3 Outline of Research on the Implementation
of Telenursing
Early research on telenursing in Japan included studies evaluating the outcomes of
patients with chronic respiratory failure living at home who received telenursing,
assessing nursing triage and telementoring practices through medical interview data
from home care patients, investigating the cost-effectiveness of telenursing practices
for patients receiving home oxygen therapy (HOT) for chronic obstructive pulmonary disease (Kamei, Yamamoto, Kajii, et al., 2010), verifying the content of and
time spent on telenursing for patients receiving HOT living at home (Yamamoto,
Kamei, Kajii, et al., 2010), and evaluating nursing techniques through a randomized
controlled trial examining the preventive effects of telenursing practice on the acute
exacerbation of illness and rehospitalization in home-based monitoring of patients
with chronic obstructive pulmonary disease receiving HOT (Kamei, Yamamoto,
Kajii, et al., 2013).
Moreover, 2013 saw a randomized comparative study examining telephonedelivered cognitive-behavioral therapy (tCBT) for workers via a remote workplace
CBT program (Furukawa & Hayasaka, 2013), a study examining a multimodal,
home-based, telephone-delivered care and support system using video calls to
patients with diabetes (Kubota, Hosoda, Eguchi, et al., 2013), and research exploring
the effects of tCBT on decreased work productivity related to depressive symptoms
and the effectiveness of an in-home care system using multifunctional video
calls (Nakamura, Koga, & Iseki, 2014). According to a secondary source, research
on this topic consisted of several studies before 2014, but the number of studies
conducted has since increased (Toyomasu, 2005).
As practical research providing strong evidence continued to expand, accompanied by the country’s incremental policy and societal changes related to the development of telecommunication technology, an official notice (10 August 2015, notice
from the director of the Health Policy Bureau of the Ministry of Health, Labour and
Welfare) was presented in 2015 and proclaimed that it was acceptable to conduct
telemedicine in response to patient requests and in combination with appropriate
face-to-face examinations. This notification allowed businesses to enter the market
to provide full-scale services.
In July 2017, it was ruled that situations in which telemedicine was provided
through e-mail or Social Networking Service did not directly violate the Medical
Practitioners’ Act. In particular, the provision of examination for outpatient smoking
cessation through telemedicine alone was permitted on the condition that a physician
confirms the performance of regular health examinations/checkups. During the short
period from February to March 2018, a review meeting was held to discuss the
establishment of guidelines concerning medical care involving the use of telecommunication equipment, resulting in the creation of “Guidelines for the Appropriate
Implementation of Online Medical Care.”
Japan has a universal health insurance coverage system. Within such system, the
calculation criteria for public health insurance are determined by the national fee
28
T. Kawaguchi and K. Toyomasu
of Telenursing
Early research on telenursing in Japan included studies evaluating the outcomes of
patients with chronic respiratory failure living at home who received telenursing,
assessing nursing triage and telementoring practices through medical interview data
from home care patients, investigating the cost-effectiveness of telenursing practices
for patients receiving home oxygen therapy (HOT) for chronic obstructive pulmonary disease (Kamei, Yamamoto, Kajii, et al., 2010), verifying the content of and
time spent on telenursing for patients receiving HOT living at home (Yamamoto,
Kamei, Kajii, et al., 2010), and evaluating nursing techniques through a randomized
controlled trial examining the preventive effects of telenursing practice on the acute
exacerbation of illness and rehospitalization in home-based monitoring of patients
with chronic obstructive pulmonary disease receiving HOT (Kamei, Yamamoto,
Kajii, et al., 2013).
Moreover, 2013 saw a randomized comparative study examining telephonedelivered cognitive-behavioral therapy (tCBT) for workers via a remote workplace
CBT program (Furukawa & Hayasaka, 2013), a study examining a multimodal,
home-based, telephone-delivered care and support system using video calls to
patients with diabetes (Kubota, Hosoda, Eguchi, et al., 2013), and research exploring
the effects of tCBT on decreased work productivity related to depressive symptoms
and the effectiveness of an in-home care system using multifunctional video
calls (Nakamura, Koga, & Iseki, 2014). According to a secondary source, research
on this topic consisted of several studies before 2014, but the number of studies
conducted has since increased (Toyomasu, 2005).
As practical research providing strong evidence continued to expand, accompanied by the country’s incremental policy and societal changes related to the development of telecommunication technology, an official notice (10 August 2015, notice
from the director of the Health Policy Bureau of the Ministry of Health, Labour and
Welfare) was presented in 2015 and proclaimed that it was acceptable to conduct
telemedicine in response to patient requests and in combination with appropriate
face-to-face examinations. This notification allowed businesses to enter the market
to provide full-scale services.
In July 2017, it was ruled that situations in which telemedicine was provided
through e-mail or Social Networking Service did not directly violate the Medical
Practitioners’ Act. In particular, the provision of examination for outpatient smoking
cessation through telemedicine alone was permitted on the condition that a physician
confirms the performance of regular health examinations/checkups. During the short
period from February to March 2018, a review meeting was held to discuss the
establishment of guidelines concerning medical care involving the use of telecommunication equipment, resulting in the creation of “Guidelines for the Appropriate
Implementation of Online Medical Care.”
Japan has a universal health insurance coverage system. Within such system, the
calculation criteria for public health insurance are determined by the national fee
28
T. Kawaguchi and K. Toyomasu