NHIS Big Data and Health Services

Consolidated Ageing Well Strategy in Korea

Soon-Ae Shin

, Dong-Soo Choo

, Tae-Hwa Han

, Jong-Heon Park

Jong-Hee Kim

and Ji-Hyon Bang

Department of Big Data Streering, National Health Insurance Service, Seoul, South Korea

Department of Medical Engineering, College of Medicine, Younsei University, Seoul, South Korea

Keywords: Ageing Well, National Health Insurance Service (NHIS), Big Data, ICT (Information and Communication

Technology), Healthcare Service.

Abstract: Due to rapid ageing, Korea is currently facing senior health issues, including elderly diseases, loss of roles

and so on. These increase concerns over ageing well which resolves the problems associated with changes

in socioeconomic structure and improves the quality of life. NHIS currently parlays big data and ICT into

ageing well service. With globally renowned big data and ICT, NHIS provides and plans various health

services to support seniors maintain not only physical and psychological health but also active sociality.

Through introducing Korean health services combining with big data and ICT, this paper shares ageing well

strategies.

1 INTRODUCTION

Over the past decade, an ageing society has become

a big social issue in South Korea. There are growing

concerns that the ratio of the Korean elderly is

increasing faster than that of Europe as stated in an

OECD report. According to a domestic report (KSIS,

Korean statistical information service), the issues of

an ageing society began in 2000, with the population

percentage of those over 65 years-old at 7.2%,

which increased to 12.7% in 2014 (NSO, National

Statistical Office). Korea will be categorized as an

aged society in 2018 and reach a super-aged society

in 2026 with an elderly population of 20%.

This is the world’s fastest ageing society as it is

1.5 times faster than Japan and 5 times faster than

France (National Health Insurance Service, 2011).

This hasty ageing is a major issue in Korean society

because along with a low fertility rate the result will

be a smaller working population to support a

relatively large number of retirees. As the

dependence ratio increases, society is likely to face

various problems such as a higher tax rate and senior

related issues, such as medical expenses, loss of

roles, alienation, and so on (Lloyd-Sherlock, 2012).

Recently, there has been a growing interest in

ageing well which allows seniors to independently

maintain their physical and psychological health and

active social lives. NHIS plans to utilize big data and

ICT for a healthy aged life as preparation for an

ageing society. As a single compulsary insurer,

NHIS provides insurance services for the whole

population within the territory of Korea and secures

all health data. Using such information, it is able to

discover and manage health risk factors, and prepare

for a healthy aged life.

Also, Korea has excellent ICT, which has won

first place for last three years in the ICT

Development Index published by ITU (International

Telecomunication Union, 2014), an affiliated

organization of the UN. We believe that the spread

of the ICTs and internet has made ICT-based

ageing-well feasible using personal, portable and

mobile devices. It is possible to accomplish ageing-

well that supports a healthy, active and independent

life style, by providing services, which combines

enormous NHIS-health data with ICT.

In this paper, we explain the existing service

platform, MyHealthBank and introduce our plan to

consolidate the empirical research and the health

insurance related big data. It highlights the 3-Axis

ageing-well strategies of standardized big data,

health index based on service and realization of

demonstration environment from the viewpoint of

the insurer (NHIS) and users.

143

Shin S., Choo D., Han T., Park J., Kim J. and Bang J..

NHIS Big Data and Health Services - Consolidated Ageing Well Strategy in Korea.

DOI: 10.5220/0005480801430148

In Proceedings of the 1st International Conference on Information and Communication Technologies for Ageing Well and e-Health (ICT4AgeingWell-

2015), pages 143-148

ISBN: 978-989-758-102-1

 2015 SCITEPRESS (Science and Technology Publications, Lda.)

2 STATE-OF-NHIS’ BIG DATA

2.1 Social Security Insurance System,

as Social Base for Health Big Data

Korea introduced a health insurance scheme for

companies with over 500 employees in 1977

(National Health Insurance Service, 2011). It

achieved universal healthcare coverage in 1989, only

12 years after its introduction, which took the

shortest amount of time in the world. In 2000, Korea

launched a single insurer, NHIS, by integrating 375

medical insurance societies, and pursued the

effective operation of the insurance system.

In 2008, it introduced the Long-Term Care

Insurance Program to support the aged population,

and became the third country in the world to conduct

both whole health insurance and the Long-Term

Care Insurance Program via NHI methods, following

Germany (1995) and Japan (2000). The Long-Term

Care Insurance Program is a program that provides

care services to the elderly over 65 or under-65 who

have geriatric diseases and difficulties in performing

daily activities regardless of their income levels.

Depending on the level of care required, these

services are provided from home care to respite care,

and lessens the financial and care-giving burden of

families for caring for the elderly.

2.2 National Health Insurance Big Data,

as an Initiative Step

NHIS is responsible for reviewing the eligibility of

the insured, imposing and collecting contributions,

distributing insurance benefits, and negotiating

medical fee schedules and assessing service quality

of healthcare service providers. Healthcare big data

is a real-time resource which is used widely in a

series of work.

With a single compulsory insurer system, the

data is regularly accumulated in a single

organization rather than separately collected into

several institutions. There are 1.5 trillion pieces of

vivid health information, including socioeconomic

information of the entire population, their medical

history, health examination results and elders’ care

services (Figure 1). It avails individuals of their

health information (personal health record). After

de-identification, it is also used as co-research with

expertise and lays a foundation of knowledge.

For the necessary research for the aged society

and the development of healthcare service, NHIS

has collective agreements with the Korean Geriatrics

Society to construct an elderly DB and conduct

research about elderly syndromes which harm the

quality of seniors’ lives. In addition, from July 2014,

NHIS has begun to provide a sample cohort DB

(NHIS-NSC) of a million people, 2% of the total

population, to support research about various target

age groups, including the elderly.

2.3

National Health Promotion Centre

(NHPC),

Middle and

Elderly-centered

NHIS provides information about personal health

and health risk factor found on big data, and

operates Senior Exercise Classes and Health

Promotion Centres for ageing-well. Senior exercise

participants are offered personalized health

promotion plans including exercise and nutrition

guides at more than 3,500 institutions, including

local senior citizens’ centres. Certified exercise

instructors are assigned to the institutions and run

classes for psychological comfort and social

facilitation. The advantage of the service is that it is

easy to access and possible to have continuous care

in the case of residential changes. This is why the

Figure 1: National Health Insurance Data (NHID) and NHIS-NSC (National Sample Cohort).

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Figure 2: Operating health promotion centres using big data.

program runs using NHIS’ health platform based on

ICT.

In addition, NHIS provides healthcare

management services by running 20 Health

Promotion Centres (Figure 2). It analyses health

insurance big data to select health risk factor carriers

as the recipients, and sends them brochures. When

the recipients visit the centre, they are offered

medical consulting and fitness examinations. Then,

they receive recommendations about exercise and

nutrition and health management services based on

the examination results. The Health Promotion

Centres program was initiated with 3 centres in 2007,

and expanded to 20 centres due to increasing

demands from users. There are about 60,683 users

annually with a high satisfaction rate and an

improvement in their health conditions.

3 RECENT APPROACHES TO

PUBLIC HEALTH SERVICES

3.1 My Health Bank, Personal Health

Record (PHR) Service

- As a Personal Health Service. NHIS has run its

own website (Health-iN; http://hi.nhis.or.kr) for

providing trustworthy health information as a single

insurer since 2007. Individuals can find it on the

homepage from anywhere using a well-developed

domestic ICT. NHIS provides a Personal Health

Record Service named ‘My Health Bank’ on the

Health-iN homepage. It means that dispersing health

information that is gathered in one place can be

handled preciously and safely like a bank. People

can log into My Health Bank, and then check their

personal health record after verifying their

identification. It contains five-year of cumulated

health examination results and questionnaires about

health behaviours such as smoking, drinking,

physical activity, and one-year medical treatment

records including prescribed medicine, and self-

recorded life log data.

Especially, when it comes to prescribed medicine,

people can check what kind of medicine is

prescribed in hospitals and pharmacies, so they can

know its efficacy, interaction, contradictions in

pregnancy, side effects and so on. In addition,

childhood immunization records are registered at the

Korea Centres for Disease Control and Prevention,

so it is linked to the relevant website.

- As a Family Health Linkage Platform. My

Health Bank provides personalized health risk

prediction services using their own health data as

well as by checking users’ records. The Health Risk

Appraisal service produces their actual age, healthy

age and target age through analysing their risk of

death based on lifestyle, family history,

environmental factors etc. It also provides risk

prediction of stroke within 10 years and updates

them with a health care message which contains

information about prevention of stroke. If somebody

has trouble in managing obesity, they can also use

an obesity management program which offers a

checklist about physical activity, nutrition and

behaviour. By using a health diary, they can

compare daily intake and burned calories.

My health bank, therefore, provides a one-stop

health service from checking personal health records

and appraising health risk to providing personalized

health information. Its usage has rapidly increased

since it launched in 2012, 52% from 1,793,041 users

in 2012 to 2,715,040 users in 2014. It implies that

people are paying attention to their health status by

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Figure 3: The present and future of personal health record (My Health Bank).

themselves. Giving proper health information on

time will encourage them to have continuous

interests in their health and help them prevent

diseases as well as maintain healthy lives.

Furthermore, NHIS plans to expand the range of

services, including fracture risk, and gather

individuals’ lifelong data, like workouts and diets in

their daily life, and medical images (CT, MRI etc.)

from the medical institutions to widen the range of

health information. It is expected to be shared with

those with medical expertise in the practical fields

for efficient treatment (Figure 3).

3.2 Participating Government-driven

Active Assisted Living Project

In order to overcome problems of ageing, Korea is

striving to activate aspects of research and

development and an industrial foundation. The

Government-driven Korean AAL (Active Assisted

Living) project started in 2014 and is planned to be

carried forward as a five-year project until 2019.

This project is to create AAL within public and

private housing areas for seniors’ independent and

healthy living, so that it minimizes disease

incidences as well as medical demands, but

promotes better living quality.

To achieve this goal, there are 3 sub-assignments;

foundation for smart public housing, development of

an active ageing platform for a healthcare smart

home, and resident-customized healthcare services.

NHIS is responsible for designing resident-

customized healthcare services. The developed

platform and services are expected to be the basis for

a compulsory health environment standard in times

of building housing areas with the cooperation of

relative institutions.

The Home Healthcare Service Project involves

development of health improvement services, health

management services, safety services, social

participation services and so on. NHIS plays the role

of producing various health assessment index using

NHI big data. The NHIS-Long-Term Care

Institution is planning to test-operate the developed

AAL service, which is likely to be a trial model to

be assessed by visitors.

4 NHIS’ CONSOLIDATING PLAN

FOR AGEING WELL

In order to collect data, NHIS is highly focused on

the health insurance scheme and Long-Term Care

services. By using the collected data, NHIS provides

a nation-wide health service. Furthermore, it tries to

counteract the trend of rapid ageing by establishing

strategies of standardizing data and diversification of

services, especially considering the 3-Axis strategies

to enhance the existing infra (Figure 4).

This enables providers to strengthen

competitiveness and opportunity to expand new

service models, while delivering users better

understanding of their health condition. The 3-Axis

are categorized into standardized big data,

healthindex based service and realization of

demonstration environment, which are explained

below;

 Data-Axis, Reference Data for Korean Health.

The Data-Axis demonstrates issues about the

sampling method and data accuracy, and resolves

such issues to secure reliability on big data. One step

to be taken is that NHIS plans to construct reference

data of those over 65 to increase the reliability in the

short-term. Meanwhile it plans to refine the DB

based on entire health records from infancy to death,

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Figure 4: Consolidation axes for ageing-well.

life-long data, to extract the representative data

about Korean health.

 Service-Axis, Unit Indicator based

Comprehensive Index for Active Senior. For the

Service-Axis, it hopes to achieve a health perception

index model for aged health consumers using the

data. As people start to observe their health

conditions in comparison with the average or age-

specific health condition, it motivates health-caring

behaviours and, thus, becomes a starting point of

providing new health supportive policies and

strategies from the national perspective. NHIS is

concerning ASIX model (Active Senior Index for

anything; Health, Emotion, Social) to alleviate users’

beliefs and understanding despite their decreasing

cognitive abilities due to ageing.

 Testbed-Axis, Real Stakeholder Panel via Senior

Care Centre and Korean AAL Project. NHIS has

opened a Seoul sanatorium in 2014. It is, in fact,

necessary to verify whether it fulfils the needs of the

users before organizing data and services. The Seoul

sanatorium possesses the best possibility of

providing verification because it is easily assessable

for seniors, their sustainers, their care givers and

facilities.

Henceforth, it has considered a cutting-edge

technology verification environment like

Fraunhofer’s in-House Center. The Fraunhofer-in-

House Center in Duisburg, Germany, is a unique

innovation workshop in Europe. It is application-

oriented, and works together to research and

develop. It is also successfully marketed in the field

of intelligent room and building systems

(http://www.inhaus.fraunhofer.de/en.html).

5 CONCLUSION

It is necessary Korea to have active attitudes not

only for elders’ physical and psychological health

through an independent life, but also for ageing-well

to achieve their active social lives, and prepare for

the rapid ageing period. In order to attain its targets,

NHIS seeks for a solution for ageing-well with

effective nurturing of an excellent national health

big data and ICT.

As Korea runs a single insurer system, health

data is regularly accumulated in a single

organization rather than separately collected into

several institutions. Universal health big data allows

tracking one’s infancy to death, and facilitates the

customized healthcare services, which accounts for

historical risk factors. The developed services, in

conjunctions with ICT, provide user-centred

services.

NHIS already provides personal health records

services using big data, and propels the development

of an active ageing platform and services for the

Healthcare Smart Home. AAL research and services

are customized services even in Europe and US,

which run in a variety sizes and depths (DWP, 2014;

Kalache, 1997; WHO, 2002; Woolrych, 2012).

Korea is seeking a breakthrough to solve legal

troubles in making an industrial ecosystem based on

a standard platform and to follow the international

standard for data coding and transmission.

Meanwhile, the government is trying to cooperate

with the public and private sectors to develop

customized healthcare services for the elderly health.

Korea, especially, combines big data application

strategies with excellent ICT to improve the Korean

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AAL service strategy as a national counterplan for

the rapid ageing, which is likely to be a world-wide

role model.

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