*Click here for the first half of the event report.
Seminar recording video second half: from the panel discussion
“AI and Digital Data for Medicine and Health: Current Status, Challenges, and Future”
Panelists: All speakers Moderator: Jun Murai
Murai: It is evident to everyone present that the advancement of the digital society is progressing rapidly, and we must keep up. The concept of the Digital Agency aims to ensure that no one is left behind, which is particularly relevant in the context of medical and healthcare services that affect everyone. Considering the vast population of over 100 million in Japan and more than 8 billion worldwide, it is worth discussing how long it will take to fully digitize medical care and health and where we can find opportunities for collaboration. These are the key topics I plan to explore in this seminar.
Ezaki: Convenience has proven to be a powerful force that can overcome any barriers. The ongoing discussions surrounding the social regulation system seem to be never-ending. A notable example is the initial skepticism surrounding drones and e-money in policy discussions, which were later widely adopted due to their inherent convenience.
Murai: I am convinced of the transformative power of convenience because I have personally witnessed a similar phenomenon during the development of the Internet.
Murai: A common challenge in digital transformation (DX) is establishing horizontal connections between vertically divided organizations. It is crucial to foster horizontal connections for sharing medical data, including data from various clinical departments. What are your thoughts on achieving this breakthrough?
Suematsu: While the importance of horizontal connections is widely acknowledged, individuals often perceive their own data as belonging solely to them while considering others’ data as theirs. Strong incentives such as ‘No share, No budget’ can be implemented to promote data sharing. For instance, in the case of the COVID-19 database GISAID, each country enters its data with regional attributes specifying the state or area. However, regarding Japan’s data, all regional tag information is labeled as Japan without any specific region specified. As a result, valuable information on new mutant strains was discovered in other areas except Japan. There was possibly a fear of being identified as the source of the epidemic in Japan, or it may have been unintentional. Nonetheless, this situation left Japan significantly behind, despite the global cooperation through a shared database. It is a matter of life and death, and Japan should deeply reflect on this point.
Murai: I believe this field related to human life and death should lead the way in DX as a whole society. Refusing to share data even for a purpose that no one says ‘No’ is because they fear risks. It’s typical behavior among government officials, but I wonder if the medical community, concerned with human life and death, avoids risks and doesn’t share data…
Murai: Regarding the data quality, what do you think about the problem of needing help to evaluate the measurement methods and accuracy?
Sakurada: From the perspective that it should be left to AI, it is impossible to determine what kind of data should be acquired and with what quality. By understanding the principles of AI and considering what kind of clinical problems can be solved with what type of data, we can narrow down which feature values should be chosen when converting codes into computable formats. As a result, it will shorten the time of DX.
Murai: The medical school of Keio has too few data scientists compared to the rest of the world.
Sakurada: The number of faculty members is undoubtedly small. However, many students understand clinical issues well and are capable. The potential is high, so I hope we can combine them.
Murai: I would like to inquire about the ownership and management of data generated from surgeries and surgical intelligence, which represents the expertise of a surgeon. Under what policy should these be governed?
Suda: This is indeed a complex question. Different stakeholders, including individual surgeons, hospitals, patients, companies, and various perspectives, hold differing opinions on surgical intelligence. Industry, government, academia, and citizens must collaborate for society’s overall public benefit rather than allowing companies’ exclusive use of surgical intelligence for profit alone. However, it is also essential to acknowledge that the collection of surgical intelligence often requires companies’ involvement. Therefore, to foster the advancement of this field, participating companies must adhere to increasingly stringent compliance regulations and transparently communicate the benefits they can provide to each stakeholder.
Ezaki: When the Personal Information Protection Law was established, we deliberated on the ownership of medical information and concluded that it does not belong to any specific entity. The Act on the Protection of Personal Information assumes that such information should be utilized for the benefit of humanity without attributing it to any individual. This approach safeguards individuals from harm from misusing their private information.
Murai: In terms of research and implementation, how can digital technology be effectively applied within hospital settings?
Jinzaki: The rapid proliferation, such as ChatGPT without sufficient verification or evidence-based discussion, is a concern. The medical community must carefully consider the risks and privacy implications, making adopting digital technologies challenging. Another obstacle in applying AI to the medical field is the tendency of AI systems to derive average values from large datasets, potentially overlooking the unique aspects that each case presents. It is imperative to research to determine the appropriate scope of AI applications and identify areas that require distinct development.
Murai: What are the critical challenges in fostering collaboration in the nursing care field?
Iwamoto: One of the most significant challenges is advocating for care recipients and facilitating effective communication with doctors and nurses. Nursing care lacks a specialized domain akin to medical science, making it essential to integrate medical and nursing expertise while digitizing and automating nursing care processes.
Murai: Are any challenges hindering home medical devices’ contribution to medical care?
Kazuma: While there is little difference in essential accuracy between home and consumer medical devices, the number of responses can vary significantly. Although both types of devices provide accurate data, there is a distinction between the person taking the measurements at home and a trained nurse.
Murai: Are there any notable differences between Japan and other countries in this regard? Should there be stricter regulations on advertising for medical devices in Japan?
Kazuma: In countries like the United States, reflecting a cultural emphasis on self-responsibility, families often rely on home medical devices when medical expenses increase. Advertising restrictions for medical devices are generally minimal in overseas markets. In contrast, Japan prioritizes safety by limiting access to unfamiliar products.
Murai: Your company possesses a unique wealth of data. How do you envision its future role?
Hamada: Given our extensive data on healthy individuals, we can provide valuable insights into areas closely related to healthcare, such as understanding how people maintain their health and expanding into domains closely linked to medical care.
Murai: The ‘Luna Luna’ and ‘Boshimo’ apps empower individuals to take responsibility for their health and utilize the apps for their benefit. How did your company ensure the successful utilization of data in these apps?
Miyamoto: We always prioritize the user’s perspective. By focusing on user convenience and considering the specific needs of women and mothers, we can collect high-quality data and deliver meaningful benefits.
Kiyoshi Kurokawa, Honorary Director, National Graduate Institute for Policy Studies and President, Japan Health Policy Institute
The participants in today’s gathering exhibited diverse themes and shared their unique stories. Despite their differences, Professor Murai’s broad perspective and organizational skills successfully united individuals in a common direction.
In Japan, there exists a tendency to rely on fixed notions of talent, which poses challenges to horizontal expansion. Consequently, such an event often favors authoritative figures with a bureaucratic mindset. Furthermore, when confronted with problems, many companies turn to government officials for assistance. This situation reflects a shortfall in achieving true democracy within Japan.
Given the current deceleration in Japan’s growth, it becomes crucial to critically evaluate the nature of democracy, free from any reservations towards the government. Part of the purpose of higher education is to foster individuals who can reflect on such matters. However, in Japan, many students, driven by the pursuit of university entrance exams, focus solely on rote learning without developing critical thinking skills. Additionally, there are a lot of second-generation politicians. Our collective responsibility is to shift from these prevailing norms and establish spaces that foster enjoyable and meaningful discussions akin to today’s gathering. Such endeavors also contribute to the development of the next generation.
(written by Hitomi Sano , photo by Shinichi Yamazaki)