Achievements and Lessons Learned from Medical Informatization in Japan

With the continuous advancements in computer sciences and telecommunication, the types of medical informatization have evolved rapidly, from simple information exchanges via telephones to the sharing of medical documentation through big data.

Japan, one of the leading countries in information technology, has applied all kinds of state-of-the-art capabilities to develop and deploy national medical informatization. Although this process was not all plain sailing, Japan’s construction process of medical informatization provides the world with some important insights and inspirations.

Achievements of Japan’s Medical Informatization

Japan’s creation of medical informatization started quite early, but it did not gain much traction until ten years ago.

The early versions of Japanese hospital information systems were mainly used for registration, human resources and service charges. They were more like organisational management systems that only rarely related to hospital-specific services deliberately. As of the mid-1990s, medical-service-centred information systems were starting to gradually be develop. By now, the scope of their application has been broadened to address outpatient departments, emergency rooms and hospitalization. Also, procurement, inventory, accounting and other administrative operations of medical machines have long since been integrated into the IT systems.

The hospital information system in Japan has been continuously improved to electronize the hospital’s primary services, including outpatient appointments, treatments, payments, laboratory tests, medicine inventory, medical records and consultation processes. In this organization, the big IT system and the small intelligent devices throughout the hospitals are interconnected, to achieve a one-stop service experience for the patients.

Medical informatization in Japan paid great attention to promoting the digitisation of three key healthcare (HC) pillars: medical treatment, medical management and medical services. The utilization of medical informatization immensely improves (i.e. streamlines, accelerates, facilitates, simplifies) the treatments of the patients; it improves the quality of medical services, and it enhances the workflow efficiency of the hospitals.

Challenges facing Japan’s Medical Informatization

Although the digitization of HC information has been a key objective on Japan’s agenda, the standardisation of such data has not yet taken shape, which presents the primary stumbling block in this process.

Despite the popularity of EHRs (Electronic Health Records) in hospitals -80% of hospitals in Japan currently have EHRs-, there is no uniform standard for the formatting of EHR data on a national scale. There is no interconnectivity between different databases from different HC sites, which would enable data from fields such as health, physical examination, medical care and nursing, to be combined systematically and analyzed respectively.

Furthermore, the Japanese government has not yet published any rules regarding how to handle and administer the circulation and sharing of data. It has not established a clear framework for the development and dissemination of modern health and individualised medical information, nor for information regarding advanced pharmaceuticals or medical equipment.

Additionally, since big data is the basis for creating Artificial Intelligence (AI) that can potentially support healthcare, the lack of data accessibility and compatibility between medical institutions hinders Japan’s capabilities/capacities concerning medical AI.

Inspirations from Japan’s Medical Informatization

Japan’s exploration of the development of medical informatization has taught us the following lessons:

  1. Strengthening basic medical management systems is the premise of clinical information system formation

To advance medical informatization, one must first strengthen the basic medical management systems of the country; ensure that care activities are streamlined, and that the entire system has quality control mechanisms, allowing continuous review and evaluation.

The government and the hospitals’ management departments are the key players in this process.

  1. The government, scholars, and enterprises should work together to develop information standards

In Japan, information-related standards or rules are formulated by the users (hospitals, health associations, physician unions, etc.). Specifically, the Health, Welfare and Information Industry Association in Japan is leading the discussion around this topic.

Relevant organizations representing the users are responsible for drafting the standards, and submitting the proposals to corresponding government departments (e.g. the Cabinet Office, Ministry of Health and Welfare, etc.) for approval. This process helps the administrative departments gradually get rid of the enormous amounts of operational work, whilst promoting the development of the medical IT industry more efficiently; more target-focussed.

  1. Actively promote seamlessly linked organisational cooperation in medical care

Japan has been trying to use information technology to help optimize the differentiation of service-provisions of its medical institutions; i.e. different medical institutions such as medical centres, reserve hospitals (e.g. hospitals for disaster relief, that have spare capacity in times when there is no emergency) and nursing homes are encouraged to differentiate their responsibilities based on the stages of the disease of the patients they receive. In other words, care tracks and the various steps they entail, in terms of diagnosis, treatment, and follow-up care, must be clearly allocated per HC facility/provider.

Coordinated through information technology, the allocation of functions can not only save significant medical resources, but it can also improve the patient’s healing process. However, to achieve this functional differentiation of institutions seamlessly, unified standards must be established and adhered to closely.

The Future of HC is Informatization

As the pressures to optimize HC provision and resources increase, accompanied by leaps of digital and technological capacity and functionality, the field of medical informatization will inevitably continue to grow. We can expect regulatory reforms and systemic changes to be introduced in HC systems throughout the world, in order to transform (the often currently solely) local networks of data into wider and more extensively compatible platforms and structures (that encompass regional and entire nation’s data sets).

Informatization is a crucial and unstoppable trend that is shaping healthcare administration and performance throughout the world.

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About Zhen Nie

Zhen is in charge of Asian Operations at TforG, with more than 6 years of experience in project management and business consulting for local and international companies. She works in a continuous basis with an extensive network of Key Opinion Leaders and Health Policy makers in Asian markets. She graduated at the University of Antwerp and has a Master Degree in Finance. Tel: +32 3 201 64 24 Mobile: +32 485 89 98 84 Email: z.nie@tforg.com