International Telehealth Trends: Insights from Japan

Observations from 2015 Travel

In 2015, I had the opportunity to visit more than 10 countries, including Japan, Mexico, the United Kingdom, Brazil, Germany, and China. After meeting with numerous healthcare leaders and government officials, a recurring theme emerged regardless of location: how can countries and healthcare systems best care for aging populations? How can coordination among providers be improved to better provide care to the elderly, and in particular serve the needs of patients who have multiple complex chronic conditions? And how can better outcomes be achieved for such patients especially with ever tightening healthcare budgets?

Increasing investment and interest in Telemedicine and Remote Monitoring as a solution to these pressing healthcare challenges

A universal sentiment I observed is enthusiasm toward telemedicine and remote monitoring technologies as a potential solution for addressing these challenges. Government and healthcare leaders in the countries I visited are hopeful that these tools will enable patients, caregivers, and providers to work together in a more effective manner to better manage chronic disease, and in turn improve health outcomes at lower costs. Forecasts suggest the international market for telemedicine will grow from $14 billion in 2015 to $34 billion in 2020.

Telemedicine and Remote Patient Monitoring: Why now?

Telemedicine and remote monitoring are not new concepts. They have long been touted as having potential to transform healthcare for the better, and peer reviewed literature increasingly supports this view (e.g., increased patient satisfaction, improved health outcomes). For a number of reasons, though, the implementation and use of telehealth has yet to fully reach its potential. Policies are often vague or confusing, and reimbursement is still lacking for many telemedicine services. This was generally the case in every country I visited, and in the United States. However, there is reason to believe this market will soon expand rapidly. Several forces, including consumer demand, advancements in technology and data security, growth in private companies entering this field, and changes in regulatory and reimbursement policies that support the use of telemedicine, are converging in such a way that will increasingly bring these services into routine care.

Variations across countries: Use cases, policies, and opportunities for growth

Here, and in a series of blogs to follow, I will highlight how the countries I visited this past year are using telemedicine and remote monitoring tools, the country-specific regulatory and reimbursement policies that affect the use of telehealth, and how Intel Health & Life Sciences is working with partners in these countries to promote the use of this technology.

Observations from Japan

During two trips to Japan this past year, discussions about telehealth technology were of top priority. Japan is in an ideal position to use telemedicine and remote monitoring for two reasons: 1) it has the technological infrastructure and sophistication to support and rapidly implement it, and 2) more than 20% of Japan’s population is over the age of 65, and this percentage is expected to rapidly increase. In providing home care for this population, telemedicine and remote monitoring capabilities will be increasingly important.

Policy Roadblocks

Japan is hardly an outlier in having policies that hinder the implementation, use, and reimbursement of telemedicine. The American Chamber of Commerce in Japan (ACCJ) and the European Business Council in Japan (EBC) have recommended amending the Medical Practitioners Act to clarify who is allowed to implement and practice telemedicine. Additionally, while some services are reimbursable (e.g., tele-radiology and tele-pathology), many other services such as disease management and patient education are not. Thus, while the technology exists to make this care a reality, policies have not always kept pace to allow it to happen.

Use cases in Japan

Policy and reimbursement challenges notwithstanding, Japan has made impressive progress in how it effectively uses this technology for patient care. For example, KOHOEN is a social welfare organization in Japan. One of its primary missions is to improve and provide community-level care, and to promote team-based care among doctors, nurses, pharmacists, and care managers. It equips care teams and patients with remote care tools, which in turn help older individuals live at home and maintain independence. One tool KOHOEN uses is a tablet solution (an Intel atom processer powered android-based ASUS fonepad) for a 24-hour visiting nurse and attendant service. The care team members use these tablets and a cloud-based information sharing system to share information with one another. The flexibility and security of this tool allows for real-time data input and transmission, which enables physicians to provide medical advice while the nurse is at the home of a patient.

Sharing best practices and learnings across countries

As countries around the world continue to integrate these types of technologies into their care delivery systems, sharing best practices will be important and valuable as other countries invest in similar tools. Policies, too, must continue to evolve to keep pace with these technological advancements for the benefits to be fully realized. Intel will continue to work with policy makers abroad and in the U.S. to encourage such progress.