We all have heard about Telehealth, Telemedicine and Virtual Health. It can somehow be confusing to distinguish what are these terms referring to? Are they all the same? First, let’s define what is what and clarify the vocabulary. We will use the definitions provided by the US Center for Connected health Policies.
Let’s visualize Telehealth, Telemedicine and Virtual Health as being part of the same « Connected Health » funnel. Telehealth is the widest part of it and encompasses nearly everything. Finally, Virtual Health is at the tip and refers only to the virtual medical consultation between a patient and his doctor. Telemedicine will be in the middle of the funnel. It will apply to the use of communication technologies to diagnose and monitor patients.
Telehealth also relies on four technology components:
1. Live Video: Two-way audiovisual communication between a person and a provider.
2. Mobile Health: Provision of Health care services and personal health via mobile devices
3. Remote Patient Monitoring: Use of digital technologies to collect and transmit data to the health provider.
4. Store-and-Forward: Electronic transmission of medical information.
Telemedicine is one the major revolution in Medicine at least for patient/doctor relationships. Statista considers that the global market for Telemedicine will reach north of $90 billion by 2023. It represents a CAGR of 18.83% over the 2015 to 2023 period. In Japan, the Yano Research Institute evaluates that Telemedicine is expected to be worth $247 million by 2019.
The increasing needs for Telemedicine correlate closely with the population getting older and with the desertification of the countryside. It also links to the natural expectation of the people to live longer but also to live longer while still being healthy. More than the increase in Life expectancy, Telemedicine is a way to increase the Healthy Life Expectancy (HLE).
Now is the right time for Telemedicine…..and especially in Japan!
Telemedicine is a promising field for startups. It can also be beneficial for all of the components of the society: Patients, employers, doctors, and even for the payers.
In the US, as of 2018, all major commercial payers cover telemedicine and in 49 states, and DC have some form of Medicaid reimbursement for Telehealth. In Japan, the laws evolved to allow more extensive use of telehealth services.
Technology is ready!
Delivering quality health to remote locations is becoming difficult, the population is aging rapidly, and the number of chronic conditions increases dramatically. Technology goes hand in hand with innovation in telemedicine. Nowadays, communication technologies are mature enough to allow reliable data transmission compatible with the needs of Telehealth. 5G technology will go even further and enable mobile devices to transmit data flawlessly.
Society is ready!
In Japan, most of the clinics or hospitals operate on the first come -first serve principle. Going to the doctor often means leaving your job and waiting for several hours. In a country, where companies have to convince their employees to take days off, a lot of ambitious salarymen do not go to the doctor when they are sick. This behavior is detrimental not only for them but also for the company and society as a whole.
Government is ready!
In 2015, Japan started to remove the legal barriers to offering telemedicine services to every patient and not only to those living on remote islands or in rural areas. Telemedicine adoption is a critical component of the « 2035 Health care » plan presented by the Japanese government which outlines the long term evolution of the Japanese healthcare system. In this plan, « the development of a health care database to support telemedicine applications such as remote diagnosis, remote treatment, and telesurgery » is explicitly considered as a priority.
In March 2018, the government went one more step further by approving an increase in the amounts of telemedicine consultations being charged by the Hospitals and clinics. Parity is critical to see acceptance and proliferation of telemedicine technologies.
The government also announced that some changes would apply to Telehealth:
1. To be covered by the National Health Insurance, the first contact between physicians and patients should happen in person.
2. The physician must not prescribe medications without a face-to-face consultation with patients.
3. Somehow for advice and conditions that do not preclude to the deliverance of drugs, the patient and the doctor can have a telehealth consultation without the need of a first face-to-face meeting. The National Insurance will not cover the consultation. For busy workers who want to know if their sickness justifies to go to the clinic and do not mind paying by themselves, this appears to be a perfect option.
Japanese startups dealing with Telemedicine are now flourishing. Major technology companies realized that Telemedicine could be a profitable avenue for growth. Tokyo-base startup Micin announced in May 2018 that they completed $10 million Serie-A. Mitsubishi Corp was leading this round of investment on the Curon mobile telemedicine app developed by Micin. Tech giant Philips is also implementing a telemedicine solution in collaboration with the Showa University hospital and Showa Koto Toyosu Hospital for Emergency Departments. Medley, a Tokyo-based company, provides the « Clinics » telemedicine platform and with its networks of 800 hospitals nationwide is gaining traction. MRT and its « Pocket Doctor » is also on a growth path. The list is long of the companies who are now trying to benefit from the rise of Telemedicine.
Now is the right time for Telehealth in Japan. The society, the technology, the government, all of the pieces are ready to embrace this next Healthcare Revolution. In the coming years, we can expect to witness a broad adoption of virtual care. The proliferation of these new solutions will then bring us to the next critical step to address: Consolidation!