IDEXX and veterinary diagnostics in Japan

Woman holding a child and smiling at a dog

Japan may be 7,000 miles away from our home in Westbrook, Maine, but the IDEXX mission there is the same as it is in North America: to give veterinarians the diagnostic tools they need to keep pets healthy. There are some differences, though, between veterinary medicine in Japan and in the United States.

Small spaces, small dogs

Toy breeds like the Chihuahua, miniature dachshund and Pomeranian are perennial favorites in Japan, where residents live close together and living spaces are small. These smaller breeds tend to outlive their larger counterparts like the Labrador retriever and golden retriever that are popular in the U.S. That means that the 117 employees of IDEXX Japan have to take special care to ensure veterinarians get the most from their in-house diagnostic products and IDEXX Reference Laboratories services.

“There are conditions that are more common in small-breed dogs than in larger ones,” says Dr. Nozomi Shimonohara, a pathologist with IDEXX Japan. “Take the miniature dachshund, for example. This breed is very popular in Japan, and with these dogs we encounter inflammatory colorectal polyps, sterile nodular panniculitis, and nonregenerative immune-mediated anemia more regularly than with other breeds. There is evidence that the common thread in these conditions is that they are all immune-mediated, but more study is needed.”

First come, first served

Unlike those in the U.S., most practices in Japan take care of customers on a walk-in basis. This works well for customers, who can take their pets in for a health checkup whenever they’re able to find the time. But it can be a challenge for the practice and for our IDEXX veterinary diagnostic consultants like Michihicko Yamazaki, who has been an IDEXX employee in Japan for more than 10 years.

“Often a customer will say, ‘Come by and see me on Wednesday,’” Says Yamazaki, “but when I drive by on Wednesday, the waiting room may be full, so I have to try back later. On the bright side, this also opens the door for me to talk with my customers about ways that I can help them create work-flow efficiencies.”

Paper, paper everywhere

It might be surprising, but one area where the Japanese veterinary market differs from the U.S. is in the use of practice management software and the adoption of electronic medical records. Few Japanese animal hospitals use a practice information management system, or PIMS. And forget about going paperless! Japanese medical charts, called car-te, are practically works of art, containing illustrations, hand-drawn graphs and pharmaceutical labels delicately pasted into the pages. As beautiful as they are, these methods can affect organization and efficiency.

Hajime Yamaguchi, integration manager for IDEXX Japan, is working to change all that. Yamaguchi’s first project when he joined IDEXX in 2013 was to bring two-way integration of diagnostic information to Japan—something that’s been available in the U.S. for almost a decade.

“People think of Japan as the world leader in workplace efficiency,” Yamaguchi says, “but in this case we are learning a lot from our customers in the U.S. about diagnostic work flow.”

Thanks to the efforts of Yamaguchi and his team, bidirectional connectivity is now available for Japan’s two largest practice management systems, with more to come soon. “We know this is the future,” he says, “not just for Japan but for veterinarians all over the world.”

Passing it down

Until about a decade ago, veterinary medicine in Japan was treated as an artisanal profession; when a veterinarian retired, his practice would simply close, unless he had a son or daughter to whom he could pass it on. Now that’s beginning to change.

“There’s a growing awareness that a veterinary practice is a business that has transferable equity,” Bob Luck, director and general manager of IDEXX Japan explains. “Until very recently, hospital management wasn’t seen as a separate role within the practice. It was a hobby for the practice owner. Japanese veterinarians are starting to realize the tremendous impact a skilled practice manager can have on the value of the hospital when it comes time to sell, and it’s critical for IDEXX Japan to help support this evolution.”

Real-time, (almost) all the time

Perhaps the most surprising aspect of Japanese veterinary medicine, at least from a diagnostics perspective, is the use of in-house laboratory instruments for most chemistry and hematology profiles, rather than reference laboratories.

Peter Kintzer, DVM, DACVIM, has travelled to Japan often in his 2 decades of work as a medical consultant and diagnostic expert for IDEXX, and he’s noticed some subtle differences in their approach to hematology.

“Japanese practitioners tend to be very comfortable examining blood smears and with interpreting hematology results in general,” says Dr. Kintzer. “As a matter of fact, part of the reason the ProCyte Dx Hematology Analyzer has been such a success in Japan is that our Japanese customers see a lot of value in the ‘dot plots’ that the system produces. There’s valuable information on the dot plot that you can’t get just by looking at numerical results, which ultimately improves patient care.”

Bob Luck agrees, but for him it’s bigger than just the ProCyte Dx analyzer. “Culturally, the Japanese have an aversion to waste. If a pet owner just spent an hour and a half on the subway bringing their dog to you, the last thing you want to do as their veterinarian is to make them wait overnight for results when that same information could be quickly and accurately produced in-house in minutes.”

“I really think that’s the heart of it,” continues Luck. “Veterinarians in Japan have always seen inherent value in real-time care as a contributor to patient health and a positive client experience. Japan is no different than the U.S. in that way—it’s all about strengthening the bonds that matter most, for patients, clients and practices around the world.”

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Japanese medical charts, called ‘car-te,’ are practically works of art, containing illustrations, hand-drawn graphs, bits of blood work results and pharmaceutical labels delicately pasted into the pages.