INTERVIEW

Fondation France-Japon de l’EHESSINTERVIEW WITH NAONORI KODATE
August 2021
Naonori Kodate is Associate
Professor in Social Policy and Social
Robotics at University College Dublin
and founding Director of UCD Centrefor Japanese Studies. His researchcovers comparative public policy,
science, technology and society, patient
safety and gender equality in STEM.
He is the Principal Investigator of aToyota Foundation-funded international
research
project“Harmonisation
towards the establishment of Personcentred, Robotics-aided Care System(HARP: RoCS)”, and on the Board ofDirectors for the Future Technologies
for Integrated Care Research Network,Japan.

First of all, as a FFJ associate researcher,member of the Cercle de la FFJ and two FFJ
projects, Capitalisms, Technologies, Societyand Health (CTSH) and Care-led Innovation,
we would like to thank you for agreeing togive us this interview. We would also like tocongratulate you on the publication of yourlatest book chapter “The Role of IncidentReporting Systems in Improving Patient
Safety in Japanese Hospitals: A Comparative
Perspective” and the publication of the book
Shin Sekai no Shakai Fukushi. Vol. 1 (JapaneseHandbook on Social Welfare in UK & Ireland).

wide range of social welfare policies across the world,
and the original Handbook Series were publishedback in the 1990s. They have been widely read andreferenced, and the main editors were all highly
respected, eminent and pioneering academics in the
research of social policy and social work (for example,the late Prof. Emeritus Yuichi Nakamura, and the lateProf. Emerita Yasuko Ichibangase) in Japan. So I
was really over the moon when a team of new editors
approached me. As a result, Ireland was included forthe first time! I invited a few of my UCD colleagues, whospecialize in housing policy, Northern Irish conflicts andtheir impact on mental health policy, as well as healthand social care policies in Northern Ireland and theRepublic of Ireland, to contribute.

Your latest book, published in 2019, iscurrently only available in Japanese.
Could you give a brief overview of the main
points of this book and, as you are basedin Ireland, maybe could you tell us in which
way Irish social welfare policies could
inspire Japanese policies in your opinion?

As you know, Ireland is an old ‘nation’, but arelatively young ‘state’, born just 100 years ago.
Taking just one example, universal access to primary
healthcare has not yet been achieved (according to theWHO definition of universal access). In response, in2017, the government proposed a ten-year programme
to transform the system called Sláintecare, and there
are great expectations for this reform, which could
potentially integrate medical and social care, making
full use of digital technologies. Historically, Ireland hasrelied on the non-governmental sector, i.e., communityorganizations and charity bodies, for providing care andservices, and we can find excellent community-based
initiatives and strong advocacy groups. In myThank you very much. It has been great to be amember of the FFJ team, and I am very happy to takepart in this interview. The edited book ‘Shin Sekai noShakai Fukushi’ (New Global Social Welfare, in English,
published by Junpōsha Ltd.) is a handbook, covering aarea of research, the Age Friendly Cities and Counties
Programme is a good example of blending strong
government commitment and local citizens’ activeinvolvement. Although it is always a double-edged
sword, when it comes to public policy based on self-help
and mutual aid, which have been promoted in Japan in
the last few decades, Ireland can provide us with a lotof unique insights and invaluable case studies.

Last May, you co-organized a film screening
followed by a Q&A discussion for the
documentary film Circuits of Care: Ageing inJapan’s Robot Revolution, with its director
David Prendergast (Professor of Science,
Technology & Society at the Department of
Anthropology of Maynooth University, Ireland),who met researchers developing and testing
assistive technologies for older adults. Whatdo you remember from the discussions
following the film screening? What would you
say to our readers to encourage them to watch
this movie?
The webinar co-organized by three organizations(FFJ, UCD Centre for Japanese Studies and Maynooth
University’s Visual Ethnography Lab) welcomed morethan 100 people, and it indeed generated a lot ofdiscussion, covering themes such as potential ethicalissues as well as possible benefits associated with theuse of care robots (e.g., improved quality of life for older
people and care professionals).
The film Circuits ofCare, which I produced
and Prof. Prendergast
directed, was shot inTokyo in the autumn of
2019. The documentary
presents a variety ofrobots, ranging fromcybernetic
walking
supports to companion
robots and automatedsensor
networks
innursinghomes.
Older adults and care
professionals share theirexperiences of the practical benefits these technologies
bring, the problems they create, and the unexpected
relationships that can grow. We recorded additional
material in the middle of the pandemic, so the film also
sheds light on how assistive technologies were usedduring this period in order to continue providing care forolder people despite all the challenges.
Throughout the springtime this year, we haveengaged in public discussions about the film, whichwere targeted at a variety of local and international
audiences. To name a few, the Service Design Networkand the Response=Ability Summit 2021. The film has
been nominated for awards at several film festivals, andwon the Best Documentary Award at Long Story Shorts
International Film Festival. It was great working withDavid and the team, but now, with these awards andnominations, I can tell you how rewarding it has been toreceive these great reactions and feedback. Once thefilm is made available to a wider audience, I would verymuch like many people to watch and share their views,
as the use of technologies in care settings will continue
to bring us benefits as well as challenges.

As we can observe from this event, yourparticipation in the CTSH project and theToyota
Foundation-fundedinternational
research project “Harmonisation towards theestablishment of Person-centred, Roboticsaided Care System (HARP: RoCS)”, for which
you are the Principal Investigator, the use ofcare robots has an important place in yourcurrent research. Could you tell us more about
your current and future projects on this topic?
The HARP: RoCS project uses a multidisciplinarylens, involving frontline care professionals andacademics from various disciplines such as nursing,social work, medical engineering, sociology andpsychology. The project has two phases: in the firstphase, we looked into social care policies and cultural
aspects related to the use of robotics in older people’s
care in Ireland, Japan, Hong Kong SAR, China andFrance. In the second phase, we will introduce sociallyassistive robots in nursing homes in Ireland andJapan and see how they affect care practices at theorganizational (care delivery) level.
In parallel, we have been conducting several
projects related to assistive technologies in nursing
homes in western Tokyo. The nursing homes have agreat director and geriatrician, and when they, theirprofessional team and I got together, we decided toform a research team, combining the perspectivesof safety science and organizational theory. We firstreviewed care processes, tried to find risks and needs,
and as a result, identified ‘slips, trips and falls’ amongolder residents, particularly during nightshifts, as thepriority area.
We originally thought this is where care robots andmonitoring devices could be useful. Since the initialadoption of care robots in 2016, we have continued
working on various projects and publishing papers. The
latest article, out in August, reports the assessment of
our original soft plush-type robot, which I named Monchan. Another paper will be published in a forthcoming
book, ‘Systems Thinking for Global Health’ (OxfordUniversity Press), which I co-edited. In both papers, I
believe the key element was how assistive technologies
are adopted by care professionals at the organizational
level. Just like my research on the use of incident

reporting systems for patient safety, future projects
will continue to be underpinned by the lens of safety
science and organizational theory, and aim to propose
how public policy can support safety and care quality.
Additionally, in 2018, we founded the Future
Technologies for Integrated Care Research Network,
Japan, and we will continue to bring together
care providers, technology users, developers andpolicymakers in order to think about the use oftechnologies for better integrated care in Japan andbeyond.

The use of care robots seems to be a goodsolution to overcome the lack of qualified
employees in the care sector. What could
be the benefits for patients who are notused to interacting with robots or modern
technologies? If you are already able todiscuss some patients in different countries,
what is their opinion on the use of eHealth andcare robots?
As we are all aware, COVID-19 has changed ourlives dramatically, in particular, the lives of older people
and their carers. Nursing homes have been particularly
hard hit by the whole pandemic. There were areas ofcare delivery that were saved by the use of technologies(e.g., remote sensing, telemedicine).
That said, having studied and spoken to many careproviders and older people, I know the idea ofintroducing care robots to replace human carers should
be a last resort, and ideally will not happen at all.
eHealth and care robots should be used only toenhance the quality of care. At the same time, theworkplace environment in long-term care is very toughand the reality is that the retention of highly-experienced
and excellent care professionals is already challenging.
This applies to every advanced economy includingFrance, I believe.

“eHealth and care robots should
be used only to enhance thequality of care.”So, we need to somehow find practical solutions sothat older people can be cared for based on their needs,
while keeping their ability to take care of themselves
and remain in their homes and communities for as
long as possible. We also know that a care systemneeds to adapt over time to support aging in place.
When we reimagine our care system, robotics ortechnology-aided care will inevitably become part of
the reconfigured system.
Just focusing on care robots for now, there aredifferent types of robots (e.g., physically assistive,socially assistive and support for independent living),
and it would be important first to know users’ needs,
then think about how to maximize the benefits for older
people and carers in their specific physical and socialenvironment. If the main user is not used to interactingwith robots or modern technologies, as you say, thenthere will be other ways of getting technological support.

“When we reimagine our caresystem, robotics or technologyaided care will inevitably become
part of the reconfigured system.”
There are still a lot of other barriers, such as
infrastructure, cost and even robot functionalities,
but these are evolving features in a broader eHealthlandscape. From the public policy perspective, theimportant thing is to watch out for the risks of widening
inequalities in society (access to care, technologies
and human contact). As the successes and failuresof implementing electronic health records fromvarious jurisdictions demonstrate, public trust in thegovernment, its public policy, care professionals andproviders matter greatly in all of this. I am sure that bothof the FFJ projects (Care-led Innovation and CTSH)
will deal with these aspects, and I am delighted toparticipate in these new projects.

Focusing on the present, do you think thatthese technologies could be more widelyused in the world as a solution for people who
stopped going to the doctor during quarantineseven if they were sick or those who are facing
extreme social isolation, for example?
This is the million-dollar question! As I mentioned
before, the use of telecare and telemedicine has
become much more accepted and more widely usedduring the pandemic. Since it is well established
now that people prefer staying in their private homes
and communities as long as they can maintain their
independent living, there will be a strong policy drivein order to realize what you have described. There arebenefits in having such a system, but there certainly
will be drawbacks as well, if more use of technologies
means less human interactions. For instance, as youmention, will interactions with communication robots
heal extreme social isolation? What about the impactof using robots on newly trained care professionals?
Will care professionals lose their human touch andbe robbed of developing their crucial skills andexpertise? How about the use of technologies in theglobal south where healthcare systems are lacking ininfrastructure and resources? More evidence needs
to be gathered concerning the use of technologies

in care settings locally and globally, and we needto assess its effectiveness. There is now a greaterneed for international and cross-disciplinary researchcollaboration,using a common
There are benefits in having such a system,
framework based
onsystems but there certainly will be drawbacks as well, ifthinking.
more use of technologies means less human“interactions.”

The Fondation France-Japon de l’EHESS warmly thanks Naonori Kodate for accepting to answer this interview.

Further information► Naonori Kodate’s profile page on FFJ website
Access: http://ffj.ehess.fr/naonori_kodate.html► Awarded Movie
Circuits of care has been nominated for awards at several film festivals, and won the Best DocumentaryAward at Long Story Shorts International Film Festival.
Further information about the movie:
https://www.ucd.ie/japan/newsevents/documentaryfilmcircuitsofcareageinginjapansrobotrevolution/► Latest article
Obayashi, K., Kodate, N. & Masuyama, S. Assessing the Impact of an Original Soft Communicative
Robot in a Nursing Home in Japan: Will Softness or Conversations Bring more Smiles to OlderPeople?. Int J of Soc Robotics (2021).
Access: https://doi.org/10.1007/s12369-021-00815-4► Latest report

小舘尚文，生活支援技術の受容をめぐる社会・文化・政策的課題―介護ロボットの社会実装を事例に―,
In:「高齢者を支える技術と社会的課題 科学技術に関する調査プロジェクト報告書」、国立国会図書館 調査及び立法考査局; 2021年3月；pp65-80. National Diet Library, Japan.
Access: https://dl.ndl.go.jp/view/download/digidepo_11656224_po_20200605.pdf?contentNo=1► Forthcoming book
Larkan F, Vallières F, Mannan H, Kodate N (Eds.) Systems Thinking for Global Health. Oxford: Oxford
University Press, 2022.

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