Asking a Tokyo Girl! Anxiety about accessible healthcare in the city

When you're feeling unwell, sick, or injured, is there a doctor you can rely on in the town where you live?

In cities, many people lack a "family doctor" they can easily consult. How many young people living away from their parents in the city actually have one? The COVID-19 pandemic has certainly increased the number of people feeling anxious about local healthcare in urban areas.

Dentsu Inc.'s newly developed medical appointment/digital consultation system "CLIEN" is a smartphone-compatible service created to alleviate these concerns and connect patients with doctors. Aaron Zu, the project leader, explains what CLIEN is, including the background of its development.

Later in the article, we feature Aoi Kawaguchi, who gained attention in "Happy! Bonbi Girl" and appeared in CLIEN's commercial. Aaron, the "Dentsu Inc. Creator" who passionately (?) directed Ms. Kawaguchi's first acting role, shares his concerns about healthcare felt after moving to the city.

The shortage of primary care physicians, which could lead to a healthcare collapse

It's truly unfortunate that despite Japan's world-class medical standards, Japanese satisfaction with healthcare ranks among the lowest in developed nations.

The COVID-19 shock has brought the social problem of "medical collapse" into sharp focus. One cause of the crisis was the excessive number of inquiries to public health centers, stemming from a lack of awareness about primary care physicians.

When the coronavirus outbreak began, many people likely felt anxious about not having a doctor nearby they could consult.

This problem won't simply disappear once the pandemic subsides. We need to help as many people as possible find clinics or hospitals they can rely on anytime. To achieve this, it's crucial to provide services that are easy to use and facilitate seamless coordination.

Let me introduce myself. I'm Aaron Zu, the project lead and creative planner for CLIEN. Today, I'd like to explain why we developed CLIEN and outline the service's key features.

That vague sense of unease was the raw gem of an idea

CLIEN is a service that allows users to search for and book nearby clinics and hospitals, and also enables them to fill out and send pre-visit questionnaires to their booked facility. Its key feature is the ability to search, book, and complete questionnaires using just a smartphone or computer. We focused on a simple design to ensure intuitive operation across all age groups.

Furthermore, through data integration, it accumulates information such as what physical and mental concerns patients have and what illnesses are prevalent in the area. This enables the rapid provision of optimal medical services tailored to each individual patient.

As someone with multiple national identities, the little frustrations I feel in daily life in Japan often become the raw material for ideas. CLIEN was precisely such a service born from that frustration.

I truly believe Japan's healthcare system and services are among the best in the world. Yet, I always felt a bit frustrated wondering, "Why do clinics still hand you paper and a pen to fill out a questionnaire?"

Precisely because advanced medical technology is so developed, it really bothers me that this one aspect remains analog (laughs). What's more, it's not uncommon for the information from the paper form to be entered into the electronic medical record later anyway. I always thought, "Why not just input it directly on a smartphone or similar device from the start?"

That frustration turned into a sense of urgency during the COVID-19 pandemic. When I saw a clinic meticulously disinfecting each ballpoint pen used by patients to fill out forms, I genuinely thought, "This needs to change."

This led me to approach a partner company I knew to create a digital consultation system, marking the first step toward CLIEN's birth. Guided by the belief that "unusable services won't catch on," we prioritized usability first, creating a simple, easy-to-use interface integrated with a medical institution search system.

To prevent the collapse of healthcare, we must unite as a community to emphasize the importance of having a primary care physician.

Interestingly, around the same time we started developing CLIEN, the Shibuya Ward Medical Association approached us about revamping their website.

Upon discussing details, we learned they wanted to incorporate a medical institution search feature. Recognizing that raising awareness of "family doctors" among residents was a challenge during the pandemic, and given that this was the Shibuya Medical Association—located in the heart of Tokyo's IT hub—we promptly proposed CLIEN. They readily agreed to its implementation. Having a partner willing to accompany us through the development phase of this venture was incredibly reassuring and truly appreciated.

While we were racing to overcome various hurdles and accelerate development, COVID-19 cases surged dramatically nationwide. Daily media reports warned of the impending collapse of the healthcare system. Driven by our strong desire to raise awareness about "family doctors" in the community, we decided to run a CLIEN commercial right in the middle of Shibuya's famous scramble crossing.

We are deeply grateful to Flave Entertainment Inc. for their cooperation in securing the talent, and to FM Tokyo (Shibuya Ward) for connecting us with singer-songwriter LOVE to provide the music.

Furthermore, to deliver the Shibuya Ward Medical Association's message to the community, local organizations like the Shibuya Ward Commercial Association Federation assisted with distributing flyers. It was precisely this combined local power that rapidly expanded awareness of the "family doctor" concept.

Looking solely at online data, within three weeks of the information release, new visits to the Shibuya Ward Medical Association website increased by 1.39 times compared to previous levels, page views rose by 1.68 times, and awareness of the commercial on the Scramble Crossing Big Vision (over two days) exceeded 22,000 people, generating a response far exceeding our expectations.

Do you have a doctor you can rely on, like your favorite restaurant?

I believe CLIEN's potential will expand even further from here. As highlighted by the COVID-19 pandemic, it's no exaggeration to say Japan lags behind in IT. Particularly in healthcare, despite having world-class medical standards and support systems, the reality is that very few medical institutions are truly responsive to patient insights.

The need for systems that can constantly analyze, in real time, what medical associations—hubs of regional healthcare—are doing, or what healthcare challenges local residents face, will only grow. We recognize that this issue is even more acute in regional medical settings than in the Tokyo metropolitan area. As a service connecting patients and doctors, we believe CLIEN must take root across generations and regions.

We will continue to increase the number of people who can answer YES to the question: "Do you have a doctor you can rely on, like your favorite restaurant?"

Aoi Kawaguchi × Aaron Zu Dialogue: "The Healthcare Anxieties of a Girl Moving to Tokyo"

For this CLIEN commercial, we offered a role to model Aoi Kawaguchi, currently soaring in popularity as the "most beautiful woman in the show's history" on the variety program "Happy! Bonbi Girl" (Nippon TV).

Why did we choose Ms. Kawaguchi? Because we felt she perfectly embodied CLIEN's concept: "Do you have a doctor you can rely on, like your favorite restaurant?" In densely populated cities, awareness of "family doctors" remains low. We believed a city girl like Ms. Kawaguchi could authentically voice this sentiment from the perspective of a local resident.

This commercial marks Ms. Kawaguchi's acting debut. Honestly, her acting was unwatchable at first (laughs), but through practice, she gradually improved her ability to convey her emotions and her acting skills grew. Ultimately, we captured truly wonderful expressions.

By the way, Kawaguchi-san is originally from Akashi City, Hyogo Prefecture, and recently moved to Tokyo, leaving her parents behind—a true "girl who came to the big city." I thought she must have various feelings about accessible healthcare in the city. So, I asked Kawaguchi-san about her real-life concerns.

The entertainment world she'd admired since childhood. She finally moved to Tokyo after applying to "Bonbi Girl" with determination.

Aaron: Thank you for appearing in the commercial. I think we were able to create a wonderful piece thanks to you, Aoi. Sorry for all the criticism (sweat).

Kawaguchi: I caused you so much trouble during rehearsals. It was hard to portray a sad expression, but with everyone's advice, I think I managed to get a little closer to a natural look during the actual shoot. I think it was Aaron's criticism that made it possible! (laughs) Thank you so much!

Aaron: How's Tokyo been for you after six months of moving up here?

Kawaguchi: I have this image of "Tokyo = a place where you're constantly followed." Ever since I moved here, the show has been following me around nonstop. Now, I actually feel weird when I'm not being followed (laughs).

Aaron: "Bonbi Girl" was the reason you came to Tokyo, right? I heard you've wanted to be in showbiz since you were little. Did you ever give up?

Kawaguchi: Many times! I worked part-time jobs while applying to all kinds of auditions, but I just couldn't get through... There were times I almost gave up. But when I turned 20, I decided I really wanted to move to Tokyo and become an actress. I thought, "Life only comes once, I don't want to have regrets," so I made up my mind and applied for "Bonbi Girl."

Aaron: I actually cast you after seeing "Bonbi Girl." But honestly, I was really torn about whether to give this job to Aoi-san, who was brand new to the entertainment world and had almost zero acting experience.

Kawaguchi: Ahaha, I know... (laughs).

Aaron: But after talking with her several times, I sensed potential in her "strength of will."

Kawaguchi: Do I have strong willpower...?

Aaron: Working on this commercial, I really came to appreciate the "strength of will" hidden within your naturalness, Kawaguchi-san. You're just not used to "acting" yet. As you gain experience, I believe you'll eventually deliver wonderful performances.

Kawaguchi: Thank you. This is turning into life advice, isn't it? (laughs)

Aaron: When you get into the acting, it's really good. When you're not immersed, your eyes start to wander, and you get that "Oh, she's back in the real world" look (laughs).

Kawaguchi: Ah, I see. This commercial shoot was difficult.

Aaron: But this time, the cuts were relatively quick and fast-paced, right? For acting that requires more sustained expression... maybe she just doesn't have the experience yet.

Kawaguchi:...(wry smile)

Aaron: Should we get to the main topic now? (laughs)

Kawaguchi: Yes (laughs).

The difficulty of finding a primary care doctor right after moving to Tokyo

Aaron: When you moved to Tokyo this time, did you have trouble finding a clinic or anything?

Kawaguchi: Yeah, it was a huge hassle. Right after moving, I got really sick. I frantically searched online for a nearby clinic and went there.

Aaron: That must have been tough. Clinics make you fill out those handwritten medical history forms, right? That felt really strange to me. Why, in a country where healthcare is so advanced?

Kawaguchi: Exactly. When you forget how to write a kanji character on the form, you end up searching for it on your phone anyway.

Aaron: Ah, I see. Makes you think, "Why not just use your phone?" Speaking of which, your move to Tokyo totally overlapped with the start of the pandemic, right? Were you okay?

Kawaguchi: Right before moving, my mom told me to at least look up what kinds of clinics were nearby.

Aaron: Your mom was worried, huh.

Kawaguchi: So I found a clinic near the nearest station, but since I'd never actually been there, I had no idea what it was like. In that sense, finding a "regular doctor" right after moving to Tokyo is tough.

Aaron: What kind of clinic do you think would make you feel secure, Aoi?

Kawaguchi: A kind doctor. Long reception hours. And whether the interior is nice. I guess?

Aaron: What do you think defines a kind doctor?

Kawaguchi: A doctor who really listens to your questions, I guess. If they just say, "This is how it is!" when you ask something, you end up not being able to say anything, right?

Aaron: I see. But it's hard to pinpoint a clinic that suits you beforehand, right? You only really start looking once you feel sick.

Kawaguchi: Exactly, that was me just the other day (laughs).

Aaron: Exactly. CLIEN, which we featured in this PV shoot, is a service that lets you quickly find a reliable doctor in your neighborhood and fill out medical questionnaires on your smartphone. How does that sound for a girl moving to the city?

Kawaguchi: It's incredibly reassuring to be able to quickly find a doctor you can rely on and get to a hospital when you feel sick or anxious in an unfamiliar city. Being able to check clinic and hospital information beforehand and even make appointments is super convenient too.

Aaron: When it comes to local healthcare services, is there anything you think, "It would be reassuring if they could do this," or "I wish they'd improve this aspect"?

Kawaguchi: I think it would be reassuring if the app could show hospitals with more female doctors and staff.

Aaron: I see, that makes sense. Hearing the real voices of Tokyo girls was very insightful! Thank you.

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What I realized through developing CLIEN is that the increased awareness of "family doctors" due to the impact of COVID-19 will lead to even greater patient satisfaction in local healthcare than before.

As Ms. Kawaguchi mentioned, even if you know a clinic exists nearby, you might not know what it's like, or finding one in an emergency can be tough. Plus, what makes a clinic feel safe varies for each person—things like office hours, cleanliness, or communication with the doctor.

The road ahead is still long, but I want to keep upgrading CLIEN so that community healthcare in this country can evolve further through technology and ideas.