We generated methods for evaluating clinical outcomes including treatment response in oncology using the unstructured data from electronic health records (EHR). This retrospective analysis used medical record database of University of Miyazaki Hospital and the Life Data Initiative EHR database of multiple hospitals in patients with lung cancer who are treated with anticancer therapy. For assessing key terms to describe treatment response (objective response [OR], stable disease [SD] or progressive disease [PD]) adjudicated by evaluators, natural language processing (NLP) rules were created. The most common key terms to describe OR were “reduction/shrink”, “(limited) effect”, “remarkable change”, “improvement”, etc., and “reduction/shrink” showed high sensitivity and specificity. These key terms were also found in the EHR database of multiple hospitals by a systematic review approach. This indicates that assessing response to anticancer therapy in patients with lung cancer using unstructured data of EHRs is feasible.

　In Japan, the adoption of health information exchange (HIE) has yet to be widespread, partly due to the absence of a suitable legal system to support it. This paper explores the current state of HIE adoption in the United States, delving into the analysis of two aspects of the U.S. legal system: obtaining patient consent for participation in HIEs and the responsibility of medical providers in processing information by HIEs. Under the federal legal system, providers are generally not obligated to ensure patient consent for HIE participation. However, the Department of Health and Human Services recommends offering patients at least the option to opt out of participating in an HIE. Furthermore, the federal rule establishes only limited liability for healthcare providers. It is important to note that both federal and state systems oversee HIEs in the U.S., with the state system having a substantial influence on the actual operation of HIEs. Drawing on the U.S. analysis, this paper puts forward potential amendments to the Japanese legal system for each of the two key elements, aiming to facilitate the advancement of HIE in Japan while taking into consideration its existing legal framework.

　Medical and residential institutions for persons with severe motor and intellectual disabilities (SMID) restricted face-to-face visitations owing to the abrupt outbreak of COVID-19. They launched online visitation as an alternative. This study investigated the perceptions of online visitations among the families of persons with SMID. A questionnaire survey was administered to each family of an institution for persons with SMID. Overall, 33 and 109 respondents used and did not use online visitations, respectively. Most users had some information and communication technology (ICT) devices, such as a smartphone, and were able to operate these devices on their own. The schedule of online visitation seemed acceptable. Most users had a positive impression of online visitation. Some, however, pointed out a limitation of online visitation in that it allows only audio-visual communication, and no physical contact. A considerable number of non-users either did not have any or could not operate their own ICT devices (approximately 60％). Another issue was the prevalence of profound communication disabilities in some of the persons with SMID. The results suggest that greater support from institutions and gaining more experience are vital for promoting online visitation.