Share Medical launches Japan's first 'remote end-of-life care' service

A digital transformation solution for end-of-life care that eliminates travel time, reduces the burden on doctors, and ensures patients can pass away with dignity.

ShareMedical Inc. is pleased to announce the launch of Japan's first “remote auscultation” end-of-life care service, combining its Nexstetho digital auscultation device and Mediline Workplace, a medical chat service.

On Disaster Preparedness Day - Uninterrupted Medical Care in Times of Disaster

Today, September 1, is Disaster Prevention Day. In the event of a large-scale disaster, it may be difficult to dispatch doctors to confirm deaths due to roadblocks or the shutdown of medical facilities. This service can be utilized at medical facilities during normal times and at the same time reduce the travel time and burden of doctors. In addition, this service has an important significance as social infrastructure from the perspective of ensuring continuity of medical care in the event of a disaster.

Background - Growing Challenges in Community Healthcare

The following issues are currently emerging in the Japanese medical field.

Expansion of medically underpopulated areas

The shortage of doctors in remote islands and mountainous areas is becoming more serious, and the number of doctorless districts continues to increase. Doctors are usually contacted by nurses at nursing homes and visiting nurses, and must go to the site day and night to confirm the death. Especially on remote islands where there is no doctor on duty, the body must be transported to the main island, or the doctor must wait for a long time for his/her arrival.

• No doctor districts: about 700 districts (about 15,000 people)

• Average age of local clinic physicians: 63.2 years old

• Projection for 2040: Shortage of approximately 960,000 personnel in the medical and welfare fields

Necessity of auscultation in the diagnosis of death

In order for a physician to diagnose death, it is necessary to confirm the “three signs of death”: cardiac arrest, respiratory arrest, and pupil dilation. Monitoring equipment is rarely installed in home health care. Traditionally, a stethoscope has been indispensable for confirming heart and respiratory sounds, but remote auscultation has been technically difficult to implement.

How innovative remote end-of-life care systems work.

ShareMedical Inc.'s “remote end-of-life care” service is implemented in the following flow

1. Preliminary information sharing: a local nurse takes photos of the pupil findings and physical condition with a tablet and sends them to the doctor in advance via “Mediline”.

2. Online connection: the doctor is connected in real time by activating Mediline's built-in online medical tool.

3. Remote auscultation: after the nurse confirms with the doctor that the “Nexstetho” is operational by applying it to herself, she applies it to the patient, and the doctor remotely confirms the cessation of heart and breathing sounds.

4. Death confirmation and paperwork: after the doctor confirms the death, the doctor explains to the family if necessary. The death certificate, which has been signed and stamped in advance, is hand-delivered to the bereaved family after the nurse, under the doctor's direction, writes the time and cause of death on behalf of the patient.

First Japanese initiative and its significance

Remote death confirmation was legally recognised earlier than online medical care, but until now, few companies have pursued its practical application. ShareMedical Inc. was the first to realise “online medical care with examination” through real-time remote auscultation. This service is an application of this, and at the same time provides a new option for the medical field as the first end-of-life care DX solution in Japan to enable full-scale “remote end-of-life care”.

Promoting “end-of-life care DX” - the role of technology

Improving the quality and efficiency of healthcare through digital technology is an important pillar of the government's “Healthcare DX 2030 Vision 2030”. The following effects are also expected in the area of end-of-life care

• Addressing the shortage of human resources: the labour force can be effectively utilised through the use of DX technology to address the projected shortage of 960,000 human resources in 2040.

• Elimination of regional disparities: high-quality healthcare provision that transcends geographical constraints.

• Dignified end-of-life care: enabling patients to meet their final days in a familiar environment and providing dignified care in line with the wishes of patients and their families. And at the same time, realising pride as a doctor who provides final medical care to patients and their families, whom he has treated in community healthcare for many years.

About Medline Workplace

Medline Workplace is a medical messaging service designed specifically for medical and care professionals. It supports the sharing of patient information and collaboration between doctors, nurses, pharmacists, care managers, and other multidisciplinary professionals, thereby improving the quality of community healthcare. High-strength security through the use of a Government Information System Security Assessment Program (ISMAP) certified cloud service and a fixed fee system with an unlimited number of users reduces the budget management and operational burden on healthcare organisations. Full-function API integration support enables seamless integration with existing healthcare systems and promotes operational efficiency.

For more information, see. https://www.mediline.jp

About Nexstetho.

Nexstetho is a next-generation digital stethoscope equipped with the latest acoustic technology. It digitises faint biological sounds such as heart and lung sounds and magnifies them up to 1000 times by means of an amplifier. The built-in digital signal processor optimises the heart and breath sounds to provide clear, easy-to-hear sound quality.

The wireless functionality enables a free and flexible examination style that goes beyond the limitations of conventional stethoscopes, dramatically extending the hearing of healthcare professionals. Furthermore, by connecting to a tablet or PC, real-time remote auscultation is also possible, contributing to improved diagnostic accuracy and efficiency in the medical field.

For more information, see. https://www.nexstetho.com

■ Future developments

As the first company to provide end-of-life care DX, ShareMedical Inc. aims to achieve the following through this service

• Improve access to medical care in medically underpopulated areas

• Promote reforms in the way doctors work

• Realise dignified end-of-life care in an ageing society

• Strengthen the medical system in times of disaster, including peacetime operations

Through the introduction of this service, we will realise better end-of-life care for patients, their families, and healthcare professionals.