Dinner at the Japanese Consulate

Last night I had dinner at the home of the Consul General of Japan, Akira Muto, to discuss Massachusetts/Japan economic development in the areas of healthcare IT, robotics and big data.

A dozen Massachusetts technology, government, and academic leaders spoke for 3 hours over elegant Japanese cuisine to brainstorm about win/win collaborations.

In 2011, I worked with Washington and Tokyo collaborators to craft a healthcare IT plan for Japan based on lessons learned from the earthquake and tsunami.

The United States experience with Meaningful Use coupled with Japan's knowledge of mobile technology and high tech innovation would be a powerful partnership.  

My specific recommendations for a national Japanese healthcare IT program included:

1. Widespread adoption of electronic health records (EHR) in hospitals and provider offices.

2. A national healthcare identifier that would enable linking of records among multiple facilities and the creation of a national emergency care database.

3. A privacy framework that would provide the policy guidance supporting the sharing of
electronic health records among all 47 prefectures as needed for care coordination, quality measurement, and clinical research.  Privacy concerns are paramount in Japan. Through the use of strong policies such as mandatory breach notification, civil penalties for privacy violations, a unified approach to consent, model data use agreements, and security standards, patient privacy preferences could be protected.

4. A security framework that would permit and encourage the use of the public Internet for transmission and sharing of electronic records, as long as appropriate standards, business practices, and controls are put in place. Japan has state-of-the-art wireless and wired networks, arguably the best in the world. However, few hospitals and clinicians now use this infrastructure to exchange healthcare information, coordinate care, or engage patients/families. The public Internet is appropriate for healthcare information as long as the proper, rigorous policies and technologies are in place before data is exchanged.

5. Data standards that would break down barriers to data exchange. These could include
international standards, such as clinical document architecture (CDA), continuity of care
document (CCD), and continuity of case record (CCR), as well as Japanese standards that have been successfully implemented, such as medical markup language (MML), which is utilized by Dr. Hiroyuki Yoshihara’s Dolphin Project at Kyoto University.

6. Decentralized implementation programs based at the prefecture level. These programs, organized on a regional basis, would assist hospitals, physicians and other providers to plan, install, and use electronic health records successfully. Iwate and Miyagi prefectures could be ideal places to initiate these decentralized programs given the need to rebuild healthcare infrastructure in these prefectures.

Our robotics discussion focused on the use of military robots in disaster recovery efforts such as Fukushima-Daiichi and the use of home healthcare robots to provide support for elders who live alone.

Our big data discussion emphasized the need to turn data into knowledge and wisdom, especially in the area of healthcare.

The conversation was stimulating, the energy was high, and the food/sake (Junmai Daigingo, Hana-no-Mai) was amazing.

Thanks so much to the Japanese consulate for organizing this amazing event.