1 Copyright(C) 2014 You Home Clinic All Rights Reserved Tetsuyu Medical Institute Corporation Shinsuke Muto, MD, MBA, Ph.D. June 16, 2014 Creation of New Social System in Super-aging Society

2 Copyright(C) 2014 You Home Clinic All Rights Reserved Aging of Asia

3 Copyright(C) 2014 You Home Clinic All Rights Reserved The demise of the “population bonus” period in Asian countries Source: Prepared by the Bank of Tokyo-Mitsubishi UFJ, Ltd. based on statistics of the United Nations. “Population bonus” Periods of Asia Japan NISS + China + Thailand Hong Kong Singapore China South Korea Thailand ASEAN + India Vietnam Indonesia Malaysia India Philippines

4 Copyright(C) 2014 You Home Clinic All Rights Reserved Source: UN, World Population Prospects : The 2010 Revision 45% 40 % 35 % 30 % 25 % 20 % 15 % 10 % 5% 0% (Year) Asia is expected to be aging much faster than ROW Changes in the aging rates of Asian countries 1. Japan 2. South Korea 3. Singapore 4. China 5. Thailand Developed regions

5 Copyright(C) 2014 You Home Clinic All Rights Reserved Aging of Japan

6 Copyright(C) 2014 You Home Clinic All Rights Reserved Japan has already entered a super-aging society Source: Population Projection for Japan―the National Institute of Population and Social Security Research 75 years of age Age (years)

7 Copyright(C) 2014 You Home Clinic All Rights Reserved Mortality Actual Estimate (Thousand) In Million

8 Copyright(C) 2014 You Home Clinic All Rights Reserved Place of death Deaths at medical institute Deaths at home

9 Copyright(C) 2014 You Home Clinic All Rights Reserved Social security cost （ Medical cost ） National medical cost JPY Trillion Ratio to National Income(NI) Ratio to GDP

10 Copyright(C) 2014 You Home Clinic All Rights Reserved Social security cost (People to support aging society)

11 Copyright(C) 2014 You Home Clinic All Rights Reserved Medical and Welfare cost will increase by 30 trillion JPY by 2025 ■Comparison of Japanese Medical and Welfare Expense in 2012 and 2025 Source: The Ministry of Health, Labour and Welfare *Graphics redesigned by You home clinic ￥ 35.1 trillion ¥54.0 trillion ¥8.9 trillion ¥19.8 trillion 2012 (Actual) 2025 ( Forecast ) ×154% ×222% + ¥29.8 trillion × 168% From 2012 to 2025 (in 13 years)... ¥44.0 trillion ¥73.8 trillion Medical cost Welfare cost

12 Copyright(C) 2014 You Home Clinic All Rights Reserved Home care saves money in caring for the elderly ■Comparison of monthly medical and welfare cost for elderly people between hospital and home care per capita Source ： MEDIVA Co..Ltd *Graphics redesigned by You home clinic Hospital care （ 30days ） Normal Unit (not ICU) Home care （ 1month ） Medical care (every other week) and Welfare service at home ¥ 487,020 / Month ¥ 166,080 / Month Medical Care Cost Welfare Care Cost 1/3 of Hospital care

13 Copyright(C) 2014 You Home Clinic All Rights Reserved Day-to-day problem-solving skills Language (vocabulary) ability Short-term memory Not everyone’s cognitive/physical abilities decrease with aging Source: Cornelius and Caspi Source: A study on the longitudinal and transverse changes in the physical functions of elderly Japanese―Takao Suzuki et al. Normal walking speed (m/sec) (Cognitive point) Walking speed classified by generation (Males) Cognitive ability classified by generation

14 Copyright(C) 2014 You Home Clinic All Rights Reserved Elderly feeling anxiety about daily lives, albeit their wealth Source: A 2009 awareness survey on the daily lives of elderly people―the Cabinet Office Source: A 2009 fact-finding survey on national consumption―Bureau of Statistics Feeling anxiety about future lives 72% 1.The disease and health problems 78% 2.Being in a physically disabled 53% Elderly people’s awareness of anxiety about their daily lives Financial assets of household heads classified by age (10,000 yen)

15 Copyright(C) 2014 You Home Clinic All Rights Reserved Our activities

16 Copyright(C) 2014 You Home Clinic All Rights Reserved Our activities to revive community where elderly live happy Step １ Step ２ ICT home medical care system ICT team care system Evolution to a new social/community model ■ 3 steps to reconstruct community model in super-aged society Step 3 ICT comprehensive livelihood support system

17 Copyright(C) 2014 You Home Clinic All Rights Reserved Step 1: ICT home medical care system Home care-use electronic medical record Cloud-based electronic medical record Back office operational support (data entry etc.) Enables doctors to focus more exclusively on medical examinations and patient care Equipped with functions needed for home care, including task and scheduled route management Electronic Medical record Contact center Home medical care cloud

18 Copyright(C) 2014 You Home Clinic All Rights Reserved ©2013ZENRIN CO ．， LTD ．（ Z14LD 第 886 号） Home medical care cloud (1/3)

19 Copyright(C) 2014 You Home Clinic All Rights Reserved ©2013ZENRIN CO ．， LTD ．（ Z14LD 第 886 号） Home medical care cloud (2/3)

20 Copyright(C) 2014 You Home Clinic All Rights Reserved ©2013ZENRIN CO ．， LTD ．（ Z14LD 第 886 号） c Home medical care cloud (3/3)

21 Copyright(C) 2014 You Home Clinic All Rights Reserved Step 2: ICT team care system Sanatorium ward General hospital Helpers Visiting nurses Pharmacists Home clinics Clinics Care managers Cloud system Facility staff Patients and families Family members not living with patients

22 Copyright(C) 2014 You Home Clinic All Rights Reserved What made us move forward

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29 Copyright(C) 2014 You Home Clinic All Rights Reserved Provision of services Step 3: ICT comprehensive livelihood support system Creation of database Coordination of support Interface with disaster- affected residents Visits made to 20,000 households, with assessments conducted of 10,000 Information was evaluated by specialists to identify the key support person required Support has been provided to approx. 3,000 households

30 Copyright(C) 2014 You Home Clinic All Rights Reserved Our system proved powerful for comprehensive survivor support ■Analysis of data ■Monthly report meeting ■Forums with government & NPOs

31 Copyright(C) 2014 You Home Clinic All Rights Reserved Our new project: Evolving to a new social/community system Elderly people in need of nursing care and caregivers Health support Livelihood support Social participation and life motivation Home medical care Home nursing care Home medical and nursing care cloud Self-reliant elderly people Communicators Face-to- face contact Coordinating function Public-private platform Family support =Newly innovated Healthy life cloud Public services Private service Medical and nursing care staff