Introduction: The Emergency Medical Team (EMT) Strategic Advisory Group of the WHO has endorsed the EMT Minimum Data Set (MDS) as the standard methodology for EMT daily report. The MDS had been developed on the similar methodology so-called J-SPEED which developed in Japan. Thus, lessons learned from the J-SPEED can be applied to the MDS. 
Aim: To review previous J-SPEED activations and to extract lessons learned.
Methods: Cases of the J-SPEED activation at the Kumamoto earthquake 2016, West Japan Heavy Rain in 2018, and Hokkaido Earthquake in 2018 had been reviewed.
Results: The first large-scale activation of the J-SPEED at the Kumamoto earthquake revealed significant burden in aggregations of submitted paper forms at the EMT Coordination Cell (EMTCC) . To strengthen this function of the EMTCC, electronic system and human capacity development has been identified as key issues. To fulfill this gap, smartphone app so-called J-SPEED+ has been developed. Also, the J-SPEED offsite analysis support team, which is a team to support analysis of data from outside of affected area has been established. These two functions contributed to significant improvement of J-SPEED data flow at the West Japan Heavy Rain and Hokkaido Earthquake. These two responses reminded necessity of strengthening the capacity of J-SPEED onsite coordinator working at the ETMCC and nationwide education and training for all EMTs.
Discussion: In order to strengthen the mechanism to run the J-SPEED, nationwide training for all EMTs, onsite coordinator, and off-site analysis support team have been tried to strengthen. The authors regard this structural approach will be required in other countries to run the MDS.

Experience of Activation of the J-SPEED(MDS) in Japan