In Japan, the total population is shrinking, but the percentage of people who are elderly (age 65 and above) is expanding. The result is a significant and growing imbalance between the size of the elderly population, and the number of working-age people who support and care for them.
Japan’s need for innovative solutions to care for its aging population has lent a new urgency to Japan Biodesign, the partnership between Stanford Biodesign; Osaka, Tokyo and Tohoku Universities; and the Japan Federation of Medical Devices. The partnership was established in 2015 to teach Japanese faculty and fellows the biodesign innovation process: a needs-driven, step-by-step process to health technology innovation.
Recently, Dean Lloyd Minor, MD, and Paul Yock, MD, director of Stanford Biodesign, traveled to Japan to discuss precision health, innovation and aging with senior officials from the ministries of education, culture and health.
“Through precision health we seek to provide more predictive and proactive health care,” Minor said. “Japan’s efforts in elder care are a great example of this. Having recognized the impending demographic crisis, Japan is responding proactively by mobilizing industry and government and stimulating innovation through partnerships like Japan Biodesign."
The biodesign innovation process could fill an important gap, Yock said:
One of the government’s biggest concerns is whether Japanese students think creatively enough to be innovators. I have had officials tell me, ‘As a culture, we’re in-the-box thinkers.’ In part because of this, the biodesign approach to innovation as a disciplined process that can be learned, practiced, and perfected, is very appealing.
Japan is investing in ways to make it easier to age at home, and is encouraging other innovation related to aging. Several major Japanese technology companies are working on very high-tech robotic approaches, such as an exoskeleton to help patients rehabilitate from stroke.
While these futuristic approaches are exciting, Yock said he worries that it is easy for innovators to get seduced by the technology instead of focusing first on thoroughly understanding the need. The result may be a solution that misses the mark because it costs too much, or is too difficult to use and so is never adopted by its target users.
The comprehensive biodesign process prevents this by considering all aspects of innovation. Before inventing anything, innovators are trained to understand the problem, who it affects, and the strengths, weaknesses, and cost of existing solutions. This information guides the design of the new technology. The process also requires innovators to think carefully about the business model, intellectual property, and regulatory and reimbursement aspects of their design. “By anticipating and solving for all of these factors, the process guarantees a concept that has a much higher chance of actually reaching patients and improving care,” Yock said.
During the trip, Yock and Minor also met with three teams of Japan Biodesign fellows who trained at Stanford earlier this year, and are now back in Japan working on their projects. All three teams are addressing needs that predominately concern the elderly. Their projects include a cost-saving approach to heart failure management, a device that helps manage stroke and a project related to preventing aspiration pneumonia. Yock said he was encouraged by their progress and reported that one team is already applying for funding to further develop its concept, and has had a positive meeting with the government head of healthcare reimbursement.
Looking forward, the goal is for Stanford Biodesign’s three Japanese university partners to eventually become faculty training hubs, so that more teachers can can train more students, Yock said:
Our next group of Japan Biodesign Fellows includes a mix of people in industry and in academia. Ideally, the industry trainees will be able to go home and teach their co-workers. And our academic fellows will in turn help mentor the next generation of Japanese fellows.
Their prospects appear good — that's a Daruma doll that Yock and the Japan Biodesign partners are touching above, a popular national symbol of luck.
Previously: Biodesign at Stanford: A whopping success, Stanford-India Biodesign co-founder: "You can become a millionaire, but also make a difference" and Defining a new way of thinking: Slower decisions could result in better medical devices
Photo by Masakazu Yagi