Videoconferencing for Home Care Delivery in Japan: Observational Study.

Hirotomo Miyatake,Akihiko Ozaki,Chie Tsunetoshi,Hidehisa Masunaga,Hiroyuki Beniya,Satoshi Arita,Makoto Kosaka,Yasuhiro Kotera,Yoshitaka Nishikawa

doi:10.2196/23539

Abstract

BackgroundTelemedicine has been increasingly used in many health care fields, including home care, where patients receive medical care at home. Owing to the current COVID-19 crisis, the value of telemedicine via videoconferencing is more recognized, particularly in allowing immobile patients to continue receiving care. However, the efficacy of telemedicine in home care settings in Japan remains to be fully appraised.ObjectiveThis study aims to identify the use and impact of telemedicine in a singular home care delivery setting in Japan.MethodsA retrospective observational study was conducted using patient and other administrative records from a home care clinic. We considered patients who were involved in videoconferencing with home care physicians and telepresenters serving patients during 2018 and 2019. We extracted sociodemographic data of the patients and details of the videoconferencing and descriptively illustrated some specific cases.ResultsIn a home care clinic in Japan, videoconferencing was conducted in 17 cases (involving 14 patients) over a 2-year period. Of all the cases, 12% (2/17) required emergency transfers and were hospitalized. A total of 88% (15/17) of cases remained; 71% (12/17) of cases were found to need extra medication or to go to a medical facility for consultation, whereas 18% (3/17) of cases were found not to be in need of urgent attention and were asked to rest. Problematic symptoms subsequently improved in 82% (14/17) of cases, and only 6% (1/17) of cases were later hospitalized.ConclusionsTelemedicine was deemed effective for assessing patients’ conditions in the home care setting in situations where home visits by a physician cannot be carried out. Our findings indicate that consultations via videoconferencing are safe and effective, suggesting more active use of videoconferencing in other clinical contexts.

Highlights

Telemedicine, the use of information and communication technology to deliver health care at a distance, has been increasingly used to deliver health care covering a wide range of specialties, for numerous conditions, and through a variety of channels and systems [1]
In Japan, specialized home medical care is overseen by physicians in specialized home care clinics
Telemedicine is a valuable substitute for face-to-face investigations where necessary or desirable. This is a valuable option in emergency situations, especially when home care health personnel cannot access the patients under their care

Summary

Introduction

BackgroundTelemedicine, the use of information and communication technology to deliver health care at a distance, has been increasingly used to deliver health care covering a wide range of specialties, for numerous conditions, and through a variety of channels and systems [1]. Significant barriers to wider use have been identified: health care providers and patients face regulatory ambiguities and financing uncertainties. Inequalities in both health and digital literacy are another concern, as patients who could benefit the most are often those who are the least able to have access to or make use of telemedicine [4]. Telemedicine has evolved to help improve effectiveness, efficiency, and equity in health care. Objective: This study aims to identify the use and impact of telemedicine in a singular home care delivery setting in Japan. Results: In a home care clinic in Japan, videoconferencing was conducted in 17 cases (involving 14 patients) over a 2-year period. Our findings indicate that consultations via videoconferencing are safe and effective, suggesting more active use of videoconferencing in other clinical contexts

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