Current Status and Issues with Japan’s
Community-Based Integrated Care System:
Health Information System and Health
Information Exchange System Framework
Kimiko Katsuyama, Ken Kato, Yukinori Murata, Takashi Yoshinaga,
Fumiaki Yasukawa, and Akinobu Nemoto
Abstract Despite superior health indicators (life expectancy at birth), Japan’s
medical care system faces problems of financial burdens and changes in disease
structure associated with a declining birthrate and aging population. Reform directions include: (1) maintenance and promotion of health, prevention of disease, and
promotion of early detection; (2) promotion of differentiation and collaboration
among medical functions (community medicine concept); and (3) establishment of
“Community-based Integrated Care System (CICS).” We examine CICS, Health
Information Systems, and discharge summary problems. The traditional medical
care system has been shifted to home healthcare and nursing care systems for the
elderly. Despite Japan’s transition to the Electronic Medical Records (EMR) system
in 1999, and the introduction of a regional medical network, current systems are
vague and costly; standardization of health information content with a simple and
affordable system is needed. We focused on transfer and discharge processes.
Discharge support nurse managers expressed difficulties preparing discharge summaries due to “differences in values between hospital and home-care nurses,” “lack
of communication and standardized terminology,” and “reduced assessment ability
by the Electronic Hospital Information System.” The Databank As Solution for your
Care and Health (DASCH) project (Ariga, H. Iryo Business to ICT System
[Healthcare Business and IT System]. Chuo University Press, Tokyo, Japan,
2017) presents solutions via opportunities to emphasize communication in the
community.
K. Katsuyama (*) · T. Yoshinaga · F. Yasukawa · A. Nemoto
Yokohama City University, Yokohama, Japan
e-mail: katuyama@yokohama-cu.ac.jp; tyoshina@yokohama-cu.ac.jp; fyasu@yokohama-cu.
ac.jp; anemoto@med.yokohama-cu.ac.jp
K. Kato
Aichi Shukutoku University, Nagakute, Japan
Y. Murata
Fujita Health University, Toyoake, Japan
e-mail: ymurata@fujita-hu.ac.jp
© Springer Nature Singapore Pte Ltd. 2021
H. Matsushita (ed.), Health Informatics, Translational Systems Sciences 24,
https://doi.org/10.1007/978-981-15-3781-3_9
155
Community-Based Integrated Care System:
Health Information System and Health
Information Exchange System Framework
Kimiko Katsuyama, Ken Kato, Yukinori Murata, Takashi Yoshinaga,
Fumiaki Yasukawa, and Akinobu Nemoto
Abstract Despite superior health indicators (life expectancy at birth), Japan’s
medical care system faces problems of financial burdens and changes in disease
structure associated with a declining birthrate and aging population. Reform directions include: (1) maintenance and promotion of health, prevention of disease, and
promotion of early detection; (2) promotion of differentiation and collaboration
among medical functions (community medicine concept); and (3) establishment of
“Community-based Integrated Care System (CICS).” We examine CICS, Health
Information Systems, and discharge summary problems. The traditional medical
care system has been shifted to home healthcare and nursing care systems for the
elderly. Despite Japan’s transition to the Electronic Medical Records (EMR) system
in 1999, and the introduction of a regional medical network, current systems are
vague and costly; standardization of health information content with a simple and
affordable system is needed. We focused on transfer and discharge processes.
Discharge support nurse managers expressed difficulties preparing discharge summaries due to “differences in values between hospital and home-care nurses,” “lack
of communication and standardized terminology,” and “reduced assessment ability
by the Electronic Hospital Information System.” The Databank As Solution for your
Care and Health (DASCH) project (Ariga, H. Iryo Business to ICT System
[Healthcare Business and IT System]. Chuo University Press, Tokyo, Japan,
2017) presents solutions via opportunities to emphasize communication in the
community.
K. Katsuyama (*) · T. Yoshinaga · F. Yasukawa · A. Nemoto
Yokohama City University, Yokohama, Japan
e-mail: katuyama@yokohama-cu.ac.jp; tyoshina@yokohama-cu.ac.jp; fyasu@yokohama-cu.
ac.jp; anemoto@med.yokohama-cu.ac.jp
K. Kato
Aichi Shukutoku University, Nagakute, Japan
Y. Murata
Fujita Health University, Toyoake, Japan
e-mail: ymurata@fujita-hu.ac.jp
© Springer Nature Singapore Pte Ltd. 2021
H. Matsushita (ed.), Health Informatics, Translational Systems Sciences 24,
https://doi.org/10.1007/978-981-15-3781-3_9
155