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. 2020 Apr 30;10:7351. doi: 10.1038/s41598-020-64123-z

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© The Author(s) 2020

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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Overview of the Japan Chronic Kidney Disease Database (J-CKD-DB) System. The SS-MIX2 (Standardized Structured Medical Information eXchange) leveraged recent progress made in healthcare information standards in Japan, including code standardization regarding laboratory data items and prescription data. The university hospitals participating in J-CKD-DB (left boxes) needed to have electronic health record systems that incorporated SS-MIX2 storage and a template-based structured-data entry function that could transfer the entered data to the SS-MIX2 storage. All data elements are extracted semi-automatically using SS-MIX2 storage and send to J-CKD-DB data centre through HTTPS (upper right box). MCDRS (Multi-purpose Clinical Data Repository System), a software system developed at the University of Tokyo, is adopted for designing and collecting the data elements. The administrative office of J-CKD-DB project is in Kawasaki Medical School (lower middle box). J-CKD-DB is maintained, and data cleaning is carried out at the office (lower right box). AP, application; DB, database; DMZ, demilitarized zone; HTTPS, hypertext transfer protocol secure; SSH, secure shell; SSL, secure sockets layer; VPN, virtual private network.