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    Reconstruction of community medical services from the Great East Japan Earthquake and establishment of a large-scale medical information system


     

    The proposed Tohoku Medical Megabank Project was envisioned for two reasons: 1) to reconstruct community medical services in the areas heavily damaged by the earthquake and tsunami disaster; and 2) to establish a brand-new medical system to meet the global trend towards large-scale medical information technology.

    Due to the catastrophic damage to many hospitals especially in the coastal areas of the Tohoku region during the Great East Japan Earthquake on March 11, 2011, the majority of hospitals, medical professionals, and municipal workers were turning all their efforts towards repairing hospitals and recruiting more physicians and allied health professionals.

    The Tohoku University School of Medicine is taking all emergency measures to cope with the damages inflicted upon the medical system in Tohoku region. However, simply bringing back the functions lost due to the disaster is insufficient to achieve a full-fledged reconstruction. In order to truly rebuild medical services, a single project is needed to serve as the centripetal force to drive the reconstruction; whilst in the long term, responding to the damages to the health of the residents of the entire region.

    There is a notable decline of medical professionals in the Tohoku region and this decline has become alarmingly severe in the more recent years. Whilst it is essential to rebuild medical facilities in the region, we need to recruit personnel who will work at these rehabilitation facilities. This would also prevent the outflow of medical professionals – whom are ultimately the most indispensable resource for this reconstruction. Therefore, it is inevitable, to propose a plan to develop a center of future-oriented medical services in the Tohoku region and to make it a driver for attracting medical professionals.

    The project involves two main cohort studies: The TMM BirThree Cohort Study and The TMM CommCohort Study, where both targets mostly the earthquake-affected areas. The output of the project, in the form of a biobank, will be an essential foundation for future medical studies. Until recently, little has been known about 1) the differences between those who lead the same lifestyle but one acquires an illness whilst the other does not, and 2) the differences between individuals who are either responsive or non-responsive to various forms of therapy. This limited understanding in this area of genomic epidemiology has led to increased awareness of the necessity to be able to diagnose individuals predisposed to certain diseases.

    Ever since the human genome has been decoded, it has gradually become apparent that the slightest differences in the genome sequence of individuals generate differences in "predisposition". From all across the globe, medical projects making use of massive libraries of collected data have already been launched to decipher the relationships between genomic information and the environment, susceptibility to illness, and therapeutic efficacy. Making sense of this massive pool of information is predicted to pave the way for the next generation of medicine to contribute to public health services and to drive industries. In Japan, moving forward, it has also been pointed out that more comprehensive and larger-scale projects need to be conducted based on the outcomes of the preceding projects.