Video conferencing for home care delivery in Japan and its emerging implications for the COVID-19 era: observational study (Preprint)
BACKGROUND Telemedicine has been increasingly used in many healthcare fields including home care, where patients receive medical care at home. Due to the current COVID19 crisis, the value of telemedicine via video-conferencing (VC) is more recognized allowing immobile patients to continue to receive care. Despite the increased use, the efficacy of telemedicine in the home care settings in Japan remains to be appraised. OBJECTIVE The purpose of this study is to identify the use and impacts of telemedicine in home care delivery in Japan. METHODS Retrospective observational study was employed using patient and other administrative records stored in our home care clinic. We considered patients who were involved in VC with our home care physicians and telepresenters (medical assistant who is present with the patient during a telemedicine session) nearby the patients during 2018 and 2019. We extracted sociodemographic data of the patients and the process of unplanned video conferences and descriptively illustrated some informative cases. RESULTS In a home care clinic in Japan, VC was conducted in 17 cases (involving 14 patients) over the 2-year period. Of all the cases, two (11.8%) required emergency transfers and were hospitalized. In the remaining 15 cases, 12 were thought to need medications or go to a clinic for consultation, while the remaining three were ordered to rest. The symptoms subsequently improved in 14 cases, and only one patient was later hospitalized due to the development of pneumonia from an upper respiratory infection. CONCLUSIONS Consultations via VC were generally as safe and effective as the face-to-face. Telemedicine was deemed effective for assessing the patients’ conditions in the home care setting in situations where home visits cannot be carried out.