reimbursement schedule. In the 2018 revision to this schedule, “online medical care”
was listed as covered under insurance, meaning that for the first time, online care
would be partially covered by public medical insurance if certain conditions were
met. In addition, there were limitations on the medical treatment covered by health
insurance premiums. Specifically, it covered specific conditions and only treatment
provided at emergency medical institutions capable of examination and treatment
within approximately 30 min of the occurrence of an emergency.
Accompanying these new stipulations, phone-based reexaminations were
reviewed, and fees were calculated under insurance limited to “cases in which
necessary instruction was provided when a patient, etc. requested an opinion on
treatment.” It was ruled that “fees cannot be calculated under insurance for cases
carried out with regular medical administration as the goal.” Regarding online
medical care, care based on a treatment plan and phone-based reexamination were
classified as emergency medical care. Because of this and major developments in
devices and online information, the “Investigative Commission for the Review of
Guidelines for the Appropriate Implementation of Online Medical Care” was
established in January 2019.
In the commission’s first guideline review, they concluded that, in reality, online
medical care was provided through teamwork by D to P and home care nursing
during home care visits in home-based medical care settings. Therefore, in addition
to establishing a setting for D to P with N (online medical care when the patient is
with a nurse), the commission began organizing and reviewing the positions of
patients, doctors, and nurses within the guidelines, caution during implementation,
and supplementary medical care procedures in which a physician could instruct a
nurse.
4 Factors Underlying the Need for Telenursing
In addition to the revision of telemedicine, the information revolution has advanced
rapidly, creating a basis for new technological innovation in the realm of information
and ICT including cloud, big data, mobile, and Social Networking Service technology. These types of technology were termed the “smart revolution” by the “2012
Telecommunications White Paper.” Concerning their effects on society, they have
led to a structural transformation in the ICT industry, particularly that of mobile
phones. Moreover, the progress of telecommunication technology is accelerating,
and remarkable developments in human decision support tools, such as the Internet
of Things (IoT) and artificial intelligence (AI), have been achieved. As information
evolves, technological innovations that apply this information are expected in the
field of medicine, which is steadily becoming more complex.
According to a figure representing the relationship between medical expenses and
illness presented by Daniel Kraft, (2011), almost 80% of medical expenses are
accounted for by patients with chronic or terminal illnesses who veer beyond the
space between health and sickness. The promotion of healthy life expectancy has
Innovation of Community-Based Integrated Care: The History and Current Status. . .
29
was listed as covered under insurance, meaning that for the first time, online care
would be partially covered by public medical insurance if certain conditions were
met. In addition, there were limitations on the medical treatment covered by health
insurance premiums. Specifically, it covered specific conditions and only treatment
provided at emergency medical institutions capable of examination and treatment
within approximately 30 min of the occurrence of an emergency.
Accompanying these new stipulations, phone-based reexaminations were
reviewed, and fees were calculated under insurance limited to “cases in which
necessary instruction was provided when a patient, etc. requested an opinion on
treatment.” It was ruled that “fees cannot be calculated under insurance for cases
carried out with regular medical administration as the goal.” Regarding online
medical care, care based on a treatment plan and phone-based reexamination were
classified as emergency medical care. Because of this and major developments in
devices and online information, the “Investigative Commission for the Review of
Guidelines for the Appropriate Implementation of Online Medical Care” was
established in January 2019.
In the commission’s first guideline review, they concluded that, in reality, online
medical care was provided through teamwork by D to P and home care nursing
during home care visits in home-based medical care settings. Therefore, in addition
to establishing a setting for D to P with N (online medical care when the patient is
with a nurse), the commission began organizing and reviewing the positions of
patients, doctors, and nurses within the guidelines, caution during implementation,
and supplementary medical care procedures in which a physician could instruct a
nurse.
4 Factors Underlying the Need for Telenursing
In addition to the revision of telemedicine, the information revolution has advanced
rapidly, creating a basis for new technological innovation in the realm of information
and ICT including cloud, big data, mobile, and Social Networking Service technology. These types of technology were termed the “smart revolution” by the “2012
Telecommunications White Paper.” Concerning their effects on society, they have
led to a structural transformation in the ICT industry, particularly that of mobile
phones. Moreover, the progress of telecommunication technology is accelerating,
and remarkable developments in human decision support tools, such as the Internet
of Things (IoT) and artificial intelligence (AI), have been achieved. As information
evolves, technological innovations that apply this information are expected in the
field of medicine, which is steadily becoming more complex.
According to a figure representing the relationship between medical expenses and
illness presented by Daniel Kraft, (2011), almost 80% of medical expenses are
accounted for by patients with chronic or terminal illnesses who veer beyond the
space between health and sickness. The promotion of healthy life expectancy has
Innovation of Community-Based Integrated Care: The History and Current Status. . .
29