Skip to main content

Advertisement

SpringerLink
Log in

Overview of Recent Trans-Institutional Health Network Projects in Japan and Germany

  • Transactional Processing Systems
  • Published:
Journal of Medical Systems Aims and scope Submit manuscript

Abstract

Worldwide populations are aging and countries have to prepare for the effects of demographic change in health care. Health information exchange (HIE), which is the process of moving patient information across health care providers electronically, can help overcome health data fragmentation and open opportunities to improve patient care in terms of quality, economy and efficiency. Since Japan and Germany are among the first countries strongly impacted by demographic changes of aging populations, we report on current developments about health information systems carrying out HIE based on case studies in both countries. Four projects that address the improvement of HIE within a defined region have been selected and investigated: the German project of the Lower Saxony Bank of Health and the Japanese projects Chiba ITnet, Nagasaki AjisaiNet and the National Disaster and Backup System of Japan. The project descriptions are based on relevant English publications, on-site visits and interviews with developers and users. The projects are introduced in terms of their basic architecture and implementation, their present status and future objectives. The projects’ developments are still in progress and all have to cope with significant challenges before they will be able to provide a fully working trans-institutional health network solution.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kluge, F., Zagheni, E., Loichinger, E., and Vogt, T., The Advantages of Demographic Change after the Wave: Fewer and Older, but Healthier, Greener, and More Productive? PLoS ONE 9(9):e108501, 2014. doi:10.1371/journal.pone.0108501.

    Article  Google Scholar 

  2. United Nations (2013) World Population Aging 2013. Department of Economic and Social Affairs. Population Division. http://www.un.org/en/development/desa/population/publications/pdf/ageing/WorldPopulationAgeingReport2013.pdf. Accessed 17 October 2014.

  3. OECD (2014) “Doctors”, in OECD Factbook 2014: Economic, Environmental and Social Statistics. OECD Publishing. doi: 10.1787/factbook-2014-103-en

  4. Ishikawa, T., Ohba, H., Yokooka, Y., Nakamura, K., and Ogasawara, K., Forecasting the absolute and relative shortage of physicians in Japan using a system dynamics model approach. Hum. Resour. Health, 2013. doi:10.1186/1478-4491-11-41.

    Google Scholar 

  5. Nomura, K., Physician Shortage in Japan: The New Postgraduate Medical Education Program and Physicians as a Human Medical Resource. Nippon Eiseigaku Zasshi. 66(1):22–28, 2011.

    Article  Google Scholar 

  6. Kopetsch, T., The German health system runs out of physicians! Study on age distribution and physician number development. (written in German). Bundesärztekammer und Kassenärztliche Bundesvereinigung, Berlin, 2007.

    Google Scholar 

  7. OECD (2014) “Health expenditure”, in OECD Factbook 2014: Economic, Environmental and Social Statistics. OECD Publishing. doi: 10.1787/factbook-2014-105-en.

  8. OECD (2014) Health Data 2014: How Does Japan Compare. http://www.oecd.org/els/health-systems/Briefing-Note-JAPAN-2014.pdf. Accessed 01 October 2014.

  9. OECD (2014) Health Data 2014: How Does Japan Compare. http://www.oecd.org/els/health-systems/Briefing-Note-GERMANY-2014.pdf. Accessed 01 October 2014.

  10. OECD (2013) What Future for Health Spending? OECD Economics Department Policy Notes No.19. http://www.oecd.org/eco/growth/aaaaaawhatfuture.pdf. Accessed 17 October 2014.

  11. Vest, J., Health Information Exchange: National and International Approaches. Adv. Health Care Manag. 2012. doi:10.1108/S1474-8231(2012)0000012005.

    Google Scholar 

  12. Dodd, B., An independent ‘Health Information Bank’ could solve data security issues. Brit. J. Healthc Comp. 14(8):33–35, 1997.

    Google Scholar 

  13. Shabo, A., It’s time for health record banking! Methods Inf. Med. 53(2):63–65, 2014.

    Article  Google Scholar 

  14. Yasnoff, W. A., and Shortliffe, E. H., Lessons Learned from a Health Record Bank Start-up. Methods Inf. Med. 53(2):66–72, 2014.

    Article  Google Scholar 

  15. Plischke, M., Wagner, M., Haarbrandt, B., Rochon, M., Schwartze, J., Tute, E., Bartkiewicz, T., Kleinschmidt, T., Seidel, C., Schüttig, H., and Haux, R., The Lower Saxony Bank of Health – Rationale, Principles, Services, Organization and Architectural Framework. Methods Inf. Med. 53(2):73–81, 2014.

    Article  Google Scholar 

  16. Shabo, A., A Global Socio-Economic-Medico-Legal Model for the Sustainability of Longitudinal Electronic Health Records: Part 2. Methods Inf. Med. 45(5):498–505, 2006.

    Google Scholar 

  17. Hafen, E., Kossmann, D., and Brand, A., Health Data Cooperatives – Citizen Empowerment. Methods Inf. Med. 53(2):82–86, 2014.

    Article  Google Scholar 

  18. Geissbuhler, A., Spahni, S., Assimacopoulos, A., Raetzo, M., and Gobet, G., Design of a patient-centered, multi-institutional healthcare information network using peer-to-peer communication in a highly distributed architecture. Stud. Health Technol. Inform. 107:1048–1052, 2004. doi:10.3233/978-1-60750-949-3-1048.

    Google Scholar 

  19. Ajisai network (2014) Ajisai network homepage. http://www.ajisai-net.org/ajisai/index.htm. Accessed 22 September 2014.

  20. Japanese Telemedicine and Telecare Association (2013) Telemedicine in Japan 2013. http://jtta.umin.jp/pdf/telemedicine/telemedicine_in_japan_20131015-2_en.pdf . Accessed 29 September 2014.

  21. Kimura, M., Nakayasu, K., Ohshima, Y., Fujita, N., Nakashima, N., et al., SS-MIX: A Ministry Project to Promote Standardized Healthcare Information Exchange. Methods Inf. Med. 50(2):131–139, 2011.

    Article  Google Scholar 

  22. Gusew, N., Bartkiewicz, T., Bautsch, W., Gerlach, A., Goldapp, M., Haux, R., et al., A Regional health care network: eHealth.Braunschweig. Domain fields and architectural challenges. Methods Inf. Med. 51(3):199–209, 2012. doi:10.3414/ME11-02-0010.

    Article  Google Scholar 

  23. Lower Saxony Bank of Health (2014) eHealth.Bank – GesundheitsdatenbankNiedersachsen. http://www.gdbank.de . Accessed 01 October 2014.

  24. Plischke, M., Wagner, M., Haarbrandt, B., Rochon, M., Schwartze, J., Tute, E., et al., TheLower Saxony Bank of Health. Rationale, Principles, Services, Organization and Architectural Framework. Methods Inf. Med. 53(2):73–81, 2014.

    Article  Google Scholar 

  25. Schwartze, J., Haarbrandt, B., Rochon, M., Wagner, M., Haux, R., et al., Design and Implementation of an Informed Consent Process for a Standardized Health Information Exchange Solution on the Example of the eHealth.Bank. Stud. Health Technol. Inform. 192:318–322, 2013.

    Google Scholar 

  26. Lapsia, V., Lamb, K., and Yasnoff, W. A., Where should electronic records for patients be stored? Int. J. Med. Inf. 81(12):821–827, 2012.

    Article  Google Scholar 

  27. Yeager, V. A., Walker, D., Cole, E., Mora, A. M., and Diana, M. L., Factors related to health information exchange participation and use. J. Med. Syst. 38(8):78, 2014. doi:10.1007/s10916-014-0078-1.

    Article  Google Scholar 

  28. Johnson, K. B., Unertl, K. M., Chen, Q., Lorenzi, N. M., Nian, H., Bailey, J., et al., Health information exchange usage in emergency departments and clinics: The who, what, and why. J. Am. Med. Inform. Assoc. 18(5):690–697, 2011. doi:10.1136/amiajnl-2011-000308.

    Article  Google Scholar 

  29. Vest, J. R., Jasperson, S., Zhao, H., Gamm, L. D., and Ohsfeldt, R. L., Use of a health information exchange system in the emergency care of children. BMC Med. Inf. Decis. Mak. 11:78, 2011. doi:10.1186/1472-6947-11-78.

    Article  Google Scholar 

  30. Vest, J. R., Zhao, H., Jasperson, J., Gamm, L. D., and Ohsfeldt, R. L., Factors motivating and affecting health information exchange usage. J. Am. Med. Inform. Assoc. 18(2):143–149, 2011. doi:10.1136/jamia.2010.004812.

    Article  Google Scholar 

  31. Vest, J. R., Campion, T. R., Jr., Kaushal, R., et al., Challenges, alternatives, and paths to sustainability for health information exchange efforts. J. Med. Syst. 37(6):9987, 2013. doi:10.1007/s10916-013-9987-7.

    Article  Google Scholar 

  32. Bouamrane, M., Tao, C., and Sarkar, I., Managing interoperability and complexity in health systems. Methods Inf. Med. 54(1):1–4, 2015. doi:10.3414/ME15-10-0001.

    Article  Google Scholar 

  33. Chaudhry, B., Wang, J., Wu, S., Maglione, M., Mojica, W., Roth, E., et al., Systematic review: Impact of health information technology on quality, efficiency, and costs of medical care. Ann. Intern. Med. 144:742–752, 2006.

    Article  Google Scholar 

  34. Hincapie, A., and Warholak, T., The impact of health information exchange on health outcomes. Appl. Clin. Inform. 2:499–507, 2011.

    Article  Google Scholar 

  35. Mäenpää, T., Suominen, T., Asikainen, P., et al., The outcomes of regional healthcare information systems in health care: A review of the research literature. Int. J. Med. Inf. 78:757–771, 2009.

    Article  Google Scholar 

Download references

Acknowledgments

We want to thank all the people who provided insights into their work and information about the particular regional health networks. This involves the staff of the Medical Informatics and Management Department at Chiba University Hospital, Kengo Miyo from Tokyo University Hospital, Takehiro Matsumoto and Masayuki Honda from Nagasaki University Hospital and Markus Wagner from the Peter L. Reichertz Institute. We acknowledge the support of Professor Kulikowski, Rutgers University, who kindly agreed to review and improve our English. Finally, we want to thank for the project support on the part of International Academy of Lifesciences, Chiba University and Chiba University Hospital.

Author information

Authors and Affiliations

  1. Peter L. Reichertz Institute for Medical Informatics, University of Braunschweig and Hannover Medical School, Muehlenpfordtstr. 23, 38106, Braunschweig, Germany

    Maren Juhr & Reinhold Haux

  2. Division of Medical Informatics and Management, Chiba University Hospital, Chiba, Japan

    Takahiro Suzuki & Katsuhiko Takabayashi

Authors
  1. Maren Juhr
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Reinhold Haux
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Takahiro Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Katsuhiko Takabayashi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maren Juhr.

Additional information

This article is part of the Topical Collection on Transactional Processing Systems

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Juhr, M., Haux, R., Suzuki, T. et al. Overview of Recent Trans-Institutional Health Network Projects in Japan and Germany. J Med Syst 39, 50 (2015). https://doi.org/10.1007/s10916-015-0234-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10916-015-0234-2

Keywords

Search

Navigation