Current Status and Issues with Japan’s Community-Based Integrated Care System: Health Information System and Health Information Exchange System Framework

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.