The country-initiated remote death diagnosis was never conducted nationwide, November 9th 6:07
In order to make it easier for the end of life to be picked up at home, the country has established a system that allows doctors to remotely diagnose death, but no one has been implemented nationwide. It is a requirement that it takes more than 12 hours for the doctor to arrive at the patient, and doctors on site point out that it is difficult to meet this.
There are many people who want to reach the end of their life at their desired place such as home, but there are few doctors who diagnose death in depopulated areas and remote islands, so patients can not be rushed to the patient immediately. There are cases where it is difficult to “get off” at home due to hospitalization.
In September, the Ministry of Health, Labor and Welfare established guidelines for remotely diagnosing deaths, and when it took more than 12 hours for doctors to arrive, it was possible to receive a patient's photos and data from a nurse and make a diagnosis. , I found out that no case has been done nationwide.
The doctors and nurses in the field point out that the reason is that they cannot meet the requirement of more than 12 hours before the arrival of the doctor, and that the nurses are reluctant to film the patient who died. The
The Ministry of Health, Labor and Welfare wants to collect information such as whether there is demand and review the guidelines as necessary.
Vice Chairman of the Japan Medical Association, Mr. Satoshi Imamura, pointed out, “Death diagnosis is the most desirable form for face-to-face diagnosis by doctors, and it is necessary to verify the actual situation, such as whether there is a remote demand.”
Requirements More stringent remote death diagnosis More flexible and realistic conditions
For remote death diagnosis, national guidelines require prior consent from the patient or family, and only if the doctor takes more than 12 hours to arrive at the patient.
A pre-trained nurse rushes to the patient, confirms breathing and cardiac arrest, etc. according to a predetermined procedure, and sends information such as the patient's photo to the doctor via a videophone or smartphone. .
In response to this, the doctor will eventually make a death diagnosis.
Regarding these guidelines, there are voices from the field of home care that the requirements are strict.
Dr. Sugao, who works in home care in Nagano City, visits the elderly and visits elderly people who live in homes and facilities.
There are three doctors, including Ms. Shira, who visit the hospital where he works, and 150 people have diagnosed death at the patient's home or facility in just one year. In the past 10 years, there is a tendency to increase, and sometimes it is 100 km one way, and it takes 3 hours to visit the patient's home to make a death diagnosis.
Dr. SQUARE believes that remote death diagnosis is one of the effective options, but it is difficult for patients to meet the requirement of “more than 12 hours before the arrival of the doctor”. thinking about.
Dr. SQUARE says, “The demand for home medical care continues to increase and the doctors in the field are in a difficult situation, so I want you to consider more flexible and realistic conditions.”
On the other hand, nurses who visited patients' homes and supported doctors expressed anxiety about being asked to be different from the usual death diagnosis.
Tomoko Hirose, a nurse working at a visiting nursing station in Sakuragawa City, Ibaraki Prefecture, is taking necessary training for nurses who support remote death diagnosis and is preparing for implementation. However, it is necessary to take a picture of a patient who has been suspected of having died in the guidelines, or a nurse in the field has died, and I find it sometimes difficult to understand the family.
Mr. Hirose says, “I am worried that there are procedures that are different from the usual Mitori. I think it is necessary to get many people to know and convince remotely.