The use of AI is the way for Japanese healthcare to survive…but vested interests stand in the way of the “medical fee system” and the “Medical Care Act

AI will solve Japan’s healthcare challenges!

Japan’s healthcare is riddled with challenges, including a shortage of healthcare professionals, rising healthcare costs, an aging population, and slow digitization …….

Without progress in the digitization of healthcare and the shift to AI, there is no future for Japanese healthcare.

Dr. Yoriyoshi Kumagai, author of “The Truth about Medicine in 2030-2040” and director of Keihin Hospital (Ota-ku, Tokyo), asserts, “Without the digitalization of medicine and AI, there will be no future for Japanese medicine.

AI can also support early detection of abnormalities by analyzing the recording work done by nurses, medical interviews during initial medical examinations, or diagnostic imaging such as CT and MRI. In fact, the use of AI-based diagnostic imaging can reduce the burden on physicians and prevent human errors such as oversight.

In addition, placing AI-equipped cameras in hospitals to prevent patients from wandering or falling would also reduce the burden on nurses, allowing them to focus on essential care. AI can also reduce the burden on healthcare workers and relieve manpower shortages.

The benefits are not limited to healthcare professionals. The increased efficiency of operations will allow them to see more patients, thus eliminating hours of waiting in waiting rooms.

In the future, we may have an app that determines data from images, voice, blood pressure, and other sources, so all you have to do is say, ‘I’m in pain,’ and AI will guess the name of the disease or condition and advise you whether you should go to the hospital or not.”

In recent years, robotic surgery, in which a doctor in a remote location uses a remote-controlled surgical robot to operate on a patient in another hospital, has been spreading rapidly, and if it becomes more widespread in the future, it will be possible to provide the same level of surgery in areas with a shortage of surgeons as in urban areas.

Current medical laws are hindering the promotion of AI.

The digitalization of medical information is an inevitable part of the introduction of AI.

In Taiwan, for example, data from about 4,000 hospitals, 20,000 clinics, and 6,000 pharmacies has been consolidated, and anonymized big data is reportedly being used for research and medical policy making. In Scandinavian countries such as Finland, Norway, and Denmark, all citizens have IDs, and all medical information is linked together.

Thanks to this, no matter where you go in the country, they know your medical history, so they can examine you and prescribe medicines smoothly.

In Japan, after a patient is examined at a small or medium-sized private hospital, he or she may be referred to a large hospital, but often has to undergo the same kind of examination again there. If information could be shared, I think it would eliminate the need for retests, allow for smoother visits and hospitalization, and reduce the waste of medical costs. ……

Although the miner’s insurance card has finally been created, digitization has not progressed well. Fear of leakage of personal information has been cited as the cause, but according to Dr. Kumagai, that is not the only reason.

In order to use AI in medical care, all medical information must be digitized, including electronic medical records, and staff must be digitally proficient, and security measures must be taken to protect against hackers.

However, even if all these precautions are taken, the current medical system does not merit the introduction of AI, he said.

The current medical care law prevents this,” he said. The Medical Service Act stipulates staffing standards, such as one doctor for every 16 patients and one nurse for every three patients in general hospital beds.

In other words, we cannot accept as many patients as we want just because we have introduced AI.

In addition, under the current reimbursement system, it is decided how many points are given for what kind of medical examination or test, and how many points are given for what kind of medicine is prescribed. It doesn’t matter how good a doctor is.

If the introduction of AI is not accompanied by reimbursement, who is going to spend money to maintain AI and make efforts to improve their skills?

In order to convert everything to electronic medical records and promote AI, Dr. Kumagai says that the government must send computers and AI to the medical field and also spend money on skill work and education.

It will cost a lot of money, but I think we should do it now so that in the future there will be no doctors or nurses available to provide medical care.

Developing Japan’s original AI

AI will acquire different data depending on who uses it and for what purpose, and the answers it comes up with will also differ.

The insurance associations established by companies, patients, medical institutions, and the government are all involved in the healthcare cost-sharing, and each side has its own merits and demerits,” he said.

Patients want to receive the best treatment at the lowest possible cost. Insurance unions want to keep spending as low as possible, so they want patients to pay more out-of-pocket. Medical institutions want to know how to survive. The government wants to manage the situation as it is without changing the law as much as possible.

Dr. Kumagai says that if each side continues to insist on its own interests, it will not be able to build a base for AI, which is the foundation of the system.

The insurance associations will be asked to cough up their profits to pay for medical care. Medical institutions may also be eliminated. From the patient’s point of view, medical costs may become a little higher than they are now. And we’ll have the government change the laws. Unless we each share the pain, we won’t be able to create a truly useful AI.”

The U.S. pays for all medical expenses out-of-pocket. In the UK, Scandinavia, and other countries, all medical expenses are paid for by the government, but it takes a very long time to see a specialist. In the U.K., it takes two to three weeks to see a family doctor, and three to four months for surgery for cancer and other conditions.

In the U.K., it takes two to three weeks to see a family doctor, and three to four months for cancer and other surgeries,” he said. However, if things continue as they are, the shortage of doctors and the burden of medical expenses on the government will increase, and the system will soon come to a standstill. There is no future unless we design a new system and promote the use of AI.

Dr. Yoriyoshi Kumagai is the director of Keihin Hospital (Ota-ku, Tokyo). He grew up in a family of doctors, with his grandfather and father also being doctors. After engaging in clinical research at a hospital affiliated with the University of Tokyo, he became the director of Keihin Hospital in 1992. In addition to devising original dementia care, he actively participates in activities outside the hospital with the aim of realizing medical services that bring the community together.

Click here to purchase “2030-2040: The Truth about Medical Care: The End of Medical Care as Seen from a Downtown Hospital Director” (Chuokoron Shinsha ).