Reflections on Japan

In my blogs of the past two weeks, I've included many references to the people, places, and experiences I had while traveling in Japan speaking about the  need to implement healthcare IT to support earthquake/tsunami response, hospital rebuilding, and the healthcare needs of the aging Japanese society.

Here are few personal observations about the country and its people in the aftermath of 3/11 (the Japanese term for the events that took place on Friday, March 11, 2011)

Impact on electric power
The area served by TEPCO does remain significantly affected by the reduction in power availability due to nuclear plant shutdown . Currently Tokyo has voluntarily reduced power consumption by 30% by limiting cooling, public lighting, and private consumption.   West of Tokyo in Kyoto and Hiroshima, I did not experience any specific power reduction measures.   When I talked to people in the Kansai  and Chugoku regions about their post earthquake experiences,  they noted that power savings of 15% is requested in the Kansai region for large institutions such as Kyoto University.   It is not mandated as in Tokyo, but folks in Kyoto feel psychologically compelled to save power.

Impact on tourism
In Hiroshima, we stayed on Miyajima (a small sacred island off the coast) at the Yamaichi Bekkan run by a wonderful woman named Shinko Yamamatsu and her son Teppei.   She noted her ryokan experienced a significant number of cancellations by foreign tourists who fear that Japan is unsafe or unstable following the earthquake.   My experiences in Kyoto, and Hiroshima were flawless - safe food, completely functional infrastructure, and a very welcoming people.  I highly recommend that foreign tourists proceed with any Japanese travel plans to Kyoto and Hiroshima.    During this trip, I enjoyed freshly prepared meals at all my favorite vegetarian restaurants in Kyoto including Okutan, Fujino,  and Kiko.   On Miyajima, all our extraordinary meals were prepared by Shinko and her staff.

Impact on government trust
Communication from government officials about the radiation levels and food safety in the area immediately surrounding Fukushima, has been problematic.  As a people, the Japanese generally trust their government to be good stewards of resources and supportive of public interests.  However, people are now doubting government reports about environmental and food safety.     Some are beginning to monitor radiation levels in their local neighborhoods by purchasing sophisticated equipment   .   Sales of pre-disaster food products are brisk.

Impact on Electronic Health Record acceleration
Currently, the use of information technology for medical care is getting attention in Japan. The Japanese Kantei created a task force on healthcare IT in August 2010 and the May 2011 task force report advocates acceleration of electronic health records and personal health records, including a concept called My Virtual Hospital.   Here's an English translation of the current thinking.  In addition to the policy recommendations that I proposed in my paper and lectures during this trip, I will work with US and Japanese experts on a privacy whitepaper to outline a path forward for secure internet-based healthcare information exchange in Japan that takes into account existing Japanese privacy regulations. There are three kinds of regulations concerning medical record privacy protection in Japan. The first is a series of laws which stipulate confidentiality of specific occupations related to medical services such as physicians. The second is the Act concerning Protection of Personal Information approved in 2003, which more generally regulates privacy protection including medical records. The third is the Guideline of Privacy Protection for Medical and Nursing Care Services, which is not legally binding but backs up the other two types of laws comprehensively in the medical and nursing care sector.

Impact on future policy planning
On August 6, 1945, the United States dropped an atomic weapon on Hiroshima.   Hiroshima hosts annual meetings in August to reflect on the policy impacts of nuclear weapons, nuclear power and health.   This year, the focus was the aftermath of the Fukushima events and the need to reconsider dependence on nuclear power.

Japan is my second home and I have deep affection for its people, culture and geography.   Recovery is proceeding rapidly and I recommend we do all we can to help by visiting Japan, contributing our expertise and volunteering our time.