A proposal for the implementation of telemedicine in Japan for rheumatoid arthritis, juvenile idiopathic arthritis, and systemic lupus erythematosus: review article

Telemedicine is a promising solution for addressing regional disparities and improving access to specialized care for patients with rheumatic diseases in Japan. This review provides a comprehensive overview of the current challenges, proposed clinical models, and future directions for implementing telemedicine for these conditions. Drawing from the European Alliance of Associations for Rheumatology (EULAR) points to consider and national surveys, we highlight the potential of hybrid care models, the importance of digital literacy, and the need for interdisciplinary collaboration in this field. We introduce innovative remote care systems currently being piloted in island regions to deliver high-quality care in underserved settings. Additionally, we discuss the outcomes of a health economic simulation, revealing the benefits and financial concerns regarding the current reimbursement structures. Key barriers-technical, clinical, patient-related, organizational, and legal-are analysed alongside proposed countermeasures. Finally, we outline a research agenda to evaluate the effectiveness, safety, and sustainability of telemedicine. With appropriate policy support and system development, telemedicine could play a pivotal role in enhancing the quality and equity of rheumatologic care in Japan.