public area. If the concentration level is higher than the standard, the “Intake and Exhaust System” will be activated automatically to import the fresh air to improve the air quality in the environment.

BENEFIT The “Smart Grid Energy Management System” can be used to reduce unnecessary power consumption by conducting the electrical equipment record and analysis. Compared to the original system, the number of entries has increased from 3/day to 1/30s, with tens of thousands of entries recorded every day and exported as the “Equipment Electricity Consumption Run Chart”. For the short-term aspect, the system has the abnormal electricity alarm function. On the other hand, the long-term aspect can be analyzed through the electricity usage of various circuits. Any abnormalities will be instantly identified. The system has improved

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the precision of electricity usage data. The “Remote Air Conditioning Monitoring System” controls from the air conditioning host equipment, the affiliated equipment and even to the blower to improve the quality and efficiency of the air conditioning, further optimizing the entire system architecture. Compared to the original system, the “Internet-Connected Temperature Controller System” is mainly used for remote monitoring. The personnel only have to look at the screen to acquire the current status of the on-site blower. If manual adjustments are made to the temperature without restoring to the original setting, the personnel can restore the original setting remotely. The air conditioning equipment can also be turned


on/off according to the planned schedule. As a result, the extra energy consumption due to human negligence can be avoided. The power saving efficiency is extremely significant. The on-site survey indicates that the system saves up to 2,555 working hours in human labor, which is equal to 652,500 NTD in the labor cost. The “Indoor Air Quality Monitoring System� is primarily for the purpose of monitoring the indoor CO2 concentration level. In the past, the indoor air exchange only relied on the pre-cooling air conditioning unit to import the fresh air without the function of detecting CO2. With the Energy Recovery Ventilator (ERV), when the indoor CO2 concentration level reaches 800ppm, the system will be activated to import the fresh air after cooling for air exchange. If the concentration level is lower than 600ppm, the system will be deactivated automatically to enhance the air quality and reduce the energy consumption.

The original pre-cooling air conditioning unit can be adjusted to be the auxiliary equipment, enhancing the environmental air quality and energy saving efficiency. Compared to 2017, the system has saved up to 982,083 degrees of electricity, not only improving the indoor air quality by reducing the CO2 concentration level but also optimizing the comfort level of the medical environment. Moreover, the system strikes the balance between the energy saving and air quality.

Fig 1. System Homepage

Fig 2. Electricity Usage Analysis of the Building Fig 3. On-Site Blower Status

Fig 4. Remote Temperature Adjustment & Current Temperature Setting

Fig 5. System Host Equipment Page

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2020 Application of Smart Medical Technology

Fig 6. Cooling Tower Operation Status

Fig 7. Indoor Air Quality Central Monitoring System

Fig 8 CO2 Automatic Continuous Monitoring Page

ABOUT THE HOSPITAL Founded in 1980, China Medical University Hospital has for long stuck to the principles of “taking pride in our hospital and viewing the patients and staff as top priorities”. We have made a committed effort to improving medical services and exterior environment, hoping to create the best medical institution in Taiwan. China Medical University hospital contain 7 medical buildings, 2,135 beds, and 6,000 staff . On average, we have more than 190,000 outpatients, 14,000 patients admitted to emergencies, and 7,500 hospitalized patients (4,900 patients receiving surgeries) every month. CMU Healthcare System has sixteen hospitals, which include CMU Hospital, CMU Beigang Hospital, Tainan Municipal

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An-Nan Hospital, Children’s Hospital, and CMU Hsinchu Hospital, etc.,We are indeed a responsible medical center and fortress of public health in central Taiwan.

Keywords Power Monitoring Expert (PME),Remote air condition monitoring system,Networked temperature controller(Fan Coil Unit),Indoor Air Quality (IAQ),Energy Recovery Ventilator (ERV)

Contact details Engineering affairs office, China Medical University Hospital


Tri-Service General Hospital

Smart medical waste management system OVERVIEW The smart medical waste management system is fully electronic. Starting from the source end, the system can be used to oversee the entire waste collection and transportation process through its online positioning function. A robust management scheme enables directly inputting waste weight data from a collecting station into the system. The system then calculates the amount of wastes generated by each ward or clinical examination room to set a threshold for the amount of wastes produced by each hospital unit. Photos taken for end-of-pipe open-bag waste inspection can be uploaded to the system, which also features a real-time online education and communication platform for discussing waste sorting. This facilitates waste disposal and sorting control from the waste source to the end-of-pipe inspection. The goal of the system is to reduce waste production, ensure logical and legal waste disposal, control environmental pollution, reduce environmental burden incurred by incineration, and lower the cost of medical waste disposal.

BENEFIT 1.After the smart medical waste management system is installed, users can scan the barcode on the waste produced by a source. Each waste collection cart is installed with a positioning beacon to track the waste collection time and routes. A positioning system is enabled by installing Bluetooth receivers throughout the hospital. This enables real-time online monitoring of waste collection time and routes for each ward. Recorded data can be tabulated and outputted to prevent disputes. 2.All collected wastes are stored in a fully electronic collection station, which features an electronic balance and directly inputs waste weight data into the smart management system. The system then calculates the amount of wastes produced by each ward or clinical examination room and produces a daily statistics report. 3.Wastes are sorted and inspected at the waste collection station. Any misconduct observed is immediately recorded by taking photos and uploading them to

the platform. Personnel from the source end can then use the platform to identify areas requiring improvement. This enhances the improvement efficiency of all personnel. Historical records are kept and categorized by waste source, type, and weight. The records serve as a reference for medical and management units to determine the effectiveness of waste reduction for further improvement. 4.A positioning system has been installed in the hospital to locate all waste collection carts, which can be monitored regularly using an online platform. This reduces the time required for manual data tracking using printed records, thereby resolving problems regarding labor shortages during weekends and at night. Moreover, this allows the hospital to backtrack the collection of biomedical wastes, thus ensuring that the retention time of wastes in a temporary waste collection room does not exceed that stipulated in relevant regulations. This not only prevents pollutions in the clinical environment but also ensures precise management of waste collection routes,

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2020 Application of Smart Medical Technology time, and frequency as well as the control of environmental pollution. 5.Statistical data regarding the weight of wastes generated by all sources are recorded. Specifically, a hospital information system is used to acquire information on the daily number of beds occupied and weight of wastes produced. The differences in the amount of wastes produced by each bed in each ward were calculated using the system, providing reference data for managers to conduct improvement. 6. The smart medical waste management

system, hospital information system, and positioning management system are integrated to automatically generate relevant reports. This allows nurses, clinical staff, cost control personnel, and management units to perform online monitoring. 7. Following system integration, the human resource cost is reduced by NT$305,000, and the incineration fee is reduced by NT$1.02 million. The system establishment cost is NT$110,000. Therefore, the total cost reduction is NT$1.215 million.

Fig 1.Architecture Diagram of Medical Waste Smart Management System

Fig 2.Architecture Diagram of Positioning System

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Fig 3.Integration of Smart, HIS and Positioning System

ABOUT THE HOSPITAL Tri-Service General Hospital (TSGH) was established in 1946. To serve the public, we are committed to continuous advanced diagnostic skills, and constant investment in procurement of edgy equipment and instruments, and provision of holistic medical care settings (ex: AIoT center). It is our anticipation to gradually improve the quality of medical services and the operating capacities provided to the army, the dependents and the public with software and hardware updated constantly. With Care, Quality, Discipline and Innovation as our core values for constant provision of prime instructions, studies and services as our goals, the TSGH hopefully is one of the top medical institutions in Taiwan. As it comes to medical services, TSGH cooperates with foreign and domestic medical and research facilities and faculties. With a new look and edgy healthcare dedicated to the armed forces

and the public as a paradigm of all military hospitals, it is our vision to be the top hospital nationwide, healthcare guardian in the community and international medical center worldwide.

Keywords Smart medical waste management system App Wa s t e s o u r c e c o d e c r e a t i o n a n d s c a n n i n g f o r registration Wireless positioning management system Bluetooth beacon positioning Recycling and reuse of biomedical wastes End-of-pipe waste inspection

Contact details Occupational Safety and Health Office, Tri-Service General Hospital

Cooperated partners THLight Co.Ltd.

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2020 Application of Smart Medical Technology

Taichung Veterans General Hospital

The smart IoT creates the new value for the hospital equipment management security OVERVIEW The Cloud Inspection System includes personnel management, equipment, inspection item, cycle planning and parameter registration, etc., using the electronic information device to record the on-site equipment operating parameter and importing the inspection operation process into the information system to conduct the analysis, report form production and database consolidation. The system is also able to guide the maintenance personnel to conduct the periodical equipment inspection operation on the preset inspection route, while completing the equipment inspection and time/data recording using the smart mobile device to sense the RFID TAG of each equipment. If there is any abnormality, the system will directly record and report it. Afterwards, the system can save the abnormality into the inspection database through WiFi. The early abnormality detection of the equipment is beneficial to conduct the repair and maintenance operation. The supervisor can also monitor the location, length of stay and current duty status of the inspection personnel through the computer or mobile phone, thereby effectively prevent the accident caused by the equipment abnormality, and improve the reliability and integrity of the inspection operation. Furthermore, the inspection and supervisory audit can be accurately implemented, further reducing the risk of “Loss Event” and “Near Miss”, and maintaining the equipment availability. Finally, the unexpected disaster can be prevented. (Fig 1 and Fig 2)

BENEFIT The major action plan is elaborated as follows 1.Assist the maintenance contractor in fully importing the electronic inspection, improve the supervisory inspection record audit and the record inquiry efficiency, establish the consensus among all three parties (engineering office, maintenance contractor, system manufacturer) and inventory the scope (location) of the various inspection routes. 2.Conduct equipment maintenance basic file archiving and utilize the information

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system to actively track the improvement progress of the abnormality reported by the inspection personnel. (Fig 3) 3.Set up the electronic inspection system parameter according to the regular inspection periodical table, confirm the abnormality notification level and response time, and provide electronic inspection training for the new personnel of the maintenance contractor. Benefit Analysis This case is applied in the facility inspection maintenance operations, including power, air conditioner, fire-fighting, boiler, sanitary water supply and drainage, automatic


door and elevator, in order to accurately implement the hazard detection, safety confirmation, and hazard prevention. Until now, 82 types of electronic inspections have been imported, with 4,023 inspection points (RFID Tag), 202 inspection routes, and a total of 5 million inspection items per year. 1. Safety-based equipment maintenance (the hospital aspect): The unexpected failure maintenance has been reduced from 21 cases to 14 cases after the improvement, with a cost reduction of 165,056 NTD (23% decline rate). 2. Upgrade the equipment failure maintenance to the preventive maintenance (the patient aspect): The equipment related to each inspection type has been archived and the inspection maintenance record form should be reviewed quarterly. The inspection execution rate of the maintenance contractor is 99%, the inspection item accuracy rate is 94% and the supervisor approve rate is 87%. 3. Provide the safe working environment and equipment (the colleague aspect): All

maintenance contractors can use tablets for inspections, with the annual number of ward or clinic maintenance reduced from 5341 cases down to 3474 cases (34.9% decline rate). Summary Currently, the patient safety issue is becoming more and more important, it is extremely necessary for the hospital to keep normal operation of hospital facilities and equipment. It is important to understand how to strengthen the facility management and accurately implement the inspection operation, and establish the principle of “Discover Instantly, Notify Instantly, Handle Instantly, and Improve Tracking”. In the case, the hospital leverages the Smart Cloud Inspection System along with the equipment maintenance quality management system to establish the comprehensive equipment maintenance smart management. Taichung Veterans General Hospital is striving to achieve the ultimate objective of “Zero” accident.

Fig 1. Cloud Inspection Concept Map

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2020 Application of Smart Medical Technology

Fig 2. Cloud Inspection Concept Map

Fig 3. Electronic Inspection Management System

ABOUT THE HOSPITAL Taichung Veterans General Hospital is located in central Taiwan. It started medical services on September 16, 1982. Since 1991 it has been accredited “Medical Center and First Class Teaching Hospital� by the governmental Department of Health. This is a 1,500-bed hospital with around 3,900 employees. It is able to handle about 7,000 outpatients and 190 patients in the emergency room daily. As a public medical

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center, it provides safe, high-quality medical services with advanced facilities and training programs as well as outstanding research and development programs.

Keywords Cloud Inspection System

Contact details Quality Management Center, Taichung Veterans General Hospital


Cathay General Hospital

Holistic Physician Smart Shift System OVERVIEW The scheduling and handover mechanism of residents involves the quality and fairness of duty hours, and also directly affects the continuity of patient care. In the past, the duty scheduling of each clinical department was mostly operated on paper. When the chief resident is arranging the duty schedule, they must consider the scheduling rules, duty area, manpower, etc. And also consider the scheduling needs of each residents. It makes the scheduling work take a lot of time, and also tests the logical thinking skills of each chief resident. In addition, when shifting schedules based on paperwork, the chief resident often can’t really grasp the situation of other resident’s duty replacing or shifting and the correctness of schedules. And it is also easy for medical team staffs to fail to contact the duty resident based on correct information ,which in turn affects the continuity and effective connection of patient care. We established of an electronic intelligent scheduling system for physician based on user-oriented to improve patient care continuity, hoping to effectively manage the scheduling process and improve scheduling efficiency. The system can also assist medical staffs’ effective communication to reduce the occurrence of abnormal event during the patient care process.

BENEFIT The project management team is composed of cross-units such as the Department of Quality Management, the Information Department, the Chief Resident of the various departments in the hospital, the Personnel Office, and the Department of Medical Education. We build the intelligent scheduling system and improve the process. Turn shifting personnel on duty, exchanges schedules, arrange the duty schedule, announcement of schedules, review and management into online. It can reduce manual work time, improve scheduling efficiency, provide complete patient-centered inpatient management services to extend patient care continuity. After multiple user needs interviews, the information needs were organized to

construct the main structure of the intelligent scheduling system. The system is divided into six major functions, including personal schedule integration management, chief resident scheduling function, automated scheduling functions, instant online announcement updates, substitution / shift application and review management, and background management functions. And make good use of the "lightweight" and "high mobility" characteristics of smart phones and tablets, the system also plans and establishes a mobile version of the interface. Scheduling residents can efficiently manage the schedules on the system, and can also shorten the scheduling time and grasp the status of personnel on duty through the system's assistance.

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2020 Application of Smart Medical Technology The results are as follows: (1) Improve communication efficiency and correctness, shorten scheduling time. Use the automatic scheduling function, it will decrease from 110 ~ 240 minutes to 6 ~ 8 minutes. (2) Medical staffs gave great feedback on the use of the system, and the overall satisfaction was 90 points. (3) Establish standardization of scheduling work procedures to avoid the lack of evidence for handover or scheduling problems. (4) Reduce manual work, improve

management efficiency, and improve the quality of patient care. The good operation of the medical care team is related to the fluency of medical care. This project builds an intelligent physician scheduling system. Through continuous communication and coordination, the process is optimized and more in line with the user-centric information management system. Improve efficiency and communication to enable better patient care.

Fig 1.Automatic Shift Arrangement Function

Fig 2.Substitution Function

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Fig 3.Administrator Verification Function

Fig 4.Shift Announcement Interface

ABOUT THE HOSPITAL With the philosophy that an enterprise should care about society and give back to the community, Cathay General Hospital was built by Cathay Life Insurance Co. inaugurated in 1977. Cathay General Hospital is a medical center conveniently located in the center of Taipei, serving the community and people of northern Taiwan with quality healthcare over 30 years. Relying on our strong reputation among the community and the nation, CGH has expended into a Healthcare Network which includes Hsinchu, Sijhih Branch and Neihu Clinic. Cathay General Hospital awarded the

title of “Medical Center” by the Taiwan Joint Commission on Hospital Accreditation. This is the highest level of accreditation, and an honor only 3 percent of this nation’s hospitals earn.

Keywords Physician scheduling,Physician on duty schedule, Electronic shift,Patient Safety, electronic intelligent scheduling system,

Contact details Department of Quality Management, Cathay General Hospital

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2020 Application of Smart Medical Technology

Far Eastern Memorial Hospital

Instrument Management Re-Innovation. The cloud data supports the decision-making management. OVERVIEW Medical instruments and equipment play an important role in the medical treatment processes. However, due to their variety and huge volume, it is necessary to integrate the relevant information in order to effectively manage all the medical instruments and equipment. Therefore, the “Medical Equipment Cloud Management System” and “Medical Instrument One-Touch Application” are established. The system builds a complete medical equipment resume, including the maintenance record, repair record, annual repair cost, contract management, abnormality monitoring, automatic output management report, etc., by connecting with various systems in the hospital. By using the application, the hospital personnel can also conduct online repair, primary maintenance, secondary maintenance, simple operation instruction consultation, simple troubleshooting, etc. on the mobile device. The system database is connected to the “Tableau System” of the hospital, which can generate various management reports such as the engineer performance, repair effectiveness monitoring, etc. Through the connection with other databases, the system has preliminarily developed the “Tube Lifecycle Prediction Model”. At the same time, the system can also provide reference for the management decision through the complete instrument resume and data integration.

BENEFIT Through the establishment of the medical instrument system and application, the instrument management of the hospital has achieved paperless maintenance and repair. Furthermore, the system also simplifies the operation process, alleviates the medical personnel workload and enhances the management efficiency. The database can be used to control the instrument information

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and manage the relevant risk on a real-time basis, further ensuring the patient safety and service quality. In the future, it is expected that the hospital can continuously leverage the cloud data in the aspect of medical instrument and equipment management, to develop the innovative system and enhance the management efficiency.


Fig 1.Tableau Management Report

Fig 2.System Structure

Fig 3.Instrument Resume

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2020 Application of Smart Medical Technology

Fig 4.Medical Instrument Abnormality Monitoring

ABOUT THE HOSPITAL Through the establishment of the medical instrument system and application, the instrument management of the hospital has achieved paperless maintenance and repair. Furthermore, the system also simplifies the operation process, alleviates the medical personnel workload and enhances the management efficiency. The database can be used to control the instrument information and manage the relevant risk on a real-time basis, further ensuring the patient safety and service quality. In the future, it is expected that the hospital can continuously leverage the cloud data in the aspect of medical instrument and equipment management, to develop the innovative system and enhance the management efficiency.

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Keywords Medical Equipment Cloud Management System One-touch Medical Equipment Management APP Data Platform Instrument Resume Performance Management

Contact details strategy planning department, Far Eastern Memorial Hospital


aHOP Co., Ltd

aHOP UDI Smart Set - Transform CINDERELLA into DIANA OVERVIEW As of the end of 2019, for special medical devices listed in the National Health Insurance System in Taiwan, 28.2% payments of the total number of 10,198 items were paid by set. Furthermore, due to the need of actual operation, hospital specified their own product combination sets. The statistical result showed that over 30% of the medical devices in Taiwan existed in the form of set in the hospital operation management. The hospital system is set up in a manner to operate by set during the acceptance test, inventory, consumption, pricing, charging and medical records. Sub-item under a set appeared to be veiled, just like the story of Cinderella. The condition expressed that if the regulation for traceability of the source and distribution direction of the medical device is in effect, more than 30% of the medical devices will not be able to be implemented in compliance with such regulation. The innovative applications of the aHOP Auto-identification Smart Set are listed as follows: 1.Passive data exchanging cloud system is used between hospitals and suppliers to ensure the information security. 2.The aHOP Unique Platform provides various systems and tools. At first, the supplier builds/maintains item data, and then completes the setting of the association and quantity of the set and sub-item. 3.The supplier can synchronously transmit the data, which is built/maintained as one-time construction on the aHOP Unique Platform. The data can be transmitted to hospitals in business relationships 4. The hospital can also define the association and quantity of the sets and sub-item, and transmit the data back to the supplier via the aHOP Unique Platform to reach the collaboration between both parties.

BENEFIT The application methods of the aHOP Auto-identification UDI Barcode “Smart Set” applied in the hospital are listed as follows: 1.When the barcode reader identifies the individual item that belongs to the set while the barcode is being scanned, the system will automatically display the set or the individual item for user to select, in order to continue the following operation. 2.While utilizing supplies, compare the sub-

item quantity of the usage setting, in order to reduce the hospital missing bill rate. 3.While utilizing supplies, check the “Prereview” approved quantity. 4.The sub-item in the set may be scanned for the barcode in order to achieve the goal of set/sub-item digitalized traceability and the need of providing corresponding statistical data upon the price-quantity investigations by the National Health Insurance Administration, Ministry of Health and Welfare.

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2020 Application of Smart Medical Technology 5.In addition to the set reimbursed by the National Health Insurance Administration, the structure design should also be applicable to the set that contains a batch of marked prices of more than 1 unit of medical devices in the hospital (e.g. selffunded set: weight-loss diets). The application effectiveness of the aHOP Auto-identification UDI Barcode “Smart Set” applied in the hospital is listed as follows: 1.Achievements of implementing the aHOP Smart Set in hospitals and suppliers: ‧The aHOP team has completed the development of the solution and has implemented such function applications in 10 medical centers and 3 regional hospitals in Taiwan. ‧Assist the supplier in constructing online data inquiry system (aHOP Line@). As of the beginning of May 2020, nearly 2,000 suppliers have joined the program of constructing data and receiving related information. 2.The promotional objectives and effectiveness of the aHOP Smart Set: ‧When data on the aHOP Unique Platform is built/maintained once, it can be (cross-hospital) used repeatedly. Currently, suppliers have constructed nearly 100,000 records of individual items of medical devices/materials on the platform, while the number of records streamed/exchanged among hospitals for use exceeded 200,000. The day when applications of medical barcodes become incredibly common just like convenience store is just around the corner. ‧The Business Model of the aHOP Unique Platform is Sharing Economy for Healthcare. By sharing, suppliers

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a n d hospitals are easy to afford the solution and the approach that accelerates the process to achieve economies of scale. ‧For hospitals that aHOP has assisted in implementing the UDI, the collaborative agreement explicitly stated that the source code is provided and all aHOP patents/technologies are authorized to be used indefinitely without any cost (currently, 7 utility model patents and 5 invention patents have been obtained) to ensure that the Auto-identification (Barcode) application implemented in the hospitals can be used sustainably. “The aHOP Unique Platform, Sharing Economy for Healthcare” through actual cooperation with entities in multiple industrial segments (suppliers, hospitals, aHOP) helps the establishment of the government’s database of tracking and tracing sources and distribution directions of medical devices in the future. This can also avoid the rework when suppliers or hospitals need to transmit data to the government. Medical item data can be used repeatedly after being built/maintained once. “aHOP Unique Platform, Sharing Economy for Healthcare” is the ultimate goal that we aim to achieve perpetually.


Fig 1.aHOP Business Model diagram Fig 2.Current Method of Recording the Sub-Item List under the Set Used in the Hospital

ABOUT THE INSTITUTION aHOP Co., Ltd(abbreviated as aHOP) was established in 2016 , and its technology is self-developed in the company and 7 new-type patents and 5 invention patents have been obtained. And, we have implementation experiences in 10 medical centers and 3 regional hospitals in Taiwan. The core members in the team come from Global Standard One(which is abbreviated as GS1) and industry of barcode software and hardware. We have experiences in assisting Unique Device Identification (UDI) project and drug bar cording project implemented by Taiwan Food and Drug Administration (TFDA). Other than assisting government to research and establish UDI and drug auto-identification regulations, aHOP team also walks deep into domestic healthcare industry and has provided in-factory consultation for nearly a hundred suppliers as well as interviewed more than 15

medical centers. We understand the issues that suppliers and hospitals face as well as their management demands. aHOP is the only service team in Taiwan that is equipped with “barcode coding and decoding & hardware and software professionalism”, “data integration technology and innovative service capability”, and “familiarization with ecology in healthcare industry”. aHOP will carry on providing auto-identification innovation application solution to the healthcare industry and create accessible environment for healthcare auto-identification application. Keywords Unique Device Identification (UDI),Passive Data Exchanging Cloud System,Smart Set,Traceability,aHOP Information Flow,Sharing Economy for Healthcare

Contact details Administration Department, aHOP Co., Ltd.

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2020 Application of Smart Medical Technology

INNOVA Medical Technology

Virtual Educational System for Clinical Decision Making OVERVIEW In order to improve the clinical diagnosis capability of the medical personnel and complement the insufficient aspects of the traditional training, as well as the difficulties and high expenses of the physical simulations, “Virtual Clinical Diagnosis Training System V-DxM” was developed to provide trainees to interact with virtual patients in the virtual hospitals. The trainees have to face various health problems from virtual patients. They need to conduct medical history inquires and physical examinations, laboratory and radiology diagnosis process to acquire a huge amount of useful data. Through data analysis and sorting, they will be able to make clinical diagnosis, helping the patients solve their medical problems. After the diagnosis, trainees will immediately receive scores and descriptive feedback. Virtual patients can be applied to replace paper-based cases and standardized patients by assisting bedside teaching and clinic/emergency teaching, allowing the trainees to have early experience in contacting with the “patients”. They are allowed to make mistakes in a safe learning environment and become proficient and skilled after practicing repeatedly. By doing so, the gap between classroom learning and clinical care would be bridged, reaching the new milestone of the clinical education.

BENEFIT ● Improve medical diagnosis capability -

not only enhance the decision-making capability of the target diagnosis, but also enhance diagnosis critical thinking. ● Virtual patient features human-machine interaction through natural language, enhancing the learning interest, and promoting autonomous learning capability. ● Provide virtual clinical on-site scenario, diagnosis process project and life-related task, leaving the trainees with realistic clinical experience. ● The system fully records the practice process and provides qualitative and quantitative feedback to the trainees on a real-time basis.

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● The trainee is required to conduct

thinking analysis practice; expert thinking demonstration is provided to enhance the learning effectiveness. ● Input various courses (such as group discussions or competitions) as supplementary teaching materials, the learning effectiveness is significantly enhanced. ● Implement participatory education and examination. Compared to the reality training, the virtual training saves much more time and cost, being able to educate a large number of examinees/trainees at the same time. ●Under the circumstance of severe pandemic and insufficient medical


protection, the clinical internship is difficult to implement. As a result, the practical care opportunity is significantly reduced. The virtual practice training and examination provides the realistic practical case experience, playing an important role in the medical training. ●Two KMU VP-PBL course studies showed that the “research group (with VP)” scored higher diagnosis points than the “control group”. ●For the 121 students of Fooyin University, Department of Nursing, VP can improve their diagnosis skills. For the medical students from 11 countries of I-Shou University, School of Medicine, VP provides the effective English diagnosis capability training. ● The results of the “National Clinical

Diagnosis Capability Competition” showed that the product can improve the examination quality, complement the disadvantages and limitations of traditional OSCE, further reducing the training and hiring cost of SP and examination personnel. ●The 2018/2019 “National Clinical Diagnosis Competition” used our product, which was highly regarded. The competition will be organized by the National Defense Medical Center in 2020. ● Institutions that currently using the product: Taipei Medical University (TMU), Kaohsiung Medical University (KMU), College of Medicine, I-Shou University, E-Da Hospital, Landseed International Hospital, College of Medicine, Fu Jen Catholic University.

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2020 Application of Smart Medical Technology

ABOUT THE INSTITUTION Landseed Asia Academy. (LAA) fostered the mission of “Human centered, Everlasting Innovation�, and aimed to apply the advances of Digital technologies in healthcare education. LAM had innovation of virtual human, Chinese Natural Language, and tools for Medical Professional development. We changed our name to INNOVA Medical Technology in 2020.

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Keywords Performance examination, medical cognition, clinical reasoning, clinical decision making, virtual technology, human-computer interaction, virtual patient

Contact details Administrative Section, INNOVA Medical Technology


Changhua Christian Hospital

Comprehensive yet Simplified-Controlled Drug Smart Management System OVERVIEW The product effectively solved the three major problems of controlled drug management that all medical institutions have faced including the medication error, record error and medical personnel theft. By deeply integrating management software and smart hardware technology, the smart controlled drug management system is suitable for the pharmacies and nursing stations at all levels. The smart system can also connect to the HIS system to control the personnel authority, instruct the medication storage location , prompt the medication dispensing and administration information, automatically upload the medication dispensing record, integrate the usage list, coupled with the debug, foolproof and remote monitoring functions, which can help all hospitals to prevent error and theft, further enhancing the efficiency and accuracy of the detailed record for controlled medications. The product can be rapidly and easily installed, featuring the customizable and flexible design. Moreover, the price is reasonable and affordable.

BENEFIT The product can be adapted to different operational process and layout of pharmacy or nurse station, to provide customized designs for hardware/software. The installation is rapid and easy without changing the existing space configuration, leading to effortless and easy operation. After the implementation, the nursing personnel will no longer have to bear the

psychological burden of medication errors or drug loss and fill in the controlled drug use record, which can save the labor cost of the pharmacist and nurse more than 50%. Furthermore, the paper consumption can be greatly saved and the medicine cabinet lock rate in the pharmacies and nursing stations can reach 100% at any time.

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2020 Application of Smart Medical Technology

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ABOUT THE HOSPITAL Changhua Christian Hospital is the oldest medical center in central Taiwan. The hospital has been established for more than 100 years and upheld the spirit of salvation and love of Jesus Christ. The hospital provides high-quality medical services based on the complete medical system. Changhua Christian Hospital and its affiliated hospitals cover multiple counties, including Changhua, Yunlin, Taichung and Nantou, with 8,900 employees and over 3,700 hospital beds. In recent years, it has been actively developing its overseas medical services and medical diplomacy by sending medical teams to friendly nations to provide medical services and personnel

training in cooperation with the New Southbound Policy.

Keywords Controlled drug, medication storage location instruction, technology integration, remote monitoring, intellectualization

Contact details Department of Pharmacy, CHANGHUA CHRISTIAN HOSPITAL

Cooperated partners Health Con Biotech Co., Ltd.

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2020 Application of Smart Medical Technology

LongGood

GaitBest OVERVIEW Clinically, GaitBest is a quantitative and objective tool to identify abnormal walking patterns of patients, helping physicians or therapists to determine the intervention for patients to prevent bigger health problems. Comparing to conventional gait analysis devices, GaitBest is an AI-powered tool that is not only more accurate than traditional assessment but also significantly shortens assessment time by 80%. LongGood aims to deliver efficient, economical and high-quality service and the following are key features of GaitBest: ● Light and portable ● Take up less space ● Diverse applications With the assessment result from GaitBest, clinicians can better administer personalized training plans remotely via our tele-rehabilitation service, and track patients’ condition anytime anywhere.

BENEFIT 1.Sales performance First 6 months after launching GaitBest, it was sold to hospitals, special education schools, and rehabilitation clinics. In 2020, the sales expanded to Singapore, China, Hong Kong and Macau. 2.Customer Feedback ● 30 spatiotemporal parameters can be generated immediately after patients walking 4.5 meters. With pre & posttests, clinicians can monitor patients’ abnormalities accurately and objectively. ● The device is small and portable. It doesn’t need any wearable devices, and it can be served as a quick health screening tool for therapists to use in individual homes or communities. 3.Global exposure

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Collaborating with a prestigious academic institution to complete a gold standard correlation research on GaitBest, we have published the research in American Congress of Rehabilitation Medicine in 2019. 4.Potential applications ● GaitBest is originally designed to evaluate stroke patients’ gait, but it can be extended to applications of other neurodegenerative diseases and orthopedic patients too, benefiting a wider range of patients. ● GaitBest help clinicians identify the problems of patients, and based on the results, they can administer personalized training plans remotely via our tele-rehabilitation service, and track patients’ condition effortlessly.


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2020 Application of Smart Medical Technology

ABOUT THE INSTITUTION LongGood Meditech is the first company that develops interactive rehabilitation s y s t e m i n Ta i w a n . T h e s y s t e m i s a comprehensive rehabilitation solution including physical therapy, occupational therapy, cognition training, physical fitness assessment and gait analysis. Using motion tracking sensors to engage patients in therapy, the interactive content has been clinically-proven to increase patient compliance. However, to effectively save patients’ and therapists’ time, we also develop tele-rehabilitation system that allows therapists to customize specific therapy to different patients, giving regular checkin or prescription adjustment to monitor rehabilitation progress remotely. LongGood’s products not only help clinicians in hospitals and care facilities, but

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also can be integrated into the long-term care services in communities or homes. As a pioneer of the rehabilitation training and evaluation service provider, now you can enjoy our services in Singapore, China, Hong Kong and Macau!

Keywords Gait analysis,Motion sensing and interactive software Machine learning,Computer vision Diagnosis assistant,Tele-rehabilitation

Contact details Sales department, LongGood Meditech Ltd.




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