Geographical Characteristics of Telemedicine in Korea and Japan

Abstract

Assessments of telemedicine from a geographical perspective have generated a variety of opinions with regard to its distribution and optimal spatial organization. Such discussions are associated with the fundamental question of health care, in other words, the balance between equity and efficiency in health care services. Accordingly, these discussions are concerned with the extent to how telemedicine can complement insufficient medical services (equity) and how telemedicine plays a role in making a profit for patients or medical institutions (efficiency). Within such contexts, it is stipulated that telemedicine in Korea and Japan aims to promote regional health care and has emerged on basis for each diagnostic area controlled at a tertiary-care level. In spite of its significance and the rise of informatization in health care, few have attempted to address telemedicine in geography. Therefore, this paper presents arguments on the geographical characteristics related to two aspects of telemedicine—distribution and network—in Korea and Japan and explores each telemedicine operation through two cases. For the most part, the medical institutions involved with telemedicine in Korea are distributed in Kyunggi (the central part of Korea as the metropolitan area). As for Japanese telemedicine, the medical institutions supplying and receiving telemedicine are mainly located in the northern and southern parts of Japan, but not in metropolitan areas. Regarding telemedicine networks, the nationwide medical institutions receiving telemedicine are considerably involved with the medical institutions providing telemedicine in Kyunggi. Contrary to the Korean case, the Japanese telemedicine networks are based in each diagnostic area and are controlled at a tertiary care level. Moreover, some of the outlying Japanese telemedicine networks lack strong referral relationships with metropolitan areas, unlike those in Korea. Therefore, it is not an oversimplification to say that the geographic characteristics of telemedicine in Korea and Japan can be summarized as “centralized” and “decentralized,” respectively. The differences in their traditional health care systems and development processes and the distinctions regarding how telemedicine is used as well as the knowledge of patients and medical workers all have a significant effect on such geographical characteristics. Accordingly, the geographical phenomena of telemedicine are influenced not only by technological aspects but also social and medical circumstances.