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 TomitaHead 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)

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Agenda

Geneva, Switzerland, 26-27 April 2012

Introduction

3 cases of Remote Healthcare ICT and Mobile Healthcare ICT

Conclusion and Recommendation

3Geneva, Switzerland, 26-27 April 2012

Introduction Current Healthcare status in Japan

Super aging society23.1% is over 65 years old20% of households are elderly only

Increasing of medical expenditure36.6 Trillion Yen （ 2011FY Approximation ） http://www.mhlw.go.jp/topics/medias/year/10/

With the advancing aging society

Increasing of life style related diseases

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IntroductionGlobal population ageing and policy trends of Japan

■ Global comparison of the elderly ratio

■ 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.

Ratio

of t

he e

lder

ly① The present Japan outweighs all other nations with the highest proportion of elderly citizens. Rapid demographic shift towards elderly.

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.

③ 20 years after The elderly ratio of high-population countries, such as China and India willshift from 10% to 20%.

①

②

③

JapanKoreaSingapore

SwedenAustraliaChinaUSAIndia

Geneva, Switzerland, 26-27 April 2012

Ref: Nikkei Electronics 11/29/2011, pp33-34

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3 cases

1.Remote Healthcare for Monitoring after discharging (for “cure” and “care”)

-MIC Project

2.Remote Health promotion for elderly( for “prevention” )

-MIC Project

3.Mobile Healthcare for Post DisasterGeneva, Switzerland, 26-27 April 2012

6Geneva, Switzerland, 26-27 April 2012

1.Remote Healthcare for Monitoring after discharging -MIC Project

Purpose: Provide Healthcare service for Homecare Patients after their discharges

Service:Remote data monitoring using vital sensorsRemote consultations over video phone

TechnologyAuthentication by PKI for HealthcareContinua Health Alliance based video phone　　

cure & care

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1.Remote Healthcare for Monitoring after discharging -MIC Project-System Image

Doctor (remote place) - Tono Hospital - Sakakibara Memorial Hospital

fixed/mobile network

In-home patient

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.

Server

Healthcare network

Videoconferencesystem

Re-examination record

Health record

Remotere-

examination

Doctor

Video conferenceregister/refer the re-examination record or health record

heart rate meter

scale

sphygmomanometer

pedometerIn-home patient

PC for data access

HPKICertificateauthority

No need for frequent hospital visits.Instant diagnosis allows early detection of illness.Easy communication between doctors, co-medicals and subjects . cure & care

8Geneva, Switzerland, 26-27 April 2012

2.Remote Health promotion for elderly-MIC Project

Purpose:Health Promotion for elderly in Rural area

Service:Sharing vital data and consultation with health professionals

Technology: Authentication by PKI for HealthcareContinua Health Alliance based video phone

prevention

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The internet

Subject （ Tono city ）Doctor （ remote place ） Utilizing for communication between doctors, co-medicals, and subjects.

Server

■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.

TV phone

PC for accessing medical data

Vital data, Blood data, etc.

コメディカル

Data communicat

ion

Consulting

　 1st measurement※ 2nd measurement ※ improvement （% ）

Belong to four groups 6 1 83.3Belong to three groups 17 6 64.7Belong to two groups 36 19 47.2Belong to one group 13 9 30.8

□Subjects’ disease are classified into 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 ％

TV phone

subject

Transmitting the data of blood pressure, pulse rate, blood sugar level. Real time communication with the video conference system.

Assisting him/her in

measurementsCo-medical

2.Remote Health promotion for elderly-MIC Project-System Image

Sphygmomano-meter

pedometer

prevention

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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 + IKEHL7

Geneva, Switzerland, 26-27 April 2012

3.Mobile Healthcare for post disaster

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3.Mobile Healthcare for post disaster -System Image

Doctors refer to patients’ medical record by using Tablet terminals

Geneva, Switzerland, 26-27 April 2012

Healthcare information exchange Platform

Mobile Medical Service Support System

Clinical Record Database

Scanner

PCODVPN Rooter

Inernet（ I ＰSec+IKE)

Shelters

Tablet terminalDoctor

reffer Commercial Closed Network

Shelters in Fukushima

Patients

Upload

Clinical Recored (Paper Documents)

Fukushima Pref. Med Univ. Hospital

Shelters

Conclusions and Recommendations ～ Easy start-up of Remote Healthcare/Health Consultation

～① Medical examinations are realized by patients inputting required information and

communicating with doctors through mobile devices and networks.② 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).

TV phone

• tape measure• body temperature• weight

tablet / mobile phone(input an access key)

<Home>

<Community Center>

Healthcare for pregnant women for children

Mobile Network

Internet • tape measure• body temperature• weight• blood pressure• the number of steps

tablet / mobile phone(input an access key)

co-medical

TV phonefor health consultationfor triage

<Doctor>

TabletMobile phone

or

13Geneva, Switzerland, 26-27 April 2012

Conclusions and RecommendationsRemote/Mobile Healthcare by using ICT is

effectiveIssues 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 VPNContinua Health Alliance