Now is the time for DX in healthcare. The Shibuya Ward Medical Association's challenge to combat healthcare collapse.

The COVID-19 pandemic has highlighted various challenges within Japan's community healthcare system.

The Shibuya Ward Medical Association, which had been working on reforming the entire medical system using IT even before the pandemic, introduced the medical institution appointment/digital consultation system "CLIEN" as one means to address the challenge of "many local residents and workers in the area lacking a primary care physician."

What problems are currently occurring in the field of community healthcare? What can be done to solve them?

We introduce the vision for community healthcare that CLIEN aims to achieve, alongside the case study of the Shibuya Ward Medical Association.

The pandemic highlighted a lack of awareness about "family doctors"

 

CLIEN is a service that allows users to search for and book appointments at nearby clinics and hospitals. It also enables users to fill out and send pre-visit questionnaires to their chosen clinic or hospital. Its key features include the ability to search, book appointments, and complete questionnaires using just a smartphone or computer. The design is intentionally simple, ensuring intuitive operation across all age groups.

Furthermore, data integration allows the accumulation of information such as what physical and mental health concerns patients have and what illnesses are prevalent in the area. This enables the rapid provision of optimal medical services tailored to each individual patient.

Currently, the "medical collapse" caused by the COVID-19 shock is drawing public attention. One factor contributing to the crisis in public institutions was the concentration of inquiries from people without a primary care physician at public health centers.

However, this problem of "no regular doctor" existed before COVID-19 and will not be resolved once the pandemic subsides. The goal is for as many people as possible to find a clinic or hospital they can rely on anytime. To achieve this, it is crucial to provide services that are easy for residents to use and facilitate collaboration between local people and medical institutions.

While Japan's healthcare system and technology are world-class, Japanese satisfaction with healthcare is reportedly among the lowest in developed nations. Convenience issues persist, such as handwritten medical questionnaires and limited appointment options to phone calls. There's also a lack of information, leaving people unsure which clinic best suits them when they fall ill or get injured. From a user perspective, resolving these issues is one key solution.

The CLIEN service leverages digital power to solve these very challenges.

Developed in close collaboration with the Shibuya Ward Medical Association

 

The Shibuya Ward Medical Association provided full cooperation for this CLIEN development.

Initially, they approached us about renewing their website. Upon further discussion, we learned they wanted to incorporate a medical facility search function and increase awareness of the concept of a "family doctor." Furthermore, since residents of this IT hub are highly tech-savvy, we proposed CLIEN, which was still in development. They agreed to partner with us to advance the project.

Just as we were developing at a rapid pace, COVID-19 cases surged nationwide. To emphasize the importance of primary care physicians to local residents, we aired a CLIEN commercial at the famous scramble crossing. The response exceeded expectations, reaffirming the vital importance of connecting local residents with medical institutions.

Now, the Shibuya Ward Medical Association, which supported CLIEN's development in close collaboration with Dentsu Inc., had been challenging the reform of medical systems using IT even before COVID-19. They have also been energetically working to prevent the collapse of local healthcare during the pandemic.

This time, from the perspective of supporting local healthcare, we interviewed Keiko Lee, President of the Shibuya Ward Medical Association and CLIEN Project Manager Aaron Zu, to learn about the challenges revealed during the pandemic and what we can do to prevent healthcare collapse.

In Shibuya, a hub for IT and tourism, leveraging IT for information sharing is indispensable.

 

Aaron: First, I understand the Shibuya Medical Association had been pursuing IT-driven reforms even before COVID-19. What challenges were you particularly conscious of?

Lee: When the current structure was established in 2019, the Shibuya Medical Association adopted a broad policy: "While assessing the national healthcare system, we will develop health, medical care, and nursing services rooted in the Shibuya community." Under this policy, we were working on reforming the association's entire system. A major challenge within that effort was effectively sharing information and capturing the needs of local residents using IT.

Aaron: Shibuya Ward is home to many prominent IT companies and startups, so it seems like there are a lot of people with high IT literacy.

Lee: Yes, in addition to Shibuya residents and workers, Shibuya is also a tourist destination attracting visitors from various countries and regions—though numbers have decreased during the pandemic. Our goal was to provide swift and effective information sharing to all these groups while understanding local healthcare needs. To achieve this two-way communication through IT, our first step was a website renewal.

Aaron: We ended up assisting with that, but the more I heard about it, the more I realized this wasn't a problem that could be solved just by rebuilding the website (laughs). So, I proposed CLIEN, which we had just started developing.

Lee: I thought it would be easy and convenient for everyone to use, and also a service that would help medical institutions understand the needs and circumstances of local residents and collaborate with them.

Determined to prevent healthcare collapse at all costs, she worked tirelessly to build community partnerships

 

Aaron: Right around that time, COVID-19 cases surged dramatically. Looking back, what challenges were highlighted during the pandemic?

Lee: First, at the national level, it became clear that a center for infectious disease control, like the U.S. Centers for Disease Control and Prevention (CDC), was not sufficiently established. This needs to be set up and operated urgently.

Furthermore, Japan actually has few infectious disease specialists, and general hospitals don't necessarily have them on staff. The number of research papers published on the current novel coronavirus infection is also extremely low compared to other countries.

In other words, there is a lack of awareness and knowledge about infectious diseases across Japan as a whole. As a result, there is a significant amount of reputational damage caused by misinformation about infectious diseases.

Aaron: There's a lack of accurate knowledge about infectious diseases, and few experts capable of conveying correct information. It's true that conflicting information is everywhere, making everyone anxious.

Lee: I feel a real sense of crisis that if we don't thoroughly learn about infectious diseases now, the next time an emerging infectious disease or new influenza strain spreads, it could lead not only to a collapse of medical care but also to the financial collapse of medical institutions. To prevent this, I've been reminded how crucial it is to leverage IT for rapid information provision and sharing.

Aaron: What initiatives did the Shibuya Ward Medical Association undertake during the COVID-19 pandemic?

Lee: Since Japan's first COVID-19 case was reported in January 2020, we've collaborated with the district's core hospitals, Shibuya Ward, and the public health center to ensure clinics could respond effectively and to share critical information swiftly to protect residents' health. However, by late February, core hospitals in the ward were already overwhelmed with patients, pushing Shibuya's healthcare system to the brink of crisis.

Determined to prevent a collapse of the healthcare system at all costs, we held emergency meetings with Shibuya Ward, the Public Health Center, and core hospitals. We created response charts for medical institutions to handle patients with fever and distributed surgical masks and protective clothing from disaster stockpiles to the most urgent medical facilities.

In April, a PCR testing facility was established under the leadership of the Medical Association, beginning PCR testing for patients referred by the Public Health Center. Currently, it also accepts patients referred from clinics and other facilities, coordinating the medical institutions conducting PCR testing within the ward.

Aaron: So, each organization is working together seamlessly to respond swiftly and meticulously to the rapidly changing situation.

Lee: Yes. Coordinating with all institutions is crucial. Establishing systems to ensure patients can smoothly receive medical care and testing is indispensable.

Aaron: As the hub of community healthcare, the Medical Association must strengthen collaboration while also constantly analyzing, in real time, the healthcare challenges faced by residents and workers in the area. Providing appropriate information as quickly as possible is also necessary, right?

Lee: During the pandemic, I believe Shibuya residents and those working in Shibuya have come to understand anew the importance of having a primary care physician. I see CLIEN playing a part in helping people find that primary care physician.

Having a primary care physician enables patients to visit hospitals when necessary, which we believe helps prevent the collapse of emergency department care.

Aaron: We'd be delighted if we could contribute to that effort. Japan's medical standards are world-class, yet the reality is that few medical institutions can fully meet patient needs. By establishing CLIEN across generations and regions, we aim to contribute, even in a small way, to connecting patients and doctors.

Lee: The COVID-19 situation remains unpredictable. As the Medical Association, we will work diligently to ensure patients with fever receive reliable and prompt medical care, utilizing CLIEN as well, to absolutely prevent a collapse of the healthcare system.

Aaron: We look forward to your continued support. Thank you for today.

---

We heard from Chairman Lee about various challenges in healthcare and the efforts to address them. However, issues like improving IT literacy and utilizing data are not limited to the healthcare industry.

The need for remote meetings, cashless payments, and digitizing paper documents has been discussed for quite some time. However, the reality is that progress has been slow.

Particularly in a country like Japan with well-established social infrastructure, achieving compatibility between new and existing systems inevitably becomes a major challenge. Seeing how other countries, despite being latecomers, are rapidly advancing IT utilization, I can't help but feel Japan needs to push harder.

In that sense, I intend to continue dedicating myself to this work so that it can significantly contribute to Japan's development.