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Mr. Sasaki, what is your opinion on the current situation where medical digital transformation using My Number cards has not progressed?
Toshinao Sasaki (hereinafter Sasaki): First of all, the penetration rate of My Number cards is in the 70% range, but this is merely the result of a campaign, and it does not mean that the meaning of My Number cards themselves is understood. I think this is because the meaning of having My Number cards has not been properly reported.
The My Number Health Insurance Cards that are currently a hot topic have become usable in the field, but the Tokyo Shimbun and other newspapers are running a negative campaign against them, citing the fact that personal information will be managed by the government. However, in terms of personal information, medical information is submitted to the government even with a paper health insurance card, so such criticism is wrong in the first place.
So the idea that paper is more convenient or inconvenient is not the essence of My Number cards?
Sasaki: That's right. For example, if you go to a hospital to get examined and get a prescription using a paper health insurance card, that data will be managed by that hospital and will not be shared with other hospitals. In that case, when you are examined at another hospital and get a prescription, the data is not shared between the hospitals, so you may end up taking medicines that should not be taken together.
Or, if you go to multiple hospitals for similar symptoms, there is a possibility of double medication.
Until now, there was no realistic way to prevent such situations. It is true that there are things like medicine notebooks for medicine, but in this paperless era, you are not sure whether you should carry a paper notebook, and the medicine notebook app is different for each pharmacy, so in the end it does not solve the problem.
That is where the My Number card comes in, and the meaning of the My Number card in the medical field is to centralize and query data such as hospital visit records, medical records, prescriptions, and pharmacy medication data.
Then, when a hospital queries the My Number card, it will be able to find out what kind of examinations you have had so far. Naturally, prescription data will also be shared, so there will be no problems with double administration or cross-combination.
I see. So this is possible by centralizing medical data.
Sasaki: Another important point is that it is said that centralizing all medical data will enable more precise analysis. Nowadays, big data in medicine and health is important. For example, Apple Watch has various built-in sensors that can measure the health status of individuals. This is a field that big tech companies such as Apple and Google have been working on for 20 years, which is medical digital transformation.
It is said that if we collect large amounts of data in the cloud and analyze it, we will be able to capture more precise signs of disease onset, and for example, we will be able to understand the tendencies of people who are prone to heart disease, and many other things will become possible. By combining this kind of everyday health information with medical data from hospitals and other sources, more precise predictions should be possible. It is said that this will ultimately lead to reduced medical expenses.
Right now, medical expenses are increasing rapidly in Japan. As medicine evolves while the population is aging, this trend is expected to accelerate even further. Japan lives under a rare and good system of universal health insurance, but maintaining it is becoming increasingly difficult, and this is an urgent issue. However, this is the greatest meaning of medical digital transformation, and the biggest reason for combining the My Number card and the health insurance card.
It seems that many citizens do not understand the true meaning of this.
Sasaki: That's right. These kinds of things are not reported in the media. Even on variety shows, there are irrelevant discussions such as what to do if you lose your card, or how elderly people can't remember their passwords.
This is not limited to the My Number health insurance card issue, but I think there are micro and macro perspectives when looking at things. A micro perspective is looking at things from your own experience and experiences, and a macro perspective is looking at things from a bird's-eye view. However, Japanese media outlets, including television, are abnormally fond of a micro perspective.
For example, when reporting on the damage caused by the Noto Peninsula earthquake, Japanese media outlets mainly reported on the voices of local residents, such as the fact that the rubble had not been cleared away. Of course, it is also important to report from a micro perspective, asking why the rubble in front of the local residents has not been removed.
On the other hand, there is also ownership of the rubble, and it is said that the removal of the rubble has not progressed well due to the problem of having to obtain the owner's permission to remove the rubble. This is what the macro perspective is about. Normally, the media should report from both micro and macro perspectives, but Japanese media, both TV and newspapers, do not have a macro perspective.
They are considered to be on-site, reporting the information on the site as it is, so they do not have a macro perspective. This is exactly what the issue of the My Number Health Insurance Card is about. They report from a micro perspective, such as the voices of the elderly and the opinions of clinic directors, but they lack the overall perspective of why the Ministry of Health, Labor and Welfare and the Digital Agency are trying to promote medical digital transformation with the My Number card.
Are you saying that the lack of public understanding of the My Number Health Insurance Card is due to the attitude of the media?
Sasaki: Yes. Also, the government is currently building a national medical information platform to consolidate and access data from medical institutions and dispensing pharmacies nationwide.
However, there are several barriers here. For example, electronic medical records are not standardized because each hospital outsources them to their own sir. The same goes for medical fees. Each clinic has a different system and is not standardized.
The government and the Digital Agency are currently leading the standardization of electronic medical records and medical fee systems, but because they have to handle an enormous amount of work, they are increasing the number of developers and engineers from the private sector and are becoming a kind of national project. The lack of standardization of such systems is a barrier to medical digital transformation, and I feel that it is not well understood that this is not leading to a reduction in future medical costs or that progress is not being made.
This is also the downside of Japan's reporting being biased toward a micro perspective.
Sasaki: Even when the government or government agencies explain things from a macro perspective, Japanese media outlets have a mindset that tends to talk in an unclear dualistic way, like "evil government vs. good people." Because they place more importance on the voices of ordinary people than on government announcements, they end up leaning towards a micro perspective.
However, it is precisely because media outlets have this kind of attitude that I think it is important in today's world for us to think about things from a macro perspective.
"Power is always evil," "The common sense of the people is always right," "The weak should be protected," "Artificial things are dangerous," "Natural origins are best"... Outdated values that continue to linger in Japanese society. A cutting-edge essay that dismantles the "myths" that run counter to the evolution of cutting-edge technology and serves as a guidepost for thinking about the future.
◉ Toshinao Sasaki
Born in Hyogo Prefecture in 1961. Dropped out of Waseda University's School of Political Science and Economics. After working as a reporter for the Mainichi Shimbun and the editorial department of Monthly ASCII, he is now a freelance journalist. He has written many books, including "The Age of Curation" (Chikuma Shinsho), "The Layered World" (NHK Publishing Shinsho), "Homemade Meals Are the Best Treats" (Magazine House), and "And Life Becomes a Community" (Anonymous Studio).
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