Interview

Advancing Global Care Technology: CYBERDYNE and TANOTECH on Japan's Innovation in Healthcare Solutions

In Japan, where the population is rapidly aging, the development of long-term care technology has become an urgent issue. However, the path forward is far from straightforward, with not only technical challenges in product development but also various obstacles in implementing these technologies in care settings and expanding them globally.

CYBERDYNE Inc., the developer of the wearable cyborg 'HAL®,' and TANOTECH Inc., which provides the rehabilitation and recreation support system 'TANO,' have both been selected for Japan Agency for Medical Research and Development’s (AMED) development support projects and are working on the creation and implementation of innovative long-term care technologies. The two companies have been collaborating to expand possibilities, including offering joint programs that combine HAL® and TANO. In this interview, we spoke with Mr. Yoshihiro Yasunaga, Executive Officer and General Manager of the Sales Division at CYBERDYNE, and Mr. Tsutomu Mitamura, CEO of TANOTECH, about their journey so far and their vision for global expansion.

To begin, could you share what inspired both of you to get involved in the long-term care technology industry?

Tsutomu Mitamura:
My involvement began when my mother developed dementia. I was 40 at the time, and I realized that starting my own company was the only way I could balance work with caring for her. Prior to this, I had developed railway simulators and similar systems, so I began wondering if I could apply that technology to help people with dementia and those in care facilities.
This led to the creation of "TANO," a gamification technology that uses motion sensors for welfare, care, and educational settings.
Initially, our focus was solely on dementia. However, as we became more involved in care settings, we began to recognize the various challenges faced by people with disabilities and children with illnesses. For example, our technology could create systems that allow children with limited mobility to play together in an enjoyable way. Similarly, CYBERDYNE, with its technology that utilizes bioelectric signals, can achieve similar goals, but in its own unique way.

Yoshihiro Yasunaga:
I previously worked in Kitakata City, Fukushima Prefecture, where the elderly population rate was nearly 30%. I was concerned about how the younger generation would manage the social security burden. That's when I saw "HAL®" featured on television. I realized that this technology could create an environment where elderly people could work longer, and in 2008, I decided to join CYBERDYNE.
At that time, CYBERDYNE was preparing for its IPO. As a U.S. Certified Public Accountant, I initially handled IPO preparations and fundraising. Later, I became involved in sales and served as the representative of the Robocare Center Group, which operates HAL training facilities. This expanded my involvement across various areas. By interacting with users in the field, I developed a growing interest in medical and nursing care, which ultimately led me to pursue a doctorate in medicine. When I joined 17 years ago, I never imagined I would become so deeply involved in this industry, but it has proven to be incredibly rewarding.

We understand that you've known each other for eight years. How did you first meet?

Mitamura:
Our journey began at the Shonan Hiratsuka Techno Fair in 2013. At that time, CYBERDYNE had a booth directly across from ours, where I saw Professor Yoshiyuki Sankai, CEO of CYBERDYNE, speaking with Yuji Kuroiwa, the Governor of Kanagawa Prefecture, as equals. Professor Sankai, a pioneer who established Cybernics (Note 1) and opened up new possibilities for Japanese long-term care technology, has always been someone I deeply admire. At that point, we had only been developing TANO for about six months, and I remember thinking, "I hope that one day I’ll be in a position to have conversations with governors too." Later, we had the chance to exhibit at CYBERDYNE’s Roboterra in Fujisawa, which helped foster even more connections.

Yasunaga:
On one occasion, Mr. Mitamura came to meet Professor Sankai in Tsukuba. That was my first time meeting him, and since we had some time before the meeting, we decided to climb Mount Tsukuba together. He showed up in a suit (laughs)！ As we hiked, we talked about various things and soon realized that TANO was highly compatible with HAL. What really resonated with us was our shared desire to bring joy to people who have been living with illness or disabilities for long periods.

Mitamura:
I’ll never forget that hike. Everyone we passed gave us strange looks (laughs). But we made the most of it, using the footage we shot there to create new TANO content on the spot.

Yasunaga:
Mr. Mitamura never wastes an opportunity. As a result, TANO is now being used in all 18 of our Robocare Centers nationwide. By combining HAL’s functional training with TANO’s exercise programs, we’ve created an environment where users can enjoy continuing their rehabilitation.

One particularly exciting initiative is the online TANO competitions held between our Robocare Centers in Tsukuba, Osaka, and Kobe. Even individuals who typically use wheelchairs are moving their bodies with enthusiasm during these competitions. Our staff are often astonished, saying, "I didn’t know they could move like that!" The strong compatibility we sensed early on has been clearly demonstrated in practice.

(Note 1) Cybernics:
A new academic field established by Professor Sankai that integrates and combines various disciplines, including cybernetics, mechatronics, and informatics at its core. It also encompasses brain science, neuroscience, exercise physiology, robotics, IT, regenerative medicine, behavioral science, ethics, safety, psychology, social sciences, and more. HAL was developed using this technology.

Both companies are actively pursuing global expansion. Could you share more about your current initiatives?

Yasunaga: A recent highlight has been our particularly successful expansion in Malaysia. With support from the Malaysian government, HAL has been implemented in a 700-bed facility, and they’ve also adopted TANO. Malaysia became the first country in the ASEAN region to implement HAL, and they’re making significant efforts in this field, including the establishment of the "Neurorobotics Rehabilitation & Cybernics Center."
What’s interesting is that Malaysian government officials frequently introduce our products to other ASEAN nations. They’ve even joined us in meetings with health ministries from Indonesia and India. While this kind of support is rare in Japan, we’ve found that when overseas governments recognize the value of the technology, they are very proactive in offering their support.

Mitamura:
We began our full-scale overseas expansion in 2018. Before that, we had focused primarily on the domestic market, but we received many inquiries from international visitors at Japanese trade shows who were interested in purchasing our technology. In Japan, facilities often wait for government subsidies before implementing TANO, but overseas, they tend to make quicker decisions when they recognize good technology.
Particularly in Hong Kong, implementation went smoothly as it aligned with their local funding system. However, choosing the right distributors has been a challenge in global expansion. For example, in China, we faced conflicts between distributors, and in Taiwan, we discovered that our initial partner was reselling demo units at inflated prices. But these experiences have allowed us to accumulate valuable know-how about expanding globally.
Regarding Malaysia, thanks to the efforts of CYBERDYNE, we've had unexpected opportunities, such as Mr. Yasunaga introducing TANO to local ministers. I haven’t personally visited Malaysia yet, but the information and opportunities we've received have been incredibly valuable for a small business like ours.

Yasunaga:
Yes, I send him photos afterward with a message saying, "I introduced your product!" (laughs).

Mitamura:
I truly appreciate how CYBERDYNE, by leading this industry in Japan, is helping pull companies like ours along with them. I’m very grateful for that. The field of long-term care technology still has relatively few participants and a short history, so standardized data is limited. That’s why I believe it’s crucial to unite where we can cooperate and share knowledge in order to improve our overall technological capabilities.

Yasunaga:
Of course, competition brings its challenges, but no single company can develop all the necessary technologies on its own. That’s why, with something like TANO, which has especially high compatibility, collaborating to develop it together is mutually beneficial.

Finally, do you have any advice for companies that are following in your footsteps?

Mitamura:
First, I recommend testing your international readiness by attending the International Home Care & Rehabilitation Exhibition, the largest of its kind in Asia. Also, consider visiting exhibitions in Beijing, Korea, and Hong Kong. If you only focus on Japanese exhibitions, you’ll miss out on global trends.
Another crucial aspect is collaboration with education. We work with students to develop games, which naturally leads them to learn about the movements and cognitive functions of elderly people. I’m somewhat embarrassed to admit this, but I only truly understood what dementia meant when my mother was diagnosed.
At the time, I regretted not addressing this issue earlier. However, the reality is that many people only learn about these challenges when they are personally affected—when they have to care for a family member or when they have children. Sometimes, that’s too late. Social issues aren’t limited to the elderly, and I believe that if we can raise awareness of various problems and possibilities earlier, both society and the solutions we develop will change.

Yasunaga:
From our experience, it’s crucial to find reliable overseas partners while still operating domestically. When expanding overseas, it’s important to develop networks, including connections with embassies. These networks become especially valuable for smaller companies.
Japan lacks natural resources like oil, which is why creating technologies that are needed worldwide holds great significance. As Professor Sankai says, our goal is to create "technology that makes the world grateful for Japan’s existence." With this vision in mind, we will continue to develop and innovate moving forward.
Aging is not just a Japanese issue. Taiwan, Korea, Singapore, China, and other Asian countries face similar challenges. This is why Japanese care technology has such great potential. What’s important is not to focus solely on independent development and expansion, but to collaborate with various companies and organizations to address these social challenges.

Tsutomu Mitamura
CEO, TANOTECH Inc.

Tsutomu Mitamura began programming in 1982 and contributed short programs to computer magazines. In 1999, he developed numerous systems designed to make learning fun, including 3D simulators. Inspired by his experience caring for his mother, He founded Lucky Soft Inc. in 2012 and later established TANOTECH Inc. in 2018 to focus on the development of TANO, and he continues to evolve the product through practical verification in care settings.

Yoshihiro Yasunaga
Ph.D. in Medicine

Executive Officer and General Manager of Sales Division, CYBERDYNE Inc.
CEO, Shonan/Oita/Suzuka Robocare Center Inc.
Visiting Researcher, Department of Geriatric Medicine, The University of Tokyo Hospital
Part-time Lecturer, Faculty of Human Sciences, Waseda University
Part-time Lecturer, Department of Rehabilitation Medicine, Fukushima Medical University
U.S. Certified Public Accountant / U.S. Certified Management Accountant

Born in 1974, Yasunaga graduated from Dokkyo University’s Faculty of Economics, Department of Business Administration. After working at Tyco Healthcare Japan and ON Semiconductor Technology, he joined CYBERDYNE in 2008. Initially responsible for IPO preparations, he later moved to the sales department. In 2015, he completed a master's program at The Open University of Japan. In 2019, he entered the University of Tsukuba’s Graduate School of Comprehensive Human Sciences, Doctoral Program in Clinical Sciences. Yasunaga assumed his current position in January 2024.