Design of and rationale for the Japan Diabetes compREhensive database project based on an Advanced electronic Medical record System (J-DREAMS)

Takehiro Sugiyama; Kengo Miyo; Tetsuro Tsujimoto; Ryota Kominami; Hiroshi Ohtsu; Mitsuru Ohsugi; Kayo Waki; Takashi Noguchi; Kazuhiko Ohe; Takashi Kadowaki; Masato Kasuga; Kohjiro Ueki; Hiroshi Kajio

doi:10.1007/s13340-017-0326-y

Design of and rationale for the Japan Diabetes compREhensive database project based on an Advanced electronic Medical record System (J-DREAMS)

Diabetol Int. 2017 Jun 27;8(4):375-382. doi: 10.1007/s13340-017-0326-y. eCollection 2017 Nov.

Authors

Takehiro Sugiyama^{1

2}, Kengo Miyo³, Tetsuro Tsujimoto⁴, Ryota Kominami^{3

5}, Hiroshi Ohtsu⁶, Mitsuru Ohsugi^{1

4}, Kayo Waki⁷, Takashi Noguchi^{8

9}, Kazuhiko Ohe⁹, Takashi Kadowaki¹⁰, Masato Kasuga¹¹, Kohjiro Ueki^{4

12}, Hiroshi Kajio⁴

Affiliations

¹ 1Diabetes and Metabolism Information Center, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655 Japan.
² 2Department of Public Health/Health Policy, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
³ 3Department of Medical Informatics, Center Hospital, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655 Japan.
⁴ 4Department of Diabetes, Endocrinology, and Metabolism, Center Hospital, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655 Japan.
⁵ 5Department of Biobank, Center Hospital, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655 Japan.
⁶ 6Department of Clinical Study and Informatics, Clinical Epidemiology Section/JCRAC Data Center, Center for Clinical Sciences, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655 Japan.
⁷ 7Department of Ubiquitous Health Informatics, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
⁸ 8Department of Information Technology and Management, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, Tokyo, 157-8535 Japan.
⁹ 9Department of Medical Informatics and Economics, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
¹⁰ 10Department of Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
¹¹ 11National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655 Japan.
¹² 12Diabetes Research Center, Research Institute, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo, 162-8655 Japan.

Abstract

The "Japan Diabetes compREhensive database project based on an Advanced electronic Medical record System" is a registry of patients with diabetes in Japan. The characteristics of this registry include a clinical information input process using the template function of an electronic medical record (EMR) system [the standard diabetes management template (SDMT)], a standardized exchangeable information storage format [the Standardized Structured Medical Information eXchange 2 (SS-MIX2)], and a secure and efficient information extraction process [Multipurpose Clinical Data Repository System (MCDRS)]. Together, these characteristics enable efficient data input during routine patient consultations, efficient and exact data extraction from each facility, and the integration of data across different facilities even though these data were generated by EMR systems from different vendors. The SDMT collects clinical information including the type of diabetes, body height and weight, blood pressure, lifestyle, and comorbidities. Completing this template triggers the automatic collection of other information such as fundamental information (sex, year and month of birth, and facility), prescription information, and laboratory examination results. As the information from every routine consultation is saved with an anonymized patient ID, linked data can be used as panel data allowing longitudinal investigations. The data obtained from the registry will allow analyses, for exmaple, mortality and morbidity risk, by various characteristics or drug types and may reveal unmet needs that inform future diabetes care.

Keywords: Diabetes; Electronic medical record; Japan; Medical informatics; Registry; SS-MIX2.