Keitai care: James Nakagawa's mobile marvel: lifewatcher connects patients with doctors to help keep them healthy - Upfront

Japan, Inc., Dec, 2003 by John Alderman

LIFEWATCHER IS A mobile "Disease Management Solution for Diabetes and Obesity" at the intersection of two important trends: software tools that empower individual lifestyles and a rise in "lifestyle diseases," whose treatment requires long-term management rather than an instant cure. Both of these trends have surged in Japan.

With assessments ranging from 6 million to 16.2 million diabetics in Japan--and over 70 million mobile phone users--a large niche is clearly waiting to be filled. While the marketing departments of major mobile manufacturers are obsessed with the frivolous end of personalization (such as cutesy screen animations and fleetingly amusing ringtones), Lifewatcher is a reminder that much more useful services are both possible and profitable.

James H. Nakagawa, the Japanese-Canadian chairman and CEO of Mobile Healthcare KK, the Tokyo firm that created Lifewatcher, says that a talk with a friend who had been recently diagnosed as diabetic changed his perspective on self-care. The friend described his situation in bleak terms and said that there was nothing he could do to help himself. He was given no options by his doctor other than drugs and a list of severe restrictions.

Calls by Nakagawa to specialists and acquaintances confirmed both the incredible rise of the disease in Japan and the difficulties in managing it. Constantly monitoring food intake is hard, and it is often impossible for most patients to find out the nutritional information at restaurants, effectively barring them from eating out with friends. Depression often accompanies the diagnoses of patients new and old. From a doctor's perspective, patients are often lethargic and forgetful, prone to slipping off their regimes of diet and exercise. Even when patients are cooperative, a busy schedule often prevents doctors from effectively communicating with them between visits.

Looking at other systems, Nakagawa was shocked not only that no one offered a service for mobile phones, but also that the user interfaces were so poor. "My god," he says, "it took you 20 minutes to find the calories of a McDonald's or Mos Burger sandwich." That is unacceptable in any medical regime, where "the main challenge is making it a habit."

"What if we could create a Disease Management Solution that was not light but could be carried by anyone with a mobile phone?" Nakagawa wondered. As opposed to what he terms "light" services--simple calorie-counting tools --Lifewatcher not only provides loads of tools that let users input, track and graph their nutritional intake and exercise, it also offers convenient add-ons like meal suggestions based on user needs and desires, along with addresses and other details of local stores or restaurants serving the suggested healthy picks. Lights flash or messages are sent as reminders if users don't report having taken their medicine.

By using a mobile phone rather than a palm top computer, Lifewatcher is part of the most popular platform in Japan. And with the addition of networked functions like the restaurant search, it takes the service from a nice idea to a very bandy tool.

When dealing with children as well as impatient adults, ease of use is a must. Developed with advice from Japanese doctors and the Japan Red Cross, the system lets registered health care providers (and children's parents) monitor use and results so that they can confirm medicine intake and exercise and be aware of any abnormalities. But no matter who is tracking their stats, Nakagawa believes Lifewatcher's convenience and comprehensiveness increases patients' self-reliance, which in turn lowers depression.

Company materials boldly declare that "users will see an immediate improvement in quality of life." Nakagawa's background as a successful high-tech financial service consultant without notable credentials gave him the notion that insight, hard work and networking are much more important than certificates.

While nothing stops patients from being lazy or doctors from being too busy to monitor them, Nakagawa says all of the doctors he spoke with were enthusiastic about the system.

Others around the world share the enthusiasm. Hospitals like Moses Cone in Greensboro, North Carolina, and universities such as the Euromed project in Athens, Greece, are hatching plans to make use of handheld wireless tools for patients and doctors. Mobile Tree in Bellevue, Washington, specializes in letting doctors write prescriptions and access patient history from PDAs.

While researchers articulate ambitious schemes for tele-medicine that look forward to doctors and hospitals linking data for MRI and X-Ray images and other patient medical history, the advantage of Lifewatcher is that it focuses on a particular need and does it well. Nakagawa emphasizes that the system is being constantly analyzed and updated, while the database of foods, stores and restaurants is also growing. Also, since Lifewatcher is not medical advice but rather a tool for self-help and activity tracking, it has room to maneuver without running into too many legal traps or liabilities.