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Bridging the Disconnect Between Patients and Pharmacists (Part 1)

CEO of KAKEHASHI, Mr.Yutaka Nakao

What is the best way to resolve issues surrounding Japanese Medical Care? KAKEHASHI was created in 2016 to revolutionize “drug stores” for the medical field. The company is focused on developing an innovative system called “Musubi”, which would allow pharmacists to access medical records electronically.imgp9865

The founder and CEO of KAKEHASHI, Yutaka Nakao, previously held the position of MR at the Takeda Pharmaceutical Company, and was introduced to the issues and possibilities that surround the medical and pharmaceutical fields during his time there.

We sat down with Mr.Nakao to discuss the challenges of creating a Start Up, issues surrounding the medical field, and the various features of “Musubi”.


―― Mr.Nakao, how did you become aware of issues surrounding Japanese Medical Care?

Although remote medical services are starting to develop, it is still mandatory for patients to meet with their doctors to be accurately diagnosed and prescribed medication. Essentially, patients usually only visit a pharmacy after being diagnosed by a doctor first. Every year, over 8 hundred million prescriptions are given out. While only slightly over 5 hundred million of these prescriptions are purchased, this means that patients are meeting with pharmacists over 5 hundred million times every year. After conducting survey research, I learned that most patients only recognize a drug store as a place to get medicine, and this inspired me to want to change they way that patients view drug stores.

On a more personal note, my mother is also a pharmacist, and not only does she dispense medication, but she also taught me the importance of having a healthy lifestyle through proper food consumption and sleep. She has helped me recover from many colds and flues over the years. She is truly the embodiment of the Ministry of Health’s vision of a “family pharmacist”. While I was able to experience the benefits of having a family pharmacist, there is a sense of disconnect in the typical pharmacist patient relationship. And so KAKEHASHI was founded with the hope that it would bridge that feeling of disconnect between pharmacist and patient.

――What do you think is the cause of this disconnect between pharmacist and patient?

I believe the problems stem from high industry demand and quality control. As I continue to meet with pharmacists, I am blown away by what amazing professionals they are. However, as I observed behind the scenes of pharmacies, it became clear how busy pharmacists are and how little time they have to spare. This is because they are burdened with “objective” responsibilities such as preparing medication, inspecting medication, and creating medical records, etc. With so many “objective” responsibilities, there isn’t any time left to work on their interpersonal relationships with patients.

The second issue stems from the fact that pharmacists play a critical role in ensuring patients take their medication safely and as instructed. Pharmacists are responsible to do their best to ensure that patients don’t experience side effects from their medication. However, patients don’t realize that it is thanks to their pharmacists that they are able to safely and comfortably take their medication. Therefore, I want to develop a service where patients will be able to recognize this value.

―― What role will KAKEHASHI play in resolving these issues?

The primary goal of KAKEHASHI is to create a platform that will optimize medical records so that more time during appointments can be spent on discussing how nutrition, exercise, and sleep can positively change a patient’s lifestyle. I believe this will lead to an increase in health awareness among patients and can change their perception of “drug stores”. If we can enhance the role of the approximately 60 thousand drug stores in Japan today, not only can we hasten the treatment of diseases and illness, but also prevent life style related diseases and reduce overall medical expenses. In order to change how people “use” drug stores, changing people’s perception of them socially is imperative. The benefit of changing the 5 hundred million or so visits to pharmacists would be immeasurable. If the role of drug stores can change, I believe this will lead to a change in medical care in Japan as well. Moreover, by encouraging patients to feel thankful for the crucial role pharmacists play, pharmacists will have an increased sense of professional satisfaction. If this can be accomplished I believe it will lead to the resolution of many issues surrounding Japanese medical care. This is the underlying reason for developing a next generation electronic medical record system called “Musubi”.

――Tell us about some of the features of “Musubi”.

Essentially, “Musubi” will compare patient medical records with the prescribed medicine to automatically provide medication consumption instructions. Once the patient clicks on the instructions, it will automatically be saved into the patient’s medical records. Moreover, each patients current and previous illnesses, allergies, age, and test results will be logged, and based on this information personalized advice that fits each patient’s unique lifestyle habits will be provided through machine learning. It acts as both a medical record system as well as provides personalized lifestyle advice and medication consumption information.

In the close future, I hope to further develop the system to be able to predict patient symptoms and save information at the click of a button. The most important thing is to be able to share this information in a detailed yet easy to understand language. For example, “Keep warm during the winter season to prevent heart attacks”. By keeping medical jargon to a minimum, patients can understand the information or diagnosis that is presented to them. Another example would be, instead of writing “eat foods that are easy on your stomach”, write “we recommend chicken breast when you want to eat meat”, so that the patient may ask the pharmacist “why?” and a dialogue is born leading to a better patient pharmacist relationship. That is not to say that patients should have lengthy conversations with pharmacists at the drug store, but rather to guide patients on what to focus on to maintain their health. The cornerstone of Musubi is to “offer 5 seconds of productive conversation”. We will feel successful once we hear more and more patients saying the words “Thank You” at drug stores.

―― How were you able to create a product that not only represents local needs but is also so revolutionary?

We spoke to over 200 pharmacists, and further developed the business idea by repeatedly speaking with the pharmacists and then going back to review and revise our business plan. The first step in creating a business model to revolutionize drug stores is to understand the needs of the pharmacists themselves. We started by developing relationships with pharmacists from university hospitals to gather real world information and feedback.

Moreover, I believe thoroughly observing pharmacists in their work space was also a major key. Through our observations, we realized that the maintenance of medical records was slowing down other operations. Pharmacists usually upload their patient notes into the system when they have some down time. With this system, backlog is occurs easily and there is no guarantee that all the information will be entered as a result of the backlog. Moreover, allowing so much time to pass between meeting with the patient and entering the notes makes it difficult to recollect the meeting accurately. That is when I came up with the idea for “Musubi” so that medical notes can be entered at the same time as prescription to resolve this issue.

Continues in Part 2