WMA-HDB-Seoul_YAMAMOTO

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Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
2 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
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3 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
4 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
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5 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
6 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
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7 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
8 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
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9 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
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10 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
Prefixed
Analysis
NDB is defined in “Elderly Persons’
Health Care Act” for creating adequate
health care insurance policy.
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11 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
Usage under “Elderly Person’s
Health Care Act”
Health Insurance bureau
of MHLW
Prefectural Governments
Analysis for creating adequate health
insurance policy
Analysis by MHLW
Publication
To evaluate the
health insurance
policy of MHLW
Analysis by
Prefectural
Governments
12 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
Usage under “Elderly Person’s
Health Care Act”
Usage for other purposes
(without any legislation support)
Health Insurance bureau
of MHLW
Prefectural Governments
Other bureaus of MHLW, Other
Ministries, local basic governments
Research Institutes
Analysis for creating adequate health
insurance policy
Analysis by MHLW
Publication
To evaluate the
health insurance
policy of MHLW
Analysis by
Prefectural
Governments
Evidence based policy for
improvement of medical or
other health services
Researches for
making adequate
policy
Researches for
public good
For example:
Survey for infectious diseases
Survey for the balanced medical care
and nursing care
Judgment by Assessment Committee
evaluating the necessity of using NDB data
evaluating the public goodness of the survey or the research
Decision by
Minister of MHLW
Advise to Minister of MHLW
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13 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
14 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
Date of birth (only month and year values)
Diagnosis
Data of beginning of care and number of days for care
Health institute ID
Kind of visit
Existence of educational guidance
Prescriptions with drug code, Injections with drug code
Codes of medical procedures, Codes of Surgical Operations
Codes of laboratory, physiological and radiological examination (without results)
Codes of Imaging diagnosis
Total costs
Double hashed value of Insurance claim ID, birth date and gender
Double hashed value of Name, birth date and gender
Date of check-up or educational guidance
Code of Health plan
Code of examination institute
Gender and postal code
Results of examinations and educational guidance
Level of educational guidance
Double hashed value of Insurance claim ID, birth date and gender
Double hashed value of Name, birth date and gender
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15 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
Prefixed
Analysis
NDB is defined in “Elderly Persons’
Health Care Act” for creating adequate
health care insurance policy.
16 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
Date of birth (only month and year values)
Diagnosis
Data of beginning of care and number of days for care
Health institute ID
Kind of visit
Existence of educational guidance
Prescriptions with drug code, Injections with drug code
Codes of medical procedures, Codes of Surgical Operations
Codes of laboratory, physiological and radiological examination (without results)
Codes of Imaging diagnosis
Total costs
Double hashed value of Insurance claim ID, birth date and gender
Double hashed value of Name, birth date and gender
Date of check-up or educational guidance
Code of Health plan
Code of examination institute
Gender and postal code
Results of examinations and educational guidance
Level of educational guidance
Double hashed value of Insurance claim ID, birth date and gender
Double hashed value of Name, birth date and gender
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17 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
18 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
Korean HIRA DB, Taiwan’s NHI Research DB, Japanese NDB
Korea Taiwan Japan
Name of DB HIRA DB NHI Research DB Claims and specific
screening information
DB
General
description
Nationwide insurance claims database (nearly 100% coverage)
(Japanese NDB incudes health check-up for LRD data)
Other linkable
data sources
Not allowed Partially allowed if
patient consent was
provided
Not allowed
Data starting Since July 2000 Since January 1996 Since April 2009
Number of
beneficiaries
48 million 23 million 128 million
Data availability
/application for
research
Open to restricted
researchers who are
performing national
projects (HIRA Claims
Data Providing
Review Committee)
approval is needed)
Open to academic
researchers through
application, review for
purpose and size of
population
Open to researchers
through application,
review for purpose
(under discussion, pilot
period from April 2011,
and available from April
2013)
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19 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
Korean HIRA DB, Taiwan’s NHI Research DB, Japanese NDB
Korea Taiwan Japan
Timing of data
update
Monthly Annually Monthly for claims,
annually for health
checkup
Latest data Last month Previous year 2 months ago for claims
Birth
year/month/date
Yes/yes/yes Yes/yes/yes Yes/yes/no
Body height
/weight
No/no No/no Limited to health check
data and/or DPC data
Prescriptions
Prescription
month /day
Yes/yes No/no Yes/yes
Dispensing
month/day
Yes/yes Yes/yes Yes/yes
Dose / strength
/quantity
Yes/yes/yes Yes/yes/yes Yes/yes/yes
Vaccine No Yes Limited to officially
reimbursed vaccines
20 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
Korean HIRA DB, Taiwan’s NHI Research DB, Japanese NDB
Korea Taiwan Japan
Procedures,
surgical
operations codes
Korea Ministry of
Health and Welfare
standardized
reimbursement coding
system
ICD-9 procedure codes Japan original
standardized
reimbursement coding
system
Hospitalization
Admission date Yes Yes Yes
Medication while
hospitalized
Yes Yes Yes
Discharge
diagnosis
Yes No Yes
Diagnosis code ICD-10 ICD-9 ICD-10
Laboratory test
order/result
Yes/no Yes/no Limited to annual health
check data
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21 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
22 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
Another National Health Database projects:JapaneseSentinel Project
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23 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
24 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
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25 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
SS-MIX:
Standardized Structured Medical record Information eXchange
Based on HL7 version 2.5 messages, CDA R2, and DICOM
Over 200 hospitals already implemented SS-MIX standardized
Storage system.
26 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
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27 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
28 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
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29 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
30 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
Using Health data for public good (versus Privacy? )
For balancing privacy and public good,We should discuss about:
We need well acceptable ethical cord.
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31 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
32 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
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33 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016
Deep Freezer is so heavy and
easily locked.
Biobank
Health database
“Database” includes:
> gathering data from various institutes
> indexing or preprocessing native data
> send subset to various analysts
> …..
There are many attack points!
34 Copy Right: Ryuichi Yamamoto, Graduate school of Medicine, The University of Tokyo, 2016