Multidisciplinary perspectives on roles of hospital pharmacists in tertiary settings: a qualitative study.

In today's complex healthcare landscape, exacerbated by resource constraints at various levels, optimization of health professionals' roles is becoming increasingly paramount. Interprofessional collaboration, underpinned by role recognition and teamwork, leads to improved patient and organizational outcomes. Hospital pharmacists play a pivotal role in multidisciplinary teams, and it is imperative to understand multidisciplinary viewpoints on hospital pharmacists' roles to guide role prioritization and organizational efficiency. However, no study extensively investigated multidisciplinary views on values of diverse pharmacist roles in tertiary settings. This study aims to address this gap by examining non-pharmacist health professionals' views on hospital pharmacists' roles, recognizing their specialized niches as a crucial step towards optimizing their roles and services in Australia and internationally. Multiple focus group discussions and interviews were held via a virtual conferencing platform. Study participants were recruited using the study investigators' professional networks who were non-pharmacist health professionals with experience working with pharmacists in hospital settings. Data were collected from transcripts of the focus group recordings, which were later summarized using descriptive statistics and thematic analysis. Overarching themes were categorized and mapped against work system models to conceptualize organizational implications of multidisciplinary feedback, linking them to patient and organizational outcomes. Twenty-seven health professionals participated across focus groups and interviews, with the majority of professions being doctors and nurses. Three major themes were identified as follows: (i) overarching perceptions regarding hospital pharmacists; (ii) professional niches of hospital pharmacists; and (iii) future opportunities to optimize hospital pharmacy services. Valued professional niches included patient and health professional educators, transition-of-care facilitators, and quality use of medicines analysts. The study highlights critical insights into hospital pharmacists' roles in Australia, identifying their niche expertise as vital to healthcare efficiency and success. Based on multidisciplinary feedback, the study advocates for strategic role optimization and targeted research for enhanced clinical, economic, and organizational outcomes.

Action framework for reproductive health promotion: Analysis of contemporary French public policies using a critical lexicometric approach and a transgender perspective / Cadre d'action de promotion de la santé reproductive : analyse critique lexicométrique et trans des politiques publiques françaises contemporaines.

INTRODUCTION: In France, since 2017 the law has allowed people to change the gender marker on their civil status documents without having undergone medical treatment and sterilization surgery. However, no legislative framework has been provided to ensure their right to family, leaving those who wish to become parents in a space of social, political, and legal uncertainty that is inconsistent with international and human rights. In parallel, France has developed an arsenal of health strategies that constrain actors working in the field. PURPOSE OF THE RESEARCH: This study examines the possibilities available to public health actors for promoting reproductive health in the absence of legislation and in the context of political and legislative adversity. To this end, it relies on a participatory, critical, and lexicometric analysis of national strategies for sexual and reproductive health and parenthood support. RESULTS: Governance strategies make no mention of parentality among transgender people. Sexual and reproductive health policies focus on tackling sexually transmitted infections, on health pathways, and on violence and discrimination. The analysis also highlights a lack of awareness on this topic. CONCLUSIONS: Shortcomings in the legislative framework and public health strategies raise ethical questions about the promotion of reproductive health and the potentially non-inclusive approach of actors in the field. These issues force communities to carry out actions outside the scope of ordinary regulations, and they highlight the political positioning of the public-health field in France.

Introduction: Depuis 2017, la loi française a mis fin à la nécessité d'intervention médicale et de stérilisation des personnes faisant modifier leur sexe administratif à l'état civil. Pour autant, aucun cadre législatif n'a été prévu pour garantir leur droit à la famille, ancrant leurs projets parentaux dans un aléa social, politique et juridique contraire aux droits humains et internationaux. Parallèlement, l'État français s'est doté d'un arsenal de stratégies de santé contraignant la place et le rôle des actrices et acteurs de terrain. But de l'étude: Cette étude interroge les possibilités des actrices et acteurs de santé publique à promouvoir la santé reproductive des personnes en l'absence de toute législation et dans un contexte d'adversité politique et législative. Pour cela, elle s'appuie sur une analyse participative, critique et lexicométrique des stratégies nationales de santé sexuelle et reproductive et de soutien à la parentalité. Résultats: La parentalité des personnes trans est absente des stratégies de gouvernance. Les politiques de santé sexuelle et reproductive se centrent autour de la lutte contre les infections sexuellement transmissibles, les parcours de santé et les discriminations et violences. L'analyse fait également ressortir la méconnaissance de cet enjeu. Conclusions: Les manquements du cadre législatif et des stratégies de santé publique interrogent les possibilités éthiques pour les actrices et acteurs de terrain de promouvoir la santé reproductive de manière non inclusive. Ce constat condamne les communautés à mener des actions en dehors du droit commun et pose la question de la place politique du champ de la santé publique en France.

AEDV Expert Consensus Document on the Organization of a Multidisciplinary Unit for Patients With or at Risk of Venereal Infections. / Documento de expertos de la Academia Española de Dermatología y Venereología sobre la organización de una unidad multidisciplinar de atención a pacientes con o en riesgo de infecciones venéreas.

Over the past few years, venereal or sexually transmitted infections (STIs) have been on the rise worldwide requiring additional specialized monographic consultations to specifically treat STIs. Therefore, the Spanish Academy of Dermatology and Venereology (AEDV) Research Working Group on STIs and HIV has drafted this document with the necessary requirements in terms of infrastructure, personnel, technology, specific materials for sample collection, and needs for current therapeutic options. Strict emphasis is placed on the protection of patient privacy. A health care circuit model is outlined too. Additionally, a section has been included on contact tracking and reporting, key elements for the effective prevention and control of STIs. These clinical practice guidelines seek to establish a clinical action framework adapted to the current challenges posed by STIs and HIV in the dermatology, venereology, and multidisciplinary settings.

[Translated article] AEDV Expert Consensus Document on the Organization of a Multidisciplinary Unit for Patients With or at Risk of Venereal Infections.

Over the past few years, venereal or sexually transmitted infections (STIs) have been on the rise worldwide requiring additional specialized monographic consultations to specifically treat STIs. Therefore, the Spanish Academy of Dermatology and Venereology (AEDV) Research Working Group on STIs and HIV has drafted this document with the necessary requirements in terms of infrastructure, personnel, technology, specific materials for sample collection, and needs for current therapeutic options. Strict emphasis is placed on the protection of patient privacy. A health care circuit model is outlined too. Additionally, a section has been included on contact tracking and reporting, key elements for the effective prevention and control of STIs. These clinical practice guidelines seek to establish a clinical action framework adapted to the current challenges posed by STIs and HIV in the dermatology, venereology, and multidisciplinary settings.

Proposing a health-specific organizational impact framework to evaluate organizational impacts in health technology assessments.

OBJECTIVES: Health technology assessments (HTAs) have traditionally included clinical and cost-effectiveness evaluation of new health technologies (HTs). However, new HTs can generate important organizational impacts (OIs) that influence their overall value. OIs are currently not clearly identified and evaluated in HTA procedures and tools are limited. To address this issue, a comprehensive framework that allows to assess OIs of new HTs in HTAs is proposed. METHODS: A working and methodological group identified the Oslo Manual 2018, 4th edition, OECD/Eurostat, on the objectives and outcomes of commercial innovations as the basis for the OIs framework for HTAs. The Oslo Manual was translated to the healthcare sector and adapted to HTA procedures through a three-step process. RESULTS: The framework is composed of three main parts. Part I tackles the context of the evaluation, Part II the categories of impacts and the specific impacts - in total, 16 OIs were identified - and Part III the stakeholders involved. The central part of the framework is Part II, and consists of three categories of impacts: (i) on the care process, (ii) on the stakeholders' capabilities and skills, and (iii) on society or the community. CONCLUSIONS: This framework provides a comprehensive and structured basis to document OIs of new HTs. It thus contributes to the extension of HTA evaluation criteria to other dimensions than clinical and economic aspects, that is, organizational aspects. Some of its intrinsic limitations and the questions they raise in the field for policy-makers, practitioners, and researchers are discussed.

Developing a programmatic approach to faculty development and scholarship using the ASPIRE criteria: AMEE Guide No. 165.

Faculty Development (FD) has become essential in shaping design, delivery and quality assurance of health professions education. The growth of FD worldwide has led to a heightened expectation for quality and organizational integrity in the delivery of FD programmes. To address this, AMEE, An International Association for Health Professions Education, developed quality standards for FD through the development of the AMEE ASPIRE to Excellence criteria. This guide uses the ASPIRE criteria as a framework for health professions educators who wish to establish or expand approaches to FD delivery and scholarship within their institutions.

"More is not always better": Park's sweet spot theory-driven implementation strategy for viable optimal safe nurse staffing policy in practice.

AIM: This paper aims to propose Park's sweet spot theory-driven implementation strategy, which makes optimal safe staffing policy really work in nursing practice. BACKGROUND: For the last 40 years, mainstream nursing workforce research has emphasized that having more registered nurses leads to better patient outcomes, and yet staffing policies have failed to implement this crucial concept. Meanwhile, global nursing shortages have become rampant, a problem that only dilutes the skill-mix ratios in the nursing workforce. Low fertility and an aging population worldwide are then accelerating these shortages. These dire circumstances may be persisting because of unclear, unsubstantiated cost-efficiency in the nursing workforce. For this reason, there remains a dearth of well-researched evidence for a clear threshold on optimal safe staffing levels that could maximize quality of care relative to cost given limited healthcare financial budgets and which could also be fitted into each care setting. Along with that, an implementation strategy for optimal safe staffing levels is nonexistent. SOURCES OF EVIDENCE: An implementation strategy has been developed through interdisciplinary consilience-based theory synthesis of both prospective theory and regulatory focus theory combined with Park's optimized nursing staffing (sweet spot) estimation theory. DISCUSSION/CONCLUSIONS: A theory-driven novel implementation strategy is proposed, which functions as a nudge strategy that uses the synchronous balance of quality of care, nurse staffing, and cost. It illustrates (1) how to create shared value among patients, nurses, and stakeholders through robust evidence-based, informed shared decision-making rationales on the optimal safe nurse staffing levels and (2) how to induce stakeholders to overcome resistance to innovation and improve their nursing workforce through value chain in management science. IMPLICATIONS FOR NURSING WORKFORCE POLICY: This novel implementation strategy may be a viable solution to mitigate the nursing shortage by leading stakeholders (1) to compete with each other (on the basis of nursing sufficiency) and (2) to competitively demonstrate the patient-centered value (patient-perceived care quality relative to cost) of their institutions.

Dimensions of Health Care Management Professionalization: A Scoping Review.

Background: Within the public sector, health managers occupy positions that are typically filled by individuals with a medical, clinical, or nursing experience who are entrusted with assuming an additional role. The primary objective of this study was to employ a scoping review methodology to ascertain a cluster of prevalent subjects encompassing the development of a proficient health care manager. Methods: The purpose of this scoping review study was to identify critical components in the field of management professionalization, as described by Arksey and O'Malley. A total of 13 studies, characterized by predefined keywords, were meticulously culled from Scopus, Web of Science, PubMed, and Embase, Magiran, and SID databases. The inclusion and exclusion criteria considered factors such as language, temporal relevance, redundancy, thematic alignment with the professionalization domain, and congruence with the overarching objectives and methodologies of the present investigation. Subsequently, the contents of the selected studies were subjected to rigorous thematic analysis and judicious categorization using a framework analysis approach. Results: From a total of 10,117 articles, a rigorous selection process yielded 13 articles to be included in this study. The identified dimensions are classified and elucidated across 6 overarching domains; namely, the science of management, educational trajectory, and curriculum, cultural infrastructure and ideologies, standards, professional institutions and associations, and licenses and certifications. Conclusion: To enhance the efficacy of health management, policymakers and planners ought to adeptly incorporate these dimensions within the framework of the country's health system.

The changes in the nursing practice environment brought by COVID-19 and improvement recommendations from the nurses' perspective: a cross-sectional study.

BACKGROUND: The COVID-19 pandemic has brought an opportunity to increase investment in the nursing practice environment, which has greatly impacted patients, nurses, and organizations. However, there were limited studies concerning the changes in the practice environment since the COVID-19 pandemic and the way to improve it from nurses' perspectives. METHODS: A cross-sectional study was conducted among 460 nurses from seven hospitals in Sichuan, China. Both the quantitative and qualitative data were collected from an online questionnaire. The quantitative data were collected using the Chinese version of the Practice Environment Scale-Nursing Work Index and compared with available norms in 2010. The qualitative data were collected through an open question following the scale and analyzed by content analysis. RESULTS: The mean of the score of the practice environment scale was 3.44 (SD = 0.56) out of 4.00. The score of the total scale and the dimensions were significantly higher than the norms, apart from nurse-physician relations and nurse participation in hospital affairs. The qualitative findings revealed positive changes in nursing foundations for quality of care, nurse participation in hospital affairs and nurse-physician relations, and poor staffing and resource adequacy. The improvement in the working model and ward environment is the primary concern of nurses. CONCLUSIONS: The COVID-19 pandemic brought some positive changes in the nursing practice environment, but more efforts are needed to solve those nagging and important problems, such as staff shortages and low participation. Nursing managers and hospital leaders were encouraged to listen to nurses' concerns and value this suitable opportunity for changing and improving to achieve better health services and coping ability to deal with emergency events going forward. Improving the ward environment and taking a professional model instead of sticking to the tedious process might be worthwhile.

Integrating organizational impacts into health technology assessment (HTA): an analysis of the content and use of existing evaluation frameworks.

OBJECTIVE: The French health technology assessment (HTA) agency initiated a research between 2018 and 2019 with the aim of determining whether other HTA organizations (agencies, bodies, institutes, and expert networks) and researchers had developed an evaluation framework of organizational impacts (OIs). METHODS: Three types of investigation were carried out: (i) an analysis of documents published by selected HTA organizations, (ii) a rapid review on the OI issues, (iii) a questionnaire survey to experts of the International Network of Agencies for Health Technology Assessment. RESULTS: The analyses highlight six key points: (i) there is no explicit conceptual definition of OIs; (ii) OIs are often not included in a specific dimension of the evaluation or in the same dimensions; (iii) three recurring categories emerge from the assessment of OIs: processes, structure, and culture; (iv) despite its limitations, the European Network for Health Technology Assessment framework (Core Model) is the most mature assessment model to date; (v) the question of the scope of OIs to be considered is unresolved (micro-meso-macro); and (vi) the delineation between OI assessment and economic assessment must be addressed. CONCLUSIONS: Although the issue of considering OI in HTA has been raised for many years, it remains largely unresolved. Defining the concept of OI is a prerequisite for taking the next step toward an evaluation framework. As the question of the impact of innovation goes beyond the health sector, extensive research on how to define and take into account these OIs may be relevant.

Confusions and responses of managerial public health nurses during the COVID-19 pandemic in Japan.

OBJECTIVE: This study aimed to elucidate the experiences of public health nurses (PHNs) in Japan during the first wave of COVID-19. DESIGN AND SAMPLE: Twelve PHNs in charge of responding to COVID-19 in X-city within Tokyo metropolis in Japan participated in this case study. MEASUREMENTS: Data were collected through self-administered questionnaires and semi-structured interviews on PHNs' experiences from January 2020 to May 2020. RESULTS: Initially, only infectious disease control division (IDCD) PHNs experienced confusion due to the rapidly increased workload. Managerial PHNs attempted to explain the need for a dispatch system for the IDCD, using available statistical data from other managerial members, within one's maximum understanding of this unprecedented situation. Without having a clear and forward-looking understanding regarding the purpose and reasons for dispatching, some dispatched PHNs had concerns and frustrations; they did not view the COVID-19 pandemic as a disaster. In the never-ending, exhausting work, PHNs managed to modify the provision of conventional services to residents. CONCLUSIONS: Despite experiencing confusion, PHNs worked to continuously provide community services, re-considering the meaning of public health nursing. Prioritizing the work and shifting tasks to other professionals at an early stage of the pandemic may prevent organizational dysfunction.

[3D printing in fracture treatment : Current practice and best practice consensus]. / 3D-Druck in der Frakturversorgung : Aktuelle Praxis und "Best-practice"-Konsens.

The use of 3D printing in orthopedic trauma is supported by clinical evidence. Existing computed tomography (CT) data are exploited for better stereotactic identification of morphological features of the fracture and enhanced surgical planning. Due to complex logistic, technical and resource constraints, deployment of 3D printing is not straightforward from the hospital management perspective. As a result not all trauma surgeons are able to confidently integrate 3D printing into the daily practice. We carried out an expert panel survey on six trauma units which utilized 3D printing routinely. The most frequent indications are acetabular and articular fractures and malalignments. Infrastructure and manpower structure varied between units. The installation of industrial grade machines and dedicated software as well as the use of trained personnel can enhance the capacity and reliability of fracture treatment. Setting up interdisciplinary jointly used 3d printing departments with sound financial and management structures may improve sustainability. The sometimes substantial logistic and technical barriers which impede the rapid delivery of 3D printed models are discussed.

Australian nurses' perceptions about workplace violence management, strategies and support services.

AIMS: This study ascertained nurses' perceptions about workplace violence management, strategies and support services. BACKGROUND: Nurses regularly encounter verbal and physical violence in their workplace. Workplace violence has long-term consequences on nurses' personal lives and professional work ability. However, more needs to be known about nurses' perceptions of violence management and interventions used. METHODS: Ninety-eight nurses from a regional public hospital in Queensland, Australia, completed a survey about workplace violence. Nurses worked in the Emergency Department, Intensive Care Unit or Mental Health Department. RESULTS: Ninety-five per cent of nurses stated that all violence should be reported, but 18% would take no action, and 22% would not complete an incident from. Perceptions and preferred responses differed for verbal and physical violence. Low-level interventions and aggression management training were preferred by nurses. Nearly all nurses felt that they should be involved in the development of workplace violence policies. CONCLUSIONS: Nurses rate aggression management training highly, and they desire more input into violence policies. The under-reporting of violent incidents remains an issue for future management. IMPLICATIONS FOR NURSING MANAGEMENT: Understanding nurses' perceptions of workplace violence management enables the identification of gaps when applying policy and adopting practical approaches to reduce the incidence and severity of workplace violence.

Identification of Workload Measurement Indicators for School Nursing Practice.

Many school districts rely on caseload or student to school nurse ratios that are not grounded in evidence-based research. There is a need for a comprehensive workload instrument to describe the work of school nurses that incorporates the complexities of the role and includes acuity, care processes, and social determinants of health. The purpose of this qualitative study was to identify workload activities from a previous Delphi study that can be empirically measured as items for a workload instrument. A nationally representative sample of 27 school nurses participated in four focus groups, describing activities important to the measurement of workload. Focus group input resulted in identification and confirmation of workload activities that impact school nurse workload. Use of the National Association of School Nurses' Framework for 21st Century School Nursing Practice™ was integral in capturing gaps and important workload activities for a potential workload instrument.

Measuring the diverse characteristics of county adult protective services programs.

Adult protective services (APS) programs vary markedly, yet few studies have quantified this diversity. In 2020, a survey of Ohio's 85 county-administered APS programs incorporated subsequent feedback from staff and described the programs in a systematic manner. This process resulted in a 100% response rate and illustrated an efficient approach to measuring organizational characteristics (e.g., whether any staff are mostly dedicated to APS), resources (e.g., access to multidisciplinary teams), and practices (e.g., how often staff create a plan to meet client goals). The prevalence of many factors differed by the number of older adults the program served. For instance, 75% of programs in large counties had regular opportunities to share complex cases with a multidisciplinary team, compared to 28% of programs in small counties. Understanding the diverse characteristics of APS programs - and how to measure them - can help agencies guide quality improvement efforts and the dissemination of innovations.

[EASYSCAN: French pilot study for securing drug administration by barcode reading]. / EASYSCAN : étude pilote française pour la sécurisation de l'administration des médicaments par lecture code-barres.

OBJECTIVES: Medication errors are common at the time of administration. To prevent them, technologies allowing consistency check by bar code technology at bedside have been developed. Our study focuses on the evaluation of a BarCode Medication Administration (BCMA) called EASYSCAN with Electronic Medication Administration Record (e-MAR) to verify both patient's identity and medication to be administrated. METHODS: A prospective observational study was conducted during seven weeks in a French medicine ward. The performance of the system was evaluated by the success rate of BCMA and by the average time for administration with and without EASYSCAN. A satisfaction questionnaire about BCMA was proposed to nurses. RESULTS: We observed 182 administrations including 87 (48%) with EASYSCAN. The verification of the patient's identity was successful in 77% of administrations and 65% of the drugs were scanned successfully. The main causes of check failures were the lack of datamatrix on the drug (81%), error messages (14%) and the lack of system functionality (5%). The average time for administration per patient was significantly increased: 4.68min/patient with versus 2.87min/patient without EASYSCAN. CONCLUSIONS: The study shows the EASYSCAN's performance in its first version. Material and software evolutions and an increase of nurses'pratices will be necessary to continue the experimentation of this system still unpublished in France.

[Stocked medications in emergency medical service vehicles staffed by physicians-is prehospital treatment according to current guidelines possible?] / Medikamentöse Ausstattung arztbesetzter Rettungsmittel ­ ist eine präklinische Therapie nach aktuellen Leitlinien möglich?

Background: High quality of care in prehospital emergency medicine is characterized by guideline-based therapy. The basic prerequisite for this therapy is the availability of the required drugs in accordance with the current guideline recommendations. It is currently unclear whether this is guaranteed nationwide. There is no uniform standard regarding which drugs must be stocked in emergency medical services (EMS) vehicles staffed by physicians in Germany. The aim of the present study is to identify important diagnoses and the drugs required for their therapy. In a second step, medical directors throughout Germany were interviewed about current drugs available in their physician-staffed EMS vehicles and these were compared with the previously defined diagnosis-dependent drug lists. Materials and methods: After a structured guideline search, tracer diagnoses were defined and relevant drugs were assigned to them. The levels of evidence and recommendations were also considered. In a second step, this was compared with the current drugs available in physician-staffed EMS vehicles. Results: A total of 156 different medications were identified. The median number of medications stocked was 58; the minimum number of medications stocked was 35 at one site, while multiple sites stocked a maximum of 77 medications . Discussion: The present study investigated stocked medications in physician-staffed EMS vehicles. Overall, compared to a 2011 study, drug availability has improved. Most of the recommended medications are available in physician-staffed vehicles in Germany. The data from this study can be used by EMS throughout Germany to evaluate their preparedness.

Dermatology Care in Spanish Public Hospitals: A Mapping Study of Health Care Resources and Medical and Surgical Activity in Dermatology Departments in 2019. / Mapa asistencial dermatológico: descripción de los recursos estructurales y de la actividad médico-quirúrgica de los servicios de dermatología de los hospitales públicos españoles en 2019.

BACKGROUND AND OBJECTIVE: No recent data on health care resources and medical and surgical activity in Spanish dermatology departments are available in the literature. The aim of this study was to compile this information for 2019. MATERIAL AND METHODS: Cross-sectional study based on an online survey sent to the heads of dermatology departments at public hospitals in Spain. RESULTS: Of the 162 department heads contacted, 59 answered the survey (participation rate, 36.4%). General findings included a shortage of staff, especially dermatologists, in hospitals of low and medium complexity. The main reason given for the shortage of dermatologists was a lack of interested applicants. Large hospital complexes had more infrastructure and equipment. Over 50% of the departments surveyed used a combination of in-person and virtual visits. Psoriasis units were the most common specialized care units. Approximately 75% of the hospitals had operating rooms with an anesthetist. More complex procedures such as sentinel lymph node biopsy and Mohs micrographic surgery were performed more often in large hospital complexes. Hospitalization and the presence of dermatology residents working call shifts were also more common in these hospitals. Teaching and research activity differed according to hospital complexity. CONCLUSIONS: We have mapped health care resource availability and medical and surgical activity in Spanish dermatology departments prior to the COVID-19 pandemic. Our findings could be useful for improving clinical management and defining future actions and areas for improvement.

[The strategic management of laboratory diagnostic service: analysis of organization models].

The modern trends in health care (strategies of optimizing costs, value-oriented medical care) require systematic development of laboratory services for administrative territories. The study was carried out to provide support for decision-making by systematizing models of laboratory services on the basis of principles of systematic approach. Four basic models (centralization, outsourcing, horizontal integration, point-of-care) were analyzed. The study applied such research methods as analytical and strategic SWOT-analysis. The SWOT-analysis was implemented using list of standard characteristics for each model of laboratory service organization. Each model is distinguished by complex combination of strengths, weaknesses, lines of functioning and development. The availability of implementing particular model depends on delicate balance of opportunities and risks against the background of local characteristics of administrative subject. The dynamics of the social economic and infrastructural development of administrative subject can significantly affect effectiveness of model implementation. The objective set of characteristics was obtained for each model of laboratory service organization. Actually it is impossible to select particular model for specific administrative subject. Hence, scientific substantiation of "flexible" model is needed to implement.

Establishment and implementation of Cancer Genomic Medicine in Japan.

Approximately 1 in 2 Japanese people are estimated to be diagnosed with cancer during their lifetime. Cancer still remains the leading cause of death in Japan, therefore the government of Japan has decided to develop a better cancer control policy and launched the Cancer Genomic Medicine (CGM) program. The Ministry of Health, Labour, and Welfare (MHLW) held a consortium at their headquarters with leading academic authorities and the representatives of related organizations to discuss ways to advance CGM in Japan. Based on the report of the consortium, the CGM system under the national health insurance system has gradually been realized. Eleven hospitals were designated in February 2018 as core hospitals for CGM; subsequently, the MHLW built the Center for Cancer Genomics and Advanced Therapeutics (C-CAT) as an institution to aggregate and manage genomic and clinical information on cancer patients, and support appropriate secondary use of the aggregated information to develop research aimed at medical innovation. As the first step in Japan's CGM in routine practice, in June 2019 the MHLW started reimbursement of 2 types of tumor profiling tests for advanced solid cancer patients using the national insurance system. Japan's CGM has swiftly been spreading nationwide with the collaboration of 167 hospitals and patients. The health and research authorities are expected to embody personalized cancer medicine and promote CGM utilizing state-of-the-art technologies.