Although Japan’s National Health System is excellent and is an example to other countries, human-medical staff find it very difficult to assimilate and use technology that will help them drastically reduce the examination and prescribing time of their patients.
The Organization for Economic Cooperation & Development (OECD) ranks Japan in the low positions in terms of its technological implementation for management and use in healthcare provision.
Japan’s digitisation is at the core of Japanese Prime Minister Suga Yoshitide policy, who has also found the right opportunity to implement it given the existence of the Covid-19 pandemic in the country.
by Thanos S. Chonthrogiannis
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Japan by digitizing its National Health System will achieve large capital savings in public spending for healthcare due to the achievable large economy of scale in its annual state budget, enabling the Japanese government to direct these saved state resources to other areas of society. Last year-2019 Japan’s annual public spending in the healthcare sector reached 11% of its GDP.
But the problem, and at the same time an obstacle to the digitisation of Japan’s healthcare sector, lies in the large age group of doctors who are close to retirement, so that they are not familiar with the use of technology, fearing as every civil servant that will adversely affect the routine of his work.
The advantages of using remote diagnosis via telemedicine are:
1. The possibility of examining a patient residing in very remote areas (e.g. islands) and for some reasons (health problems, adverse weather conditions, etc.) is impossible to move from his place of residence to the doctor’s place.
2. The patient can also receive health services from the largest hospital in the capital of Tokyo if it is initially judged by his physician that his health condition requires more investigation and without being moved from his home.
3. Drastic reduction in the size of bureaucracy which automatically means saving time that can be channeled into increasing the productive work of the physician by looking at more patients.
4. Increase the well-understood competition in the medical profession which in this case the most effective and most productive physician will increase the number of his patients.
5. Drastic reduction of the cost of moving patients from their home before the clinic and vice versa. That means higher disposable income for the patients (especially for the retired patients).
6. For working patients this means more hours of productivity available.
7. Increasing the income of doctors since if a doctor examined x number of patients per day with the application of telemedicine, he would be able to examine x +n, n=1,2…i number of patients and since the cost of the tests remains stable. This means more revenue a day for the doctor as well, while an increase number of tests while the cost remains stable means more income for the diagnostic institutes.
What needs to be done to maximise efficiency
1. All clinics in Japan should digitize all the data and records available to each of their patients. A personal number on an id card should be given to each citizen since his date of birth-stating the personal number-id who through it will make all his contacts with the public sector as well as with the clinics. Each time the doctor writes the patient’s personal ID number, his entire medical history will appear in front of him. This personal number-id will apply and after the patient’s death-it will not be deleted.
2. High-level safety protocols should be applied to the information systems of clinics and doctors so that no private or unscrupulous civil servant can intercept them.
3. All the information platforms to be used should be fully compatible between them because if they are the different ones will create even greater problems through the incompatibility among them.
4. Complete integration of data sources so that there are no multiple records per patient in the system.
5. Networking and analysis of all this data will drastically reduce overall costs but also further accelerate the accurate and rapid diagnosis by high-level clinics if requested, as a second opinion, by patients’ physicians.
6. In any case, because there should be a limitation of the number of examinations per patient, a small number (one examination) per month should be justified by his/her social security fund for each patient. In case further examinations per patient are required, the reasons for these examinations should be justified in writing by the treating doctors to the patient’s social security fund and then the social security fund or his insurance company if it deems them to be paid otherwise if they are not justified should be paid by the patient.
7. The payment of doctors should correspond to a single compulsory examination and examination per patient per month. In addition, there should be a compensation scheme something like a bonus to be attributed to doctors with the result achieved per patient. This bonus will be awarded to doctors either every six months or at the end of the year.
All doctors of all ages should understand that both the medical staff as a whole and patients will be the most profitable from the completion of the digitisation of their country’s National Health System.
