With the FY2024 revision shifting the management of hypertension, diabetes, and dyslipidemia to the Lifestyle-Related Disease Management Fee, creating the treatment plan has become a new practical burden for internal medicine clinics. Note that the fiscal 2026 revision removed the patient signature requirement, though creating, explaining, and delivering the plan remains necessary. Creating a plan at each visit, explaining it to the patient, and obtaining a signature is a major task in busy internal medicine outpatient settings. This article explains how to auto-generate the treatment plan from electronic chart entries to streamline work centered on the Lifestyle-Related Disease Management Fee (II), based on the official materials of the Ministry of Health, Labour and Welfare (MHLW). Note that specific requirements and forms are set in notices and notifications, so always confirm them in the primary sources.
What is a treatment plan?
The treatment plan is a document whose creation and delivery are required when billing the Lifestyle-Related Disease Management Fee. It shares target values for blood pressure, blood glucose, weight, and the like, as well as guidance on diet, exercise, and medication, with the patient, playing a role in continuous lifestyle improvement. The MHLW presents form examples for first-time and continuing use, and explanation to and delivery to the patient are the basis of operation.
The Lifestyle-Related Disease Management Fee has category (I), which bundles tests and the like, and category (II), which does not; both involve treatment plan operation. For details of the requirements by category, please check the MHLW and Regional Bureau of Health and Welfare materials cited below.
The challenges of treatment plan operation
Treatment plan operation carries the following burdens for internal medicine clinics.
- The effort of creation: You must enter target values and guidance content for each patient.
- Duplicate transcription: The double work of re-copying content written in the chart into the plan easily arises.
- Delivery operation: The flow of explanation and delivery must be built into the consultation.
- Continuing management: Forms differ for first-time and continuing use, and you must manage update timing.
In particular, the inefficiency of entering the same content twice, into the chart and the plan, is a loss that cannot be overlooked in busy internal medicine outpatient settings.
The Patient Signature Became Unnecessary in the Fiscal 2026 Revision
Regarding the treatment plan, operations around the patient signature were reviewed to reduce the burden on patients and institutions, and in the fiscal 2026 revision the patient signature became unnecessary, applying from June 1, 2026. What disappeared is only the signature field and the act of obtaining it: creating, explaining, and delivering the plan all remain required. The clerical burden eased, but producing the plan itself still takes effort—and with the signature bottleneck gone, the efficiency of creation and delivery now sets the pace of operations. Because operations may change, always confirm the latest requirements in MHLW materials, and it is desirable that the system side can also respond flexibly. It is important to avoid rigidly fixing operations and to keep up with updates to the primary sources.
The benefits of auto-generating the treatment plan from the chart
If a draft treatment plan can be auto-generated based on electronic chart entries, operations change greatly.
- Eliminating double entry: Test values and guidance content from the chart are automatically reflected in the plan, so transcription becomes unnecessary.
- Shorter creation time: Rather than creating from scratch, you can complete it by simply checking and revising a draft.
- Preventing omissions: Required items are templated, preventing forgetting to write them.
- Efficient continuing management: You can update based on the previous plan, making creation for continuing use easier.
This frees physicians from the work of creating plans and lets them devote time to the essential task of explaining to patients.
Auto-generating treatment plans with AI Karte
"AI Karte," developed by Pottech, is an integrated receipt-computer cloud electronic chart equipped with a document AI draft function. Working in tandem with the chart content entered during the consultation and with AI receipt checking, it auto-generates a draft of the treatment plan. Because physicians can complete the plan simply by checking and adjusting the content, the effort of double entry and transcription is greatly reduced.
Furthermore, because AI Karte's system is automatically updated in line with medical fee revisions, it keeps up when the form or operation of the treatment plan is reviewed. Because the AI receipt checking function detects billing omissions and erroneous claims for the Lifestyle-Related Disease Management Fee in advance, it supports plan operation and billing in an integrated way.
In closing
Creating, explaining, and delivering the treatment plan is unavoidable practice for internal medicine clinics billing the Lifestyle-Related Disease Management Fee (the fiscal 2026 revision removed the signature, but creation, explanation, and delivery remain). The key to reducing double entry and the effort of creation lies in a mechanism that auto-generates a draft plan from chart entries. Taking into account that operations may be reviewed, by choosing a system that automatically handles revisions, you can keep the burden down while ensuring reliable billing.
Through the provision of AI Karte, Pottech serves as the optimal business partner for clinics—supporting not only better working conditions for physicians, nurses, and medical clerical staff, but also helping clinics achieve to the fullest what they want to accomplish.
For details, please do not hesitate to contact us.
References / Sources
- Lifestyle-related disease treatment plan (first-time use) form example (MHLW)
- Facility standards for the Lifestyle-Related Disease Management Fee (Kinki Regional Bureau of Health and Welfare)
- About the FY2024 Medical Fee Revision (MHLW)
The form and entry requirements of the treatment plan change by fiscal year and notification. This article does not assert them; please always confirm the latest information in the official sources above.