### 7. Potentiality of ICT Utilization in Medical Sector

## (1) Effects of ICT utilization in the medical sector

Generally, the promotion of ICT utilization in the medical sector is expected to provide a big benefit to the whole nation, not only to medical organizations; on the other hand, for the promotion of ICT utilization, the benefits brought by ICT utilization should be clearly presented because the cost of ICT-utilization has to be shared by medical organizations and others. However, so far in Japan, with regard to the presentation of the benefits and effects realized by the ICT utilization in the medical sector, only a few case-studies have gone beyond mere case introductions to offer quantitative evaluations.

The following paragraphs will provide quantitative evaluations based on the data and facts brought by the comprehensive survey of the evidence contained in the cases collected from a wide variety of fields.

## (2) The framework of the survey and analysis

A “medical/health care field” consisting of medical, nursing care, and preventive medicine is assumed as a model representing the whole medical sector; according to a cross-relation analysis in the model, the three types of players — clients, medical organizations, and insurers — are picked-up as significant players; with regard to those players, the definition of the effect-items expected to be brought by the ICT utilization is possible, because, although the ICT-utilization effects will involve a variety of players, the typical activities in the medical sector are related to those significant players.

## (3) Collection of evidence and evaluation

The survey and the analysis was carried out as follows: for each of the effect-items, domestically or internationally publicized documents, such as academic papers or articles/reports of cases were surveyed; the reports on the proof-of-the concept experiments/projects where public organizations were involved and the system-installment case-reports by medical organizations were picked-up in search of evidence, and at the same time, through the domestic academic-paper search on a database $ ^{3} $ , 205 papers were picked-up and then 32 papers expected to be useful for the quantitative evaluation of the effect-items, and in addition, other cases were collected through interviews; the calculation method for evaluation was reviewed; then with regard to the collected evidence, the quantifiable items were quantitatively evaluated.

As a result, with regard to the ICT-introduction effects recognized at present in the medical sector, 16 effect-items were quantitatively evaluated and 9 effects-items were qualitatively evaluated.

## (4) Calculation of quantitative effects

Before calculating quantitative effects, with regard to each of the effect-items eligible for quantitative evaluation, according to the estimated micro-level mechanism, the following were reviewed: who are the beneficiaries, what effects or benefits are expected, and to what medical systems ICT is applied; then, the mathematical expression for benefit-calculation was formulated; finally, the effects or benefits were obtained by using the formula.

Figure 1-4-7-1 shows the obtained quantitative evaluation of the effects in terms of the target medical systems and expense-items — medical expense, income/expense, and social benefits; the sum of the effects (100 millions of yen/year) of each item is 104.31 billion yen for the medical expense, 129.26 billion yen for the income/expense, and 313.71 billion yen for the social benefit. The analysis, although not covering all the medical systems, has provided sufficient evidence of ICT-utilization effects in the medical sector; therefore, the ICT-utilization in the medical sector is expected to provide more effects as the ICT introduction is promoted.

Note that the present method of analysis, being limited by the following constraints, will need further sophistication for the application in a specific field:

○ Because of the constraints of the evidence, not all of the 25 effect-items are quantified, and some are only qualitatively analyzed.

The quantification is limited to the effect-items for which the evidence is available from the results of the existing research, etc., and the items for which sufficient evidence is not collected are only qualitatively analyzed.

○ Although to the extent possible, the calculations are based on domestic cases, some are based on the cases of another country because sufficient evidence was not available for the domestic case.

## (5) Activities for ICT-utilization in the medical sector — Medical Information Integration Infrastructure (EHR)

Since 2011, the Ministry of Internal Affairs and Communication, for the purpose of the development of the wide-area EHR system, has conducted the proof-of-concept experiments on the computerization, medical file integration, medical-nursing care integration and sharing of patient registration cards, in three regions — Takamatsu City, Kagawa Prefecture, Onomichi City, Hiroshima Prefecture, and Izumo, Shimane Prefecture, as one of the “health Information Utilization Infrastructure Projects.”

The poll-surveys carried out in the three regions show