Forecast on the Application of Japanese Universal Service Fund to Remote Diagnosis for Frozen Section

Abstract

Due to the socioeconomic reason in Japan, some cancer patient is sometimes operated at a rural hospital where only several surgeons perform and no pathologist checks its malignancy. Therefore, the system of the remote diagnosis for frozen section has been standing up in this country for 7 years. In Japan, the USF has started from February 2007 to support only telecommunications operator’s hardware (NTT’s equipments such as digital switch board) in high cost areas, not for the reimbursement of the tariff of the public users, such as telepathology. To solve such social cormorant equality, when the USF and PAs were supported in the present quick frozen intraoperative telepathology diagnosis, the quality of the cancer treatment in rural area will be improved. Based on the past data of the Japanese telepathology with beta distribution function, it can be estimated that user terminals becomes five times more than present users with support of USF and PAs. Moreover, using VPN on the B’FLETS, the effect of other teleconsultations will spread to the nationwide.

Appendix

Distribution

The basic data used in the beta distribution and gamma distribution is listed at the end of the document. The relationship between the beta distribution and gamma distribution is as follows (Fig. 7).

Fig. 7

The definition of the beta distribution

ξ is a parameter that indicates a position, and it is set to 0 in this paper. Another condition used is if λ is 1, ${\text{f}}{\left( x \right)} = {\text{ $ \beta $ }} \bullet {\text{exp}}{\left( { - {\text{ $ \beta $ }}x} \right)}$, which expresses an exponential distribution (Figs. 8, 9, and 10).

Fig. 8

Beta distribution for rural hospitals and clinics

Fig. 9

Uniform distribution for the PAs

Fig. 10

Beta distribution for hospitals (universities and cancer centers)

Definition of terms ( in Japan)

• 1. Doctorless area

An area with no medical institution where 50 or more people live within a radius of 4 km from the central district; medical institutions are not easily accessible.

• 2. Regional hospital in rural area

A hospital authorized to offer continuous healthcare activities, such as a traveling medical service and the dispatch of doctors to regional clinics, etc., in doctorless areas and quasi-doctorless areas. These activities would be performed under the guidance and coordination of a rural healthcare supporting organization in accordance with the guidelines for implementing rural healthcare measures (Health Policy No. 529, notice by the chief of the Health Policy Bureau, Ministry of Health, Labor and Welfare dated May 16, 2001). Regional hospitals in rural areas are designated by prefectural governors. There are presently 252 designated hospitals in Japan, most of which are also designated core regional hospitals in rural areas.

• 3. Core regional hospital in rural area

A secondary hospital that serves people in doctorless areas and quasi-doctorless areas in order to ensure the provision of healthcare services to rural areas. As of March 2004, there were 236 designated core regional hospitals in rural areas. The designated regional hospitals in rural areas usually have main diagnosis and treatment departments and about 200 beds for general patients. The core regional hospitals in rural areas are required to assign consulting doctors in charge of healthcare to rural areas and to plan rural healthcare activity programs and provide appropriate guidance.

• 4. Rural healthcare supporting organization (hospital)

An organization that dispatches healthcare professionals to rural clinics, supports and coordinates traveling medical services for doctorless areas, and ensures the smooth and efficient execution of activities, or a healthcare center or medical institution equipped with such functions.