Helicopter Emergency Medical Services in Japan: Past, Present, and Future Perspectives.

Helicopter emergency medical services (HEMS) in Japan, known as "Doctor Heli," have revolutionized emergency medical care since their inception in 2001. This paper provides a comprehensive overview of the system's evolution, current operations, and future prospects. Japan's HEMS program, born from lessons learned during the Great Hanshin-Awaji Earthquake in 1995, has grown to 57 units across 46 prefectures, handling approximately 30,000 dispatches annually. The system's primary goal is early medical intervention, significantly improving patient outcomes with a 27% decrease in mortality rate and a 47% reduction in severe aftereffects compared to ground ambulance transport. Despite its success, the system faces challenges such as lack of nationwide standardization and shortage of specialized personnel. To address these issues, advanced technologies like the Medical Trainer simulation system and internet protocol-based mobile radio are being introduced. These innovations aim to enhance training, improve communication, and standardize operations across regions. Furthermore, Japan's HEMS system is expanding its influence internationally, collaborating with countries in Asia and Europe to share knowledge and best practices. As Japan continues to refine its HEMS program, integrating technological advancements and strengthening international cooperation, it not only enhances the quality of domestic emergency medical care but also contributes to the global advancement of pre-hospital care systems.