Information sharing during disasters tends to be confusing. We started the trial operation of a digital whiteboard (DWB) as a communication tool during disasters in 2019 and fully introduced it in 2022. The DWB is a large tablet that allows interactive communication in close to real-time in remote locations through Wi-Fi.

To verify the usefulness of the system, DWBs were placed at triage posts in severely, moderately, and mildly damaged areas during a 2022 disaster drill responding to mass casualties to facilitate the sharing of patient information between Disaster Response Headquarters and each treatment area. In each treatment area, doctors, nurses and paramedics completed a standard form to share information about each patient. Information collected included the triage tag number, patient name, age, gender, type of injury or disease, and description of the treatment.

Six DWBs were remotely shared, with the triage post noting the number of patients passing through each severity level, and each treatment area noting the treatment status of each patient. The Disaster Response Headquarters replied with the results of adjustments such as hospitalization ward and time to start surgery. The descriptions were reflected in the remotely shared DWBs in about one second. Text conversations through the DWBs were also seen. In the post-event survey, some said that the smooth sharing of information led to quick decisions. Compared to conventional radios, DWBs have the advantage of allowing communication through text, which allows more detailed and accurate patient information to be communicated quickly. The results suggest the survival rate can be improved by assisting early medical intervention or rapid entry of patients into operating rooms. The next goal is to use DWBs for medical coordination among disaster base hospitals.

DWBs are effective for the rapid and accurate sharing of patient information during disasters.

Recently, the risk of flood disasters due to concentrated heavy rains has been increasing in Japan. While some cases of hospital evacuation have been reported, standards for hospital evacuation have not been established and regional administrative evacuation plans do not include medical facilities.

To clarify the timeline for in-hospital vertical evacuation during a flood disaster.

A timeline was set for vertical evacuation as criteria of the hospital’s emergency response based on the Arakawa River Downstream Timeline, which is an estimate of the time until river flooding based on the water level of the Arakawa River located near the facility. The timeline was calculated backward from 0 hours to when the river floods. A drill was held for verification.

The timeline was based on the water level of the Arakawa River and objective evidence of risky transfer of critical patients; therefore, the decision to evacuate was made when the water level reached a dangerous level (-3 hours). However, this did not provide enough time to evacuate patients in all hospital departments simultaneously, resulting in a shortage of human resources. There was a planned shutdown of the electronic clinical record system at 0 hours to avoid water damage and evacuation of its server, but three hours were not enough to prepare patient clinical summaries.

There is a need for greater and earlier preparation for evacuation to reduce or discharge patients who can leave the hospital when a flood disaster is predicted. Only in-hospital vertical evacuation was considered because it is very risky to transfer critical patients without an evacuation order from government or municipal officials. In fact, over 10,000 patients would need to be evacuated in the region if the Arakawa River floods. Therefore, a regional plan is indispensable for such large scale and simultaneous hospital evacuations.