Rational Medicine and Digital Technology in Japan: Connecting the Silos

Kazuhiro Kanmuri
Ascent Development Services, Inc.

nnovations such as robotics, artificial intelligence, information technology, and digital technology are creating expectations for improving individual productivity and optimizing organizational resources. These innovations are also creating an emerging vision of “total optimization” not only for organizations but for our broader communities and societies, and the entire world. Discussions of innovation and optimization ultimately lead to “connectivity,” which is fundamental to success in numerous industries and fields.

Delivering “rational medicine” to patients in the form of pharmaceuticals, medical devices, or emerging therapies such as regenerative medicine is an industry-wide challenge. Through collaboration with academic and medical research institutions, industry has contributed to the invention and development of healthcare and related technologies that further adapt and expand the concept of patient-centricity into a new realization that such collaboration can truly lead to a healthier world for all.

The ethical design of technology has become a new and indispensable component of how healthcare and related data are collected, connected, and acted upon toward the goal of total data optimization to help deliver future medical care. For example, opening healthcare databases to automation or artificial intelligence is expected to help uncover new components of healthcare value by serving as a complementary tool to the limitations of the randomized clinical trial (RCT). Decentralized clinical trials (DCTs) are emerging as another innovation in Japan through use of mobile and wearable technologies.

These are complicated issues which healthcare research and industry stakeholders in Japan basically understand. Even so, dilemmas arise as these data and their connections seem to grow more complicated every day. The DIA Cutting Edge Series AI/Digital Symposium 2021 in Japan provided seven venues for stakeholders to plot the role of digital transformation in creating a better medical environment and pursuing the golden prize: true innovation that benefits patients all around the world.

For example, patient data in healthcare databases in Japan can rarely be connected and interchanged because most if not all medical institutions have independently developed their own digital application (such as electronic medical records, EMRs) optimized for their own use. Furthermore, these data are rarely connected to the data generated by the patient’s lifetime of physician’s care. Taking advantage of our technological opportunities to connect these and other data sets will improve the resilience of the healthcare development and delivery system in Japan in both “normal” and pandemic times.

This symposium illustrated the Japanese government’s national plan for mega-healthcare data linkage led by the Ministry of Health, Labour and Welfare (MHLW) and the roles of technologies and humans in the digital transformation of healthcare in Japan. The hierarchical, vertical nature of Japan’s society sometimes carries over into highly stratified data collection, processing, and analysis frameworks. Overcoming these artificial barriers will require innovative technology platforms that can effectively collect, analyze, and connect these data across different silos. More advanced use of data increases the possibility of more effective preventive care, measures against lifestyle-related diseases in long-term care, new treatment modalities, and even optimized healthcare expenditures, and create a vision for how healthcare can improve the entire social system.

But at present, medicines development has grown more and more costly, and success rates continue to decrease. Japan may need to consider new rules not only for how we treat patient data but how we treat the actual patient. First, modern healthcare systems are expected to improve the quality of conventional care through information and communication technology (ICT). Key concepts within this framework such as electronic and/or mobile health (eHealth, mHealth) services, electronic records management, and smart or interconnected medical devices grow more popular. The concept of smart hospitals, carefully and comprehensively designed toward system optimization, is essential to sustainable healthcare delivery: the vision is that each system component, such as cloud computing services, machine learning methods/tools, artificial intelligence, and process automation will be assembled into one unified infrastructure. Lessons continue to be learned about whether it is more efficient to develop these components in-house or to collect them off-the-shelf from disparate outside sources. Smart hospital design founded upon total system optimization can also provide a model for the “smart city” of the future.

Second, global discussion around connectivity is contributing to global healthcare advancement. New connections between new technologies will give rise to new ideas for further technological innovation, including in healthcare. But these technologies must ultimately connect people to people. The pharmaceutical industry in Japan was built not just on technology but upon the work of influencers and innovators. By engaging in conversations outside of our traditional work comfort zone (or silo), we can discover new perspectives for ourselves while working with others to create the optimum healthcare system for the complex modern world.

Third, the MHLW has led development of a roadmap for healthcare data reform formulated by each cooperating ministry and agency as a step toward its overall goal of developing a platform for national healthcare data integration and utilization.

As Japan faces the challenges of caring for its rapidly aging population, improving the quality and efficiency of healthcare will become increasingly essential. “Design-driven total optimization,” already proven successful in other industries, may provide the clue to healthcare reform and building a more sustainable healthcare system, helping Japan to lead the way into a new era of healthcare.