ASOURCE Navi

More than a year has passed since online medical consultations, including initial consultations, were approved as a time-limited measure in April last year due to the coronavirus pandemic. Although it has attracted attention as a new treatment option, there are still few medical institutions that support online consultation. However, in order to respond to the rapid increase in the number of people receiving medical treatment at home due to the recent spread of the new coronavirus infection, there is a growing movement to utilize online medical treatment.

Ministry of Health, Labor and Welfare 15th Study Group on Review of Guidelines for Appropriate Implementation of Online Medical Treatment (held on May 31, 2020) Materials

In April 2020, the government lifted the ban on online medical consultations as a special measure to avoid the risk of hospital-acquired infections caused by the new coronavirus. Prior to that, use was not permitted from the first visit, and the scope of disease was limited to chronic diseases such as hypertension and diabetes. Until the novel coronavirus infection subsides, restrictions have been removed, and even acute symptoms such as fever and headache, including those suspected of being infected with the novel coronavirus, can be examined. However, there are few medical institutions that support online medical consultation, and about 16,000 medical institutions, which are about 15% of the total, are conducting telemedicine, including telephone consultation. In addition, only about 7,000 facilities, or about 6%, respond from the first visit. Most of the consultations are done by phone, and the number of online first consultations is not increasing. The reason for this is that the introduction of the system is expensive, and the medical fee is lower than face-to-face medical treatment.

Against this background, medical associations are starting to spread the use of online medical treatment for home care patients with new coronavirus infections. In principle, people with mild symptoms who have a low risk of becoming severe are treated at home, but due to the explosive increase in the number of new corona cases, in areas where the medical system is tight, even moderate symptoms cannot be hospitalized and are forced to be treated at home. is also seen. Online medical consultation is expected to lead to early treatment of these patients and prevention of aggravation. From August 16, the Ministry of Health, Labor and Welfare has decided to raise the medical fees for home care patients infected with the new coronavirus when they are examined online or by telephone. The fee for the first visit will be more than double, and the revisit fee will be more than four times as much as before.

In Fujisawa City, Kanagawa Prefecture, since late March this year, we have partnered with the Fujisawa City Medical Association to identify those who are at a relatively high risk of exacerbation of symptoms (waiting for hospitalization or those with a blood oxygen saturation level of 95% or less) among those receiving home care. ), we have started initiatives such as online medical treatment and home visits 24 hours a day. About 120 clinics and eight hospitals in the city responded, and 34 online consultations were conducted from March 23 to May 6. Kamakura City and Hiratsuka City are also conducting online medical consultations similar to Fujisawa City.

In July, the Shinagawa Ward Medical Association in Tokyo, in cooperation with the Ebara Medical Association and the Shinagawa Ward Pharmacists Association, began online medical treatment for patients receiving COVID-19 treatment at home and waiting at home while adjusting for hospitalization. When the public health center determines that online medical treatment is necessary for home care patients, it issues a URL for online medical treatment to the patient. The patient enters the virtual waiting room from the URL and waits. Then, the computer or tablet of the registered medical institution will be notified that the patient is in the room, and the doctor who is free will take care of the online medical treatment. This is a system in which multiple doctors in the area provide online medical care for home care patients. At a press conference on August 13, the Tokyo Medical Association also announced that it had started developing a follow-up system for home care patients using online medical treatment.

From August 11th, the Fukuoka City Medical Association has started online medical consultations for patients receiving COVID-19 treatment at home. About 190 medical institutions in the city are responding. Based on interviews with the public health center and requests from the patient, medical institutions in the city provide medical care over the phone or online. Home care recipients will be instructed in advance to contact a medical institution directly if their condition worsens, and a pulse oximeter will be distributed. Medicines will be delivered to your home by mail. As of August 10, about 3,000 new coronavirus patients are being treated at home in Fukuoka City.

There is an urgent need to establish a system in which familiar local clinics can appropriately grasp the situation of people receiving COVID-19 home care through online medical examinations and home visits, and can lead to treatment at any time.