Introduction

Technology evolves over time through different stages, from centralisation to decentralisation and further on to individualisation. In recent years, this trend has affected every sphere of our lives, including the food chain, accommodation, finance, transportation, safety, hygiene, education and communications. With the passage of time, humans have developed a huge variety of systems, to dispel anxiety and concerns, and to pursue greater convenience and comfort. Medical equipment is no exception.1 In the centralisation stage, the medical equipment for treatment was used only inside limited medical institutions such as hospitals under the close control and management of trained medical personnel because it was expensive and difficult to operate. It gradually became less expensive, easier to operate and more portable as a result of the rapid progress of technology and it came to be used in a distributed or decentralised manner at primary-care medical facilities such as clinics. In more recent years, it has become more individualised in the form of devices for mobile health (mHealth) and handy healthcare devices for disease prevention, health enhancement and healthcare, and has come to be used in medical care outside of formal medical facilities such as home medical care, and is even accessible to ordinary people. In the past, it was generally believed that specialist physicians provided medical care with heavily armed high-grade equipment, whereas primary-care physicians provided it with lightly armed lower-grade equipment. Recent advances in technology, however, have enabled medical personnel other than doctors to provide services with lightly armed high-grade equipment, which is quickly blurring the borderline between medical care and healthcare as it is also used even by ordinary people. This paper discusses the impact of individualised medical equipment, as observed in Japan, a country that is experiencing a rapid ageing of society, and attempts to identify specific challenges on the medical front …