3 ．Utilization of the Tokushukai Medical Database

Abstract

The Tokushukai Group is one of the largest hospital groups in Japan. By connecting all the hospitals via a network, the group has been able to achieve centralized management of clinical information. The Tokushukai Group has been utilizing the data in various ways, such as participation in clinical trials, development of anticancer drug protocol systems, participation in BioBank Japan, and provision of data to MID‒NET^®. These days, the Tokushukai Group has started to provide the data, named as the “Tokushukai Medical Database (TMD)”, to academia and industries for research purposes. The TMD mainly consists of inpatient and outpatient administrative claims data, Diagnosis Procedure Combination (DPC) data, electronic health records including blood test results and vital signs, and hospital-based cancer registry information. The strengths of the TMD include the availability of blood test results and vital signs in an standardized format, and the possibility to go back to each patient's electronic medical record from their claims data and DPC data, with the permission of headquarters and the ethics committee in the Tokushukai group. By taking advantage of these strengths, there have been increasing number of studies in the TMD, such as research on acute kidney injury defined as blood test results, hyperkalemia in dialysis patients, and validation study on rheumatoid arthritis. The issues newly raised during the utilization of data (e.g., echocardiography data not standardized) are expected to be resolved with the update of the network system for a wider range of research topics in the future.