Dr Makoto Kitada demonstrates a telemedicine application service called CLINICS, developed by Japanese medical start-up Medley Inc, in Tokyo, on Wednesday. Photo: REUTERS/Issei Kato
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Telemedicine shakes up Japan's health care sector

16 Comments
By Kaori Kaneko and Izumi Nakagawa

The coronavirus crisis has prompted Japan to ease regulations on remote medical treatment, creating an opening for tech companies and offering a glimpse of the future of healthcare in the world's most rapidly aging society.

As coronavirus cases spiked in April, Japan temporarily eased restrictions on remote medical care, allowing doctors to conduct first-time visits online or by telephone and expanding the number of illnesses that can be treated remotely.

The changes mark a potential shake-up in one of the world's biggest medical markets, which has lagged countries like Australia, China, and the United States in telemedicine. The reforms could also help Japan grapple with both a skyrocketing healthcare burden and few doctors in rural areas.

Previously Japanese doctors were only allowed to treat recurring patients remotely, and for a limited number of diseases.

The rapid pace of change caught executives at Line Corp off guard, forcing Japan's most popular social networking service to accelerate plans for the roll-out of its Line Healthcare business in the coming months.

"The effect that COVID-19 brought was a huge innovation in the healthcare industry," said Shinichiro Muroyama, representative director of Line Healthcare. "The situation has totally changed, much more rapidly than we thought."

Line, which says it has 84 million users in Japan, aims to link doctors and patients by video.

Homegrown medical start-ups such as Medley Inc and MICIN Inc say they have also seen a surge in demand. Both companies offer application services for appointments, video consultations and payments.

Telehealth, or telemedicine, refers to technology that includes online consultations, cloud-based medical records, remote monitoring of patients and use of artificial intelligence to screen for diseases.

Japan's market for such technology is set to grow by 60% to nearly 20 billion yen ($185 million) in the five years to March 2024, according to the Yano Research Institute.

Japanese Prime Minister Shinzo Abe has made deregulating the medical industry part of his growth strategy.

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So Ishii, a doctor who runs a clinic in Tokyo that started offering telehealth in 2017, has seen a jump in online consultations since the outbreak, with 600 patients using the service as of mid-June compared to 400 two months earlier.

Ishii said telehealth could lead to better treatment for patients with lifestyle-related diseases that require continuous attention because it gave them easier access to doctors. Such ailments typically include diabetes and high-blood pressure.

"Ideally, medical care should be designed to provide necessary support for patients regardless of whether it is online or on site," he said.

About 16,100 Japanese medical institutions excluding dentists - nearly 15% of all such facilities - offered remote medical services, including by telephone, as of early July, according to the health ministry.

That marks substantial growth since July 2018, when only 970 medical institutions were registered to offer online care.

Still, the health ministry has not decided whether to make the changes permanent, while the national medical association is less than enthusiastic, citing concerns about misdiagnosis.

"We should be extremely cautious about using evidence drawn from telemedicine in the emergency situation for consideration of how it should be after the coronavirus infection wanes," Japan Medical Association President Toshio Nakagawa told Reuters. He was vice-president at the time of the interview.

Analysts say telehealth can also put smaller clinics at a financial disadvantage.

Goichiro Toyoda, representative director and a medical doctor at Medley, agrees doctors can better check first-time patients in person but says telehealth suits patients who want second opinions, have trouble visiting hospitals or need long-term treatments.

"Telemedicine will not replace face-to-face treatment," said Toyoda. "But I've been stressing the importance of it becoming an option."

© Thomson Reuters 2020.

©2020 GPlusMedia Inc.

16 Comments
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citing concerns about misdiagnosis.

Is it a problem with telemedicine? Because it seems misdiagnosis is a thing here. Perhaps everywhere, but at least back home, I was given more explanations and answers and therefore more power to look it up and perhaps realize something isn’t right.

With no 2 way conversation happening in the office, I wonder what telemedicine looks like in japan....

5 ( +5 / -0 )

Last year my brother in New York took part in an experiment. Surgeons at a major hospital there carried out an operation at another hospital in Germany using robots. It lasted a whole day. My brother's role was to maintain the internet and video links.

7 ( +7 / -0 )

What are the major players in Japan? Does Teladoc have a presence?

4 ( +4 / -0 )

It's an aging population, getting on bord with new technology and the social distance is hard for people who's whole life untill now has been face to face. But give it time, change can happen, might be forced but it can happen.

1 ( +1 / -0 )

Still, the health ministry has not decided whether to make the changes permanent, while the national medical association is less than enthusiastic, citing concerns about misdiagnosis.

"We should be extremely cautious about using evidence drawn from telemedicine

Are you sure the concerns are not due to the fact that remote consultation gets a smaller govt medical fee rebate than a face to face one for the doctors, Nakagawa san?

3 ( +4 / -1 )

No, telemedicine won’t replace face to face contact for diagnosis.

-3 ( +0 / -3 )

Still unable to take blood or other body fluids for checking remotely, measure physical symptoms such as heart or lung function, touch the patients to ascertain pain or physical symptoms, and administer diagnostic tests or medicines; but it does provide a useful screening service, and as stated above, is useful for longer term monitoring. Should be integrated into total health plan.

1 ( +1 / -0 )

American companies will take over the Japanese health care system. Be warned.

-2 ( +1 / -3 )

After my operation in May I suppose to visit the hospital every month. But my doctor decided that with the COVID-19 it was better not to go. We spoke over the phone every couple of weeks about my progress. I managed to visit him last month and have now moved to a local hospital. My next appointment is in September.

2 ( +2 / -0 )

What do these companies offer that is an improvement over Skype?

1 ( +1 / -0 )

In Australia we use Telehealth and its always with your own GP or if like myself I regularly talk to my Transplant Hospital doctors via Telehealth and as both my GP and hospital doctors have my medical records. With this information and seeing and listening to you via Telehealth your doctor can make a diagnosis based on your current and past symptoms and medical history.

1 ( +1 / -0 )

Going to reload prescription meds when your condition hasnt changed should not require going to the clinic or hospital sitting in a waiting room only to get to see the doctor to be told your medicine will be continued like it has for the last 10 years, then going around the corner to pick up the damn stuff.

Surely they can figure out a teleconsultation will suffice and a message to the dispensary to collect the meds instead of all the faffing around once a month.

Not comfortable having to sit in a waiting room with a bunch of sick people just to get a reload on meds i have been taking for 10 years .

But then this is Jpan the land of advanced technology and intelligence after all cough cough .

0 ( +0 / -0 )

and how come the meds cant be delivered from the pharmacy like they do when they are unable to fullfil your script when they are out of stock. Simply too stupid to figure it out.

0 ( +0 / -0 )

I have been on a daily drug for tsufu. The doctor usually gives mes three months supply. If I run out the wife phones the hospital and goes to pick up a new note. Pharmacy companies each have their own way of working but they need to see you health insurance card every time you collect and your drug record book.

Last week I also picked up a three month supply of pain killers for my op.

0 ( +0 / -0 )

and how come the meds cant be delivered from the pharmacy like they do when they are unable to fullfil your script when they are out of stock. Simply too stupid to figure it out.

Not sure what you mean but my Japanese mother-in-law is having her meds delivered.

0 ( +0 / -0 )

therougou - quite simply why cant the doctor email the pharmacy the repeat of the prescription and so then the pharmacy can simply arrange to deliver the medicine or even a regular patient could just go in and pick it up.

Sitting around in waiting rooms full of sick people makes alot of sense though I guess....... if you are in the business of making money off treating sick people, the sicker they are or become the better your business becomes, until they eventually die, but those who implemented this stupid system do not have the foresight to understand that .

0 ( +0 / -0 )

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