A Telemedicine System Using the Remote Diagnostic Imaging App “Join” for Emergency Medicine Throughout Wakayama Prefecture in Japan

Background Telemedicine is expected to play an increasingly important role in building universal emergency medical systems without geographical disparities in the future. To eliminate healthcare disparities between regions, Wakayama Prefecture in Japan has been promoting telemedicine for closer inter-hospital coordination with secondary and tertiary emergency medical care hospitals. The "Join" diagnostic image-sharing app has been used since November 2018 for operating a remote emergency support system that shares medical images of emergency patients between 13 secondary and tertiary emergency medical care hospitals in Wakayama Prefecture. In this study, we investigated the effects of remote emergency medicine between hospitals after the introduction of Join. Methodology Four medical specialties use the remote emergency support system, namely, cardiovascular medicine, cardiovascular surgery, neurosurgery, and emergency care medicine. We investigated the results from 497 cases for which the system was used between November 2018 and February 2023. Results Of the 497 cases, treatment for 148 (29.8%) patients was continued in the same hospital, without a transfer. Emergency medicine was the group with the largest number of uses, in 232 cases. Of the 211 patients in the neurosurgery group, 88 (41.7%) were not transferred, the statistically significantly largest number of patients among the usage group (p < 0.01). An estimated transportation cost of 6,973,900 yen was saved due to 148 patients not being transferred. Tertiary emergency medical care hospitals were most frequently consulted, but secondary emergency medical care hospitals located long distances from tertiary emergency medical care hospitals also received large numbers of consultations from neighboring rural hospitals. Conclusions The Wakayama Prefecture remote emergency support system using Join has made it possible to communicate accurate information quickly between hospitals. This has contributed to fewer non-essential transfers to tertiary medical centers, reduced medical transport costs, and more effective distribution of medical resources to secondary medical institutions because ambulance transport was not necessary.