As one of the largest health facilities in the Yamanashi Prefecture, the JA Yamanashi Koseiren Health Care Center has been supporting the health of the Yamanashi citizens for many years. The center was the first to take measures against infection in the event of the COVID-19 pandemic, and as part of these measures, they introduced Gravio's CO₂ sensors and a visualization solution.
By measuring the CO₂ concentration in densely populated areas in the facility and displaying it in a position where it can be seen by staff and patients, indoor ventilation based on objective evidence has been implemented, and patients now feel safer as they can see that the rooms are ventilated sufficiently.
Mr. Saito: Since its establishment in 1986 as a health management center of the JA Group, the center has been providing health management and promotion services to JA members and local residents. In 2001, we opened the present facility and established a system to accept institutional health checkups such as physical examinations, and now we are helping to protect the health of the people of the prefecture by providing health checkups to about 120,000 people a year, including mobile health checkups using medical checkup vehicles.
Mr. Shimura: Yes. We opened a fever outpatient clinic in the prefecture very early to deal with COVID-19, and we are also working with the local government on various measures to combat infectious diseases, including vaccinations and dispatching staff to local governments to help where possible. We also take all possible measures to prevent infections among people who come for checkups and physical examinations, such as wearing masks, ensuring thorough disinfection, increasing the space between waiting room chairs to avoid "crowding", and increasing ventilation.
Mr. Sakurada: Until 2020, in order to avoid the risk of infection in the center, staff on each floor visually counted the number of people and opened the windows for ventilation if they judged there to be too many people in the area. However, this was a lot of additional work for the staff who were already busy with COVID-19 countermeasures, and it was difficult to know exactly whether ventilation was really necessary based on a subjective judgment. Moreover, opening the windows in the middle of summer makes the room hotter, and colder in the winter, so we wanted to have an objective standard for judging when to open the windows for ventilation.
Mr. Saito: In the beginning, our first priority was to avoid infection, so we had a policy of "just keep opening the windows" but if we just opened the windows blindly, the indoor comfort would be greatly impaired depending on the season. Therefore, we began to search for a way to accurately measure the current CO₂ concentration. The Ministry of Health, Labor and Welfare guideline suggests that a concentration of 1,000 ppm or higher indicates that the room should be ventilated. which the Ministry of Health, Labor and Welfare indicates as a guideline for indoor ventilation.
Mr. Sakurada: We found a relatively inexpensive and easily available measuring instrument on the Internet, so we tried it out, but it required us to go near the instrument periodically to check the measured values, which seemed to be a lot of work for the frontline staff. When we were looking for a better way, we came across an article about a hospital that used Gravio to visualize the CO₂ concentration in their waiting room. “This is exactly what we were looking for!” we thought, and decided to contact Asteria immediately.
Mr. Sakurada: I thought it was very practical that the CO₂ sensor could be installed to accurately measure the CO₂ concentration, and if the measured value exceeded a certain level, a warning light would notify the public. This way, the staff does not have to go to the equipment to check the readings every time, and can determine at a glance whether ventilation is necessary or not. In addition, our center is currently working on the advancement of medical care using IoT technology, and Gravio's IoT solution using CO₂ sensors fits in with this policy.
Mr. Sakurada: First, a staff member of Asteria told us about Gravio’s features and gave us a demonstration. As a result, I felt that I might be able to implement the product on my own without the help of the IT department.
Mr. Saito: Our IT department is always busy with various projects, so it was expected that it would take a long time to deploy Gravio. However, this initiative is part of our COVID-19 countermeasures and we wanted to bet it done as soon as possible, so the fact that we could install it without relying on the IT department was very attractive.
Mr. Sakurada: Not at all. I'm not particularly computer savvy, and I'm not an IT literate person, but even so, as the Asteria staff member explained in the product demo that the system could be operated with no code, I became convinced that I could do it myself. So I decided to take the plunge and try to build it myself without the help of the IT department.
Mr. Sakurada: We first contacted Asteria in November 2020, and we went live in January of the following year, so about two months. It only took about a day to install the equipment, including the CO₂ sensor, and only a few days to set up the software.
Mr. Sakurada: In January 2021, as a first step, edge computers were installed on each of the three floors, and CO₂ sensors and colored indication lights called "Gravio Lights" were placed in 14 locations, including the waiting area, reception counter, and café space, which tend to have the highest concentration of people.
When the CO₂ concentration measured by the CO₂ sensor is 800 ppm or lower, the light is lit green; when it rises to 800-1,000 ppm, it turns yellow; and when it exceeds 1,000 ppm, it turns red to notify the people nearby that it’s time to ventilate the room. Furthermore, in March 2021, the LED panel, called the "Gravio Matrix" was installed during the second phase, and a system to display the constantly changing CO₂ measurement in real-time was implemented. In June of the same year, a function to notify the administrator by email when the normal range is exceeded was also added.
Mr. Sakurada: Yes. I proceeded on my own with advice from Asteria. Whenever I had a question, I could just ask Asteria and they would answer it right away. And it was really easy to build, because I didn't have to write any program code at all, just a simple setup process. Personally, I felt that it was so easy that even people who are not familiar with PC or smartphone technology could install it.
Mr. Shimura: The warning lights and LED display panels are always visible to the staff and patients on each floor, so anyone can see at a glance whether ventilation is necessary or not. Unlike the subjective judgments made by the staff in the past, these judgments are based on objective data. In fact, we have made it a rule to ventilate the room as soon as the color of the light changes from green to yellow, and we have never exceeded 1,000 ppm.
Mr. Saito: We have received feedback from patients that they felt very safe, and some of them have shown great interest in the program and said they would like to introduce it in their companies. I think it was a very meaningful effort to provide a clear and visible countermeasure in order to provide peace of mind to the examinees.
Mr. Sakurada: We have already received requests from doctors in the field asking if we can add CO₂ sensors. Particularly at sites where gastroscopy examinations are performed, more stringent ventilation measures are required because patients may have to remove their masks and some procedures may trigger them to labored breathing. For this reason, some people have suggested that individual CO₂ sensors should be installed in the private rooms for examinations. We also think that it will be more convenient if we can link the data with external systems and devices, such as health management systems and digital signage.
Mr. Sakurada: We're still in the conceptual stage, but we're hoping to use a temperature sensor to visualize changes in room temperature when a window is opened for ventilation, and to digitize access control for rooms where important information is managed by using an open/close sensor and a camera instead of handwriting. I also saw an example of a clinic that uses Gravio's AI with cameras to automatically detect overcrowding in the waiting room and disclose the number of people waiting in real-time on their website. I would love to implement a similar system at our center.
Mr. Sakurada: I am very grateful for the technical support, which was so thorough that I could not have asked for more.
Mr. Saito: In the future, the center would like to promote digital transformation by actively utilizing advanced technologies such as IoT and AI, while continuing to receive advanced proposals from Asteria.
The introduction of a system that allows us to visualize CO₂ concentration in real-time using Gravio has enabled us to provide greater peace of mind to our staff and patients. Starting with this, we would like to further accelerate our digital transformation measures by effectively utilizing IoT.
Our center has been one of the first in the prefecture to focus on countermeasures against infectious diseases, and we have taken all possible measures to avoid the 3Cs (three main factors promoted in Japan: Close spaces, Crowds and Close-contact settings) in the building. We are proud to say that the introduction of the CO₂ concentration visualization solution using Gravio has made our efforts more reliable.
Gravio can be operated with no code, and even I, with no programming experience at all, was able to build it on my own without the help of the IT department. I also think that the generous support from the Asteria staff was a major factor that made it possible for the non-IT department to build the system in-house.
JA Yamanashi Koseiren Health Care Center
1-1-26 Iida, Kofu City, Yamanashi Prefecture 400-0035, JAPAN