The government will establish a system infrastructure in 2030 that will allow medical institutions across the country to share patient electronic medical record information over the Internet. The medical system will be strengthened so that patients can smoothly receive treatment and prescriptions for medicines outside of their primary care hospital. To build the foundation, consider providing financial support to medical institutions and system development over multiple years.
The Ministry of Health, Labor and Welfare will support small and medium-sized hospitals and clinics with the cost of implementing ``cloud-native'' electronic medical records that share medical record information online. Sales of the same electronic medical record system based on national standard specifications are scheduled to begin next April, and the ministry has earmarked 60.4 billion yen for the budget request for fiscal 2027. We are considering setting a cap and providing subsidies for half of the installation costs.
We will provide multi-year support to promote the introduction of a cloud-native model, including updating from the traditional "on-premises" electronic medical record system, which involves installing a server within a facility to build a system.
We support cloud-native system development for large hospitals that have many medical departments and have different information management systems than small and medium-sized hospitals. The aim is to conduct a demonstration experiment of the system in FY2017 and introduce it in FY2030. The budget request for fiscal year 2017 calls for a budget as a matter of request without specifying a specific amount.
Many large-scale hospitals are already operating on-premises systems, and will be able to transition to cloud-native systems as early as 2030. A decision will be made in the future as to whether support for implementation costs will be provided to large hospitals.
If cloud-native models are introduced at large hospitals, medical institutions across the country will be connected through a network that shares medical record information, allowing people with chronic illnesses to quickly receive treatment at the nearest medical institution even if they become unwell while on the go. By supporting its introduction, the government hopes to help medical institutions improve their operational efficiency while also improving security measures.
The government is building a platform for sharing electronic medical record information in order to resolve the problems faced by conventional systems that make it difficult for medical institutions to share information, and to improve security while reducing costs. However, medical institutions have complained that the cost burden of electronic medical records is too heavy, and measures to reduce the burden will likely be an issue in moving forward with the introduction of the new system.
Conventional electronic medical record systems called ``on-premise'' systems, which have become popular mainly in large hospitals, are managed and operated by installing servers and equipment in medical facilities. Because it depends on the technology and specifications of the vendor providing the system, it is difficult to share information with other vendors' systems.
In addition, not only the selling prices of servers and equipment but also the costs of maintenance, management, and system updates are rising, putting pressure on hospital management.
A survey of hospitals in nine prefectures in Shikoku, Chugoku, found that the average cost of introducing an electronic medical record system was 250 million yen for hospitals with 200 to 299 beds, and 1.27 billion yen for hospitals with 500 or more beds. Annual maintenance costs are also high at 23 million yen and 170 million yen, respectively.
Commenting on the survey, Tomoe Kato, specially appointed director of Yamaguchi Rosai Hospital and president of the Yamaguchi Prefectural Medical Association, pointed out, ``Electronic medical records are a huge administrative burden, and there were many requests for support from the government, and many opinions that the cost of changing vendors is prohibitive.'' ``Current medical institutions are in a financial crisis, and the introduction of the system is only a financial burden,'' he said, complaining of their plight.
The government hopes to reduce costs by introducing a ``cloud-native type'' of information sharing over the Internet. For clinics, the price for an on-premises model is around 3 million yen, but the price for a cloud-native model is expected to be around 500,000 to 1 million yen. Cloud-native models are said to have the advantage of being able to strengthen security measures at low cost, which is another advantage of promoting adoption.
The government will support the introduction of cloud-native models in small and medium-sized hospitals and clinics, but will consider how to support large-scale hospitals in the future. Opinions seem to be divided within the government and ruling party over the extent to which support should be given to the introduction of electronic medical records, which will become the core system of medical institutions, given the limited government budget.
Electronic medical record A medical record in a medical institution that converts a patient's medical records, medical history, test values, allergy information, contraindicated drugs, etc. into electronic data. As of 2020, the penetration rate is 65.6% in hospitals and 55.0% in clinics. 93.7% of hospitals with 400 beds or more have adopted the system, which is large.
