By Takayuki Fuchigami
The Daily Yomiuri
TOKYO — A telephone service in which people call #7119 to speak to medical staff about whether they need emergency treatment has failed to gain traction nationally.
The around-the-clock service was introduced to reduce requests for emergency care for people with illnesses or injuries that do not require immediate treatment. Ambulance response times have been slowing in part because of the growing number of unnecessary emergency requests.
But due to staff shortages and budget problems, only Tokyo, Osaka and Nara prefectures introduced the system.
Medical experts say for the system to proliferate, frameworks covering wider regions are necessary.
The counseling service is free, although callers are charged for the phone call. It is jointly operated by local governments, doctors associations and firefighting authorities.
Callers describe symptoms or conditions to doctors and nurses. If they are judged to require urgent treatment, medical staff will ask firefighting stations that operate ambulances to provide immediate care.
When the situation is less serious, the medical staff will recommend a range of nearby facilities such as hospitals that can be visited for treatment.
The Tokyo Fire Department in Chiyoda Ward, Tokyo, has a counseling center for the #7119 service, which is called frequently.
“My child has fever and he looks painful,” a recent caller said. Another caller said, “My baby fell off the bed and hit her head.”
Replies from the medical staff included, “Has the child been knocked unconscious?” and “Did the child vomit?”
In a recent case, a phone counselor said, “If conditions do not worsen, it’ll be OK to go to a hospital tomorrow,” causing the panicked caller to become calmer.
A nurse working on the phone service said, “In many cases we can help relieve the callers by discussing the symptoms.”
The number of ambulance dispatches throughout the nation reached a record high of about 5.46 million in 2010, according to Fire and Disaster Management Agency statistics.
During the first half of last year, the number of calls rose 6 percent from the same period a year earlier, an increase due to the nation’s aging population. The national average length of time for ambulances to reach a hospital after collecting a patient has grown by nine minutes during the last 10 years.
Firefighters say patients with light injuries and mild illnesses account for about half of the call-outs.
To counter this problem, the agency implemented the #7119 service as a trial for six months from October 2009.
The Tokyo metropolitan government had already created a similar system that resulted in the number of ambulance dispatches falling from about 690,000 in 2007 to about 650,000 in 2008 when the service was fully implemented.
The percentage of ambulance call-outs to people with light injuries or mild illnesses fell from 2008 to 2010.
Tokyo’s system proved that the service can be effective in reducing the number of unnecessary emergency requests. Osaka and Nara prefectures implemented the system in fiscal 2010. But the agency said the only other area thinking of introducing the phone service is the city of Sapporo.
An agency official said the service has not become popular nationwide because “local governments do not have sufficient number of doctors and nurses to create the system.”
At least 10 doctors and nurses are always on hand at the center in Tokyo, with the metropolitan government allocating 440 million yen annually for the service.
A Saitama prefectural government official who visited the center said: “Our firefighting stations have a different system to that used by the Tokyo Fire Department, which covers most of Tokyo. Our budget is smaller so it’s currently difficult for us to start this service.”
Another issue is how this system can effectively coexist with another phone service that was introduced nationwide by the Health, Labor and Welfare Ministry in 2004. This nationwide program allows people to call #8000 and speak about their sick or injured child to medical staff who evaluate whether emergency treatment is needed.
The Aichi prefectural government implemented the #7119 service in a six-month trial from October 2009 but it was discontinued.
A government official said: “We have the #8000 service and the prefecture’s own system to tell patients about suitable hospitals. So administering these systems [in conjunction with the #7119 service] is difficult.”
Prof. Futoshi Iwata, a medical safety expert from Sophia University, said: “The number of medical practitioners who can work as counselors in this system is limited. So it’s difficult for small local governments to introduce the service.
“It would be better to develop a system where centers in urban areas can receive phone calls from rural areas,” he said.