Nurse Sayaka Yamasaki, 37, drives her car down a narrow road to visit an elderly patient who lives alone in the mountains of Shikoku.
“How are you feeling? Have you been experiencing any change in your health?” She then video calls a doctor at the Shionoe branch of the city hospital using a smart tablet.
Spending his time under a kotatsu (a heated table covered with a blanket), Akira Fujisawa had low-temperature burns on his leg. Yamasaki showed the burns to the doctor via the tablet. The doctor decided the burns were not anything urgent.
“If I tell them about my condition, they will look into it and provide me with medication. I appreciate it,” said Fujisawa.
Fujisawa is one of those benefiting from telemedicine, or telecare, in which doctors treat patients via video and other communication means.
The move is part of a Kagawa Prefectural Government project to test telemedicine after the prefecture was designated by the central government as a special zone for such services.
Although telecare had long been prohibited by the health ministry, a notice issued last year effectively lifted the ban, allowing various startups to offer the service.
Before then, the Ministry of Health, Labor and Welfare had ruled that treatment must be given face-to-face, limiting telemedicine to patients with chronic illnesses who live in remote areas, including islands.
According to a 2014 health ministry survey, only 18 hospitals and 544 clinics nationwide offered telemedicine and telecare. But with the advance of technology, a government panel on deregulation urged the ministry to revise the policy. In August, the ministry issued a notice saying telemedicine need not be limited to patients in remote areas.
This prompted many medical startups to launch telemedicine services targeting busy white-collared workers in metropolitan areas.
With the help of an IT firm, MRT, a job-matching company for doctors, launched a new service last April that offers medical consultations from doctors via smartphones. About 1,300 medical facilities nationwide are registered with the service.
Patients need to see the doctor face-to-face on the first consultation, but telemedicine is available from the second time on, covered by public health insurance.
The company is also considering offering health consultations by doctors for a fixed fee, where public health insurance won’t apply. MRT hopes to have 10,000 medical institutions registered for its service in the next three years.
Medley, which offers an online encyclopedia of diseases, developed a telemedicine system called Clinics that allows patients to pay with their credit cards. A few clinics have introduced the system, which would also allow doctors to send prescriptions by mail.
Mnys, which operates four pediatric clinics in Tokyo, started offering treatments via video conferences in January for children with parents who can’t visit the clinic on a regular basis.
However, under the nation’s health insurance scheme, medical institutions receive lower fees than they would get if they treated patients face-to-face, casting doubt on whether the service will expand.
In telemedicine, doctors only receive ¥720 as a medical fee under the public health insurance system, or about 10 to 20 percent the amount for treating someone face-to-face, where they are allowed to charge patients under various categories, pushing up the fee.
Those launching telemedicine services are seen, therefore, as entering the business not for immediate profit. Experts claim the government should raise medical fees for telemedicine treatment and create a criteria for the business.
“If used properly, it will help ward off lifestyle diseases, lead to more efficiency in medicine and reduce the burden on families with nursing care patients,” said Kazuhiro Hara, who chairs the Japan Telemedicine and Telecare Association. “It will benefit the public as a whole.”
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