Mobile Health for senior populations in Japan

Yoko NAKATA

Ministry of Internal Affairs and Communications (MIC)

JAPAN

6 October 2016

Coming of Super-Aging Society in Japan

0

10

20

30

40

1950 1960 1970 1980 1990 2000 2010 2020 2030 2040 2050

日本

イタリア

ドイツ

フランス

カナダ

イギリス

アメリカ

Japan

Italy

Germany

France

Canada

UK

US

Transition in Population Aging Rate

Source 1: Prepared by MIC based on data culled from “World Population Prospects: The 2012 Revision” by the United Nations. Note that data for Japan up to 2012 is based on the “2010 National Census” by MIC.

Source 2: Prepared by MIC based on date from “An Aging Australia: Preparing for the Future by Australian Government Productivity Commission

The rate of the population aged 65 years and over

Decrease in Population of working age

Working Age Population

※ Working Age Population: Population of 15-64 years old

Source : National Institute of Population and Social Security Research “Population Statistics Year of 2012”

2010 → 2050 Decrease in

population of 31 million

2010 → 2030 Decrease in

population of 13 million

87.17 81.03

67.73

50.01

44.18

100

90

80

70

60

50

40

30

20

10

(million)

49.66

Challenge we face in Medical Field

Increase in health care costs Increase in burden of medical worker A shortage and uneven distribution of doctors in

rural areas

What can we do with ICT ?

Strategy for ICT in health care Field

（Cabinet Decision July 2, 2016） Japan Revitalization Strategy 2016 -Towards fourth industrialization-

Key Policy Measures 2. Toward a world leading healthcare country

1) Providing diagnosis support and

innovative new drugs and medical device by using Big Data

2) Providing personalized healthcare services using IoT

3) Improving the quality and productivity of nursing care by utilizing technologies such as robot and sensors.

１９７０’s １９８０ ～９０’s

２０００’s ２０１０’s

On-line receipt

○ Coordination among medical facilities

○ Information sharing with patients and fields other than the medical field

Image system (PACS)

Systems by each

department

Coordination among

departments

Medical accounting system

Department system (inspection, goods management, etc.)

Ordering system

Integration of intra-hospital

systems

Medical × ICT Computerization of medical information

Medical ×ICT Usage of medical information etc.

Technical progress of ICT

Big Data Sensor

Cloud computing Smart phone etc

ICT utilization in Medical Field in Japan

ICT in Medical Field

Medical Information Cooperation

System

Patient

Hospital（Medical Specialist）

Nursing Home

Pharmacy

blood glucose

Weight/Fat

Pulse

Remote Medicine

Diagnosis

Image Clinic

Regional MEDICAL COOPERATION

Mobile Health

Blood Pressure

* mainly FTTH

Patient Cooperating medical institution

①

Cloud

Image server

Non-medical specialist

Medical Institution

Doctor on call

Medical specialist

Only displayed on terminals with no downloading (not saved).

Guidelines between the cloud and each hospital (e.g., VPN guidelines).

[Current status] No security standards between the cloud and mobile terminals.

Establishing security standards through the demonstration.

Engaru-Kosei General Hospital, Furano Hospital., Japanese Red Cross Kitami Hospital, Fukagawa Municipal Hospital, and Rumoi City Hospital

②

③

④

Demonstration of Telemedicine Model Utilizing Mobile Terminals

Asahikawa Medical University Hospital

・Confirmation of abnormal values

・Feedback to patients by uploaded personal data

Clinicians

Monitoring data

NTT Server

National Health

Platform

Data ・BG ・BP ・Steps ・Weight ・Food ・Medication

・Receiving Alert ・Encouragement by

communication function

Patients

Family or Supporters

Walking Intensity Monitor

Food log

Blood Glucose Monitor

Blood Pressure monitor

* NFC: Near Field Communication

Tele-health for chronic disease in Singapore

NFC

Use Case of Personal Health Records (PHR)

EHR (Via each medical institutions, long-term care facilities, etc.)

PHR operators

Primary care cooperation record book

Local government

Obtaining applications of their life stage

Authentication and viewing

Insurer (under a health insurance plan, such as including National Health Insurance)

[Collecting and utilizing medical and personal health information in chronical order with apps used]

・・・

Care prevention

Maternal and child health record book

School medical

examination Health care

Lifestyle-related disease

record book

1) Disaster/Emergency rescue

4) High-value-added healthcare services

2) Medical institutions of the destination of the move.

3) Private insurance company

ID/PW Distribution

Data collection Data utilization

5) Clinical research organizations

Secondary use Personal number card

Using Handbook Culture in Japan for PHR

Ｂｉｒｔｈ Enter School Start Working Retirement Nursing

Maternal and child health Record book

Family Doctor Cooperation Record book

Preventive Care

Record book School medical

examination

Medical Check Up Info.

Medical Record book

Disease Management Record book

Each individuals manage and use own medical info. In choronicle order

Health Making (Preventing

severe symptom)

Insurer Medical/Nursing workers

ＥＨＲ Home Health care/Nursing

Before

After

Regulatory Issues

Promoting use of Medical and Health Data

Hospital Ａ

Hospital Ｂ-1

■ ■ ■

Hospital Ｂ-2

Research Institute /University

Pharmaceutical/ Medical Device

Company

Agency Ｂ Agency Ａ

Gov.

Hospital Ｃ

Local Gov.

Hospital Ｄ Clinic

Examination Center

■ ■ ■

■ ■ ■

PMDA etc.

Insurer

Prescription Data DPC Data etc

（Management Services etc. for Personal Health/Health

Care info. ）

Hospital Ｅ Dental

Clinic Pharmacy

Data utilization Business by Government. etc.

control tower function

Authorization Authorization

Information Sharing

Health Care Service

Agency Ｃ（PHR Business)

Request to send the Examination Data

Sends Examination Data

School etc.

Authorization

Medical Information

Sends Examination Data

Information Sharing

Pharmaceuticals and Medical Devices Agency =PMDA Personal Health Record = PHR Diagnosis Procedure Combination = DPC Data

(Definitions) Article 2 (1) The term "personal information" as used in this Act means information about a living individual, and falls under one of the following items: (i) information that can be used to identify that specific individual due to its inclusion of a name, date of birth, or other description contained (any and all matters (that excludes individual identification codes) written, recorded or otherwise expressed using voice, movement or other methods in documents, drawings or electromagnetic records (meaning records made by electromagnetic format (electronic, magnetic or any other format that cannot be recognized through the human senses; the same applies in next paragraph, item (ii)); the same applies in Article 18, paragraph (2); the same applies hereinafter) in such information (this includes any information that can be cross-checked against other information and thereby used to identify that specific individual). (ii) Information that contains individual identification codes

Security Issues for Medical and Health Data

Amended Act on the Protection of Personal Information

Article 2 (3) The term “sensitive personal information” used in this Act means a personal information that contains descriptions that have been specified by Cabinet Order to require special consideration in handling so as to avoid any unfair discrimination, prejudice or other disadvantage to an individual based on person's race, creed, social status, medical history, criminal records or the fact that a person has incurred damages through an offense, etc.

Security Issues for Medical and Health Data

Amended Act on the Protection of Personal Information

Article 2 (9) The term “the de-identified information” as used in this Act, according to the categories of personal information set forth below, means information regarding an individual that is gained from processing personal information so as to prevent the identification of a specific individual taking measures prescribed by the items below, and that do not allow restoring of said personal information. (i) The deletion of a part of descriptions that contains personal information falling under paragraph (1), item (i) above (this includes replacing said part of descriptions with other descriptions through methods that do not allow for the restoring of said part of descriptions). (ii) The deletion of all personal identification codes that contain personal information falling under paragraph (1), item (i) above (this includes replacing said personal identification code with other descriptions through methods that do not allow for the restoring of said part of personal identification codes).

Security Issues for Medical and Health Data

Amended Act on the Protection of Personal Information

Protection of Personal Information

Promoting Medical Data Application

To balance out, we will need + Security Standard for the network / code etc… + Rules to follow for those handling the personal information

ARIGATO!!! ( Thank you very much!!! )

If you have a further question… you can reach me at, Yoko NAKATA (Ms.) Information Application Promotion Office, Information and Communications Bureau Ministry of Internal Affairs and Communications Japan TEL:+81-3-5253-5751 E-maill: y.nakata@soumu.go.jp