Impact of regional medical network systems on emergency transport time for older patients in Japan: a retrospective observational study.

Abstract

Background: The Saitama Tone Health and Medical Care Region Medical Collaboration Promotion Council has established a regional medical network system (Patient-Centered Digital Health Records, Tonetto) that shares medical information among healthcare facilities and provides medical services to Tonetto users. This system has facilitated the sharing of medical information between core hospitals, general hospitals, and clinics, thereby contributing to improved medical care. Furthermore, Tonetto has facilitated the availability of patient information for emergency transport. This study aimed to evaluate the impact of Tonetto on emergency transportation times for older patients.

Methods: The study population consisted of 1,820 older patients (aged 65 and over) among 2,542 emergency patients transported to East Saitama General Hospital between January and December 2023. Based on their registration status in the Tonetto system, the patients were divided into two groups: a Tonetto-registered group (n = 319) and a Tonetto-nonregistered group (n = 1,501). Statistical analysis was performed using a general linear model that included main effects and interaction terms for the three categories of transport distance (< 5, 5-10, and ≥ 10 km) and two categories of Tonetto registration status. The difference in transport time was estimated based on Tonetto registration status for each transport distance category. To control for confounding variables, the model included severity, age, sex, and transport distance as covariates.

Results: The difference in transport time (minutes) between the Tonetto-nonregistered group and the Tonetto-registered group (95% confidence interval) was - 0.3 (- 3.0, 2.4), - 3.5 (- 8.9, 1.9), - 24.3 (- 38.3, - 10.2), respectively. A reduction of 24 min in transport time was observed in the Tonetto-registered group for distances of 10 km or more (p = 0.001).

Conclusions: Tonetto registration was associated with a substantial reduction in emergency transport time for older patients over long distances. These findings demonstrate the potential of regional medical information networks to improve the efficiency of emergency care and support the development of a nationwide emergency medical information system in Japan.