Sometimes it seems like Japan just can’t figure out medtech startups.

In theory, Japan should be one of the most active startup markets for medical technology. In practice, however, there are relatively few success cases.

Today we are going to meet one of those success cases and talk with Sho Okiyama, MD and founder of Aillis, who has developed a minimally invasive flu and covid test that is already in widespread use in Japan. Hopefully, no one will ever need to stick another swab up your nose.

We also talk about Sho’s time as a rural doctor, what’s straining Japan’s healthcare system, and how to fix it before it breaks.

It’s a great conversation, and I think you’ll enjoy it.

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Show Notes

  • Why influenza diagnosis has been so resistant to AI
  • You’ll never get another swab stuck up your nose
  • What practicing as a rural doctor taught Sho about Japan’s healthcare system
  • Some Japanese still turn to Shamanism for medical advice
  • Starting an AI startup without a technical founder
  • Building a medical training dataset from scratch
  • The challenge Anthropic and OpenAI face in medical tech
  • Aillis’s plans for global expansion
  • Why there are so few medtech startup in Japan and how to fix that
  • How to drive meaningful change in Japanese society

Links from the Founder

Transcript

Welcome to Disrupting Japan, Straight talk from Japan’s most innovative founders and VCs.

I’m Tim Romero, and thanks for joining me.

Japan has a real problem with life science startups.

I mean, there’s no shortage of brilliant ideas and patents. There’s no shortage of support programs and investors looking to invest in Japanese medtech and biotech startups.

Everyone in Japan wants this to happen. Everyone knows this is about to happen. And yet, everyone is also a bit frustrated at just how slow this is happening.

But of course, it is happening.

So, today we sit down with Sho Okiyama, medical doctor and founder of Aillis, who has developed an AI-powered throat camera that can actually diagnose both influenza and COVID. It’s the first device of its kind ever approved as a diagnostic medical device, and it is already in widespread use in clinics and hospitals in every prefecture in Japan. It’s really an amazing success story that is just getting started.

Sho and I talk about what it really takes to bring a new medical device to market in Japan, what it’s like to be the only doctor on a string of remote Japanese islands, and how we’re going to get more Japanese doctors to start startups.

But you know, Sho tells that story much better than I can. So, let’s get right to the interview.

Interview

Tim: So, we’re sitting here with Sho Okiyama, the founder and CEO of Aillis, who is using AI to make medical diagnosis faster and more accurate. So, thanks for sitting down with me.

Sho: Thank you for having me, Tim.

Tim: I’m really looking forward to this, because I think there’s so much innovation going on in biotech and medicine in Japan right now, and what you guys are doing is really interesting. So, you’ve got two products, and I’d like to kind of cover them briefly. First, you have the Nodoka diagnostic camera.

Sho: We produce Nodoka, which is a medical device. This is a pharyngoscope. In other words, it’s a throat camera. So, whenever you go to the doctor, the doctor would take a look at your throat, right? You know, find out whether it’s reddish, swelling, or something like that. But all those inspections were based on knowledge inside the doctor’s brain. So, what we developed was the database of the pharyngeal photo.

Tim: So, when a doctor is looking at someone’s throat, they’re looking for all kinds of different things. But Nodoka, as I understand it, is looking for two very specific things, right? It’s able to diagnose influenza and recently COVID as well, right?

Sho: Yes. We used to diagnose influenza and COVID using PCR or similar methods.

Tim: How accurate is it compared to the PCR test? Because I would be very, very happy if I never have to get another swab up my nose for testing these things.

Sho: Yeah. Nodoka has gone through a clinical trial and has proven that it has approximately equivalent accuracy compared to the antigen testing.

Tim: That’s fantastic. And it’s in widespread use already, right?

Sho: Yes. It has been introduced to more than 2,000 hospitals or clinics in Japan.

Tim: And is the driving factor just patient comfort? Nobody likes getting the swab up the nose? Or is it more accurate? Is it faster?

Sho: Yeah, it’s faster. And of course, it’s less invasive, right? And what’s more, Nodoka only has indications for two different diseases as of now, but it has the potential to have more indications, like cancers such as tongue cancer or pharyngeal cancer. And we also wrote a paper that the AI is able to detect signs of diabetes only through the image of the pharynx.

Tim: Really? Okay, I want to get back to Nodoka because it’s super interesting. But before we do, I want to talk just really briefly, introduce your other product, which is Evidence Finder.

Sho: So, this is an LLM-based tool we developed for doctors. There are tons of medical information coming out. There are hundreds and thousands of papers published every day. So, doctors need to keep up, right? But it’s a huge burden for doctors. So, what Evidence Finder does, it’s a chat-based tool, such as, ChatGPT or Gemini, but it cites scientific papers. We use multiple techniques to prevent hallucination, which is very, very important in the field of medicine. And it also gives the doctors concrete evidence why the AI had said what he has said.

Tim: So, is this more of a research tool, or is it something that could potentially be a diagnostic tool?

Sho: It could be used in both ways. If the doctor were to use it in clinical settings, it needs to be approved as a medical device, which also could be the case for us developing the medical device version of Evidence Finder in the future.

Tim: Well, I understand that getting certified as a medical device is very much on your roadmap at the moment, right?

Sho: Yes.

Tim: Okay, I really want to dig into that. But before we do, I want to back up a little bit and talk about you.

Sho: Thank you.

Tim: So, you graduated from University of Tokyo Med School in 2010. And after graduation, you ended up practicing in some very rural areas of Japan, right?

Sho: Yes.

Tim: I mean, University of Tokyo Medical School is the most prestigious medical school in Japan. Graduates go into top-tier internships and hospitals all over Japan. Why did you decide to go to Okinawa and these rural areas and work as a rural country doctor?

Sho: Yeah, I started my residency in Red Cross Hospital in Shibuya. This is a huge hospital. It has like 20 doctors on duty at midnight. And you can perform MRIs, CAT scans 24/7. But the hospital was too developed for myself. And if I were to work there for 10 years, I would end up as a doctor who is only able to work a developed hospital like the Red Cross Hospital in Shibuya. So, I found in myself that I needed to go to rural areas or small clinics to develop my physical examination skills, as well as not ending up as a niche specialist. I wanted to be a generalist.

Tim: That makes a lot of sense. So, I mean, I could see that on one hand, going into prestigious hospitals, it’s a very smooth escalator. On the other hand, it sounds kind of like the medical equivalent of being a sour man.

Sho: Oh, yeah, you could say it in that way.

Tim: I mean, things are decided for you. You sort of get pushed into doing one specific track or rotated through. So, how long were you in Shibuya before you made that call?

Sho: I was in Shibuya for three years. And then I went to Ishigaki and Hatsuka Islands for one year. And Hatsuka has only 500 inhabitants on the island. And there is, of course, I’m the only doctor on the island. So, you have to be on call for 24/7. If there are emergency patients, I had to call the helicopter and ride the helicopter with the patient to the main island.

Tim: Right, right. Because I imagine you’re responsible for a number of the surrounding islands.

Sho: Yes, yes, we are.

Tim: The lack of rural doctors in Japan, it’s a real problem now. Do you see technology as being able to kind of address this? For example, the Ministry of Health and Welfare is pushing hard on things like telemedicine and technology sandboxes to allow new technology to be experimented with. Do you think technology is the solution or is it more getting human doctors interested in going?

Sho: It’s both technology problem and the doctors themselves. But it’s less difficult to solve this problem in a technological matter because human beings or doctors don’t switch their ways of thinking instantly. But technology, it’s changing every day, every week.

Tim: Yeah, that’s true. You’ll certainly make faster progress on the technology front than on the human front.

Sho: Yeah, but the decision I made to go to the island, this was 2012 or so, 15 years ago. So, there was less technology, there was no telemedicine at all. So, I had to go there, I went there, and noticed that there’s a huge gap between the medicine practice in Tokyo and on the island. But I was taught in the university that Japan is the top one country which has the least discrepancy between the medical level within the nation.

Tim: Really? I believe that, I could see that. That’s something to be proud of.

Sho: But the reality was that there still is a huge gap. So, after going to the island, I want to lessen this discrepancy. And medicine is not for the rich people. It’s for the humanity itself.

Tim: In another interview you gave, you mentioned that many of the patients you treated still consulted shamans.

Sho: Oh, yes, Ishigaki and Hatsuka Islands. Yeah, it’s part of their culture.

Tim: I mean, that kind of blows my mind. This is 2026 in Japan, and was it connected to Shinto or Buddhism or older?

Sho: This is very interesting, and I respect their thoughts and culture. And we’re talking about people in their 90s or 100s in some cases. Okinawa is known for its longevity. And they trust science as well as their shamanism or their religion. They go to the doctor, they ask for medicine. But there are cases when you need to make decisions whether you should take a surgery or other alternative. Then the patient would ask the doctors, Oh, yeah, your recommendation is this is blah, blah, blah. And then before giving my decision, I want to go back to my home, ask my family as well as my shaman to support my decision making.

Tim: So, frequently in disease eradication in, say, sub-Saharan Africa, in South America, the local, let’s call it folk traditions, often hinder medical care. Was this something that was hindering care or was it more just something that was actually helping soothe the patient’s nerves?

Sho: I thought the shamanism and the religious aspect of medicine was giving relief to the patient and their family. So, it’s not like the shaman preventing the patient from getting surgery, but it’s something to value in making important decisions.

Tim: It makes a lot of sense. So, after your internship in Shibuya, and you found yourself spending a lot of time in helicopters jumping between islands, what drew you to startups?

Sho: After Ishigaki and Hatsuka, I came back to Shibuya, worked for a year, and then went to another island in the Ogasawara Islands. And I found out that there’s got to be something done to this gap of the medical level within this country. So, I went to the Ministry of Health for the internship opportunity. I went to events held by Medicine San Frontier. Also, another choice was to join or found a startup. After having all these choices in my hands, I chose to found a startup. Aillis was founded in 2017. I have a co-founder who is from the Ministry of Health. His name is Kato. I was a physician. He was from the government. And we both founded Aillis.

Tim: Well, it seems like there’s still one very important part missing here. Did either of you have a technical background or a computer science background?

Sho: No, not at all. But we two both had the common passion. So, we founded our company anyways. And afterwards, we found our CTO from IBM.

Tim: So, let’s talk about those early days. So, did you have the idea of Nodoka, the throat AI camera from the start? Or was that something that you iterated a few other ideas and wound up on that one?

Sho: We had our idea of Nodoka at the day one of our company. What we decided not to do was to develop a product that already exists. So, there were tons of X-ray AIs or CAT scan AIs.

Tim: There’s plenty of data for that, right? There’s millions and millions of radiology of all kinds available.

Sho: Exactly. So, what we wanted to do was to develop a novel product, which still has medical value. So, oral inspections was only physical. And it didn’t concern any kind of devices, which means that there are no data left after the patient is gone.

Tim: It’s just in the doctor’s head.

Sho: Exactly. So, that made sense until 2010 or 2015, because the doctor’s brain was the only processor that existed. But after 2015, the AI, machine learning, or all these technology has developed. And in order to give this data to these processors, we need the data itself.

Tim: So, how did you go about building that data set?

Sho: That’s what we focused on the first two years. So, we developed this camera without the AI. It was a plain oral camera in those days. And we provided the camera to 100 hospitals or clinics. So, all those hospitals or doctors would ask the patients for their voluntary. And the doctor would take the photo of the pharynx. And afterwards, there would be the diagnosis, right? They might use a PCR. They might use a CAT scan.

Tim: So, what was their motivation for using the camera and generating these images?

Sho: So, since this is a clinical research, it wouldn’t give the answer via AI. So, it’s all the doctor’s passion to develop the future of medicine themselves.

Tim: So, they just wanted to support medical research and see this device come into being. So, did you have to make the data set freely available? Or is it still your data set?

Sho: It’s our proprietary data set, yes.

Tim: And how many images did you end up collecting to build this AI?

Sho: We collected about 300,000 to 500,000 images. And then we developed this AI. We went through clinical trial. And then we went to the Ministry of Health.

Tim: So, it seems now that it’s also in widespread use. You’re getting more and more data coming in. And you should be seeing an increase in accuracy.

Sho: Exactly. Our database consists of millions of images for now. And Nodoka generation, we call it Nodoka 3 right now.

Tim: Now, you make both the hardware and the software for Nodoka. So, who’s producing the hardware for you?

Sho: We design the hardware ourselves. And we have a manufacturer partnership within Japan. The company is based in Nagano. They are Techno Horizon.

Tim: There aren’t many startups or small companies making medical devices. And there aren’t many companies that are qualified to manufacture them.

Sho: Exactly, yes.

Tim: So, was that a hard negotiation?

Sho: It wasn’t a hard negotiation. But it was difficult to reach out to them. So, some guy from the Nagano government had introduced us to Techno Horizon.

Tim: Okay. And I’m sure that smoothed things out quite a bit.

Sho: Yes.

Tim: That’s awesome. Let’s talk a bit about Evidence Finder. What’s your business model on this?

Sho: It’s free, as for now. In the future, we have plans. But we cannot tell this at the moment on the show. But we benchmark this company, Open Evidence.

Tim: U.S. company, right?

Sho: Yeah, U.S. Open Evidence. Open Evidence is widely used. It’s infrastructure for medicine in 2026. Their first launch was, I believe, three or four years ago. But nowadays, more than 80% of the medical doctors has their account on this platform. And this is unbelievable. But I believe this would be the way of future medicine. And it should be in this way. Because doctors are not specialists in all the fields of medicine. They cannot be. It’s impossible.

Tim: It’s impossible. Too hard.

Sho: But if you are the patient, you want your doctors to be perfect, right? So the point is that you want to be seen by a doctor who uses the AI.

Tim: Let’s break this down. Because I think there’s a very, both with Evidence Finder and with Open Evidence, there’s a big jump between using an AI-enabled medical specialized research tool and using an AI-enabled medical specialized diagnostic tool. In terms of medical research, sure, that’s useful ones. But something that could be used in a clinical setting to support a doctor during a diagnosis, during a consultation. What has to happen to make that jump?

Sho: That’s a good point. Beforehand, I want to point out the difference between the United States and Japan. There’s a law prohibiting in Japan the usage of products like Open Evidence in clinical settings. In the United States, you don’t need medical device certification for providing the product. Open Evidence is not a certified medical device. But in Japan or elsewhere outside the United States, including EU and Asia, you need a medical device certification to use in a clinical setting. So, the medical device version of Evidence Finder, we call it Evidence Finder Pro, but that would take a year or so. So, today we provide non-medical device version of Evidence Finder, which is a lookup tool used to search for clinical knowledge as well as research knowledge.

Tim: So, what prevents Open Evidence from coming into the Japanese market? Is it just a matter of getting that certification as a medical device?

Sho: Firstly, you need a medical certification. That is very, very difficult. There is no LLM-based medical device that is approved in Japan as for now. There is none.

Tim: Okay. So whoever does this first, and I assume it’s going to be Aillis, is taking a big risk. This could be something very difficult to get certified.

Sho: Exactly. That’s exactly what we have done through Nodoka, because Nodoka was the first AI medical device to go through clinical trial. This was very tough. The PMDA, the Japanese equivalent of FDA, we asked them, how could we go through the regulatory process using this oral AI camera? And the answer was, we don’t know.

Tim: That’s not what you want to hear from the regulators.

Sho: So, they are not bad guys at all. They simply had no idea or no experience regarding AI-based medical device. So, what we did was, we went to the FDA, we searched for past examples, we made a report, we handed it to PMDA, and all those steps and relationships between PMDA and us provided us a narrow, narrow pathway through the regulatory path. So, that’s what we have to do using this LLM-based AI. After three years, we’re doing the same thing.

Tim: Right, right. And so I’ve noticed you’re using Sakana AI as your engine. And David was on the show a couple months ago. Why did you choose Sakana over Anthropic or ChatGPT?

Sho: There are many reasons. But one simple reason is that Sakana provides their own proprietary AI. This is a matter of sovereignty. You know, I myself use Cloud Code. I use Codex by OpenAI. But regarding patient information, there is a risk from the viewpoint of the Japanese government of the patient information being sent to third parties. Maybe you could imagine if Prime Minister Takaichi were to be in the hospital and her personal information would be sent to Google or OpenAI, they assure zero data holding and enterprise.

Tim: Will stay in Japan.

Sho: Right.

Tim: That makes sense. And that’s not necessarily a policy. It’s just a general concern when building these kind of tools.

Sho: Exactly. And it could be Prime Minister Takaichi. It could be the president of Toyota.

Tim: Sure, sure. Yeah, yeah. That makes a whole lot of sense. You know, medical diagnostics has always been a target for AI some of the very first AI systems ever developed in the 70s and 80s, probably as early as the 60s, were these medical diagnostic expert systems. And every time they kind of follow that same pattern as they would get a lot of good press, a lot of good feedback from doctors. They’d have a positive initial rollout and then they just kind of fade away. So, what happened to them? Why haven’t these systems succeeded in the past?

Sho: It was simply a matter of the technology not sophisticated enough. But in 2020s, the era is completely different.

Tim: So in that era, they just weren’t useful enough.

Sho: No, they weren’t.

Tim: That makes sense. On the other side of that, as these diagnostic tools get more and more useful, how do you fight the human tendency to delegate? Because as something gets more and more accurate, if something is right most of the time, we humans have this tendency to trust it more and more and challenge it less and less. How do you fight that tendency? Is it something that’s going to involve changing the tools, changing the training?

Sho: This is a very important question. First thing to say, I value human touch. On that basis, we human beings need to change our mindsets. Let’s talk about automobiles or Tesla cars, maybe. So autonomous driving. People were worried about autonomous driving, right? And after they had seen evidence that they have less accidents, they still were worried. But nowadays, at least in the United States, people trust more of autonomous driving, I believe.

Tim: Well, I think there’s a really important difference. Autonomous driving, where you can 100% hand something over to a machine, is great. There’s no gas pedals, no steering wheel, just drive. That’s great. Something that’s 100% human done, that’s also fine, because the human being is paying attention constantly. But I think the danger is in something that’s mostly done by the machine and requires the human to help out. And so no matter how accurate these diagnostic tools are, the doctor has to be the one to have the final say. And so how do you combat that natural human tendency to just agree with something that’s right most of the time?

Sho: That’s a great point. The aspect that is needed in order to trust the AI is the process that the human doctors can follow the reasoning process that the AI had. This is the reason we call our product Evidence Finder. It’s not an answer finder. It’s an evidence finder. Evidence Finder might provide answer, but it also provides evidence 100% of the time. So, the evidence is not necessarily needed for the patient side, but it’s needed for the doctor’s side. The doctor is the one who’s responsible for the judgment. So, he needs to go through the process.

Tim: Okay. It’s not just providing an answer. It’s not providing a diagnosis. It’s providing possible thinking and steps that could support one or more diagnoses. All right. That makes sense. What does the future look like? The domestic market in Japan is, it’s big, but it’s limited. How are you looking to expand? Are you looking at overseas markets? Are you looking to expand into other products?

Sho: A year ago, Open Evidence was used in Europe. But in April 2026, they retreated from Europe because they needed to go through medical certification. And at the same month, ChatGPT for healthcare also retreated from the European market. So outside of the U.S., you need a medical certification. Our plan is to get the approval in Japan first, afterwards in Asia, especially Southeast Asia, and then after EU.

Tim: So, you definitely see Evidence Finder as a global product.

Sho: Yes. And the great point is that there are partnerships between Japan and Korea, Japan and India, Japan and Indonesia, Malaysia, that medical devices that is approved in Japan could be approved via QuickPath in those countries.

Tim: All right. Do you see possibly opening it up to other types of medical professionals, pharmacists or researchers, or even nurses responsible for intake and triage?

Sho: Yes, it should be. And we are aiming for that. For the patient use, we need to be more careful. It’s a sensitive matter. If we were to provide evidence, some patients might be able to comprehend, but others may not.

Tim: That, I think, is a really interesting areas. Can this be or should this be a consumer-facing, patient-facing tool? Because I know every doctor in the world is probably really tired of having patients come in after talking to ChatGPT or the internet and convinced they have some rare disease. But is this something that could be used to support patients or consumers in general?

Sho: I believe generative AI or agentic technology itself, yes, I believe so. But as Aillis would focus more on medical professionals, the tool provided to patient side could be from OpenAI, could be from Anthropic. It could be a general-purpose chat tool.

Tim: What do you see as the big difference between the two, just the amount of evidence and detail provided?

Sho: The difference lies in medical experience. For healthcare providers, disease and illness is an everyday matter, right? But for the patient, it’s not an everyday matter. It’s a once-in-a-while experience. For healthcare providers, we have literally hundreds or thousands times more experience than the patient. But if you are the patient, and if the AI tells you to do something, you cannot say something against the AI because you do not have experience.

Tim: You know, that’s a really interesting point. In one hand, you can say both the doctors and the patient want a diagnosis, but actually they want radically different things, even though we’re using the same word to describe it. What about Nodoka? This seems to be something that would be very useful in many markets all over the world.

Sho: Yeah, we want to bring Nodoka overseas. In the European market or the United States market, there are no equivalent of Nodoka as for now, so we see this as a huge opportunity.

Tim: I imagine so. Do you have a timeline for that? Is that certification on the roadmap?

Sho: I cannot clearly state that, but we have plans.

Tim: I would imagine you do, yes. But that’s fine. Let’s talk a bit about Japan in general. There is amazing biotech and medical research being done in Japan. You know, it’s being done in the hospitals and universities, but very little of it is being commercialized and turns into products. And why do you think it is that so few doctors and so few medical professionals across the board go into entrepreneurship?

Sho: That’s something we Japanese need to overcome. This could be an educational thing or environmental. I spent my childhood in the United States, in Philadelphia, and afterwards I moved to Italy, Rome. So, when I was a teenager, I lived overseas. That could be one of the reasons I founded my company. But coming back to the point, yes, I agree with you that there are tons of science Cs that have been developed through Japanese research, but there are less entrepreneurs. What we should do as Japan as a whole is to invest more on these kind of deep tech startups which is exactly what Prime Minister Takaishi is doing. And also providing environments to hold research especially talking about medicine, there are very few fields that we can practice this kind of experience. So, that’s one of the reasons that we’re using Woven City, Toyota as one of our fields. And this is an experimental city that Toyota has built just for the future…

Tim: It’s incredibly ambitious.

Sho: Yes and we try out future technologies including the Evidence Finder and Nodoka.

Tim: But when you look at the most innovative medical startups that are coming out of the United States and out of Europe, the founding team, maybe not the CEO are the doctor but the founding team usually includes doctors.

Sho: Yes.

Tim: It seems to me that if we want to create a meaningful medical innovation to mean product innovation, the doctors themselves need to be willing to move to start-ups.

Sho: Exactly, yes.

Tim: And so few do. Why do you suppose that is?

Sho: One of the reasons is that clinical doctors in Japan is a very stable career. You get paid highly. You do not have risk of losing your job. You will never be sent by your manage to move to another prefecture. You can develop your own career. So they do not have the motivation of taking risks. But at the same time, there is so little portion that you can affect the country or the system itself. You can treat your patient, but that’s all you can do in the clinical fields. Many of the medical doctors who face this problem has gone to pharmaceutical companies. That is a developed pathway. But there needs to be another branch which does not directly go to pharmaceutical companies, but goes to start-ups.

Tim: That’s true. Something really new is called for here, isn’t it?

Sho: Yes. I believe there needs to be more role models.

Tim: Well, you know, you’re out there doing it. We have a handful of other doctors who have successfully started start-ups in Japan. But it’s a small handful. Listen, Sho, before I let you go, I want to ask what I call my magic wand question. And that is if I gave you a magic wand and I told you that you could change one thing about Japan, anything at all, the education system, the way doctors think about the medical profession, the way industry thinks about risk, anything at all, to make things better for start-ups and innovation in Japan, what would you change?

Sho: If there is one thing that I can change, what I want to do is to change the people’s mind regarding responsibility and risk-taking. The traditional Japanese way of thinking is they do not want to change. You might not believe, but most of the Japanese people prefer change. They just don’t want to be the one who is making the change.

Tim: Yes, everyone likes change and disruption for other people.

Sho: Right. So, that doesn’t make sense. You want change, but you don’t want yourself to change. That’s one thing we have to change. This would affect a lot regarding medical regulation or the doctor’s way of thinking, adaptation of new technologies. You want evidence that something is safe before the technology is even introduced.

Tim: Well, I think that’s a really interesting point in that you’re right. In Japan, everyone likes the idea of change as an abstract concept and progress happening around them, but not then themselves. But do you see that changing? Because I look at it and it seems like we’re making progress there. I mean, if you look at the Ministry of Health, the large companies, all of them seem to be trying to welcome change, either with the sandbox, from the government sandbox for innovation, whether it’s large companies setting up teams to drive innovation. It seems that people are embracing change for themselves at least a little bit now.

Sho: Right. Yeah, we were making progress. And the startup will be the breakthrough maker. The startup would develop novel technology and they would have to take responsibility. Of course, Aillis has the responsibility as well. And the government themselves don’t have to develop the change. They would just provide a sandbox environment…

Tim: And let the change happen.

Sho: Exactly. You know, we Japanese people are creative and love change. Like we have tons of animes, Akira, Doraemon, and all those science fiction. But the point is that they don’t want to be the one bringing the change. So, the startup will be in that role.

Tim: Excellent. Well, listen, Sho, thank you so much for sitting down with me.

Tim: Thank you, Tim.

Outtro

And we’re back.

Sho is exactly right about how people view change. Everybody loves disruption as long as it’s somebody else that’s being disrupted.

Even Facebook, once it got to a certain size, they changed their motto from move fast and break things to move fast with stable infrastructure. Basically, move fast, but don’t break anything. Or perhaps more accurately, move fast and break other people’s things.

But as Sho pointed out, despite its reputation, Japan is just as welcoming to change as anywhere else. It just has to be packaged the right way. And it has to be supported by a system that does not result in harsh punishments for the occasional failure.

We need to create an environment where regulators can take a small step back and let the right kind of change just happen. And that seems to be what’s happening right now.

You know, Japan is really primed for its life science startups to have a huge global impact. To realize this potential, of course, we definitely need to get a lot more doctors to become involved with startups. But once that begins to happen, there is already a deep well of IP and research to draw from. There is an advanced network of clinics and hospitals and regulatory bodies that are all increasingly supportive of startup innovation.

And most important, medtech startups, startups like Aillis, are solving the most truly universal of problems. We are all human. We’re all affected by the same conditions and ailments. It’s an amazing chance for Japanese startups to become market leaders around the world by actually doing a lot of genuine good in the world.

 

If you want to talk more about medical innovation or bringing change to Japan in general, Sho and I would love to talk with you. So come by disruptingjapan.com/sho257 and let’s talk about it.

And if you enjoy Disrupting Japan, share a link online or just tell some friends about it. Disrupting Japan is free forever and letting people know about it is the absolute best way you can support the podcast.

But most of all, thanks for listening. And thank you for letting people interested in Japanese startups and VC know about the show.

I’m Tim Romero, and thanks for listening to Disrupting Japan.