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Social Value Creation Report "Quality of Life"

The key is to extend healthy life expectancy
A sustainable longevity society made possible with digital healthcare

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January 21, 2019

As the super-aged society continues to develop in Japan, social security costs are forecast to rapidly increase as the ratio of elderly aged 75 or older continues to increase.

There are also concerns that the current social security system will not be able to support a longevity society, while properly reducing social security costs and building a sustainable society are now urgent issues facing the government. This is a common issue facing developed countries, and will become an issue in many countries mostly in Asia as their societies rapidly age. One solution gaining attention as a key to resolving this issue is to extend healthy life expectancy so that everyone can continue to live healthy and autonomous lives. Efforts are underway in countries all over the world to develop advanced healthcare systems to extend healthy life expectancy that use healthcare/ personal data and digital technology such as IoT and AI. This report introduces conditions surrounding this issue and some advanced initiatives both inside and outside Japan. It also introduces the new healthcare of the digital age NEC is working to realize and some initiatives being conducted toward that end through co-creation with customers and partners.

Measures required by a super-aging society to curb social security costs

Falling birthrates, aging populations, and the expanding burden of social security costs

The population of Japan continues to drop gradually. In 2010, the population peaked at 128.06 million and then began to drop, and the population is expected to fall below 100 million in 2055.*1

Looking at the population ratio shows that, although elderly aged 65 or older accounted for 25.6% of the total in 2013, that same age group is predicted to account for 30.4% of the total in 2025. The ratio of elderly aged 75 or older will rapidly increase from 12.4% to 18.1% over the same period.*2

Due to the rapid progression of the super-aging society, social security costs are expected to increase more than 10% every five years, from 119.8 trillion yen in FY 2015, to 134.4 trillion yen in FY 2020 and 148.9 trillion yen in FY 2025.

Among these continuously rising social security costs, healthcare and nursing care payments are increasing at an especially rapid rate. A comparison of transitions in FY 2012 and FY 2025 shows an actual increase of 1.5 times for healthcare costs and 2.4 times for nursing care costs.*3

With Japan's overall population decreasing, we are already seeing a situation where the relatively small young adult segment is supporting social security costs.

*1 Source: Cabinet Office, "Annual Report on the Aging Society"

*2 Source: Ministry of Health, Labour and Welfare, "Agenda (First) for Dialog on Relationship between Healthcare and Nursing Care"

"Healthy life expectancy" holds the key to reducing social security costs

One possible reason for increasing social security costs in Japan is the difference in healthcare expenses by age. In contrast with 218,000 yen per person for people below the age of 75, it costs 930,000 yen per person to provide healthcare for those 75 years or older.*4 The difference is clear. Nursing care expenses similarly increase with age.

What is gaining attention as the key to curbing increases in social security costs is "healthy life expectancy." If healthy life expectancy can be increased, it should be possible to curb healthcare and nursing care payments even if the number of elderly people increases.

However, there is a difference of around nine years in men and 12 years in women between average life expectancy and healthy life expectancy, and this has not changed much over the last 15 years. Reducing this difference as much as possible could reduce the burden of social security.

Japan is not the only country concerned over the rapid increase of social security burdens due to the aging society. There is a global trend of aging, especially in developed countries. There are even countries within Asia expected to exceed Japan in the rate at which their societies are aging, and countries all over the world facing this issue are watching the leading country of Japan with interest to see how it deals with the situation.

*3 Source: Ministry of Health, Labour and Welfare, "Overall Perspective on Social Security System Reforms"

*4 Source: Institute for International Socio-Economic Studies, "Investigative Research Report on Innovation Using AI/IoT in the Health, Healthcare, and Nursing Care Fields"

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Efforts to implement data-driven healthcare systems throughout the world

Denmark is engaged in government-led initiatives to use data

Efforts to utilize healthcare and health-related data are underway in countries around the world with the goal of realizing healthier societies. These efforts are being conducted through a variety of means, such as e-government initiatives and innovative services provided by healthcare-related corporations.

One country actively involved in government-led data utilization is Denmark. Since introducing its personal identification number (CPR number) in 1968, the government has had more than 40 years of experience running this system and has promoted government streamlining through digitization under its e-government strategy.

One characteristic of Denmark in the healthcare field is that personal medical record information, healthcare application information, and healthcare/ health-related data are all associated with an individual's CPR number and centrally managed. An individual or his or her registered family members can access this data on "sundhed.dk," the government's healthcare portal site. This helps to increase individual health awareness and can even be used for health management and preventive medicine. Medical personnel can also access patient medical examination and prescription records through "sundhed.dk," making it possible to provide consistent treatment processes.

In January 2018, the government announced a new four-year plan on utilizing data in the healthcare field. This new plan aims to digitize prevention, care, and treatment data, enhance the use of this data, and continue to develop healthcare systems.

Private-sector-led efforts to extend healthy life expectancy in the Netherlands

Efforts to promote the use of data toward extending healthy life expectancy are underway in the Netherlands. In 2016, the "MedMij" project was launched to promote personal health records (PHRs), which are electronic lifetime health records that contain data taken throughout the patient's entire life for the benefit of improving his or her health.

A characteristic of this initiative in the Netherlands is that it urges voluntary health promotion through the self-reliant efforts of citizens. The role of the government here extends only to providing a rough policy and leaving the operation of services to private organizations and corporations, in order to encourage improvements to healthcare quality through market principles.

For MedMij, the government is responsible for standardizing data, ensuring interoperability between systems, protecting personal information, and establishing security. Private corporations are responsible for developing PHR platforms. Individuals independently choose platforms offered by multiple companies. In this project, health information is summarized and visualized for each individual, and the information flow from doctors to individuals is corrected, in order to build a system in which individuals are able to manage their own health information.

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Building the Japanese government's next generation healthcare system

Building a healthcare information network through establishing EHRs

Initiatives to use data to improve healthcare and advance health have also begun in Japan. One of the themes in the Japanese government's "Growth Strategy" (a series of national growth strategies) is "extension of healthy life expectancy," and the government has set a policy of promoting the use of data as a foundation for providing health, healthcare, and nursing care services.

Growth Strategy 2018, which was approved by the Cabinet in FY 2018, provides five concrete measures: build a framework to confirm qualifications online, link and use health/healthcare information in healthcare providers and other organizations, link and use nursing care information from various professions in the nursing care field, establish PHRs, and build a foundation for analyzing healthcare/nursing care information in the form of big data. With regard to linking and using health/healthcare information, the government has already verified network interconnectivity, data exchange, and security protection in FY 2017, with the goal of bringing a national healthcare information network into full operation. The plan is to link around 250 regional healthcare linked networks (EHRs) across the country, establish bidirectional and low cost EHRs that make use of the cloud, and build a national healthcare information network in 2020.

Promoting the use of PHRs with the introduction of private service providers

Government research institutions continue to work on research projects to develop PHR service models that cover four life stages (supporting pregnancy/childbirth/child raising, preventing illness/nursing care, preventing lifestyle diseases from worsening, and healthcare/nursing care collaboration) and research toward meant to establish foundational technologies. Institutions are also investigating whether a wide range of healthcare information (such as vaccination records or health check data including specific health checkups and infant health checks) should be provided, with the goal of providing data to individuals through the "Mynaportal" My Number*5 ID website.

Private service providers are also making more use of individual health, healthcare, and nursing care data with the consent of individuals. This is expected to promote creativity and ingenuity in private services, such as providing feedback to individuals or their families on vital data measured by wearable devices or the state of nursing care service being provided, and linking this information with electronic drug history handbooks.

During the 18th Growth Strategy Council*6, it was stated that "it will be necessary to attempt to increase the number of production workers and improve social productivity through preventing presymptomatic illnesses for dementia and other lifestyle diseases and stopping illnesses from getting worse." With this in mind, the goal of the Growth Strategy is to "open a path to sustainable growth by overcoming the falling birthrate and aging population" through the use of ICT. Building a next generation healthcare system has been positioned as one way to realize this.

*5 "My Number” is the national identification system of Japan in which a 12-digit ID number is issued to all citizens and residents.

*6 Growth Strategy Council: A conference held as a means of controlling growth strategies under the Headquarters for Japan’s Economic Revitalization, in order to promote bold public-private investment in fields that will contribute to future economic growth, and to accelerate growth strategies and structural reforms toward expanding "investment in the future."

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NEC's initiatives to use data to extend healthy life expectancy

Visualizing future health conditions to promote behavioral changes

NEC continues to work with a wide range of stakeholders to promote unique initiatives that make the most use of data and AI, with the goal of using data to extend healthy life expectancy. One such initiative is a joint project with Suginami Ward in Tokyo to use data from specific health checkups to help improve the lifestyle habits of its residents.

In Suginami Ward, one of the technologies of a group of cutting-edge AI technologies collectively known as “NEC the WISE”*7 was used to conduct an "NEC health check result prediction simulation" using the Heterogeneous Mixture Learning Technology that discovers multiple regularities from connections among a wide range of data and generates predictive formulas for each regularity during the 2018 fiscal year. This solution uses AI to create a model to predict health check results, in order to visualize future health conditions.

The simulation predicts future medical exam results on a yearly basis for three years. Two sets of results are provided on advice sheets: one in which the resident maintains their current lifestyle, and one in which the resident revises their lifestyle. The goal of the simulation is to improve lifestyle diseases early on by predicting the future health condition of each individual from specific health checkup data gathered from ward residents and providing advice sheets to those residents who might need to improve their lifestyle habits.

The goal is to make it easier for residents to realize the risk that health problems could pose in the future and voluntarily make improvements to their lifestyle habits, by presenting results as numerical data, allowing residents to easily visualize the state of their health in the future.

*7 NEC the WISE is a group of NEC’s cutting-edge AI technologies that maximizes human intellectually creative activities.

Providing optimal care plans to promote autonomy among the elderly

One other example of using data is the joint research being conducted with NICHIIGAKKAN CO., LTD. on developing nursing care and autonomous support services for the elderly.

Normally, a care manager is responsible for writing individual care plans for elderly patients. The goal of this joint research is to propose care plans that could help support the autonomy of elderly patients by using NEC's AI (Heterogeneous Mixture Learning Technology) to learn from and analyze a range of data gathered from them.

As society ages, there will be a growing need for nursing care service personnel to support the autonomous lifestyles of the elderly. The aim of this joint research is to reduce the load on care managers and other nursing care business staff and to train personnel capable of writing care plans that are even more effective.

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Implementing wellness services to support the switch to preventive medicine

Increasing health awareness through providing individualized wellness services

Using IoT and wearable devices to gather daily vital data is key when considering healthcare based on data analysis. Gathered data is analyzed and optimal feedback is provided toward realizing effective health management. NEC continues to work with specialized partners to apply the use of data toward preventive medicine.

For example, FiNC Technologies Inc. and NEC are working together to develop a new wellness service that combines FiNC's corporate wellness service, "FiNC for BUSINESS," and NEC's IoT devices and cutting-edge AI technology group, "NEC the WISE." NEC is conducting internal trials to visualize and analyze vital data obtained from wearable devices together with life log data, such as diet and exercise data, gathered by FiNC Technologies Inc.. This will make it possible to obtain data on daily changes to health conditions that would be difficult to obtain with conventional routine physical examinations—without requiring the individual to enter any data—and to provide timely improvement advice for each individual.

Both companies have strengths in AI and IoT technologies, and these technologies are being used to develop new solutions in combination with a range of data from offices, regional healthcare providers, sports facilities, and more—with the ultimate goal of building a healthcare platform.

Health changes and signs seen from walking status

Maintaining a constant awareness of one's health is difficult even for those who are trying to live a healthy lifestyle to extend their healthy life expectancy. Wearable devices can monitor health conditions without the wearer even knowing it. A solution that focuses on walking is being jointly developed by both NEC and FiNC Technologies Inc. for just this purpose.

Until now, identifying someone's walking status required analyzing video or attaching wearable sensors directly to their body, and was problematic in terms of location, convenience, and cost. However, smaller and lighter wearable sensors can now be inserted into shoes or insoles, making it possible to gather walking data every day without the wearer even being aware.

This solution is used to analyze walking data gathered by wearable sensors together with life log data collected by FiNC Technologies Inc. and provide health advice to the individual, in order to help make improvements. All of this data can then be analyzed in "FiNC for BUSINESS," allowing companies to promote corporate wellness.

Wearable devices are one means of gathering required data without intruding on day-to-day life, and can draw attention to health conditions and urge suitable action.

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NEC's digital healthcare to realize an healthy longevity society

Utilizing data and engaging in co-creation with partners to extend healthy life expectancy

NEC has provided a range of solutions to support the work of healthcare providers and local governments, such as electronic health records and linking community healthcare. In order to face the issue of rising social security costs following the aging of society with only limited healthcare resources, NEC believes that we will need to transform awareness "from treatment to prevention" and extend the healthy life expectancy of each individual.

Using data that makes use of IoT and AI will be the key to resolving this issue. Using digital technology will make it possible to gather a wide range of individual data that could not previously be obtained. Providing advice at the appropriate time and using the appropriate means based on each individual's state of health could bring people to realize things they would not otherwise have been able to.

In order to provide actual services, it will be crucial to engage in co-creation with highly specialized partners. We will continue to create new services that can help to extend healthy life expectancy, by combining the data and expertise of our partner corporations with NEC's cutting-edge IoT/AI-related technologies and data analysis know-how.

Efforts to realize healthcare in the digital age

NEC continues to work with its partners to provide new healthcare system for the digital age, through its analysis/integration platforms that allow healthcare data from healthcare providers and wellness corporations to be used safely and conveniently.

More specifically, we continue to gather a range of data, such as personal data from daily life and healthcare data obtained from healthcare providers and nursing care facilities. This data is integrated, structured, and then analyzed using technologies such as AI, allowing for realization and recognition that would otherwise not be possible.

This system also makes it possible to use personal data safely with the consent of the individual, and can help to create new value through promoting the use of data with healthcare/nursing care-related corporations and organizations, local governments, healthcare providers, and other partners.

In defining what a Healthy City is, the WHO*8 states that, "it is important to promote health throughout the entire city as the population becomes concentrated within it." NEC will continue to actively provide assets in which it boasts strengths such as IoT and AI, create new healthcare systems through co-creation with partners in a wide range of fields including healthcare, help to realize healthy longevity society in which people can live active lives healthy in mind and body, and help to create towns to support all of this.

If you have any comments or concerns regarding the contents of this report or NEC initiatives, please feel free to contact us.

*8 WHO: World Health Organization

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