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Shigeru Tomita Head of Strategy Planning Office NTTDATA CORPORATION tomitasg@nttdata.co.jp

Joint ITU-WHO Workshop on e-Health Standards and Interoperability (Geneva, Switzerland, 26-27 April 2012). Remote Healthcare ICT and Mobile Healthcare ICT -Model Project in Japan by Ministry of Internal Affairs and Communications-. Shigeru Tomita Head of Strategy Planning Office

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Shigeru Tomita Head of Strategy Planning Office NTTDATA CORPORATION tomitasg@nttdata.co.jp

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  1. Joint ITU-WHO Workshop on e-Health Standards and Interoperability(Geneva, Switzerland, 26-27 April 2012) Remote Healthcare ICT and Mobile Healthcare ICT -Model Project in Japan by Ministry of Internal Affairs and Communications- ShigeruTomita Head of Strategy Planning Office NTTDATA CORPORATIONtomitasg@nttdata.co.jp

  2. Agenda • Introduction • 3 cases of Remote Healthcare ICT and Mobile Healthcare ICT • Conclusion and Recommendation

  3. Introduction Current Healthcare status in Japan • Super aging society • 23.1% is over 65 years old • 20% of households are elderly only • Increasing of medical expenditure • 36.6 Trillion Yen (2011FY Approximation)http://www.mhlw.go.jp/topics/medias/year/10/ • With the advancing aging society • Increasing of life style related diseases

  4. IntroductionGlobal population ageing and policy trends of Japan ① The present Japan outweighs all other nations with the highest proportion of elderly citizens. Rapid demographic shift towards elderly. ■ Global comparison of the elderly ratio Japan Korea Singapore ② 10 years after The elderly ratio of other Asian nations, such as South Korea and Singapore, follows closely behind Japan. Speed of population aging is) more rapid than Japan. Sweden ① Australia China USA Ratio of the elderly ② India ③ ③ 20 years after The elderly ratio of high-population countries, such as China and India will shift from 10% to 20%. Ref: Nikkei Electronics 11/29/2011, pp33-34 ■ The policy trends of Japan   ○Putting the model projects into practice and collect the evidences in order to promote remote healthcare.   ○Cooperating with in-home patients as well as medical care after hospital discharge, promote efforts to improve regional medical care system.

  5. 3 cases 1.Remote Healthcarefor Monitoring after discharging (for “cure” and “care”) -MIC Project 2.Remote Health promotion for elderly( for “prevention” ) -MIC Project 3.Mobile Healthcare for Post Disaster

  6. 1.Remote Healthcarefor Monitoring after discharging -MIC Project cure & care • Purpose: • Provide Healthcare service for Homecare Patients after their discharges • Service: • Remote data monitoring using vital sensors • Remote consultations over video phone • Technology • Authentication by PKIforHealthcare • Continua Health Alliance basedvideophone

  7. 1.Remote Healthcarefor Monitoring after discharging -MIC Project-System Image Videoconference system • Perform remote re-examinations for in-home patients or elderly with an automated monitoring with the vital sensors and the video conference system. • Medical relief and safety are ensured. Workload reduction for patients and co-medicals is proven and evaluated. HPKI Certificate authority Doctor (remote place) - Tono Hospital - Sakakibara Memorial Hospital In-home patient sphygmomanometer Healthcare network heart rate meter Server Doctor In-home patient Remote re-examination scale pedometer Re-examination record Health record fixed/mobile network PC for data access Video conference register/refer the re-examination record or health record • No need for frequent hospital visits. • Instant diagnosis allows early detection of illness. • Easy communication between doctors, co-medicals and subjects . cure & care

  8. 2.Remote Health promotion for elderly-MIC Project prevention • Purpose: • Health Promotion for elderly in Rural area • Service: • Sharing vital data and consultation with health professionals • Technology: • Authentication by PKIfor Healthcare • Continua Health Alliance based video phone

  9. 2.Remote Health promotion for elderly -MIC Project-System Image ■Information shared by the medical specialists of a remote place and the co-medical in the local area. ■Based on the test result, the doctor of the remote place carried out advice and health instruction, etc. by practical use of a videoconference etc. for a circulatory organs, a lifestyles, etc. Activities based on 17 city areas including the district center, with the participation of approximately 400 residents mainly the elderly. Assisting him/her in measurements Subject (Tono city) Doctor (remote place) Utilizing for communication between doctors, co-medicals, and subjects. The internet Co-medical TV phone Sphygmomano -meter TV phone コメディカル Server PC for accessing medical data Consulting subject Vital data, Blood data, etc. Data communication pedometer Transmitting the data of blood pressure, pulse rate, blood sugar level. Real time communication with the video conference system. □Subjects’ disease are classifiedinto 4 groups: Hypertension group, Diabetes group, Hyperlipemia group and Hepatic dysfunction group.※1st measurement: 02/2009 2nd measurement: 08/2009□Blood pressure improvement 62.7%, LDL cholesterol improvement 47.1% prevention

  10. 3.Mobile Healthcare for post disaster • Purpose: • Provide better healthcare service at the shelters after the earthquake • Service: • Sharing medical records with doctors in some Medical Service Teams • Technology: • OnDemand VPN • IPSec + IKE • HL7

  11. 3.Mobile Healthcare for post disaster -System Image Fukushima Pref. Med Univ. Hospital Shelters in Fukushima Clinical Recored (Paper Documents) Shelters Upload Inernet (IPSec+IKE) Commercial Closed Network reffer Tablet terminal PC Doctor Patients ODVPN Rooter Scanner Clinical Record Database Mobile Medical Service Support System Shelters Healthcare information exchange Platform Doctors refer to patients’ medical recordby using Tablet terminals Geneva, Switzerland, 26-27 April 2012

  12. Conclusions and Recommendations ~Easy start-up ofRemote Healthcare/Health Consultation ~ • Medical examinations are realized by patients inputting required information and communicating with doctors through mobile devices and networks. • Doctors can directly check patients’ condition with TV phone over the internet at community centers. (if no TV phone is available, co-medicals can substitute). <Home> • tape measure • body temperature • weight Mobile Network <Doctor> Healthcare for pregnant women for children TV phone tablet / mobile phone (input an access key) Tablet Mobile phone Internet <Community Center> • tape measure • body temperature • weight • blood pressure • the number of steps co-medical or TV phone for health consultation for triage tablet / mobile phone (input an access key)

  13. Conclusions and Recommendations Remote/Mobile Healthcare by using ICT is effective • Issues to be discussed • Security • Interoperability Recommendations: • We need to discuss the standardization in ITU workshops (considering of unique colors and real-time capability in medical services) • On demand VPN • Continua Health Alliance

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