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Doctors could help smokers in Japan quit online under health ministry plan

People hold cigarettes in this March 25, 2014 file photo. (Mainichi)

Smokers struggling to kick the habit could soon be eligible for completely remote outpatient treatment without ever having to see a doctor face-to-face, thanks to a policy close to approval by the Ministry of Health, Labor and Welfare.

The proposal would allow doctors to consult patients via personal computers or smartphones to help them quit smoking, as long as the consultation uses accepted information communications technology and is offered through trusted organizations such as corporate health insurance associations.

Implementation of the new system, which would be limited to those seeking to quit smoking, is expected to save patients time and money, hopefully leading to an overall improvement in health nationwide. The ministry is expected to announce its final decision on the service by September.

The Medical Practitioners' Act states, "No medical practitioner shall provide medical care ... without personally performing an examination," and up until now, exceptions were granted only to those living on remote islands or in secluded countryside areas where face-to-face examinations would be physically difficult, or to those who had to receive treatment in their own residences due to cancer or other serious ailments.

The move to expand remote services did not come from the health ministry alone -- patients also requested it. In a 2015 notice, the ministry removed restrictions on remote treatments based on where patients lived and what disease they had. However, at least one face-to-face diagnostic meeting with a doctor was still required before remote treatment could begin.

Health insurance covers up to five doctor's visits over a period of 12 weeks for outpatients seeking to quit smoking. The majority of patients, however, find it hard to continue making the visits, and a health ministry survey revealed that 64 percent of those who start the treatment regime don't finish it.

Responding to the situation, the ministry moved toward approving completely remote outpatient treatment for quitting smoking considering the development of communications technology and an increase in health consciousness.

The remote treatment system cuts down the time and cost for patients, and the prescribed medicine can be mailed to the patient's home or workplace. Sticking with the treatment becomes simpler, and health insurance associations for large companies have recently been adding the system to their coverage in succession. Additionally, because a face-to-face meeting with a doctor is no longer necessary, employees that live in regions with no outpatient treatment for quitting smoking can also more easily access treatment, which is hoped to reduce the health gap across different regions of the country. Still, to ensure the safety of patients, those with other illnesses are still required to meet with a doctor at least once before beginning treatment.

While the treatment would be covered by insurance, the remote treatment would still incur some fees. However, according to a private company offering a remote outpatient service for quitting smoking, the treatment would be more than 10 percent cheaper overall compared to frequently visiting a hospital. If those covered by health insurance associations pair the treatment with their regular medical checkups, then over 10 million people could be eligible for the service.

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