In Japan, where 29% of the population is over 65, we have already entered a super-aging society. At the same time, the caregiving industry is still grappling with issues such as workforce shortages and high workloads. Taking on these challenges is Rehab for JAPAN with their product, Rehab Cloud. We spoke with them about the industry’s environment, their product’s focus, and their design process.

Kazutoshi Wakabayashi | CPO (Chief Product Officer) at Rehab for JAPAN

After working at a systems consulting company, Kazutoshi joined Recruit in 2006. He was involved in product management and UX design for major projects like Hot Pepper, SUUMO, and AirREGI, serving as lead designer, head of a functional unit, and executive officer. He joined Rehab for JAPAN in August 2020 as an executive officer and CPO.

A product aiming to extend healthy lifespans for a sustainable nation

── First, can you tell us about “Rehab Cloud”?

Kazutoshi: We offer various products under Rehab Cloud, including “Rehab Cloud Rehaplan” and “Rehab Cloud Daily” (collectively referred to as Rehab Cloud) to meet diverse rehabilitation needs for day service centers. Our products support tasks like calculating the “individual functional training addition” (*1) by automatically suggesting rehab plans, and streamlining implementation records, and billing processes.

*1 Businesses can receive additional payments by assigning a functional training instructor to create individual functional training plans for users and provide training based on those plans. This is covered by long-term care insurance, boosting business revenue.

Kazutoshi: Day service centers are the first place people go when they need care, essentially the entry point of caregiving. There are over 43,000 such centers nationwide, more than convenience stores. The users are elderly people who feel anxious about walking alone, and Rehab Cloud is designed for the staff at these centers.

Our product not only streamlines complex paperwork but also enhances the quality of care by using data and AI to perform scientific rehabilitation, ultimately aiming to make the elderly more active. That is the outcome we strive for.

── The caregiving industry faces various issues, but what exactly is happening?

Kazutoshi: Japan is already a super-aging society, and by 2040, our current social security system is expected to become unsustainable. By then, there will be 10 million people requiring care, with care costs projected to reach 24.6 trillion yen. Despite needing to increase care workers by 690,000, we saw a decrease of 63,000 workers in 2022, creating a very tough situation.

Previously, the government focused on increasing care facilities, but due to these circumstances, since 2021, there’s been a greater emphasis on productivity improvement through digitalization and promoting self-reliance. Over the next three years, starting this April, there will be an even stronger focus on outcomes, specifically improving the condition of those needing care. Implementing scientific rehabilitation to extend healthy lifespans and reduce the number of elderly requiring care is crucial for the future of the caregiving industry.

── What aspects of rehabilitation need improvement?

Kazutoshi: Currently, only about 20% of day service centers have rehab specialists. Moreover, rehabilitation tends to rely on the experience of these specialists, making it subjective. It’s necessary to formalize the knowledge of specialists using data and technology, making it accessible so that even non-specialists can provide effective rehabilitation.

Previously, this issue was overlooked due to the government’s strategic priorities. However, moving forward, it’s crucial to provide accurate rehabilitation at the entry-level stage of caregiving to extend healthy lifespans.

Individual functional training plans

── How is Rehab Cloud used? Can you tell us about the process of creating individual functional training plans (referred to as plans)?Kazutoshi: The automatic proposal of plans begins by entering information according to the process specified by the long-term care insurance system. We check life function issues with a checklist (e.g., “Can they move indoors alone?”) to assess their level of independence and use an interest checklist to confirm their wishes (e.g., “What do they want to be able to do again?”). After entering this information and performing a physical function assessment, goals and rehab menus are suggested with the push of a button, completing the plan.

── In what situations are the plans used?

Kazutoshi: When personalized rehab plans are created and implemented, service providers can receive care compensation. The plans and implementation records serve as evidence to be presented to the government. Because the government invests its budget in these services, there are extensive rules, and even minor non-compliance can lead to the return of documents and loss of compensation. Creating these plans is crucial for the sustainability of day services as a business.

── Are there any benefits for users receiving rehabilitation?

Kazutoshi: A survey on the living independence levels of users who followed the rehab menus proposed by Rehab Cloud showed a 236% improvement after one year. Typically, these levels decline with age, so this is a remarkable result. Some users see results in just a few months and can walk again. This success comes from formalizing previously subjective knowledge and making it accessible through our product.

In day services without rehab specialists, it was often difficult to explain the purpose of each menu to users. Rehab Cloud also suggests explanations and visualizes monthly progress with numbers and graphs, raising user awareness. The product motivates users to engage in rehabilitation, leading to positive outcomes.

Creating solutions that fit the field without being bound by systems

── Can you tell us about the distinctive features of Rehab Cloud?

Kazutoshi: One of the standout features is the “Functional Training Group Management.” Individual functional training aims to provide tailored rehab for each person, so “group exercises” are not eligible. However, if the goals and rehab menus are similar for a small group (up to five people), they can form a group as per regulations.

Manually forming these groups daily based on attendees is challenging. This feature automates the process with a button click, and the same records can be applied to the entire group.

── That sounds very helpful. How do you deepen your understanding of the domain?

Kazutoshi: Rehab for JAPAN has 20% of its employees from the care fields, including some who still work part-time as rehab specialists. Our team consists of caregiving experts and business and design members who continuously exchange knowledge. Having members with real-world experience allows us to have frequent discussions like “This is how the work is actually done, so this approach won’t work.” This interaction ensures our product truly meets the needs of the field.

── Are there other examples where field understanding influenced the features or specifications?

Kazutoshi: For the group management function, simply categorizing by similar goals and menus wouldn’t work practically. So, we also consider daily living independence, like wheelchair or cane use, and the personal compatibility among participants. After auto-grouping, individual adjustments can be made. This consideration came from our product manager’s experience working in day services, including how transportation routes and compatibility are even considered.

Kazutoshi: Over-engineering the system can make it too complex and impractical. We aimed for a solution that fits field operations, resulting in an automated grouping with manual adjustments. 

Ensuring smooth implementation was challenging, especially with individual compatibility, but we achieved it and received great feedback.

A step ahead of the designer’s perspective

── Were there specific considerations in design tailored to the rehab field?

Kazutoshi: A clear example is the temperature input screen with buttons like “35.”, “36.”, and “37.”

Kazutoshi: In caregiving settings, staff measure the temperatures of nearly ten people, take another person’s blood pressure simultaneously, reinsert thermometers for those who have removed them, and stop others from going to the restroom—all at the same time. In such a hectic environment, recording measurement results on familiar paper is still quicker.

To outperform paper, we aimed to minimize the burden as much as possible, resulting in this input screen. For normal temperatures, the input can be completed with basically just two taps.

── Have you made improvements based on feedback from the field?

Kazutoshi: In this example, displaying the user’s name at the top left of the numeric keypad was implemented based on feedback from the field. It’s common for someone to head to the restroom while entering measurement results, prompting staff to quickly assist them. This often leads to forgetting whose information they are inputting. We were committed to making it just two taps, like “36” and “5,” but we realized even those two taps could be interrupted. It was very impactful feedback.

Helping seniors enjoy their golden years

── What barriers do service providers face in adopting your product, and how do you address them?

Kazutoshi: Our newly released billing management system, “Rehab Cloud Receipt,” was developed to address such barriers. The biggest adoption barrier we heard was the lack of billing management, which would require dual management with existing software. Despite the challenges, we prioritized developing this feature to increase adoption. With this, we hope to increase the number of day service centers adopting Rehab Cloud.

── With more products now, what’s the roadmap for the future?

Kazutoshi: We’re focusing on leveraging our accumulated data. We have data on 260,000 seniors regarding their lifestyle and independence, and a million plan documents. This allows for precise analysis to identify what contributes to positive outcomes.

Another challenge is adapting to each municipality’s unique rules. Day services are categorized based on the degree of care needed. Individual functional training is designed for those with moderate care needs as defined by the Ministry of Health, Labour, and Welfare, while municipalities set their own rules for those with lower care needs.

Currently, Rehab Cloud’s calculation logic doesn’t cover the unique rules of each municipality. While maintaining a certain level of uniformity in our product is necessary, each service provider wants to comply with their respective municipality’s rules. Therefore, we need to consider this aspect moving forward.

── What value do you aim to provide to the industry through your product?

Kazutoshi: As an impact startup, Rehab for JAPAN has defined our long-term goals and how to achieve them logically.

Kazutoshi: Our ultimate goal is to create a society where getting older is something to look forward to. We aim to contribute to extending healthy lifespans and increasing the number of active and healthy seniors. If people remain healthy as they age, they can enjoy their own lifestyles and hobbies, leading to a richer and more fulfilling old age.

Additionally, we want to create a world where even those who need care can choose services that suit them from a wide range of options. Personally, I want to spend my time playing mahjong or fishing even if I need care, but current caregiving options don’t easily allow for that. That’s why we want to design elderly lifestyles so that people can choose how they want to live their later years in their own way.

Related Links
Rehab for JAPAN
Rehab Cloud