2023 Volume 50 Issue 6 Pages 549-559
Endoscopic screening for gastric cancer started in the Itabashi Ward, Tokyo in 2019, which involved the participation of eight clinics and ten hospitals. The secondary interpretation is recommended as an accuracy control; however, improving the work efficiency of interpretation is necessary for increasing the number of screening facilities. Following the discussion with the Itabashi Medical Association and Itabashi ward office, a cloud-based secondary interpretation system (Fujifilm Medical) was introduced for endoscopic screening. The handling of personal information was a matter of concern while introducing this interpretation system. It was necessary to work closely with cloud operators, such as the development of personal computers (PCs) and internet environments at each facility along with the dissemination of operation methods to these facilities. The features of endoscopic screening included countermeasures against the leakage of personal information while using the cloud, such as deleting personal names including endoscopic images and setting rules related to PCs used for screening and the large proportion of hospitals. The cloud-based secondary interpretation system allows a secondary interpretation to be performed at one's own clinic or hospital, and there is no need to participate in a medical association hall. An advantage of the cloud -based secondary interpretation was observed in infection risk reduction, particularly during the coronavirus disease 2019 pandemic. However, it is a challenge to communicate with all doctors from different clinics and hospitals participating in the screening the important rules associated with this system, such as on-time reading, input of required items in cloud systems, and compliance with the manual of shooting order of endoscopy. Moreover, the importance of conducting workshops and creating easy-to-understand documents has been considered.
