January 16, 2008

Distribution of Telemedicine in Japan

BY Dr. Keith J. Kaplan

Japan and other parts of Asia have serious issues with access to care, in particular sub-specialty care for rural areas and transportation to urban centers, where for example, most pathology practice is conducted.  Not too disimilar to the practice of pathology in the United States but the ratio of over 16,000 pathologists for 300 million people here is multiples the ratio of pathology practioners in Japan for their population.  A recent editorial on the pathology literature mentioned 2000 pathologists on the academic board of the Japanese Society of Pathology.  The majority work within university settings making community pathologists scarce and the work diffucult.  Much has been written about telehealth and telepathology initiatives in Japan with several Japanese companies like Nikon, Olympus and NEC trying to address this issue.  According to some metrics I found below, it appears some progress has been made in certain areas but the market for telepathology in Japan is sizeable:

“Of 1,006 telemedicine projects initiated between 1997 and 2004, 348 were active in 2004, representing a two-fold increase in active programs. There was a four-fold increase in home health and telepathology. Telemedicine is widely distributed in Japan with most serving rural populations, but 30% of the projects in urban areas."

Takashi Hasegawa, Sumio Murase. Telemedicine and e-Health. 2007, 13(6): 695-702.

This paper reports the situation of telemedicine in Japan. A comprehensive database search showed that a total of 1,006 telemedicine projects had been implemented from 1997 to 2004. Teleradiology accounted for the largest proportion (37%) of these projects and home-care telemedicine (home telecare) accounted for one third of the total number of projects. The subsequent questionnaire-based survey revealed that 348 projects were active in 2004, indicating a more than twofold increase in the number of ongoing projects from the 151 projects reported in 1997. In particular, the use of home telecare and telepathology has exhibited an approximately fourfold increase since 1997. Telemedicine was most common in remote areas, although approximately 30% of the projects were implemented within urban areas. The number of telemedicine projects peaked twice: in municipalities with populations ranging from 10,000 to 30,000 and in municipalities with populations ranging from 100,000 to 300,000. However, with regard to the population density, there was no characteristic distribution of implementation. The present data suggest that in Japan, there are various population sizes and densities for which telemedicine may be valuable.”

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