As we teeter on the brink of a super-aging society in most developed economies, arguably the biggest risk many nations face is an increase in healthcare costs and a dearth of nursing staff. Being at the forefront of such demographic change, Japan, however, regards this not as an onus but as a bonus for growth. To support more growth opportunities to arise, the government has been taking various measures to proceed deregulations and create supporting environment, and various new business have started to grow.
Dr. Shinsuke Muto, a former imperial physician as well as McKinsey alumnus, has launched an online medical consultation system that employs high-quality business analytics and communication tools to help patients monitor their conditions via an app, check on progress of treatments, hold doctors’ appointments via video chat, and access all their medical data in a mobile device of their choice.
With no time spent on travel or waiting, both physicians and patients plug straight into the system for a service that Dr. Muto says could bring efficiency and a peace of mind especially for senior citizens, who need minor yet regular medical consultation. For the doctors, the system called YaDoc and launched nationwide last year, promises on-hand tools to analyze patient data and a better shot at working “normal” hours.
The system could be especially positive for those in rural areas and living remotely. “As things stand, the ‘physical access’ aspect of the patient-doctor relationship is set to deteriorate, and this is one of the major challenges we face,” Dr. Muto said. “It’s hard for the elderly to visit a hospital, where there is an ever-greater shortage of human resources. Online medical consultations could help both sides.”
Still, YaDoc is not entirely the product of a doctor with a few spare hours on his hands. The system was developed by Japanese startup Integrity Healthcare Co., which is part of a larger elderly care services group. Dr. Muto is a director of both firms.In some ways, Dr. Muto and the startup could be described as lucky, because they operate in Japan. The country has become a modern-day mecca for academics and enterprises that wish to test medical, business and social solutions for aging societies, according to Professor Sudhesh Kumar, the Dean of Warwick Medical School at the University of Warwick, U.K. “Japan is almost like a big laboratory for aging societies. It is a great test bed to look at the impact of new tech and innovation” on the quality of life for seniors, Prof. Kumar, who is also a physician and non-executive director focused on big data for NHS Digital Board, said in an interview.
NO COUNTRY FOR OLD MINDSET
Japan has become a global leader in super-aging, a status ascribed to nations where at least 21 percent of citizens are aged 65 and older 1. That rate reached 28 percent in 2018. One in five Japanese today is a septuagenarian 2. Long slated as a drag on Japan’s economy, the severity of the trend has ended up working in its favor, motivating government and businesses to think differently.
Japanese firms used to enforce mandatory retirement at 65. They are now finding ways to retain older workers. The nation’s financial firms, known for their hard-sell approach, are turning to “heartful” teams that specialize in dealing with the elderly and clients with dementia 3. Japan’s Cabinet Office even set up a special council, consisting of state and private sector leaders to brainstorm ways to “design the 100-year life society 4” taking cue from The 100-Year Life, a book on longevity and societal change by Lynda Gratton and Andrew Scott. The book became a best-seller in the country in late 2016.
In terms of healthcare, in particular, a new appreciation of longevity has motivated the government to begin re-shaping its medical system based on data and digital-first products.
The target is to provide more “personalized healthcare services” by transferring medical records from paper to digital, and feeding this data into AI analytics tools for better and more cost-efficient care, according to the Growth Strategy 2018, Japan’s New Economic Policy Package 5. Japan is also putting more effort into robotics, sensors and high-end ICT services to create patient monitoring systems that minimize human and financial burdens. The country has among the best patient logs in the world, as workers undergo mandatory medical checks on an annual basis. Yet until now over 70 percent of doctors used paper records.
Pooling patient data into a single digital space will not only make record-keeping more efficient, it will give individuals more control over their health planning, said Erwin Böttinger, Professor for Digital Health and Personalized Medicine at the Hasso-Plattner-Institute in Potsdam, Germany.
“This is enabling the democratizations of health data,” which helps patients make more involved decisions by having access to their records, Prof. Böttinger said. It also opens up medical services to more innovation as new market entrants can use raw data to create and test improved improve applications.
The result will be a gradual transformation of healthcare as a whole.
“We will see a transformation of most ‘non-acute’, ambulatory health services to online, especially to smartphones and other mobile devices. This is especially relevant to aging societies as it will provide us with much more efficient services. This will improve the quality, the efficiency and access to health care,” Prof. Böttinger said.
A study published by the University of Edinburgh this March showed that smartphone apps are five times more effective at diagnosing serious heart conditions compared to standard tests 1. AI-based tools are as effective, if not more, than human radiologists at scanning X-rays – and we no longer have enough specialists to handle this task anyway, adds Prof. Kumar from Warwick University.
Digital services will also open up new areas of medicine, such as genome-level diagnosis, which is simply not possible without big data and high-end computational power, Prof. Kumar said.
“How do we improve healthcare and help the aging population? It has to be with technology,” Prof. Kumar said. “Japan has a lot of potential in this area” in terms of developing AI based tools to improve healthcare planning.
BETTER PATIENT CARE THROUGH METCALFE’S LAW?
What’s also becoming clear, according to global experts, is that digital innovation in the medical professional is not possible without collaboration. In a way, that’s only natural given how modern care works with several specialists from different fields involved, said Dr. Muto.
Establishing a communication platform between doctors, and between patients and medical professionals, is at the core of YaDoc, said Ai Sonoda, President of Integrity Healthcare, the company behind the system’s development. YaDoc can also help monitor medicine intake, making sure patients are drinking drugs as prescribed. “What many elderly, or those with a chronic disease, need are regular checks on their condition, to catch something early on if it’s serious, or ease their worries if it’s not,” Sonoda said. A five-minute chat on the day is worth more than lengthy treatment later, she said.
That opens up platforms such as YaDoc to cooperation with foreign businesses and medical institutions. Working with partners that have more advanced AI technology to drive product development would be a real boon, said the doctor, showing his ex-McKinsey, business side.
In fact, the doctor-cum-entrepreneur has already embarked on such a partnership, setting up a medical company in Singapore with Li Liang Ng, a former banker with two decades of experience in financing. Also, the two set up Tetsuyu Healthcare in 2015 to find “urgent solutions” to Asia’s rapidly aging population through ICT, robotics, and quality home care.
We will surely see a lot more such tie-ups, many with enterprises from different countries, since digital healthcare “cuts across engineering, data science, IT, traditional medical care and more,” Prof. Kumar said. “Yes, there are some differences in each country, but we can come up with solutions that can be used everywhere. That is far more efficient than trying to do everything locally.”
With global medical market success at stake, there so much activity in this field, especially through new entrants like IT giants and healthcare companies collaborating, adds Prof. Böttinger. “There is a lot of momentum and drive.”
CHECK-IN FOR CHECKUP
To be sure, online medicine is not the be-all and end-all, it will not serve as a direct replacement of hospital visits and meetings with a physician, according to Dr. Muto. “Many things you cannot tell without physical contact with the patient.”
Its value, however, is in “preserving the value of doctor-patient meetings” by cutting out time and money spent on consultations over minor issues, he said.
Instead, patients will become part of their own medical team, using new tools at-hand to monitor their own conditions and make decisions, with advice, on the best healthcare planning for them.
As of spring 2018 online medical consultations took a major step forward in Japan as they started to be included in national health insurance coverage.
“There are still lots of guidelines and restrictions on what online consultations can entail, so we’re not going to see a sudden jump in its use,” Dr. Muto said. “But, this is a big step.”
Other social and regulatory challenges surely lie ahead. Changing national medical systems has never been easy, or fast. Still, the potential for business, for healthcare professionals, and most importantly for patients, is absolutely “huge,” said UK’s Prof. Kumar.
“Digital healthcare will help solve some of the big problems in healthcare and improve further the longevity of the population,” Prof. Kumar said. Then, “one of the challenges going forward will be to design not only healthcare, but a broader society that can accept and manage 100-year-life.”
For more information on Japan’s innovation, please go to www.japan-go.jp/technology.
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