We created the questionnaire by taking advantage of the characteristics of web-based questionnaires, and also devised the operation.
Kudanshita Ekimae Koko Clinic - Internal Medicine, Cardiology, Psychosomatic Medicine
The Kudanshita Ekimae Koko Clinic is a clinic located in Tokyo that offers internal medicine, cardiology, pediatrics, psychosomatic medicine, and smoking cessation services.It is a clinic for the working generation, with 80% of patients in their 30s to 50s. We are committed to being a clinic that is easy to access from work and provides high quality primary care.
We interviewed Dr. Ishii, the director of the clinic, about the background of the introduction of the Melp web-based questionnaire and the unique way of using it.
- Could you tell us what made you decide to introduce Melp?
Initially, it was Dr. Yoshinaga who approached me. I think it was quite a while ago, right after we opened the clinic. I thought Melp was good. At the time, I considered several iPad and tablet interview systems, including the Melp, but they were expensive compared to the number of patients at the clinic when we first opened. So we decided to forgo it at the time.
- Oh, I see. So that was the case.
Yes. However, we were aware that we could not avoid the digitization of medical questionnaires. About two years after that, I contacted a Melp distributor, and they came to my office with a sales proposal, and at that time they were running a campaign and it was cheap.
At that time, the number of patients in my clinic was increasing, so I thought the price was worth the cost benefit and introduced the system. The timing was also good, because as the number of patients increased, we began to feel that we needed to address issues such as how to increase the turnover of first-time patients and how to reduce the time required to enter medical records.
- Thank you very much. Why did you choose to use Melp when you introduced it?
Our medical records were on-premise, so we couldn't really link them with ASP, so we thought that MELP would be good because it would allow us to flow smoothly into the on-premise system.
I thought that web-based medical questionnaire was not only about taking web-based medical questionnaires, but also about making sure that the information was fed into the medical record, so I was happy that they had a system for that.
- Well, I see. After the introduction, was it difficult to create the medical questionnaires?
We ask patients to make an appointment on our website or through the clinic's official LINE account, and then we ask them to answer the questionnaire on our website.
For those who come to the clinic in person, we ask them to scan the QR code and answer the questionnaire.
- By the way, how do you deal with elderly patients or patients who are not familiar with filling out the questionnaire online?
We had a pretty good support team, so it was stress-free. We had them transfer our default medical questionnaire to the web, and based on that, the office staff and I gradually customized it to make it easier to use.
As for the operation of the medical questionnaire correction, I think it takes some getting used to, but the UI is not particularly bad, and I didn't particularly mind it. However, I felt that I had to be aware of the differences from paper medical questionnaires.
- Do you mean including the way to make the questionnaire?
Yes. With a paper questionnaire, it is easy to see that even if the questions are far apart, it is easy to understand that this question and this question are similar but have different meanings.
On the other hand, in the case of Melp, since it is a chat format and each question is answered, when you look at the first question, you don't see the questions below it, so it is not as easy to list as paper.
But that's a structural limitation, on the other hand, the chat format has a friendly design and familiar feel, so I think it's a good thing if we create the questionnaire based on that characteristic.
- Thank you very much. Can you tell us how we can improve the Melp?
It's more of an operational point, but in the case of paper questionnaires, it was easy to file the paper questionnaires and have the nurses look at the contents of the questionnaires and reorder the priorities so that the waiting time is optimized, but with web questionnaires, it's harder to do that.
In the case of our hospital, we are trying to hybridize with paper so that we can get through it better.
- Will you be using paper questionnaires as well?
Yes, we keep a paper form to manage the status of patients, like a reception sheet. Not for all patients, but if necessary, we print out the results of the web-based questionnaire so that we can take it with us to the examination or accounting.
We can tell at a glance whether a patient is coming in for a cold, an abnormal medical checkup, or a psychosomatic medicine visit.
- Well, I see. I've never heard that point before, so it was very helpful.
- Were there any good points after the introduction?
The time required for the initial consultation has been reduced. In the past, we would look at the contents of the paper questionnaire and ask, "What does this mean?
Because the basic outline of the questionnaire is entered by the patient, this time has been reduced.
Since we only need to add a few words to the text data that is output as a medical questionnaire, the time to write the S column in the medical record has been greatly reduced.
How do you operate the system? Are there many elderly patients?
We have a relatively small percentage of elderly people. Even among younger people, there are people who are not comfortable with web-based questionnaires or who have forgotten their smartphones. We also provide tablets in the clinic for those who have forgotten their smartphones, but some patients say it is too much trouble.
This season, we have switched to Melp for preliminary examinations for influenza, so we use much less paper, but we still have to use paper for publicly subsidized influenza, so we use paper questionnaires for that part.
- Oh, I see. In most other cases, do you ask the patients to fill out the web questionnaire on the clinic's website in advance?
That part was also quite difficult, because if you don't fill out the web questionnaire before you come to the clinic, you end up filling it out in the waiting room at the clinic, so I think it's important how to get people to fill it out in advance.
The merit rating on the website also went up and up. At first, it was just a guide at the back of the reservation page, saying please use this page as well, but now it appears on the top page in the top banner section.
We felt that it would be difficult to get patients to use the service in advance unless we made it that much more appealing.