Full Automatic Syndromic Surveillance System Using Prescription in Japan

I Medical services for outpatients are well developed due to universal public health insurance. Even patients who have mild symptoms can visit a clinic freely in Japan. Thus the monitoring of outpatients provides very timely information to detect unusual events. On the other hand, EMRs haven't had much penetration, less than 10% at clinics and 20% at hospitals. Moreover, almost nobody uses HL7 or other standards for EMRs. Therefore, it is very difficult to develop a syndromic surveillance system using EMRs like the U.S. We have to develop a system for each EMR and it has a heavy cost. In Japan, there are about 40 thousand pharmaciesand almost half of drugs prescribed are delivered through pharmacies. Almost all pharmacies record prescriptions electronically. Objective: So that full automatic syndromic surveillance cover the whole of nation, we construct the system using the information of prescription.