Topics Thinking about the ecosystem in the healthcare field Discussion Points on the Data Ecosystem

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Masami Morita, Senior Researcher, Pharmaceutical Industry Policy Institute

The term "ecosystem" has come to be used frequently in the context of the rapid progress in the IT field, which has led to major changes (paradigm shifts) in industries, systems, and society. As you know, the term originally referred to an ecosystem in continuous harmony with the interaction between living organisms and the environment in nature, but it has become a "business term" to refer to the environment surrounding business, and now often refers to a harmonious and continuous environment among all social phenomena. It is truly a buzzword, but it has become a key word in the great social transformation known as the Fourth Industrial Revolution.

This revolution is also the embryo of a new social model, a data-driven society. This is an era in which those who control data control business and society. In the field of medicine and healthcare, we are in the process of changing into a society where new discoveries and solutions are created by analyzing the relationships among various data, including not only medical data and health-related data, but also lifestyle data, preference and behavior data, and bio-molecular data such as personal genomes and omics, as well as environmental data surrounding the individual. The society is about to be transformed into one in which value, such as new discoveries and solutions, are created by analyzing the relationships among various data.

In order to promote and revitalize this trend, it is necessary to share widely at the national level the recognition and events that the utilization of such data creates great social and economic value, and to build a data ecosystem in which data generation, distribution, utilization, and implementation of the results (enjoyment of the benefits) circulate smoothly. It is necessary to aim at the national level to build a data ecosystem that smoothly cycles through data generation, distribution, utilization, and implementation (enjoyment of benefits).

Let us take a look at the "future of healthcare" from the perspective of the data ecosystem, which encompasses medical care and has become borderless with the rest of society.

Ecosystem Concept

First, let us consider the ecosystem. It is said that the concept began to be widely used in the business field in the early 1990s as an explanation of the success or failure of start-up ventures in Silicon Valley on the West Coast of the United ^States1). As an environment surrounding startups, an ecosystem was described as a coexisting situation that promotes cooperation with venture capitalists and related companies, leads startups to success, and creates a win-win virtuous cycle as a whole to become sustainable. Currently, the expression "aiming for an ecosystem" is used in a wide range of industries, including the ICT industry, for the introduction of new systems and innovations, and for the establishment of new businesses and open platform research systems.

For example, in the case of a new ICT-related business, the main players driving the business (often described as the ^keystone2 ), the various companies involved in the business (niche players; borderless across industries), and in many cases, all the various stakeholders including consumers and society, form a collaborative economy. The main players in this "ecosystem" are the companies that are involved in the business (niche players; borderless across industries). In this "ecosystem," the main players can create new value and innovations that would be difficult to obtain through conventional "self-focused" approaches, as well as collaborate to expand complementary relationships in the value chain. In addition, the system will be sustainable and expand as many participants and society will be able to benefit from the system.

The SOMPO Institute for the Future describes the patterns shown in Figure 1 as a typology of business ecosystems4) . The SOMPO Institute for the Future describes the patterns shown in Chart 1 as a typology of business ^ecosystems4). (However, this is not a comprehensive or exclusive classification.)

The following is a brief description of this type of ecosystem with some additional information.

The term "ecosystem" is often used to refer to a wide range of ecosystems, but the term "ecosystem" is often used to refer to a wide range of business and open-platform research systems. However, it is important to understand the difference between these ecosystem concepts as they relate to business. In addition, the term "ecosystem" is often used to describe an environment that is not structured for autonomous and continuous collaborative evolution. It should also be noted that it is often used metaphorically in social activities other than business.

The common thread that runs through types (1) through (5) is that within each ecosystem, cooperative and competitive relationships are fostered among the participants, while the community as a whole aims to develop in a co-evolving manner. In addition, competition, selection, and interdependence are generated among similar ecosystems, forming an ecosystem from a larger perspective. The scope of an ecosystem is not unitary.

In nature, there are forests, mountains, plateaus, and sand dunes, each of which has its own ecosystem, and there are regional ecosystems that encompass multiple ecosystems, as well as ecosystems at the national and global levels.

Data ecosystem in the healthcare sector

How should we conceptually view the data ecosystem in the healthcare sector in Japan?

In the "data-driven society" that we are about to see in the near future, all available data will be used as intermediaries to add and accumulate interpretations of data through collection and analysis, to make judgments and predictions about individual data, to clarify the causes of events and to control them, and to discover new things that have gone unnoticed by humans until now or that have been difficult to deal with, This will provide new discoveries and value to matters that were previously unnoticed or difficult to deal with. These will lead to innovations that will realize paradigm shifts, and the environment in which the collection and utilization of such data will expand autonomously and sustainably should be considered a "data ecosystem.

In the healthcare field, data acquired from various platforms, mainly in the medical, health, and nursing care fields, will be organically combined to form a data ecosystem that creates new value, and the importance of building various platforms for data collection and utilization is recognized.

On the other hand, it is not necessarily true that the utilization of a platform is an ecosystem. Although platforms and ecosystems are sometimes described as similar concepts, an ecosystem is formed when an environment is created in which co-evolution is achieved with suppliers and recipients of services, products, etc. provided using platforms. In this sense, it is easier to understand that it is one of the important elements of ecosystem formation.

GAAF is promoting the creation of a platform in the healthcare field on a global level, and is also involved in services such as complementary devices and computer analysis within the platform itself. Digitalization has changed the cost structure and created a situation where economies of scale continue to work, and a collaborative economy is being formed for companies and users of the platform due to the convenience, efficiency, low cost, etc. of using the platform. This is the type of (4) mentioned earlier, and also the type of (5). How to utilize these platforms within the overall healthcare ecosystem in Japan should be seen as a promising strategy for expanding and improving the quality of the overall ecosystem.

When considering the relationship between the data ecosystem and the platforms that collect data on the scale of the Japanese healthcare sector, individual platforms are undoubtedly important elements, but they can also be viewed as merely providing data for specific areas. Comparisons with complementary platforms and platform evaluation, including alternatives, are also necessary. There is competition, selection, and interdependence among platforms to remain in the ecosystem, and it is expected that information acquired by each platform will be organically linked to form an environment (ecosystem) in which multiple information analysis and its results can be provided based on the individual. Dynamic movements in the formation and growth of platforms used for data collection and utilization, including those already being formed domestically, are expected to continue. Progress in architecture (institutional design, legal reform, etc.) at the national and international level that links these useful platforms will support the construction of the overall data ecosystem.

Solutions in the healthcare sector and the role of industry

As this data ecosystem is formed, the target "goals (solutions)" for the next generation of medical and healthcare fields are changing. In other words, the goals are shifting from conventional medical and healthcare treatment and health solutions to goals based on the ideal direction of society, such as "support for healthy longevity and independence in life. In other words, this also coincides with the objective of digital transformation in the healthcare domain. The source of this activity is data, and the individual characteristics of various types of data are becoming increasingly important.

Considering what role the pharmaceutical industry is expected to play in creating "solutions" to advance this ecosystem, it is clear that it is not just about traditional drug discovery. While it is unlikely that breakthrough new drugs will ever be less important, the solutions are not necessarily drugs when we think about health care, disease management, preemptive medicine, prevention, disease treatment, rehabilitation, and quality of life in all of these situations. They are increasingly being positioned as complementary materials such as apps and devices used for digital health and disease management, and a major shift from "things" to "things (services)" is already emerging.

Various data will be acquired in data-driven healthcare, and diverse outcomes and values are expected to be created in data-driven research that progresses from health management to disease management and disease treatment (prevention and preemptive medicine). Research to reach innovative new drugs is an in-depth research phase that involves clarifying the cause and effect of diseases, and as a preliminary step, a great deal of knowledge is accumulated, including factors affecting diseases and data showing disease-relatedness. Such information and discoveries are also expected to be fed back as new value that can contribute to data-driven medicine and healthcare. Within the data ecosystem, it may be necessary to consider changing strategies to seek a wider variety of outcomes, including digital health and digital therapeutics.

Healthcare data ecosystem from the viewpoint of data flow

The goal should be to bring together various platforms (or data ecosystems) to target a system that leverages a wide variety of data and achieves significant outcomes in terms of health, economy, society, and public satisfaction.

The main actor in the data cycle in healthcare (including medical care) is the data itself, which is digitized and can be analyzed and utilized in a wide range of ways. The key elements of data can be summarized as shown in Figure 2. (1) Data diversity and connectivity, (2) data continuity, (3) ensuring data quality (quality of data according to purpose, standardization, structuring, cleansing, understanding of time-series outcomes, etc.), (4) data accessibility (an environment that both users and providers can access is necessary. It also includes addressing data security, ethics, etc.), and in addition to that, (5) smooth implementation of the return of analysis results and outcomes to the data providers (value creation and social return). Satisfying the above five elements will establish a mechanism for data circulation, and the formation of a data ecosystem will be ensured when data is circulated as a cycle.

Although various stakeholders (players) exist for data distribution and utilization, let us consider a simple model to shorten the concept. Figure 3 shows the relationships within the data utilization ecosystem among data providers (who use data and its results), data managers (who collect data and make primary use of it), and data users (who make secondary use of it and widely create results).

The "data providers" are generally patients and consumers. In other words, the entire population has the potential to be a data provider. The "data manager" is the entity that collects these data and attempts to make primary use of them. In many cases, they are medical institutions, public organizations such as national governments and insurers, and in the case of PHR (Personal Health Record) collections, companies and private businesses. The collected health care information then flows to "data users" such as public institutions, academia, and private health-related companies, where multiple analyses are conducted and new value is created from the data. The results are returned to data providers and society at large. The source connecting all players is "quality data," "establishment of data accessibility," and the flow of "feedback of new value (deliverables)" created by the data.

How exactly to establish this trend is the very point of contention in the construction of a data ecosystem in the healthcare field. Although we will not go into the details of the issues here, it is clear that from a macro perspective, the key to achieving a "data ecosystem" that supports next-generation healthcare lies in the utilization of digital data in particular and the return of the results to society. The approach of how to develop an architecture that facilitates the overall management and flow of data is important and must be left to the government and public administration in many areas. This approach is also an activity aimed at creating an environment that enables the realization of Digital Transformation in Healthcare. (Chart 4)

Discussion Points on Building a Data Ecosystem in the Healthcare Sector in Japan

In the Future Investment Strategy, the entire country is discussing Society 5.0 and the transformation to a data-driven society, and the healthcare sector is also taken up as an important area, and KPIs, issues, and measures have just been compiled. However, the approach is not necessarily clear as to whether a concrete roadmap is presented from a macro perspective, such as what kind of data ecosystem is to be built.

I would like to comment on four issues in particular from the perspective of data collection and utilization in this field.

What kind of data ecosystem will be built in the healthcare field in Japan? Discussion, including specific architecture, is needed. In this report, I have organized the ecosystem in terms of business concepts and considered the issues of the data ecosystem from the perspective of data distribution. In addition, I have commented on four issues that I have focused on from a macro perspective, and will continue to deepen the discussion in the study group's reports and other publications.

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