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The Future of Healthcare and Technology

Part 1:Considering the Future of Medical Care in Japan

Advanced technologies such as artificial intelligence (AI), the internet of things (IoT), virtual reality (VR), augmented reality (AR), and 5G, the next-generation communication standard, have begun to spread, marking the beginning of a major turning point deemed the Fourth Industrial Revolution. Further, the impact of the recent COVID-19 pandemic has made these technologies more ubiquitous.

At the same time, the latest technologies are bringing about a variety of changes in the field of medicine and healthcare. In this series of five articles, written by Dr. Hiroaki Kato, a practicing physician and an authority on digital health, including tools such as AI and IoT, we peer into the future of medical care, looking ahead to 2030. First, let's take a look at the current state of medical care in Japan, as the background for the use of technology in the field of medicine and healthcare.

Author: Hiroaki Kato, M.D.

Dr. Kato develops surgical instruments and telemedicine services while maintaining a medical practice. In 2016, he joined the Ministry of Health, Labour and Welfare (MHLW), where he was involved in legislation and policy making as Assistant to the director in the Health Policy Bureau. Since leaving the MHLW, he has been practicing medicine and supporting the development of new businesses throughout the medical field, including co-founding an AI medical device development company. Dr. Kato is the author of several books, including Medical Care 4.0 (Nikkei BP).

Medical Demand with Regional Differences

You have likely heard that Japan’s aging population is expected to grow more than ever going forward. In 2020, the proportion of the population aged 65 and over (aging rate) was 28.1%, which comes to one person out of every 3.3 people (Ministry of Internal Affairs and Communications, “Seniors in Japan from the Viewpoint of Statistics—Inspired by Respect for the Aged Day—” [September 2020]). The aging rate will rise to 31.2% by 2030 and 36.8% by 2040.

In fact, the over 65 population growth is not uniform across Japan; only nine prefectures—Tokyo, Osaka, Kanagawa, Saitama, Aichi, Chiba, Hokkaido, Hyogo, and Fukuoka—account for 55% of this growth. In 2045, a population decline is predicted to occur outside of Tokyo, especially in Akita and Aomori prefectures, where the population is expected to decrease by about 40% compared to the present (National Institute of Population and Social Security Research, “Regional Population Projections for Japan” [2018 estimate]).

These regional differences in aging and population decline are also causing differences in the peak in medical demand from prefecture to prefecture. While some areas already peaked in 2010–2015, other regions will peak in 2030–2040 (All Japan Hospital Association, “What hospitals ought to be — Report of the Committee on the Future of Hospitals” [2015-2016 edition]).

Aging of and Growing Labor Shortages Among Medical Care Providers

On the other hand, what is the situation among medical care providers? The number of medical institutions (about 100,000 clinics and 8,000 hospitals) has been almost flat in recent years (Ministry of Health, Labour and Welfare, “Overview of the (Dynamic) Survey of Medical Institutions and Hospital Report (2019)"). However, the number of doctors practicing in these institutions is decreasing in some areas, and it has been pointed out that doctors are aging throughout Japan. The average age of the current 320,000 doctors is about 50 years old, while the average age of doctors in clinics is about 60 years old*. Assuming people become doctors at the age of 25, there is data showing that about 50% are likely to still be working as doctors 50 years later, at the age of 75.

*Reported by Ministry of Health, Labour and Welfare (PDF).
 (Only in Japanese.)

There are regional differences in the peak of medical demand, and there are problems such as the aging of and labor shortage among medical care providers. In this situation, there are three needs: improvement of access to medical care, reduction of medical care costs (improvement of efficiency), and improvement in the quality of medical care. The use of digital technology can help resolve these challenges.

In fact, “online medical consultations” between doctors and patients, and “telemedicine” for the exchange of information between medical professionals have already being introduced. In addition, more than 10 medical devices using AI for history-taking and diagnostic imaging have been approved in Japan, and are being used to prevent doctors from missing medical conditions. In addition to smartphone medical apps, some smartwatch apps have also been approved in Japan as medical devices.

What changes have these technologies brought about in medicine and healthcare fields? From next time, we will delve into each technology and consider future developments.

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