Plan Data Health is a framework for Japanese health insurance organizations to implement data-driven managed health services based on analysis of member health checkup and medical receipt data. The goal is to improve preventive health management and outcomes using a business management cycle approach. Health insurance organizations will use outsourced experts and collaborate with employers to provide tailored health promotion programs and monitor their effectiveness over time through continuous data analysis and review.

1. What is Plan Data Health?
a translation of a guideline for introducing
Plan Data Health published in Dec. 2014
by MHLW of Japan
Suda Yasuji (sudays17@gmail.com)

2. Japan national cabinet required
in Japan revitalize strategy “Japan is
back”(2013.6.14),
"all health insurance organization from
municipal-base to private-base
will implement Plan Data Health
to analyze data of medical receipts
and a like to promote better health
condition of its member."
http://www.kantei.go.jp/jp/singi/keizaisaisei/pdf/saikou_jpn.pdfsource(Japanese)
Why Plan Data Health introduced ?

3. According to this MHLW issued 2 revised-
directives of health promotions applying
to all health insurance organizations.
• to apply business management system
cycle to health promotions for more
efficient and more effective way
• to implement them based on analysis of
digitized health and medical data
Why Plan Data Health introduced ?
source(Japanese) : directive of health promotions private health insurance org.
directive of health promotions public health insurance org.

4. What is Plan Data Health ?
Plan Data Health（PDH） is …
to do a business (health promotions) based on analysis
of data of health checkups and medical receipts.
is a game changer from cost(burden) to invest in
employee health management.
to apply to all payers (health insurance organizations)
under Japan national health system.
focusing to improve preventive health management
performance using PDCA business cycle. (A)
(B)
(C)

5. Make a plan based on data analysis
・target health issues and business
・set purpose
・select activities considering cost-effectiveness
Revise a plan for next cycle
Review effectiveness of planned
activities(numerical base)
Execute planned activities
・tailored information to each
member
・health check ups and coaching
・actions to progress of health
problems
（A）management system approach to managed
health services

6. PDH
of
private
health
insurance
org.
Step 2
Target health issues
Step 3
Select business
depending its
health issues,
set KPI
Step 4
Apply management
system approach
Step 1
Survey health stats.
Planning steps Examples of activities
Use medical
receipts info. sys.
Use info. sys.
of outsourcer
Get analysis results
・expenditure per capita of
cardiovascular disease
Execute walking
program
Distribute brochures
Support smoking
cessation
Prevent diabetes
advancing
Newly grouped to
metabolic syndrome
⇒notify them what
are needed
（B）PDH execution steps model

7. invest
purchase health
products & services
Effect
providers &venders
health
exam.
counsel&
coach
sample
analysis
productspayer employee
employer
improve productivity
& corporate image
improve member’s health
manage expenditure
promote health
prevent life-style related
diseases
Golden cycle to
create or expand
marketsCycle of investment for health
Focusing collaboration with occupational health
⇒Occupational health could be a leverage of PDH.
（C）Conceptual model of investment for health

8. Features of PDH
for employee of private companies(private sector health
insurance org.)
※these feature also fit for member of municipal
health insurance org.
１ handle health and medical info. including specified
medical check-up and medical receipts
２ set managed health services depending its financial
and business environment
３ collaborate with employer(occupational health) for
services, namely “collabo(ration)-health”
４ will use experts outside of org.
Data driven
managed health service providers

9. Features of PDH
service providers
①ideal scheme of employee health management
Source : about plan data health
payer
(health insurance org.)
core tasks
・execute business with PDCA
・finance and recruit
・data management
core roles
・make alliance principle
with payer
・provide resource to
payer
collaboration
employer
outsource
report member’s health conditions
report about health promotion
finance
stuff
・planner
・info./data provider
・coach/counselor
member
(employee and
their dependent)
improve and maintain
their health
Focusing collaboration with occupational health

10. Why will they use experts outside of org. ?
• Health insurance organizations have been positioned
as administrative center.
• And small and medium size organizations have
insufficient stuff.
※health insurance law require these organizations to
provide health promotions to its member, but their
main task is to collect premiums and pay medical fees.
For this reason,
quite a few of them have data experts, enabler of PDH .
PDH create business opportunity for outsourcing
managed health service providers. Sure thing ?
Features of PDH

11. Good practices of PDH
19 practices are awarded as excellent empirical
studies in 2013, 2014.
・managed health services based on analysis of medical
and health data
Some of them
•Designing occupational health for high blood pressure employee
•Designing services using ICT
•Designing “healthy scores” and “programs for married couples”
•Preventing services for MI advancing
•Supporting programs for asthma
•Designing prediction models of disease advancement
•Designing personalized managed health services
•Designing programs with visualized health status

12. Timeframe of PDH
PDH
round Ⅰ 2015－2017
round Ⅱ 2018－
Synchronize to specified medical
check-up execution plan
round Ⅱ 2013－2017
round Ⅲ 2018－
Specified medical check-up

13. Recap what PDH is
Plan Data Health（PDH） is
a framework of data driven managed health services.
★empowering payers (health insurance org.)
and indirectly empowering its member
★somewhat limited to basic statistical approach
PDH is not a data maniac approach, but
strengthen feedback loop using
systematic review of previous activities
(12p, “guideline introducing Plan Data Health”)

14. In my view, PDH is a challenge
and somewhat skeptical.
Checkup
follow up assumed
necessary cost
additional money
expecting
curve out cost
Stay on track
(healthy zone)
(out of medical account)
Motivated by
any type of incentives
A > B ?
B
A
Regimen adherence assistance is not more useful ?
－point programs
get more attention