Systemic constraints are further reasons underlying the competition in caregiving
industry. The caregiving industry functions based on the long-term care insurance
system, and the government is closely involved in it. Caregiving services that
operators can provide are predetermined, and their income is dependent on the
long-term care fee schedule. In this structure, users receive certification for caregiving and utilize approved services. Each time the long-term care insurance system is
improved or the long-term care fee schedule revised, operators need to adapt their
practice. They have recently been allowed to provide fully out-of-pocket non-longterm care services for users, such as chaperoning travel, in addition to services
covered by long-term care insurance. Hence, operators have the right to determine
prices, and thus, in these limited areas, competition based on market principles is
seen to be possible.
Some caregiving homes have been forced to withdraw from the market due to
deterioration of financial conditions and labor shortages. Caregiving includes a
variety of tasks and a heavy workload while paying a relatively low wage. As
such, the industry has a high rate of turnover and chronic labor shortage. Highly
stressful care items for which there is a high demand for improvement from those in
the field include transferring (e.g., to a wheelchair), bathing, dementia care, toileting,
monitoring, as well as sharing information and maintaining and improving their will
to live (Ministry of Health, Labour and Welfare, 2012, p. 37). The most timeconsuming caregiving tasks are those concerning sharing information, which have
been reported to account for up to 25% of all work hours per employee (Miwa,
Watanabe, Fukuhara, & Nishimura, 2014). Accordingly, new efforts aimed at
increasing productivity, improving efficiency and the work environment, and resolving labor shortages in caregiving homes are sorely needed.
2 Moving Toward the Use of Information Technology (IT)/
Artificial Intelligence (AI) and the Introduction
of Caregiving Robots
The Japanese government has been supporting the introduction of Information and
Communication Technologies (ICT), AI, and robot technology to assist innovation
in the field of healthcare service (Ministry of Economy, Trade and Industry,
Manufacturing Industries Bureau, Office of Robot Policy, 2019). A robot is defined
as “an intelligent mechanical system possessing three underlying technologies:
sensors, intelligence/control systems, and a drive system” (Ministry of Economy,
Trade and Industry, Robot Policy Research Group, 2006, p. 7).
The Ministry of Health, Labour and Welfare and Ministry of Economy, Trade and
Industry have indicated “priority areas in the use of robot technology in caregiving”
and set forth policies for the active utilization of robots in care. A revision from
October 2017 added “communication” as one of the priority areas (Ministry of
Economy, Trade and Industry, Manufacturing Industries Bureau, Office of Robot
Information Technology/Artificial Intelligence Innovations Needed for Better. . .
39
industry. The caregiving industry functions based on the long-term care insurance
system, and the government is closely involved in it. Caregiving services that
operators can provide are predetermined, and their income is dependent on the
long-term care fee schedule. In this structure, users receive certification for caregiving and utilize approved services. Each time the long-term care insurance system is
improved or the long-term care fee schedule revised, operators need to adapt their
practice. They have recently been allowed to provide fully out-of-pocket non-longterm care services for users, such as chaperoning travel, in addition to services
covered by long-term care insurance. Hence, operators have the right to determine
prices, and thus, in these limited areas, competition based on market principles is
seen to be possible.
Some caregiving homes have been forced to withdraw from the market due to
deterioration of financial conditions and labor shortages. Caregiving includes a
variety of tasks and a heavy workload while paying a relatively low wage. As
such, the industry has a high rate of turnover and chronic labor shortage. Highly
stressful care items for which there is a high demand for improvement from those in
the field include transferring (e.g., to a wheelchair), bathing, dementia care, toileting,
monitoring, as well as sharing information and maintaining and improving their will
to live (Ministry of Health, Labour and Welfare, 2012, p. 37). The most timeconsuming caregiving tasks are those concerning sharing information, which have
been reported to account for up to 25% of all work hours per employee (Miwa,
Watanabe, Fukuhara, & Nishimura, 2014). Accordingly, new efforts aimed at
increasing productivity, improving efficiency and the work environment, and resolving labor shortages in caregiving homes are sorely needed.
2 Moving Toward the Use of Information Technology (IT)/
Artificial Intelligence (AI) and the Introduction
of Caregiving Robots
The Japanese government has been supporting the introduction of Information and
Communication Technologies (ICT), AI, and robot technology to assist innovation
in the field of healthcare service (Ministry of Economy, Trade and Industry,
Manufacturing Industries Bureau, Office of Robot Policy, 2019). A robot is defined
as “an intelligent mechanical system possessing three underlying technologies:
sensors, intelligence/control systems, and a drive system” (Ministry of Economy,
Trade and Industry, Robot Policy Research Group, 2006, p. 7).
The Ministry of Health, Labour and Welfare and Ministry of Economy, Trade and
Industry have indicated “priority areas in the use of robot technology in caregiving”
and set forth policies for the active utilization of robots in care. A revision from
October 2017 added “communication” as one of the priority areas (Ministry of
Economy, Trade and Industry, Manufacturing Industries Bureau, Office of Robot
Information Technology/Artificial Intelligence Innovations Needed for Better. . .
39