Jun NakayaCo-Chair of IMIA Standardization WG

Tohoku University School of Medicine

Tohoku University Hospital, Medical IT Center

　 Tohoku Medical Megabank Organization

MEDINFO2013. 2013.08.23

Japanese National Projects

aroundGreat East Japan Earthquake

toward

Standardization

1

The beginning is ・・・

2

Great East Japan EarthquakeHappened 2 and half Years ago

For Successful Reconstruction

■ We required Symbolic “Core” toward Reconstruction/Regeneration■ We designed 2 huge core national projects for regeneration/reconstruction in the

field of Life Science.• MMWIN (Miyagi Medical and Welfare Information Network) which covers all

areas of Miyagi pref. with MI network to make disaster-area better place than before earthquake. (National Budget: 60 Million Dollars)

• ToMMo (Tohoku Medical Megabank Organization) which develops/supplys Future Medicine and related required technologies to start a new leading Medical innovation in Japan from Tohoku Region. (National Budget: 600 Million Dollars)

Emergency Headquarter of Graduate School of Medicine of Tohoku Iniversity Immediately Started on March 25, 2011 　

3

Nursing Care

Nursing Care

MedicineMedicine

WelfareWelfare

Problems before 3.11Problems before 3.11Problems before 3.11Problems before 3.11 An elucidated problem after 3.11An elucidated problem after 3.11An elucidated problem after 3.11An elucidated problem after 3.11

• Shortage of doctors and medical resources• Aging• Falling behind in construction of highway traffic

network

• Shortage of doctors and medical resources• Aging• Falling behind in construction of highway traffic

network

Loss of Medical Information makes Medical practice entirely impossibleLoss of Medical Information makes Medical practice entirely impossible

Then we are in construction of Regional Medical & Welfare Information Networkwhich has both disaster robustness and usefulness in time of peace

Then we are in construction of Regional Medical & Welfare Information Networkwhich has both disaster robustness and usefulness in time of peace

To reduce the burden on

medical workers

For relief of patients and their

families in disaster areas

First we established Human Network （ MMWIN ） before constructing ICT network,

which is always necessary in both disaster and peace timeBased on this ‘All Miyagi Human Network’,

We aim to achieve not just restoration but reconstruction to better society than before 3.11

We summarized our concept and experiences as a typical model of Regional Healthcare Network in Japan, which is called as ‘Miyagi Model’

Basic concept of MMWIN (Miyagi Medical and Welfare Information Network)

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・ Prefectural Flagship Hospital

・ UniversityHospital

Prefecture Layer

RegionalCore Hospital

Medical Administration Area Medical Data Center

Administrative Regional Medical Area Layer

Accumulated Data Sharing

Core HospitalHIS

Regional Data Center

Medical Information Inquiry

Inspection Reservation

Small & Medium sized Hospitals/Clinics Zone

Temporary Houses Support Center Care Zone

Daily Life Medical Area Layer

Specialized Diagnosis/TreatmentHigh Medical Screening Request

SS-MIX2

SS-MIX2

ICD11GSVML

Green CDA

SS-MIX2

ICD11

GSVML

CDA R2

HL7 V3

GSVMLCDA R2

en13606

ICD11

Basic Concept of Regional Medical and Welfare Information Network Miyagi Model (3 layer Model)

Private CloudPrivate Cloud

ASP type EHRASP type EHR

StandardsStandards Seamless cooperation among home care, nursing care, and medical care for daily life

Cooperation among hospitals and clinics in regional medical area for hospital treatment

Cooperation among Central Hospitals and Regional Hospitals for high advanced medical treatment

■ Construction　of　Medical　Megabank　as　combined　Bio-Bank　can　be　a　long-term　base　of　all　biomedical　researches　toward　future　medicine

■ Prospective　Cohort　Study　in　conjunction　with　whole　genome　analysis　can　be　a　basis　of　designing　future　medicine

■ Establishment　of　standardized　network　model　of　regional　healthcare　can　be　a　direct　help　for　disaster　suffers’　healthcare　and　also　can　be　a　base　of　next　generation　regional　healthcare

■　Linking　with　education　of　disaster　suffers　to　have　medical　skills　in　these　projects　can　be　direct　help　for　disaster　suffers

■Job　creation　and　industrial　accumulation　around　these　projects　in　disaster　area　can　be　a　life　support　for　disaster　suffers.

Features of Features of ToMMo ToMMo (Tohoku Medical Megabank Organization) (Tohoku Medical Megabank Organization)

ProjectProject 　　

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Ground ICT Design of ToMMo & MMWIN

Daily Life Medical Area

Administrative Regional Medical Area Layer

Prefecture Layer

Distributed Cloud

Server for publication

Physically closed network 　 in the Medical Megabank Building

InternetIntegrated System

Integrated System

Interated System

IP-VPN virtual closed network

Bio Bank Business

Access Control

Cohort Molecules, Specimen DB

1st ＤＢ

3rd ＤＢ

Disease-related clinical data

Database for Data publication

Bio Bank Database

Clinical ＤＢPhase 0 Elemental DB

Batch Transfer

2nd ＤＢ

Integration

Regional healthcare ICT Regional healthcare ICT NetworkNetwork （（ Miyagi ModelMiyagi Model ））

Medical megabanks analysis and storing ICT NetworkMedical megabanks analysis and storing ICT Network Biobank publication ICT NetworkBiobank publication ICT Network

SpecimenClinical

Info.Cohort

Info.Specimen

CohortInfo.

Health Check Up and Cohort ICT Health Check Up and Cohort ICT NetworkNetwork

Gateway Server

Anonymizing Control Room （ Iwate ）Anonymizing Control Room （ ToMMo ）

Info. which does not require Super Computers

Info. which does not require Super Computers

Info. which requires super computing

Info. which requires super computing LIMSLIMSLIMSLIMS

専用線

Iwate Tohoku Medical

MegabankOrganization

Molecular Info.

Molecular Info.

Clinical Info.

Anonymizing Control （ ToMM

o ）

Anonymizing control

room （ ToMMo ）

ToMMo Phase 0 ： Operating

ＭＭＷＩＮ：

Operating at 74 facilities

Constructing at 300 facilities

ToMMo Phase 1 、 Phase 2 ：

(under construction)

ToMMo Phase 3: Designing

Integrated MMB Repository

Ontological integration

Anonymizing

Control Room（

MM

WIN

）

TRITRI

Unified viewpoint for Construction （ in Tohoku Region ）

MMWINMMWIN

Tohoku Univ. School of Med. Tohoku Univ. School of Med. ICT InfrastructureICT Infrastructure

Foundation of Regional Medical Network ModelFoundation of Regional Medical Network Model

Prospective Cohort Analysis InformationWhole Genome Sequence Analysis

Information

Regional Medical ・ Nursing care ・ Welfare Information

Info. of Integrated Clinical Trials

Integrated Clinical Information including Research & Education

from all Tohoku region

Research/Analysis Information From Multi Medical fields

New Plan

InformationPipeline

Information around Future MedicineInformation around Bio-bank

ToMMo ToMMo

Groundwork of Advanced ResearchGroundwork of Advanced Research

Big DataBig Data

Multi-viewpointof Advanced Medical Information

Accumulated with respect to providing each medical care

Accumulated with respect to performing each analysis

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Tohoku Univ. Hospital Tohoku Univ. Hospital HISHIS

Tohoku Univ. Hospital Tohoku Univ. Hospital HISHIS

Tohoku Medical Information Tohoku Medical Information HighwayHighwayInformation

Pipeline

Then

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StandardPackaging

Road Map from Tohoku Medical Information Highway to Standards

Tohoku Medical Information HighwayTohoku Medical Information Highway

Japan Medical Information HighwayJapan Medical Information Highway

StandardPackaging

Spread to other Japanese regions

Export of disaster area Export of disaster area Healthcare IndustryHealthcare Industry

ToMMo MMWINTohoku Univ. Nerwork

Tohoku Univ. HIS

Tohoku Univ.TRI

National integration New industry creationin disaster area

5 years

3 years

10 years

Integrationof other

Japanese projects

Standardization Proposals will be

submitted

ISOISOWHOWHO

Standards for the Future Medicine

Other Japanese Regions Other Japanese Regions MI HighwaysMI Highways

Typical Construction by unified view point

J-MIPs: JapaneseMedical ICT Package

for Standardization

Tomorrow’s discussion issues

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What are the requirements to standardsin Disaster Medicine ?

in Future Medicine ?

How do we combine/utilize our standardsin Disaster Medicine ?

in Future Medicine ?

Thank　You

12

Jun　Nakaya

Tohoku　University,　School　of　Medicine

バイオバンク公開情報基盤バイオバンク公開情報基盤

公平な分配原則に基づいたセキュリティーに配慮したバイオ・バンク公開情報基盤

地域医療福祉連携情報基盤（みやぎモデル）地域医療福祉連携情報基盤（みやぎモデル）

災害に強く、利用者にとって役に立つ被災前より良い医療を実現しうる地域医療福祉連携情報基盤・情報収集基盤

メディカル・メガバンク解析保存情報基盤メディカル・メガバンク解析保存情報基盤

スーパーコンピュータ、オントロジー、分散クラウド、といった最新の技術レベルを結集した世界初の統合生命医療情報－解析・保存基盤

健診・コホート情報基盤健診・コホート情報基盤

被災者とその子供たちの未来に向けた健康管理とコホートデータ収集のための生命健康情報基盤

Ground ICT Design

４つの情報基盤を統合的に組み合わせた世界最高峰の

次世代生命医療情報基盤次世代生命医療情報基盤

収　　集

解析 保存 公　 　開

健康管理追跡医療福祉

Ministry of Education, Culture, Sports, Science and Technology budget (ToMMo)

Ministry of Internal Affairs and Communications, Ministry of Health, Labor and Welfare budget (MMWIN) 71