診療技術・運営・デジタル活用から考える地域医療の未来　　article number e26_005, (2026)

廣瀬英生（編集委員）
県北西部地域医療センター 国保白鳥病院

　地域医療の現場では，限られた人的・物的資源の中で，住民により良い医療を届け続けるためのさまざまな工夫が日々積み重ねられている．本号に掲載された３編の報告は，そうした取り組みをそれぞれ異なる角度から示している．

　笹井らは，大腸内視鏡検査において水浸法と内視鏡挿入形状観測システムを組み合わせることで，挿入が難しい症例でも痛みを抑えながら安全に検査を行う手技を紹介した．高齢化が進む地域では，鎮静剤を使わずに実施できる検査技術の価値はますます高まっている¹⁾．

　弘田らは，新型コロナウイルス感染症流行期の発熱外来を分析し，人員数の多寡だけでなく，役割分担や診療フローといった運営体制が診療能力に大きく関わることを示した．感染症への備えを考えるうえで，地域医療機関のしなやかな対応力の重要性を改めて感じさせる研究である²⁾．

　さらに，同道らは持続血糖モニタリング（CGM）データとSNS上のコミュニケーションデータを組み合わせ，健康行動や患者エンゲージメントを新たな視点で評価できる可能性を示した．デジタル技術の進歩によって医療の場は診察室の外へと広がりつつあり，地域住民の行動変容を後押しする手法として今後の展開が期待される³⁾．

　これらに共通しているのは，「技術」そのものよりも，それを地域の実情に合わせて活用し，住民の利益につなげようとする現場の知恵である．人口減少や医療資源の不足が進むなか，地域医療に必要なのは大きな制度改革だけではない．日々の実践の中で生まれる工夫を積み重ね，その成果を共有していくことが，持続可能な地域医療の未来を支える力になるのではないだろうか．

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Hideo Hirose (Editor)
Shirotori Hospital, Center for Community Medicine in North-Western Gifu prefecture

In community healthcare settings, various innovative approaches are continually being developed to provide better care for local residents despite limited human and material resources. The three reports featured in this issue highlight such efforts from different perspectives.

Sasai et al. describe a colonoscopy technique that combines the water-immersion method with an endoscope insertion shape observation system, enabling safe and minimally painful examinations even in patients with difficult colonic anatomy. In communities facing rapid population aging, techniques that facilitate high-quality examinations without the need for sedation are becoming increasingly valuable¹⁾.

Hirota et al. analyzed the operation of fever clinics during the COVID-19 pandemic and demonstrated that organizational factors, including role allocation and clinical workflow design, can substantially influence healthcare delivery capacity, independent of staffing levels alone. Their findings underscore the importance of flexible and resilient operational systems in community healthcare settings when preparing for future infectious disease outbreaks²⁾.

Furthermore, Domichi et al. integrated continuous glucose monitoring (CGM) data with social networking service (SNS) communication data, demonstrating the potential of combining physiological and behavioral information to evaluate health-related behaviors and patient engagement. As digital technologies continue to advance, healthcare is expanding beyond traditional clinical settings, and such approaches may contribute to promoting behavioral change and supporting population health in local communities³⁾.

A common thread among these reports is not the technology itself, but the ingenuity of healthcare professionals who adapt available tools and methods to meet local needs and translate them into tangible benefits for residents. In an era characterized by population decline, workforce shortages, and constrained healthcare resources, sustainable community healthcare will require more than large-scale systemic reforms. The accumulation, evaluation, and dissemination of innovations emerging from everyday clinical practice will likely serve as a key driving force in shaping the future of community healthcare.

Reference

1. 1) 笹井平，他：挿入困難が予想される事例での大腸内視鏡水浸法の利点とコツ．月刊地域医学 2026；40(7)：e26_008．
2. 2) Hirota Y, et al: Organizational Factors Associated With Patient Volume in Fever Clinics During the COVID‑19 Pandemic: A Primary Care Study. Monthly Community Medicine 2026; 40(7): e26_006.
3. 3) Domichi M, et al: Continuous Glucose Monitoring and Social Media-Derived Insights for Diabetes Prevention and Community-Based Care in Prediabetes: A Feasibility Study. Monthly Community Medicine 2026; 40(7): e26_007.