Q&A: Discussing Japan’s National Health Data Initiative & Innovative Approaches to Fragility Fractures

Mike Hodin, CEO of the Global Coalition on Aging (GCOA), spoke with Mamoru Yamashita, Director of the Division for Health Care and Long-term Care Integration, Health Insurance Bureau at the Ministry of Health, Labour and Welfare (MHLW) to discuss a new Japanese initiative that will link healthcare data to strengthen multi-stakeholder responses to key health challenges, such as osteoporosis and fragility fractures.

More than 13 million people in Japan live with osteoporosis, and the incidence of hip fractures is projected to increase from 190,000 in 2012 to 320,000 by 2040. In total, fragility fractures are estimated to generate more than $8 billion in costs in Japan—a central health and economic challenge requiring data-driven solutions at scale.

Mike Hodin: What is Japan’s vision for the new national health data initiative? How will this benefit patients and help address age-related health challenges?

Mamoru Yamashita: This new initiative will integrate different health data sets, such as insurance, claims, and hospital data, and then empower patients to control and share their data—driving better care, more informed policy decisions and faster medical innovation. People will be able to share medical information, for example, who provides what treatment and when, not only with their healthcare providers, but also with research institutions and other stakeholders in an anonymized form.

This can help a more diverse group of stakeholders—patients, providers, caregivers, policymakers, academic experts and the private sector—collaborate to improve healthcare. And it’s especially critical for major health challenges like fragility fractures, which require more innovation and research on complex decisions about prevention, rehabilitation, treatment and care.   As a result, we are developing a proposal about “outcome” data collection in the new information system, through medical societies.

MH: When will this system launch, and how do you see it progressing in the years ahead?

MY: The system will launch in the fall of 2021. As it progresses, it will grow to include more data and more types of data, such as information about procedures and outcomes over longer periods of time. This increasingly digitized healthcare landscape means that we can better standardize, share and analyze the information needed to best serve patients, whether that’s detecting risk factors for chronic disease or figuring out how to prevent and respond to fragility fractures.

MH: Until now, experts in the health and aging field have often focused primarily on clinical issues, rather than policy discussions. How will this project help diverse stakeholders contribute to policy discussions, especially in the orthopedic area?

MY: This effort will give a diverse group of experts and stakeholders better data to inform the policy dimensions of healthcare. One of important policy discussions is the bi-annual medical fee revision. In the discussion, up-to-date information about bone fractures and treatment technologies are presented by experts to shape reimbursement and other policy discussions among academic experts, healthcare providers and policymakers, with industry’s perspective also included.   I am pleased to use this forum to suggest that If there are  idea that will be beneficial for osteoporosis and bone fracture treatment management to add into this new information system, I would encourage academic experts and healthcare providers to propose with a supporting data to MHLW through appropriate academic societies. 

This decision-making process is only as good as our data. Improved access to data—such as data around osteoporosis and fragility fractures—enables stakeholders from every constituency to contribute to informed policy decisions.

MH: How can these applications for osteoporosis and fragility fractures support global collaboration and align with the UN Decade of Healthy Ageing?

MY: A data-driven approach to osteoporosis and fragility fractures can provide a model for the kind of comprehensive, detail-oriented mindset we want to bring to healthcare overall—ideally driving towards global comparisons and collaboration. This requires understanding the issue at every level: structure, process, and outcome. For incidents like fractures, more outcome data can help to understand incidence by age group, how many days it took to recover, home-based or hospital care, cost, and more. Collection of such outcome information could be integrated into the new information system. As mentioned earlier, ideas and even proposals to show how best we can capture outcome data would be encouraged.

Such a broad, rich approach will provide a bigger picture as we ask ourselves how best to serve an aging population. And if we can begin to compare this information with data from other countries, the entire global community can begin to move towards best practices for prevention, rehabilitation and care. This would represent an important model and milestone for the WHO’s Decade of Healthy Ageing. It is important to look at the challenges of an aging society not only from the perspective of medical costs, but also as a field where innovation is expected from multiple aspects, such as the cost or burden to society as a whole that enables a better quality of life (QOL) for patients, caregivers and their families, such as being able to work longer and enjoy their lives. Healthier and more active aging along with fiscal sustainability of health systems is clearly a goal of the WHO/UN SDG Decade of Healthy Ageing with which Japan is aligned.  Measuring such outcomes on the basis of the WHO’s new approach of functional ability is a good lever for us here in Japan, especially for Osteoporosis/Fragility Fractures challenges to our super-ageing society.

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