Since the outbreak of COVID-19, we will look at various attempts and changes in Japan’s medical response system. As the number of patients increases rapidly due to COVID-19, there are more people who have become self-isolated like any other country. In Japan, the number of companies providing telemedicine services is increasing exponentially. However, although it is called a telemedicine service, few Japanese companies provide a service that allows doctors and patients to be connected by video, like TELADOC, which has 71 million subscribers in the United States. Most telemedicine services in Japan form networks with various hospitals to connect doctors at nearby hospitals to consult by phone or send emergency vehicles from nearby hospitals to provide visiting medical counseling.
In this situation, J:COM (formerly.Jupiter Telecom), Japan’s largest cable TV company, began providing TV-based video medical counseling services to each household in July 2021. This is a collaboration with a telemedicine service company called MICIN to link it with doctors on their hospital network so that they can perform video medical counseling with doctors through a TV with a Web Camera. However, only users in the metropolitan area, mainly in Tokyo, can use it, and this also depends on the condition that it must be a hospital that has signed a J:COM service use contract and must obtain permission from the doctor.
According to the Review report released in August 2020, according to the Ministry of Health, Labor and Welfare’s online medical practice policy, the ratio of using telephone and video medical counseling was found to be about 2:1.
In terms of age, telephone medical counseling is for under 10s (30%), 10s (8.5%), 20s (13%), 30s (23%), 40s (13%), 50s (7.7%), and 60s or older (4.8%). In the case of video medical counseling, under 10s (41%), 10s (5.9%), 20s (14%), 30s (17%), 40s (13%), 50s (6.5%), and 60s or older (2.6%). The ratio of major diseases and symptoms varies slightly by age group, but fever, upper respiratory tract inflammation, bronchitis, eczema, and allergies account for 60-70% of the total. In the past medical records, about 54% of teens and 50s have no medical records, 83% of under 10s have no medical records, and 65% of 60s or older have no medical records. In the proportion of medical departments, internal medicine, pediatrics, and dermatology account for about 80% in telephone and video medical counseling. (In the case of internal medicine, there are many phone consultations, and in the case of dermatology, there are many video consultations.) This is a statistic that the Japanese people used about 15% (16,202) of the 110,898 medical institutions in Japan by phone and video, and about 6% (6,801) had first-time consultations at medical institutions.
Almost two years later, telephone/video medical counseling may have increased a lot, but analyzing statistics shows that there are quite a lot of medical consultations for children under 10s and that the utilization rate is surprisingly low. In addition, it can be seen that the frequency of use is very low for the elderly in their 60s or older because they are poor at signing up and using the service. In addition, due to COVID-19, most of the counseling related to internal medicine and pediatrics such as cold symptoms is available, and there are some uses for dermatological diseases.
Despite this medical response system, Japan feels the need for a new medical response system for the underprivileged, that is, the elderly in their 60s or older, who are not familiar with telephone medical counseling and video medical counseling. Since everyone knows that Japan has entered a super-aged society, it is important to ensure that the elderly receive medical benefits even if they do not move directly. In addition, a new medical response system is needed not only for the elderly but also for those living in mountainous areas outside the city center.
So, it is the Mobility as a Service (MaaS) service that was born.
Focusing on large Japanese companies, it is promoting ‘healthcare mobility service’ that combines telemedicine and next-generation mobility service (MaaS). (MaaS (Mobility as a Service): A service that combines the operation information of various means of transportation, such as railways, buses, and taxis, and suggests an optimal route for users.) Toyota Motor Corporation and SoftBank Group Corp. established MONET Technologies in February 2019 to provide various mobility-linked services such as logistics, medical care, and finance in cooperation with companies and local governments to promote the MaaS business. Philips Japan is working with MONET Technologies to promote “delivery of healthcare” through a “mobile clinic” service that has upgraded telemedicine services to the next level. (Philips Japan is a healthcare total solution company that sells products and services for each process of healthcare such as prevention, diagnosis, treatment, and home care for a healthy life.) In December 2019, Philips Japan tested the commercial Van (9seats) called HiAce of TOYOTA in Nagano-Ken, Ina-City, equipped with a monitor capable of remote diagnosis, a vital data meter such as blood pressure, body temperature, weight, and blood sugar, and an automatic heart shock device (AED). The “mobile clinic” provides remote and face-to-face treatment services regardless of physical location by moving mobility to where patients want it. It is a system in which a nurse visits a patient with a healthcare facility, a doctor in a hospital treats the patient through a video call, and then the nurse examines and prescribes the patient under the doctor’s direction. This is what the ‘mobile clinic’ provides by synthesizing the three concepts of ‘remote treatment + home treatment + mobility’.
However, it is noteworthy that in the COVID-19 situation, no matter how many hospitals in the city center, there is inevitably a lack of space for PCR tests or vaccinations, and test waiting rooms. Even if there are as many as 110,898 medical institutions in Japan, there is a lack of space and facilities of medical institutions to prevent infection with COVID-19 across Japan.
So, what JAPAN C.R.C. Co.,Ltd. created with a new planning power is the Rent-A-Car business, which allows them to rent camping cars to local governments or hospitals for PCR tests or vaccinations. In this way, camping car rental costs used by local governments and hospitals to prevent infection and secure a treatment system can be subsidized as an emergency comprehensive support grant to the Ministry of Health, Labor and Welfare. If local governments or hospitals use camping cars, they can rent them immediately on the day, move and remove them at any time without being courted by the location, and are not affected by the weather. The camping car is ventilated by a fan on the inner ceiling, has a large window to look out, and has a power outlet for medical devices. Camping Car can use a simple examination bed in case of emergency, a refrigerator that can store PCR test samples or vaccines, and a sink that can wash hands immediately. Sometimes, Camping Car can be used as a space for long-term isolation of severely infected patients, and can also be used as a space for resting, eating, and helping medical staff recover from fatigue. In addition, the camping car can install an isolation partition of vinyl inside, and a simple tent can be installed on the side or rear of the vehicle.
JAPAN C.R.C. Co.,Ltd. has about 700 camping cars nationwide, and has formed a network to sufficiently respond to demand from local governments or hospitals in cooperation with other companies in the same industry, and has a platform to receive them online.
As such, Japan is supporting healthcare MaaS centered on large companies so that medical benefits can be evenly distributed to the elderly and people living in mountainous areas, and is changing with a new attempt to support medical MaaS by renting camping cars to local governments or hospitals to respond to COVID-19.
In other countries, it seems worth paying attention to Japan’s move.
MIKE CHOI
ASIA JOURNAL
