In regions with a number of rural areas like the Tohoku district, or areas with a large number of isolated islands, crumbling hospital systems due to a lack of doctors is becoming a major issue. The existence of problems with crumbling community healthcare and the uneven distribution of doctors is already widely known by the public, however a formal statistical study on the national level had not been conducted until recently. These issues have become a significant topic of discussion nationwide, and there is speculation that the lack of a formal statistical survey up to this point could have been due to major problems in government. On September 29th, 2010, the long-awaited results of the study conducted by the Ministry of Health, Labor and Welfare were presented. These statistics revealed for the first time formally that the unevenness in the allocation of medical resources in Japan is considerable, and that such disparities are becoming a serious problem.
Tohoku University has developed a system capable of transmitting high-definition images and biological information in a mobile environment, with a consortium being set up to research ways for such technology to be used ubiquitously in health services in sparsely populated areas, medical house calls, population screenings, and on-site care in emergency and disaster situations. After gaining approval from the Medical Ethics Committee of Tohoku University Graduate School of Medicine, clinical testing of the "Electronic Doctor’s Bag," used to facilitate medical care administered in isolated locations, began October 19th in the "Umuyasumyasu-n health clinic" on the isolated island of Miyakojima, in the Okinawa prefecture.
The "Electronic Doctor’s Bag" is a telemedicine system which includes a communication subsystem that allows it to transmit medical information from anywhere, at any time. Since a nurse carrying the "Electronic Doctor’s Bag" can send a patient’s biological information and high-definition images to a doctor at a hospital or clinic in real-time online, they can travel to the home of a patient in place of a doctor, and are able to create an environment similar to that found in face-to-face treatment.
The Electronic Doctor’s Bag consortium consists of Tohoku University, Sony Co., Fukuda Denshi Co., Ltd., OMRON HEALTHCARE Co., Ltd., HONDA ELECTRONICS Co., Ltd., WILLCOM, Inc., Net One Systems Co., Ltd., and Three Links Co., Ltd., and in the 2009 fiscal year, the first prototype was utilized in in-home medical practice trials in Sendai. In the 2010 fiscal year, an improved second prototype was completed and demonstration experiments began on a representative outer island in Okinawa.
In recent years, the inflation of medical costs due to an increase in the elderly population of Japan has become a problem, particularly in the Tohoku area where a lack of doctors has put the existence of numerous central hospitals in danger. As such, the utilization of information and communications technology (IT) in medical services has been attracting some attention as an effective solution to these problems.
Based on these types of circumstances, the Institute of Development, Aging and Cancer at Tohoku University is making efforts in research toward the implementation of remote medical care for use in remote locations and on isolated islands. Some of the efforts promoted include the "Greater Sendai Area Knowledge Cluster Initiative (Second Stage)," (Ministry of Education, Culture, Sports, Science and Technology), the "Regional Innovation Research Center" (Ministry of Economy, Trade and Industry), and "Development and Research of High-level Service and Medical Information Transmission Systems for Ambulances" (Ministry of Internal Affairs and Communications). The Electronic Doctor’s Bag cannot be used with a fixed internet connection, however it is characterized by the fact that it can transmit from anywhere mobile communication is possible, specifically remote locations, isolated islands, ambulances, and disaster sites, making it suitable for a wide variety of uses. Of these, the geographical conditions in isolated island environments result in a number of difficult situations for doctors on medical visits, and the need for the Electronic Doctor’s Bag is even greater. The aim of proving tests for the Electronic Doctor’s Bag is to work not only with simulated patients, but actual home-bound patients with the goal of revealing its effectiveness and problem areas.