Emergency Medical Doctor Joins Nago City's Emergency Transport Reform – Nationwide Model Demonstration Project to Begin in FY22026

Nago City, Okinawa Prefecture (Mayor: Taketoyo Toguchi) is embarking on a "Public-Private Partnership Emergency Transport System Demonstration Project" starting in fiscal year 2025. Ryo Osako, Representative Director of the General Incorporated Association OPHIS (Location: Setagaya-ku, Tokyo), will participate in this project from April 2026, utilizing the Ministry of Internal Affairs and Communications' Regional Revitalization Entrepreneur System (side-job type). In the northern Okinawa region, which faces challenges of vastness and an aging population, he will leverage his specialized knowledge as a doctor of emergency medical science and an emergency medical technician to support the construction of a sustainable emergency transport model through status surveys and research.

## Background: Intensifying Strain on Emergency Transport in Rural Areas

According to the Fire and Disaster Management Agency of the Ministry of Internal Affairs and Communications' "Emergency and Rescue Situation in Reiwa 7th Edition," the number of nationwide emergency dispatches in 2024 exceeded 7.71 million, marking a new record high for the third consecutive year. The time required to reach the scene has also extended by approximately 14% over the past 10 years, from 8.6 minutes to 9.8 minutes.

Particularly in rural areas that are vast and experiencing an aging population, the burden on fire and emergency services is increasing due to a shortage of regional medical resources and means of patient transport. The northern Okinawa region is no exception; inter-hospital transfers (patient transfers between hospitals), which are not originally the role of fire ambulances, occur frequently, forcing reliance on fire ambulances. In fact, at the Nago City Fire Department, inter-hospital transfers accounted for approximately 11% (Reiwa 5, 2023) of all emergency dispatches, which is about 1.5 times the national average (7.3%) for the same year.

## Nago City's Challenge and OPHIS's Participation

Against this backdrop, Nago City is undertaking the "Public-Private Partnership Emergency Transport System Demonstration Project" from fiscal year 2025, which aims to redesign the division of roles between fire and emergency services and private patient transport operators. OPHIS began its activities in Nago City in December 2023 and concluded a business agreement in March 2025. The formal participation of the Representative Director is part of efforts to strengthen the system for the start of operations in fiscal year 2026 and expansion across the entire northern prefecture from fiscal year 2027 onwards.

This initiative aims to provide one answer to the common challenges faced by many rural areas in Japan: vastness, an aging population, and uneven distribution of medical resources.

## Comment from Ryo Osako, Representative Director of OPHIS

The Nago region in northern Okinawa Prefecture is advancing a challenge that could serve as a national model for the sustainability of emergency transport systems: the "construction of a new emergency transport system centered on public-private partnerships." I am deeply honored to be able to directly contribute my research knowledge to this challenge through the Regional Revitalization Entrepreneur System (side-job type).

I will diligently proceed with effective surveys and research, valuing real-world data from the field, the Nago City Fire Department, and the voices of the local community, and strive to share this knowledge nationwide.

## Inquiries Regarding This Initiative

We welcome consultations from local government officials, medical institutions, and media organizations facing similar challenges.

[Contact Information]

- Contact Person: Toshihiko Maehara
- TEL: 090-1659-1864
- Email: t.maehara@ophis-ems.org

## Reference: About the Regional Revitalization Entrepreneur System (Side-Job Type)

This system, managed by the Ministry of Internal Affairs and Communications, dispatches employees from urban companies to local governments for a certain period (6 months to 3 years) to address regional issues by leveraging their specialized know-how and expertise. There are three categories: "corporate dispatch type," "senior type," and "side-job type." In this case, the "side-job type," where individuals engage in local government work, is being utilized.

Reference: Ministry of Internal Affairs and Communications Website

## Organization Overview

The General Incorporated Association OPHIS is a non-profit organization dedicated to making emergency transport systems sustainable in a super-aging society. It focuses on three main pillars: emergency transport system reform projects, research and study projects, and emergency system support projects, all aimed at realizing a society where "savable lives are saved."

- Organization Name: General Incorporated Association OPHIS
- Representative Director: Ryo Osako (Lecturer, Kokushikan University Research Institute for Disaster and Emergency Medical Services)
- Established: January 2024
- Location: 3-27-10 Matsubara, Setagaya-ku, Tokyo 156-0043
- Homepage: https://ophis-ems.org

[Contact Information]

- General Incorporated Association OPHIS
- email: info@ophis-ems.org