Japan Healthcare Factbook #2:

The following article is a translation of a Japanese article of the Japan Healthcare Factbook Series posted by the Public Affairs Team at Ubie AI Lab.

We would like to explore the present and future of the healthcare industry in Japan through the. In the 2nd edition, we aim to unravel the concept of "Community Healthcare Collaboration," which has been increasingly pursued as a new form of healthcare in recent years.

We will provide insights into the background and benefits of community healthcare collaboration. If you have come across the term or are hearing about it for the first time, we encourage you to check it out.

"Community Healthcare Collaboration" - Patient Treatment is Carried Out Across a Specific Region

In Japan, the "2025 Problem" is a widespread societal issue emerging as the baby boomer generation enters advanced age, specifically those aged 75 and older. This demographic shift is expected to lead to a substantial increase in social security expenditures, presenting a formidable financial challenge. Consequently, efforts are being made to develop a robust healthcare and caregiving infrastructure to address this impending crisis.

Cooperation among stakeholders in each region is indispensable to estimate the healthcare needs in 2025 and develop a corresponding medical system. Consequently, the "Regional Healthcare Vision” concept has emerged, envisioning the establishment of frameworks for the roles and collaboration of medical institutions in each region. Medical institutions voluntarily report their chosen regional roles to the prefecture, and the area formulates a healthcare vision for each part. This initiative has been positioned as a regional healthcare plan for prefectures since April 2018.

The essential project to realize this "regional medical vision" is "Regional Medical Collaboration."

Medical institutions, based on the realities of their facilities (such as equipment and specialization) and the local medical situation (such as a high proportion of elderly residents), choose their roles and functions according to their circumstances. Then, through smooth collaboration among medical institutions, each utilizing its functions effectively, the goal is establishing a system where patients can receive continuous and appropriate medical care in the region.

For example, routine medical care is entrusted to a local "clinic or medical office," known as the "primary care physician.” If more specialized tests or advanced treatments are required, the primary care physician issues a referral letter for the patient to seek treatment at a "hospital." After completing treatment at the hospital, the patient may transition to a rehabilitation-specialized medical institution or continue receiving post-treatment care from the primary care physician. In essence, the project aims to manage the treatment and care of patients at the regional level, not at the facility level, to utilize limited medical resources efficiently.

The Japanese healthcare system is characterized by its free access policy, allowing individuals to choose their healthcare providers. However, a drawback of this system is the emergence of a "hospital-oriented" mindset, where individuals, even with minor ailments, prefer to seek medical attention at large hospitals, believing that being treated at a major institution provides a sense of security. As a result, there is a concentration of patients in hospitals, leading to issues such as HCPs facing overwork and working overtime to the extent of risking exhaustion and even death.

The functional differentiation of healthcare institutions through regional medical collaboration is expected to address the challenges associated with the 2025 Problem and contribute to the reform of working conditions for healthcare professionals.

Examining Community Healthcare Collaboration Through Case Studies: the Key Lies in Establishing Mechanisms for "Information Sharing"

Let's take a look at examples of regions that are already engaged in regional healthcare collaboration.

Case 1: Patient-Centric Information Collaboration through Medication Notebooks (Aizu City, Fukushima Prefecture)

Let's explore a case where a mechanism for information sharing through patient-carried record books, such as medication notebooks, is being developed. This initiative is underway in Aizu City, Fukushima Prefecture.

In response to the 2011 Great East Japan Earthquake, the Takeda Health Foundation Takeda General Hospital, a public interest corporation, took the lead in establishing the "Aizu Medication Collaboration Council.” In the following year, in 2012, they created the "Community Unified Medication Notebook."

This system’s pages are dedicated to hospital pharmacists recording information such as the patient's diagnosis, test results, and assessments. Additionally, there are "message entry sections" for both the pharmacy to communicate with the patient and for the patient to communicate with physicians and pharmacists, aiming for a bidirectional information flow centered around the patient.

Case 2: Utilizing ICT for Inter-Facility Information Sharing (Sado City, Niigata Prefecture)

Next, let's examine a case of ICT utilization spearheaded by Director Sato of Sado General Hospital in Sado City, Niigata Prefecture.

The "Sado Himawari Net" system has been established on Sado Island. This system facilitates the sharing of residents' diagnoses, prescriptions, test results, images, and some caregiving information. Approximately 60% of island medical, caregiving, and welfare services participate, and about 30% of the population consented to information sharing. Given that Sado General Hospital is the sole facility on the island with an electronic medical record (EMR) system, the platform also accommodates institutions and facilities lacking EMR systems.

Sado Himawari Net not only supports collaboration among medical institutions but also enables collaboration between medical and dental care, medical and pharmacy collaboration, referencing medical information in care facilities, and referencing caregiving information in medical institutions. It is valuable for information sharing among caregiving facilities as well.

A seminar report from March 2021, featuring a conversation between Director Sato and Dr. Abe, Co-representative of Ubie, regarding this matter, is available. For more details, please refer to the following source.

Will Medical Institutions that Do Not Engage in Community Healthcare Collaboration Suffer Losses?

As seen in the two earlier cases, the number of regions actively engaging in regional medical collaboration gradually increases. It can be said that regional medical collaboration significantly influences the "medical fees" (*1), which can be considered a source of income for medical institutions.

*1 "Medical fees" refer to the fees paid by insurers (the medical insurance to which patients are subscribed) for medical acts performed by medical institutions or prescriptions of pharmaceuticals. These fees are revised approximately every two years to ensure they align with medical advancements and economic conditions.

To realize the vision of regional medical care, the promotion of primary care functions and the functional differentiation of medical facilities were advanced through the fiscal year 2020 revision of medical fees.

Under the category of "Medical Information Provision Fee (III)," a new evaluation has been introduced for medical institutions that provide continuous care to patients referred by their primary care physicians, where they comply with requests from the referring primary care physician and obtain the patient's consent to provide medical information.

Additionally, when patients visit hospitals without a referral, and the facility is above a certain size, the patient's financial burden increases. Furthermore, hospitals with a low referral and reverse referral rate (*2) (less than 50%) may face deductions in initial consultation fees, among other measures.

*2 Referral rate refers to the percentage of patients referred from other medical institutions. Reverse referral rate indicates the percentage of patients referred to other medical institutions.

In this way, rules have been established where medical institutions that do not engage in or cooperate with regional medical collaboration end up at a disadvantage. This development has compelled them to commit to such cooperation seriously.

Benefits of community healthcare collaboration

Is there significance in pursuing regional medical collaboration? Summarizing the benefits.

Benefit 1: Appropriate Utilization of Healthcare Costs

By allowing multiple medical institutions to access and manage the same patient information, redundant tests and prescriptions can be minimized. This benefits patients, medical institutions, and the country by ensuring that healthcare expenses are used appropriately.

Benefit 2: Improvement in the Management of Medical Institutions

Sharing information about the facilities of each institution and clarifying their roles as medical facilities can eliminate the need for unnecessary facility investments. Additionally, joint procurement of pharmaceuticals, for example, enhances the transparency of management.

Benefit 3: Mitigation of Concentration in Large Hospitals

Guiding patients to the appropriate medical institution based on their symptoms helps reduce waiting times and emergency care delays at each medical facility. This, in turn, alleviates the concentration of patients in large hospitals.

Conclusion

We researched the Next-Generation Medical Infrastructure Law in Japan this time, but the Japanese government is also advancing various initiatives for collecting and utilizing medical data.

Medical digitallization is indeed at a pivotal stage and is an industry full of potential for significant growth in the future.

Riding the waves of such regulations and market conditions, I am genuinely stimulated and delighted to think about how we can effectively contribute to people's health in our daily work.

In the future, we at Ubie will continue investigating and sharing various topics related to the healthcare industry and medical digitalization.

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Ubie's AI Symptom Checker enables users to easily access healthcare information and find appropriate healthcare providers. Available in both Japanese and English, it supports users in identifying symptoms and connecting with the right healthcare providers.

About Ubie

Ubie, Inc., established in 2017, is at the forefront of the digital health revolution. As an innovative startup, Ubie harnesses the power of artificial intelligence to seamlessly navigate individuals towards appropriate healthcare services. Our mission is rooted in the belief that everyone, regardless of location or circumstance, deserves access to comprehensive healthcare. We are committed to transforming this vision into reality by creating a more accessible and user-friendly healthcare experience.

Our global presence is anchored at our headquarters in Tokyo, Japan, situated at the heart of Nihonbashi-Horidomecho, and our U.S. headquarters in the bustling hub of New York City. These strategic locations enable us to cultivate and expand our impact on the healthcare industry worldwide.

U.S. Headquarters:
1460 Broadway, New York, NY 10036

Japan Headquarters:
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2-4-3, Horidomecho, Nihonbashi, Chuo-ku, Tokyo, 103-0012

Inception:
May 2017 - Japan Operations
October 2022 - U.S. Operations

Leadership:

Co-founders, Kota Kubo and Dr. Yoshinori Abe, spearhead our ambitious journey with a shared dedication to enhancing healthcare accessibility through innovative solutions.

Discover more about our vision and endeavors at: https://ubiehealth.com/company

Disclaimer: Please be advised that Ubie's AI Symptom Checker is intended solely for informational purposes and does not constitute a substitute for professional medical diagnosis, advice, or a treatment plan. Users should always seek the advice of qualified health professionals regarding any medical conditions or treatment decisions.