On February 22, 2022, NCD Alliance Japan (Secretariat: Health and Global Policy Institute (HGPI)) hosted freelance announcer and founder of the “#Hospital Room Wi-Fi Council” Mr. Shinsuke Kasai for our second seminar for patients and other affected parties titled, “The Hospitals We Need in the Era of COVID-19: The Need for Wi-Fi in Hospital Rooms.” At the lecture, Mr. Kasai shared good examples of Patient and Public Involvement (PPI) and his experiences working to encourage policy change as a person affected by an NCD based on difficulties he encountered during his own hospitalization.

To help accumulate useful knowledge and know-how for patients and other affected parties who want to take part in policy making in the future, a video of the lecture will also be made available. (Please note that the video features excerpts from the main part of the seminar only.)

 

Key points of the lecture

• In-person visitations continue to be restricted or suspended to prevent the potential spread of Coronavirus Disease 2019 (COVID-19), but many patients say they are saved by the feelings they get from remote visitations. “Hospital room Wi-Fi” is becoming a new standard criteria when picking a hospital.
• The current presumption that Wi-Fi is only a source of leisure for patients no longer applies in the era of the COVID-19 pandemic. Hospital room Wi-Fi is actually a lifeline.
• In September 2021, we conducted our first nationwide survey, “Every Room At This Hospital Has Wi-Fi! The Grand Survey.” We have presented in-room Wi-Fi introduction rates by prefecture and municipality and a list of hospitals where every room has Wi-Fi on our homepage, which has made an impact.
• Based on the nationwide survey mentioned above, Iwate Prefecture introduced free Wi-Fi in every room in all its prefectural hospitals. It is important to drive policy by involving multi-stakeholders, including the Government.

 

The era in which hospital room Wi-Fi for patient use is a given will definitely come

A major issue brought to the forefront by the Coronavirus Disease 2019 (COVID-19) pandemic was the fact that Wi-Fi for patient use is not provided in rooms at many hospitals in Japan. There are many countries where free Wi-Fi for patients in hospital rooms is considered a given. Many voices from countries in Europe, North America, and Asia have expressed surprise that Wi-Fi is still unavailable at hospitals in Japan.

I think one reason Japan has fallen behind the curve in introducing Wi-Fi for patient use in hospitals is because the idea that “Providing Wi-Fi in rooms will not increase profits” has taken root among hospital administrators. There are also factors on the patient side. When we consider common conditions for picking hospitals in the past, we see people only asked if the hospital could cure them, if they offered a full range of healthcare services, if they had good hospital room environments, and if they served good food. However, recently, more people have started to think, “Next time, I want to stay at a hospital where I can use Wi-Fi.” This has become the new norm for selecting hospitals, but many people involved in operating hospitals still do not realize it.

To prevent the potential spread of COVID-19, restrictions and suspensions have been placed on visitations at hospitals nationwide for over one year. These circumstances increased the importance of remote visitations. There are many people who say their mental state was truly saved just by having access to remote visitations. As such, the thinking that “Providing Wi-Fi in rooms will not increase profits” is already obsolete. Now is the time for reform.

In 2019, right after I retired from Fuji Television Network, Inc. after 33 years to become a freelance announcer, I was diagnosed with malignant lymphoma, a cancer of the blood. In 2020, I was hospitalized for four and a half months for high-dose cancer therapy. During the first month, I was visited by many people like friends, announcer colleagues, my juniors, and relatives. But after that, the COVID-19 pandemic began, and nobody was allowed to visit anymore. Later, a state of emergency was declared, and not even my family members were allowed into the hospital. Without firsthand experience, I do not think anyone can understand the pain of loneliness I felt.

The nurses at the hospital were a great help. Even then, I would like you to imagine how encouraging it can be to laugh and talk with your friends when you are facing treatment. The internet provided at the hospital, which allowed me to have remote visitations like that, saved me from an abyss of loneliness.

The establishment of the #Hospital Room Wi-Fi Council in 2021

One million people are diagnosed with cancer every year and to tell people about my firsthand experiences as one of them, I am involved in charities and other activities to raise awareness toward cancer. When I talked to people I met through these activities about how troublesome it is when hospital Wi-Fi is unavailable, there were people with similar experiences and who sympathized with me. This led to the establishment of the #Hospital Room Wi-Fi Council in January, 2021. We are currently active with nine members.

After establishing the Council, we immediately started the “Hospital Room Wi-Fi Movement” and began encouraging Government subsidies for installing Wi-Fi in hospital rooms. We also approached Diet members, including Mr. Tetsushi Sakamoto, then Minister of Loneliness; and Ms. Junko Mihara, then State Minister of Health, Labour and Welfare. As a result, just three months after starting our activities, in April 2021, the decision was made to provide a subsidy for setting up Wi-Fi in hospital rooms. Politicians and government officials realized who needed saving at the moment.

However, the subsidy ended in September of that same year. Shortly thereafter, the House of Representatives was dissolved and the new Kishida cabinet took office. This reset the relationships we had established, so we are currently looking for new connections.

The reason all hospital rooms need free Wi-Fi

Looking at the results of the FY2020 “Survey on Promotion of Appropriate Radio Wave Usage in Medical Institutions” (released in May 2021 by the Telecommunications Technology Council Radio Wave Utilization Promotion Committee for Medical Institutions), we see that wireless LAN (Wi-Fi) is already in use for operational purposes at approximately 90% of hospitals. Another survey reported that among those hospitals, approximately 30% have their Wi-Fi open for hospitalized people to use. This means we must continue our activities.

Additionally, a certain university hospital only told the Wi-Fi password to patients staying in private rooms that cost over 50,000 yen per day. For patients who can afford high-priced, special rooms, the burden of a Wi-Fi usage fee is relatively small. On the other hand, for patients staying in large, shared rooms, that burden, as a share of the household budget, is relatively large. This is why I think Wi-Fi should be free.

Our public opinion survey on internet (Wi-Fi) use in hospital rooms

In survey conducted jointly by CancerNet Japan, the Project for the Future of Muscular Dystrophy Wards, and the #Hospital Room Wi-Fi Council, we asked 600 people with experience being hospitalized about their use of the internet (Wi-Fi) in hospital rooms. We found that approximately 40% of respondents said they were enduring their hospitalizations without it.

Furthermore, when asked about why they wanted to use the internet, 256 respondents said it was to communicate with family or loved ones, making it the most popular response. That was followed by searching for information, collecting information, and leisure (watching movies, playing games, listening to music, etc.). Leisure was fourth most-popular and was selected by 204 respondents (we received 338 responses and multiple selections were allowed). The assumption that the internet is a leisure service for patients no longer applies in the era of COVID-19. Hospital room Wi-Fi is actually a lifeline.

Conducting our first nationwide survey, “Every Room At This Hospital Has Wi-Fi! The Grand Survey”

When the subsidy program to set up hospital room Wi-Fi began, the story was picked up by many newspapers, and the importance of providing it was pointed out during a live broadcast of a Diet question and answer session. Awareness toward the importance of providing in-room Wi-Fi expanded, and because many hospitals did not mention if they provided Wi-Fi on their homepages or in other publications, the #Hospital Room Wi-Fi Council began to receive many questions on which hospitals provided Wi-Fi to hospitalized patients.

This led the #Hospital Room Wi-Fi Council to conduct its first nationwide survey, “Every Room At This Hospital Has Wi-Fi! The Grand Survey,” in September 2021. The results showed that among 563 hospitals nationwide (451 core cancer hospitals, 15 core pediatric cancer hospitals, and 140 national hospitals), free Wi-Fi was provided in all rooms at only 107 core cancer hospitals (23.7%), 2 core pediatric cancer hospitals (13.3%), and 11 national hospitals (7.9%). Furthermore, Wi-Fi was completely unavailable in every room at 47% of all hospitals surveyed.

When we presented these findings on our homepage, we received one update request after another saying, “We have now set up Wi-Fi in every room, so please include our institution on your list.” In particular, Iwate Prefecture successfully introduced free Wi-Fi in every room at all nine of its prefectural hospitals. This result was only possible because those involved in healthcare administration at the Iwate Prefectural Government encouraged it. Instead of relying only on hospitals to make changes, I feel that it is also important to push for change through policy.

Concerns toward the potential effects of Wi-Fi on electronic medical record networks are based on an outdated understanding

One reason hospitals are hesitant to provide Wi-Fi in rooms is because they are concerned about its potential effects on networks used for electronic medical records. We received an email that said, “I work at a medical emergency center. Our doctors and I made an effort to get a Wi-Fi environment set up, but it can cause interference with our network for electronic medical records. In particular, there are opinions from electronic device manufacturers that doing so can cause trouble for nurses in particular, because they need to access electronic medical records wirelessly while moving around the facility. That is why we were told the construction could not be done.” However, this is a mistaken opinion that is based on outdated information.

Free Wi-Fi is already being provided in every room at the Japanese Foundation for Cancer Research Cancer Institute Hospital. If it were dangerous, then there would have been no subsidy provided to do the necessary construction. We can consider this proof that the national Government considers hospital room Wi-Fi to be safe. For example, it can be done using methods like installing a repeater to share access points and setting up room Wi-Fi on a different frequency band than the one used for electronic medical records, or by creating new access points. Certain companies have already started providing discounts on installation fees.

To “leave no one behind,” Wi-Fi usage must be encouraged

In recent years, a mass infection occurred at Yokohama Prison and visitations were suspended for a long period. The Kanagawa Bar Association pointed out this was an infringement on prisoners’ rights, which was reported on by the press. However, for patients, even when visitations are suspended for long periods, it does not often become news. The catchphrase for the SDGs is, “Leave no one behind.” I would like for people to notice there are people hospitalized right now who are enduring without internet access because their rooms do not offer Wi-Fi and are being left behind.

According to stories I have heard from someone working at a major Wi-Fi device manufacturer, hospitals today are similar to the hotel industry ten years ago. When the person I spoke to used to make sales calls on hotels, they were told “We won’t draw more guests just by adding Wi-Fi” and were turned away. Five years later, hotels came calling, saying “Without Wi-Fi, we don’t get any guests.” Now, every hotel has Wi-Fi. In other words, the message was, “The same thing that happened in the hotel industry is sure to happen in the hospital industry.”

Meanwhile, in FY2020, subsidies to secure vacant beds for people infected with COVID-19 amounted to 1.1 trillion yen, and I have heard cases in which certain public hospitals which had been operating in the red became profitable by a wide margin. If possible, I wonder if some part of that funding could be set aside to install Wi-Fi in hospital rooms. I would like for everyone to speak up and make your opinion on this issue heard.

 

[Overview]

• Speaker: Mr. Shinsuke Kasai (Freelance Announcer; #Hospital Room Wi-Fi Council)
• Date and time: Tuesday, February 22, 2022; from 18:30 to 19:30 JST
• Format: Online webinar using the Zoom conferencing system
• Participation fee: Free
• Languages: Japanese only
• Capacity: 500 people
• Hosted by: NCD Alliance Japan (Secretariat, Health and Global Policy Institute)
• Target audience: Anyone who
  – Is currently participating in the policy formation process
  – Wants to participate in policy making in the future
  – Wants to make their voice heard in policy making, but is unsure how to do so
  – Is interested in healthcare policy, whether living with a disease or not

[Program]

18:30 – 18:35 Opening remarks
Yuko Imamura (Manager, HGPI)

18:35 – 18:40 Welcoming comments
Ms. Yoshiko Kobata (Director, CSR and SDGs Promotion Office, General Affairs Bureau, Fuji Television Network, Inc.)

18:40 – 19:20 Lecture “The Hospitals We Need in the Era of COVID-19: The Need for Wi-Fi in Hospital Rooms”
Mr. Shinsuke Kasai (Freelance Announcer; #Hospital Room Wi-Fi Council)

19:15 – 19:30 Question and answer session

 

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■ Speaker profile

Mr. Shinsuke Kasai (Freelance Announcer; #Hospital Room Wi-Fi Council)
Mr. Shinsuke Kasai was born in Tokyo. After graduating from Waseda University, he became an announcer at Fuji Television Network, Inc. After serving as host of variety program “Time 3,” as main newscaster of evening news program “The Human,” and as host of “Nice Day,” he was host of morning information program “Tokudane!” for 20 years.
After 33 years at Fuji Television Network, Inc., he retired in 2019 to become a freelance announcer. Two months later, he was diagnosed with malignant lymphoma, a cancer of the blood. He achieved complete remission after being hospitalized for four and a half months. Currently, Mr. Kasai is active in a broad variety of activities for people with cancer, including TV and radio appearances as well as lectures.

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■ Introducing NCD Alliance and NCD Alliance Japan
NCD Alliance was launched in 2009 by four international federations: The International Diabetes Federation, the International Union Against Cancer, the World Heart Foundation, and the International Union Against Tuberculosis and Lung Disease. NCD Alliance is a collaborative platform for the fight against NCDs that currently consists of about 2,000 civil society and academic groups in around 170 countries with the mission of eliminating preventable suffering, disability, and death caused by NCDs. Since 2013, NCD Alliance Japan has served as the Japanese branch of NCD Alliance and has provided forums for holding multi-stakeholder discussions and for promoting the importance of civil society’s role in the fight against NCDs.

■ To register as a member of NCD Alliance Japan
In the future, we will host more seminars for members of NCD Alliance Japan.
If you would like to register as a member, please click here.

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■ NCD Alliance Japan Seminar for People Living with Non-communicable Diseases

In recent years, there has been a growing need for participation from patients and the people close to them in the healthcare policy formulation process. As such, there has been a substantial increase in situations in which these parties have been able to serve as committee members and speak at committees and at review meetings hosted by the national Government (such as the Ministry of Health, Labour and Welfare) or local governments. This type of involvement is called Patient and Public Involvement (PPI) and is recognized internationally as an essential element for achieving patient- and citizen-driven healthcare policy.

However, after participating in these committees and review meetings, many patients and patient representatives have given comments like, “I could not speak up proactively,” or “I could not express my opinion.” In light of these circumstances, NCD Alliance Japan hosts seminars where attendees are able to learn about the significance of PPI, hear good examples of participation, and obtain the knowledge and skills necessary to take part in such meetings with the goal of achieving PPI as originally envisioned.

These seminars feature speakers who have participated in many committees and review meetings as patient representatives, who are working to broadcast their voices to society based on their lived experiences as patients, and who are actively pursuing the enactment of laws that will achieve patient- and citizen-centered healthcare. Attendees will be able to listen to firsthand stories of efforts from people with broad experience in PPI, hear about best practices and challenges encountered during PPI activities, and share perspectives needed for advocates to raise their voices in the future.

NCD Alliance Japan plans to hold a series of seminars for alliance members. At those seminars, we would like to provide the basic knowledge on healthcare and policy needed to engage in PPI and create opportunities for participants to connect with each other. We would like this seminar to be an opportunity for patients and other affected parties who currently serve on or are planning to serve on committees and at review meetings to share their doubts and concerns so we can incorporate their views in our platform for achieving better PPI. We hope this seminar will be a good opportunity for people affected by these issues to expand their connections and for disseminating PPI throughout society.

The first seminar “The Significance of Reflecting the Voices of Patients and Other Healthcare Beneficiaries in Policy” (December 7, 2021)
Ms. Kyoko Ama (Representative, Children and Healthcare Project / Fellow, Health and Global Policy Institute)