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Editorial: Convenience of online medical checkups in Japan must be balanced with safety

The Japanese government has laid out a policy of expanding the scope of online medical consultations, and the Ministry of Health, Labor and Welfare has started considering concrete measures in line with instructions from Prime Minister Yoshihide Suga to advance digitalization in Japan.

    The policy would enable doctors to consult patients at home and other locations via video, and prescribe them medicine, among other actions.

    Up until now such online consultations had generally been permitted from the second checkup onward, but not for the first, in principle. Insurance coverage, meanwhile, had been provided only for illnesses designated by the health ministry, such as lifestyle-related diseases.

    Due to the spread of the coronavirus, patients have increasingly shied away from checkups at medical institutions, and so as a special measure, doctors have been allowed to see patients online for various illnesses, including for their first consultation. The plan is to leave this expanded scope in place, with certain provisions, even after the spread of coronavirus infections is brought under control.

    However, this is an issue that pertains to the health and lives of patients. When determining the extent of permissible online consultations after the outbreak is brought under control, officials must ascertain the merits and demerits of such a system.

    Online consultations save people the hassle of having to go to a medical institution to see a doctor. It has been pointed out that this makes it easier for patients in depopulated areas where medical systems are sparse to receive care. It also becomes easier for busy people in Japan's working generations to get checkups.

    However, while face-to-face consultations allow examination by touch and with stethoscopes and other equipment, online checkups rely mainly on video images. The amount of information that can be gathered is limited and testing by health care professionals isn't possible online. From the perspective of doctors, there remain concerns that they wouldn't be able to sufficiently examine patients, which could hinder them from making apt decisions.

    The appropriateness of online consultations varies according to the medical department and the type of illness. There is a need to carefully consider the purpose of moving consultations online and think about which patients and illnesses should be eligible for examinations over the internet.

    During the first consultation, it can be particularly difficult to ascertain the illness online. In some European countries where online consultations are allowed, there are cases in which examinations are limited to the family physician. Health minister Norihisa Tamura has indicated that the ministry is similarly preparing to limit the first consultation to the person's regular doctor.

    If the scope of online examinations is permanently expanded, it will probably be necessary to prepare manuals to raise the quality of consultations. Patients, too, need to sufficiently understand the characteristics of online medical checkups before going ahead with them.

    Online consultations are convenient for patients, but officials should consider a mechanism to make sure that the safety and credibility of medical treatment is not damaged.

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