Japan Association for Medical Informatics is a place for academic exchange among all researchers and practitioners interested in medical information, and aims to conduct research, education, and technology improvement related to medical informatics with the aim of contributing to the advancement of medicine and medical care. In order to promote , and other social applications, we will carry out academic activities related to the following through academic conferences and study groups.

  1. Development of next generation medical information system
  2. Social implementation of health and medical information infrastructure
  3. Analysis of medical big data
  4. Establishing medical information security
  5. Developing medical information personnel 

[Overall policy] Regarding medical information and related fields

 Regarding medical information, large-scale health and medical databases such as various patient registries and medical receipt databases have been constructed, and there is a need to utilize the data accumulated in these databases to promote medical practice, basic research, and clinical research. In addition, medical care related to genes is already being practiced in Japan, such as in cancer treatment, and although there is a social issue of how to handle genomic information in hospital information systems, medical information such as genomics and biomedical The flow is to add data and information from the healthcare field to basic research, clinical research, clinical practice, and medical care provision.

 Internationally, as there is a growing movement to utilize knowledge obtained from the analysis of all kinds of information surrounding individuals, such as medical information, genomic information, life data, and health data, for clinical application and individual health promotion and disease prevention, medical information It is necessary to take a broader view or expand the scope of science. This field is called Bio Medical Informatics, or Biomedical and Health Informatics, etc., and is considered to be a field that is mainly carried out at research institutions. In addition, at the same time as the interdisciplinary field of Biomedical Informatics has developed, clinical informatics, population health informatics, pharmacoinformatics, and nursing informatics have also been developed. Specialized fields such as ``Informatics'' and ``Dental Informatics'' are being developed.

 Japan Association for Medical Informatics organizes issues from the aspects of medical information systems and clinical databases, social aspects, ethical aspects, etc., and works towards solving them, with an eye to the interdisciplinary field of biomedical informatics. At the same time, we will encourage more researchers to participate in this field, which can also be called specialized medical informatics, where activities in medical informatics specialized in specialized fields are already being actively carried out. We will promote the contribution of science.

1. Development of next generation medical information system

1-1. Bridge between medical information systems and clinical epidemiology, etc.

 The concept of EBM (Evidence-based Medicine) has become widely recognized, and clinical research is actively being conducted both domestically and internationally. In order to find the truth in observational research, the existence of a high-quality database, that is, a reliable, accurate, and complete database, is a prerequisite. Receipt data, specific health checkup data, electronic medical record data, etc., which are attracting attention as real-world data, are candidates for such data sources, but none of these are data collected for the purpose of observational research. In particular, electronic medical records should contain important data for conducting clinical research, but at present, much of the data is unstructured and data is accumulated in a form that is not structured or standardized. Therefore, there is a big gap in treating it as a high-quality data source for clinical research.

 Japan Association for Medical Informatics will promote collaboration between medical informatics and clinical epidemiology, organize issues with medical information systems and clinical databases, and work to bridge EHR (Electronic Health Record) and EBM.

1-2. Creation of data with quality, structure, and granularity that creates value

 Electronic medical records are basically created to be read by humans, and most of them are stored as unstructured data that is difficult to use directly for analysis. In order to solve this problem, we need to develop a method to convert unstructured data into structured data using natural language analysis technology, or use input templates to collect data as structured data from the time of data collection. need to be taken. Furthermore, it is necessary to systematize the semantic concepts of the collected data as structured data that takes the medical care process into consideration, and it is also necessary to construct a thesaurus and ontology system. In other words, in order to use data collected from electronic medical records, EHRs, and PHRs for analysis, quality management that focuses on data control and management is necessary.

 Japan Association for Medical Informatics has a history of specialized research and development of hospital information systems and electronic medical record systems, and will continue to lead the way in data quality management.

1-3. Informatization of quality indicators

 Improving the quality of medical care is a common goal of academic and professional organizations in the medical field. The "Quality Indicator" is published by many medical facilities as an indicator of the quality of medical care, and is also used in the formulation of medical plans by national and local governments. However, given the variety of patients and various types of medical care, it is not easy to design quantitative indicators that can appropriately evaluate the quality of medical care at any facility. Furthermore, in order to ensure comparability across multiple institutions, data collection and calculation methods must be standardized. Furthermore, the data to be evaluated should be able to be collected from an electronic medical record system or the like without human intervention.

 Japan Association for Medical Informatics, as an academic organization that connects clinical medicine and medical information systems, collaborates with various professional organizations to measure and evaluate the quality of medical care. We will promote discussions regarding system measurements, calculations, reporting, and communication.

1-4. Medical records legislation suitable for the information age

 Today, as clinical sites become increasingly computerized, the inconsistency between the operation of electronic medical records, which can be achieved through information and communication technology, and medical record legislation has become an important issue. The current medical record legal system is designed on the premise that limited data collected manually by medical professionals is recorded discretely on paper, and large amounts of data automatically acquired by various medical devices are continuously recorded. It is out of touch with the reality of the information society that is sent to us. Furthermore, it cannot be said that there has been sufficient discussion about how to handle cases where records that should be written by medical professionals, such as medical assistants, are entered by other professions.

 Japan Association for Medical Informatics designs and proposes a system that improves efficiency and safety in clinical settings through the introduction of information and communication technology, while ensuring informatically rational and legally sound electronic medical records. We will continue to work on this.

1-5. A system that improves the quality of medical care and reduces the burden on clinical sites

 Medical information systems have been constantly evolving with the aim of improving the quality of medical care and increasing the efficiency of clinical operations. By electronically recording patient medical records and test results, it has become possible to share information quickly, leading to appropriate medical treatment and the prevention of medical accidents. In addition, operational efficiency has been improved by introducing a medical accounting system, departmental system, order entry system, electronic medical record system, etc. Continuous improvement of medical information systems is closely linked to providing higher quality medical care to patients and improving the efficiency of clinical processes.

 In recent years, addressing the long working hours and overwork of doctors and other medical professionals has become an issue in medical practice, and in order to realize a sustainable healthcare delivery system in the future, it is necessary to improve medical practice. We must take further measures to reduce the burden.

 Japan Association for Medical Informatics uses technologies such as artificial intelligence, RPA (Robotic Process Automation), and telemedicine to improve the quality of medical care, reduce the burden of clinical work, and create a sustainable medical delivery system. We will promote discussions aimed at continuous improvement of medical information systems so as to lead to securing.

1-6. Medical devices as components of information systems

 It is now becoming common sense for medical devices that collect biological information in medical institutions to be connected to hospital information systems via information networks, as reflected in terms such as IoT (Internet of Things). On the other hand, the legal system governing medical devices is limited to regulating the performance of individual medical devices, and has not been able to properly evaluate interoperability as part of an information system. . In order to ensure interoperability, we must actively promote the adoption of standards, including the standardization of interfaces.

 Japan Association for Medical Informatics views medical devices as information system components, removes barriers to achieving the informatization of clinical sites necessary to ensure interoperability, and promotes further informatization of clinical sites. To go.

1-7. Development and distribution of medical device programs

 With the development of information and communication technology and the accumulation of medical information, software combined with medical measurement devices connected to consumer information devices such as computers and smartphones, or stand-alone software, plays the role of medical equipment. It's starting to look like this. Additionally, software (treatment apps) aimed at assisting treatment that can be used under insurance medical treatment have appeared. Although it is important to ensure that newly developed medical software can be quickly distributed to the market, it is also important to appropriately prevent medical software of poor quality from being distributed to the market. In this regard, certification of the medical device program (SaMD: Software as a Medical Device) stipulated in the Pharmaceutical and Medical Device Act will be carried out cheaply, quickly, and appropriately, and certified software will be distributed to the market in a manner that clearly indicates whether or not it has been certified. It is necessary to develop a framework to do so. At the same time, there is also a need to discuss the handling of non-SaMD, such as software that does not fall under the Pharmaceutical and Medical Device Act, that is, apps aimed at promoting health.

 Japan Association for Medical Informatics will work together with academic societies involved in medical device development to advance academic discussions for the development of Japan's medical software industry.

1-8. A mechanism for analyzing the dynamics of diseases, including unknown infectious diseases, in real time

 In the early stages of the COVID-19 outbreak, Japan was slow to grasp the dynamics of the disease and the severity of the disease, and it was extremely difficult to formulate countermeasures. In reality, electronic medical records and medical accounting systems store medical records on a daily basis, and by establishing input/output and information integration methods, data can be analyzed in real time and the dynamics of unknown infections and diseases can be investigated. It is hoped that this will be discovered earlier.

 Japan Association for Medical Informatics will organize the legal and technical issues necessary to achieve these goals and work to make them a reality.

2. Social implementation of health and medical information infrastructure

2-1. Efficient data linkage from electronic medical record systems to patient registries and clinical databases

 Multiple institutions are actively building patient registries that collect data on predetermined items regarding target diseases, and clinical databases that comprehensively collect and store data stored in electronic medical records. . Currently, methods are being considered to record items according to the registry as medical records using templates, but there are a wide variety of types of data that exist in hospital information systems, and it is necessary to add functionality to each. , it is not realistic to develop for each purpose.

 Japan Association for Medical Informatics works with related academic societies and organizations to develop standard data items to be collected, and extracts data from electronic medical record systems in a standard format to create efficient patient registries and clinical databases. We will consider ways to build it and work toward implementation.

2-2. Comprehensive care system for patient engagement in the information age that connects health medical information and nursing care information

 In Japan, which is the first country in the world to become an aging society with a very low birthrate, establishing sustainability in health, medical care, and nursing care is a major issue. This issue is an important policy issue faced not only by Japan but also by welfare states around the world. The construction of a national medical information platform promoted by the government will share medical information between medical institutions and pharmacies with patient-centered care (engagement) in mind, and improve the nation's health care by streamlining and improving the quality of services through medical DX. It is expected to be a silver bullet to solve the above problems by improving the

 Japan Association for Medical Informatics is fundamentally reviewing the division of roles between health, medical care, nursing care, and home care, and is working to design a social system for personalized health care that involves medical professionals, nursing care professionals, residents and their families, government, etc. We will make information-based and rational recommendations for issues in legal and social contexts.

2-3. Healthcare management needs and information and communication technology seeds

 A variety of information regarding each person's health management, treatment, prognosis management, and nursing care is shared among various parties based on various requests. If we organize this from an informatics perspective, we can analyze multiple axes such as the time axis (real-time communication/storage sharing), the media axis (numerical information/textual information/image information), and the scope of sharing (face-to-face, small number of people, large number of people), etc. It is possible to organize information and communication technologies (videophones, SNS, cloud) and applications that are suitable for each. Information and communication technology is highly developed, and an environment in which various information and communication tools and services can be used is already in place, and the technological environment is such that most objectives can be achieved by combining appropriate existing technologies and services. is mature. It is necessary to develop social systems for the application of various information technologies and services.

 Japan Association for Medical Informatics will foster social consensus by presenting an overall picture of the health information infrastructure that supports medical and nursing care as a social system in the information age.

2-4. Utilization and evaluation of data accumulated in EHR and PHR

 The implementation of the Next Generation Medical Infrastructure Act is expected to pave the way for the secondary use of information stored in EHRs (Electronic Health Records) and PHRs (Personal Health Records). However, unless EHR and PHR are first spread and utilized domestically, we cannot hope to accumulate information that will contribute to "improving the quality of medical care" and "population health." Furthermore, in the future spread of EHR/PHR, I think it is inevitable to discuss the division of roles with the "National Medical Information Platform." In any case, academically discuss how EHRs and PHRs should be used and evaluated, regardless of primary or secondary use, within the information infrastructure that supports social systems in the information age. This is very important.

 Based on past results, the Japan Association for Medical Informatics will promote the use of data accumulated in EHRs and PHRs and academically evaluate its effectiveness.

2-5. Continuous accumulation, availability improvement, and promotion of utilization of medical knowledge infrastructure

 In the medical field, we have not only accumulated various real-world data including actual clinical data, but also accumulated various medical knowledge such as various terminology concept systems, medical information models, and clinical guidelines. The preparation of the database has been progressing. It is thought that the amount of knowledge accumulated will continue to increase in the future due to the fragmentation of medical knowledge and the promotion of integrated analysis of genomic information and clinical information. On the other hand, some of this knowledge becomes outdated after a few years, so continuous updating is required. Establishing methodologies and systems to accumulate and integrate these diverse medical knowledge bases across clinical departments and continuously improve and update availability from an informatics perspective, as well as from various AI (Artificial Intelligence) applications. It is necessary to socially promote the utilization of

 Japan Association for Medical Informatics will work with AI application development vendors and related academic societies to advance academic discussions to resolve this issue, as well as work to develop a social system.

2-6. Sensing and collection of medical information suitable for big data analysis

 With advances in machine learning methods such as deep learning, AI applications are progressing in various fields including medical image analysis. In the future, in order to integrate and analyze various data surrounding medical care and utilize it to realize cutting-edge medicine and precision medicine through data-driven medicine and treatment, it will be necessary to sense objective and comprehensive medical information. It is necessary to consider how records should be kept.

 Japan Association for Medical Informatics collects medical records separately from data obtained from various sensors and records recorded by the medical personnel who observed them, and then links them so that it is possible to trace their mutual relationships. We will consider ways to efficiently collect time-series data and promote academic discussions to implement this in society.

3. Analysis of medical big data

3-1. Promoting secondary utilization of medical information

 Along with the development of laws such as the Next Generation Medical Infrastructure Act, the utilization of accumulated medical information (real world data) obtained in daily clinical practice for research in genomic medicine, epidemiology, pharmacology, health economics, and social medicine is increasing. It is being promoted. In particular, the evidence obtained through the use of high-quality, comprehensive real-world data acquired and accumulated under the universal health insurance system is expected to contribute to the advancement of medical care not only in Japan but also around the world. be done. On the other hand, real world data is extremely sensitive personal information, and its utilization requires not only ensuring safety through sufficient technical measures, but also sufficient social consensus.

 Japan Association for Medical Informatics actively engages in research using real-world data, and clarifies the R3 (Risk/Reward Ratio) of medical information utilization from an academic perspective. We will work to gain consensus (promoting the spread of dynamic consent acquisition, etc.).

3-2. Proper way to concatenate multiple DBs

 When organizations such as medical facilities and academic societies collect clinical data for the purpose of analysis, patient identifiers are assigned to each administrator. At this time, in order to achieve a certain analysis objective, the data items in one database may be insufficient, and there may be item data that can be supplemented in databases compiled by other administrators. Methods for linking data of the same patient from multiple databases of different administrators (data linkage) include a method of setting and linking an integrated patient identifier in an organization that is permitted to view patient identification information; One possible method is to loosely combine the common attributes of two databases by comparing their values. However, these methods may violate anonymization from the perspective of protecting patients' personal information, and must also be considered from legal and ethical perspectives.

 Japan Association for Medical Informatics will work to sort out these issues and present appropriate methods for data linkage.

3-3. Data infrastructure and joint usage for developing medical artificial intelligence technology

 Developing applications that utilize AI technology requires a large amount of real-world data, but there is a limit to the amount of data that each medical institution can collect, so it is necessary to collect data from multiple facilities. However, in reality, there are issues of personal information management, incentives for data providers, who can use the collected data, and practical operations for collecting, managing, and maintaining quality of data. Issues such as this become a barrier. In AI development, rather than focusing on the development of large-scale domestic databases, it is important to share data in a way that allows multiple stakeholders, including corporate data users, to mutually benefit. Therefore, it is necessary to sort out related issues and consider what kind of regulations are appropriate among each stakeholder (data provider, data user/academic, and data user/corporate). On the other hand, worldwide, the development of AI using federated learning that solves personal information issues is becoming more active, and research is expected to be promoted in Japan.

 Based on the Next Generation Medical Infrastructure Act and the Personal Information Protection Act, the Japan Association for Medical Informatics aims to provide data to promote the development of future AI applications based on Japan's grand design and trends. We will make recommendations regarding the ideal form of infrastructure and shared use, and foster social consensus.

3-4. Promoting the development and social implementation of medical artificial intelligence applications

 As research and development of medical artificial intelligence (AI) applications is actively being carried out, in order to proceed quickly and safely to social implementation, advanced basic technology including models, algorithms, computational resources, and medical facilities are required. Appropriate regulations are needed to safely utilize the large-scale data generated for learning in medical settings, and mutual collaboration between industry, government, and academia is essential. In addition, by actively bridging each area of ​​clinical medicine and informatics, the knowledge, information, and data accumulated in the medical field will be organically linked with informatics, and we will develop advanced AI applications more efficiently. It is expected that this will lead to the creation of a cycle in which this can be done.

 Japan Association for Medical Informatics plays the role of a bridging hub to promote the development and social implementation of medical artificial intelligence applications, and takes the lead in collaboration between industry, government, and academia, and collaboration between medical and informatics experts. We will discuss related issues together with related academic societies and organizations.

3-5. Consideration of social issues for the spread of medical artificial intelligence

 Artificial intelligence technology is being used to assist in diagnosis in medical settings, and is rapidly expanding. Furthermore, studies have begun to consider the use of generative AI. When replacing some of the services provided by medical professionals with artificial intelligence technology, the following social issues must be considered.

(1) Judgment when using AI technology: It is necessary to check whether the target for which AI technology is to be used is SaMD or non-SaMD, and consider how to use it according to the purpose.

(2) What review and approval standards should be within facilities: The development of AI applications requires data generated in actual medical practice, but it is expected that the data itself will change due to the influence of AI applications. Therefore, the standards for review and approval for hospital use of AI applications are expected to be different from those for pharmaceuticals and medical devices, and it is necessary to consider what standards are appropriate.

(3) Safety of AI applications and where responsibility lies: When introducing AI applications, how do we explain the safety to patients, and who takes responsibility if they replace the work of medical professionals? It is expected that this problem will arise. In addition, it is necessary to define methodologies for detecting errors and misdiagnoses in AI applications in research and clinical practice, and the functional requirements necessary to ensure the safety of human life.

 Japan Association for Medical Informatics will examine these issues from legal, social, and ethical aspects in collaboration with related academic societies, and will make recommendations to society by formulating guidelines and other means.


4. Establishing medical information security

4-1. Building an information infrastructure and operational system that takes cybersecurity into consideration

 Cybersecurity threats are rapidly increasing both domestically and internationally, and there have been multiple reports of damage caused by long-term suspension of medical services at medical institutions in Japan.

 Japan Association for Medical Informatics promotes discussions on building information infrastructure and operational systems that take cybersecurity into account, and collaborates with related ministries and organizations to formulate IT-BCP in the medical field and develop information security human resources. Through these efforts, we will promote the necessary efforts to maintain an environment where medical information can be used safely.

4-2. Ensuring security trust in large-scale data analysis

 The amount of medical data accumulated in medical information systems is increasing day by day, and the acquisition of healthcare data output from smart devices and sensors is also progressing. In order to analyze a large amount of medical information, including sensitive information, by making full use of cutting-edge computer technology while ensuring the confidentiality of the information, high-performance computing in a widely distributed parallel computing environment is necessary.

 Japan Association for Medical Informatics is proceeding with discussions on the construction of a computer environment that ensures confidentiality in order to perform highly reliable analysis of large-scale data in real time, and on methods of confidential calculation that maintains calculation speed. At the same time, we will work to develop an analysis system that links multiple medical facilities.

4-3. Establishment of a disaster operation system for medical information systems

 Japan is one of the world's most disaster-prone countries, having historically experienced earthquakes and tsunamis, and contributions from the perspective of medical information to disaster medical care are extremely important.

 Japan Association for Medical Informatics will proceed with discussions on BCP (business continuity planning) and BCM (business continuity management) methods for medical facilities in the event of a disaster, as well as the use of medical information in disaster medical care. In addition, we will promote the verification of the effectiveness of new technologies for disaster countermeasures through the research and development knowledge gained through the fusion of new technologies such as IoT that enable information collection and processing and medical informatics. To go.

4-4. Enhancement of cybersecurity performance and skills that are fast, dynamic, and sustainable

 Cybersecurity threats in our country are rapidly expanding. Due to the increase in cyberattacks from Japan and overseas, and the increasing sophistication of organized attacks and attack methods, attacks on critical infrastructure, including medical institutions, are becoming particularly serious, with reports of damage such as system outages and information leaks. There is. In response to this situation, medical institutions need to improve their cybersecurity performance and skills in a swift, dynamic, and sustainable manner.

 Japan Association for Medical Informatics aims to improve cybersecurity performance and skills to be swift, dynamic, and sustainable in response to new organized attacks and the increasing sophistication of attack methods that have emerged in recent years. We will discuss initiatives and promote them together with related organizations.

5. Developing medical information personnel

5-1. Training of next-generation researchers and social medicine specialists in the medical information field

 In order to develop the academic field of medical informatics into the future, we must steadily develop human resources who will be responsible for academic research, and create an environment that allows them to sustainably carry out academic activities that will serve as a career path. There is a need.

 Japan Association for Medical Informatics is working to develop medical informatics educational curricula, based on the International Federation of Medical Informatics' recommendations regarding medical informatics education, in order to train researchers who will be responsible for future medical informatics. We will proceed with discussions regarding the educational content of medical informatics in each specialized area. In addition, we will work to develop an educational curriculum for medical informatics education, which is necessary for acquiring the core competencies in the social medicine specialist program.

5-2. Developing human resources with skills as CIO and CISO in the medical field

 The CIO (Chief Information Officer) is the person in charge of information and systems within an organization, and the CISO (Chief Information Security Officer) is a management position that is positioned as the person in charge of information security. As the informationization of medical care continues to advance, medical institutions are required to improve the quality of medical care, ensure sound management, and ensure the safety of medical information systems. We need people with management skills who can supervise planning, project management, personal information protection, and information security.

 Japan Association for Medical Informatics will discuss the human resources profile, roles, and abilities of medical CIOs and medical CISOs who can take leadership roles in medical settings, as well as the personnel who can assist them.

5-3. Developing human resources capable of handling everything from the development of medical information infrastructure to the practice of data utilization

 As the informationization of medical care progresses, it is necessary to continuously produce human resources who understand the mechanisms of medical information systems and the information generated during medical treatment, and who can build and manage information infrastructure that can contribute to improving the quality of medical care and management. There is.

 Japan Association for Medical Informatics has been training medical information engineers and senior medical information engineers as human resources who can handle everything from the development of medical information infrastructure to the practical use of data. We will continue to discuss the skills required for medical information professionals, which are necessary for medical DX, cybersecurity, data utilization, etc., and promote the development of human resources with a certain level of quality through proficiency tests and lifelong training seminars. To go. We will also provide the necessary support for medical information engineers and senior medical information engineers to play an active role.