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An Interview with Dr. Sébastien Lechevalier
Professor, L’Ecole des Hautes Études en Sciences Sociales (School of Advanced Studies in the Social Sciences; EHESS)
Founding President, Fondation France-Japon de l’EHESS (FFJ)
Care-Led Innovation in Eldercare: A Three-Year Franco-Japanese Project Enters an Exciting New Phase
Japan-Insights met in Tokyo recently with Dr. Sébastien Lechevalier, a labor economist and professor whose work addresses innovation, institutional change, and public policy. As president of a foundation that promotes scholarly exchange between France and Japan, he also leads INNOVCARE, a multidisciplinary initiative supported by TIFO that aims to put well-being at the center of technological innovation, particularly in the field of eldercare. The project has grown to involve 60 individuals from 18 member institutions, seven of which are in Japan. Now in its third year, it is entering a new phase where the research being done may eventually inform national policy goals in France with regard to the long-term care of older adults.
Interview by Susan Rogers Chikuba
Launched in 2021 and uniting researchers and practitioners in the social sciences, medicine, robotics, demography, and engineering, INNOVCARE is a project coordinated by the Fondation France-Japon (FFJ), an organization for scholarly exchange between France and Japan that is affiliated with the School of Advanced Studies in the Social Sciences (EHESS), headquartered in Paris. Led by FFJ founding president Sébastien Lechevalier and supported by TIFO since its inception, INNOVCARE aims to develop an alternative, care-led framework for innovation as it applies to the long-term care of older adults. Reassessing what well-being and autonomy should ultimately mean from a public policy perspective, its research teams are examining better ways to integrate real social and individual needs with the possible technological responses offered by such tools as robotics, medical devices, and information and communications technologies including AI.
I’m fully convinced that we can improve the technology, and I’m also fully convinced that we should not focus only on the technology. We need the human side, the well-paid staff, the warmth of communication. This sort of hybrid solution is important.
As a labor economist specializing in forms of Asian capitalism and institutional change, Lechevalier had not set out with any particular interest in eldercare, nor questions about well-being. “Fifteen years ago I was studying robotics used in manufacturing,” he explains. “It was when they had just started to move robots outside of plants to begin looking at other applications, and eldercare was one of them. Initially I had no particular interest in that, but, coming from the viewpoint of innovation as I did, I looked at what they were doing and felt the model was wrong—you cannot apply innovation to eldercare in the same way you might in fields such as electronics or machinery. My thesis was that if you try to adapt the same manufacturing model to the case of care, then the probability of failure is 100 percent.”
By the mid-2010s, Lechevalier was engaged in a project called “Innovation beyond Technology,” whose findings he later compiled into a book of that title: Innovation beyond Technology: Science for Society and Interdisciplinary Approaches (Springer Singapore; 2019). Presenting detailed case studies from diverse sectors about equally diverse technologies, it afforded him the opportunity to critically reconsider the inter-relationships of science, technology, innovation, and society.
“In that book we were a little critical of the dominant model of innovation,” Lechevalier says. “There is a tendency to let engineers develop wonderful technologies on their own and, once that is done, to say ‘Now let’s make it acceptable. Let’s convince people they should use it—it’s for their benefit.’ Our view, which is not unique, is to proceed the other way around. We should involve, from the beginning, engineers who have the knowledge, the capability, to develop several types of technologies—but let’s start with the recognition of needs that have already been identified, and ask the engineers to build their technological solutions around them.”
The potential theoretical contributions of the project are, on the one hand, to integrate technology, engineering, sociology, and innovation. And on the other, to mobilize what we call a care-led approach
—to emphasize that inter-relation, communication, and sociability are essential to our well-being.
While technologies such as robotics, AI, and digital applications can help to facilitate the autonomy of older adults, they can also be inherently difficult to use, and pose ethical concerns as well. “We have a responsibility to question what we are doing in terms of innovation,” Lechevalier says. “Innovation is not always good—we may expect that it is for the benefit of society, but some innovation is potentially detrimental to freedom, to well-being.” At the same time, he points out, decision-makers must bear in mind that technology is no panacea for social issues. “You can have the best technology, but if your society is not ready to accept equality between women and men, for example, then you can imagine that with any type of technology you introduce, you will still have gender inequality. Some social problems have to be dealt with by people themselves.” As they conduct the studies that will enable them to formulate proposals on the technologies and care-led processes that will benefit recipients of care, familial caregivers, and professional care workers alike, INNOVCARE researchers are looking as well at the systemic and structural issues that must be overcome. At the same time, some are deeply engaged in research on the subjective, emotional aspects of eldercare and care settings.
In the project’s first year, the work centered on analyzing what policies and practices would place well-being at the center of innovation. In year two, project members looked more specifically at the use of robotics and other technologies for eldercare, and began to examine the diverse needs found within actual care settings. Now, in its third year, the initiative has assumed a still larger scope. Selected by the French government as a priority national research program with regard to aging, autonomy, and disability, it has been made part of the “France 2030” investment plan for the next five years (2024–2028). INNOVCARE researchers are now tasked with developing blueprints that could inform national policy goals with regard to long-term care.
“This is a priority for France in that we are an aging society, although not at the same pace as Japan,” Lechevalier explains. “Nonetheless, we look at Japan and think maybe in the future we, too, will look like this. So we have to invent a social system that will help people age with dignity, at a social cost that we should accept. Which is to say, if we are a civil, humane society, then we should accept that society as a whole is responsible for individuals’ ability to age with dignity. We are challenged to understand what, exactly, autonomy is for older adults. What does it entail? How do you define it, and what should your targets for long-term care be?”
For the questions surrounding eldercare that we are addressing in this program, we need the mobilization of the entire society.
For care-led innovation to happen, Lechevalier says, the input of all stakeholders is necessary. “We need scholars, we need caregivers, we need elderly people themselves, we need local communities. We need large companies, we need smaller companies. We need social economy—non-profit economy—and we need to create a platform where all of these stakeholders will collaborate for the benefit of society.” Lechevalier adds that while EHESS faculty are accustomed to formulating interdisciplinary research projects within the social sciences, INNOVCARE requires collaboration outside of those disciplines, too—with engineers and medical doctors, for example. It will be critical, he says, to establish borderless platforms of engagement that do no replicate those divisions. Doctors have their own matrices and ways of thinking about the social needs and vulnerabilities of the elderly, as do demographers, who use other indices. To address this, the project will hire early-career researchers and require that they be mobile across different work teams. In this way they will be exposed, for six months to a year at a time, to a variety of issues and diverse approaches to solving them. “If we are able to educate 15 to 20 young international researchers with such skills, then—let me be a little optimistic—we will have people with great ideas and the right skills to implement them,” he says.
There is a high level of complementarity between Japanese and French colleagues in the field of robotics. Our Japanese collaborators are very strong in the manufacturing aspects and applications, while the strengths of the French, who have a good reputation in mathematics, lie more in programming and abstract development, including AI.
While the project incorporates a comparative perspective between France and Japan, Lechevalier is quick to assert the fundamental view that a Franco-Japanese connection is nothing exceptional or unique. As someone who has been closely involved with Japan for 25 years since his days as a post-graduate researcher, to Lechevalier collaborations among Japanese, French, and other European scholars should only be seen as a matter of course. Indeed, opening new avenues for scholarly exchanges with Japan has been a personal passion that led to his establishment of FFJ back in 2009. “INNOVCARE is French-founded, so it’s very French-centered, but definitely we want to involve Japan as we would any European country. It has been my dream for 15 years that collaborations between Japanese and European scholars should be natural, including in the field of social sciences. It should be natural for many Japanese scholars to be visiting Paris, gathering and developing joint research, and this is a dimension of the project that we are trying to develop. It’s so natural to collaborate—we have different backgrounds, we have different ideas, but fundamentally we have the same values.”
The fact that Toshiba International Foundation has supported, from the beginning, a project that is interdisciplinary, international, and intersectoral is, for me, quite symbolic of the values it is promoting as a foundation. Our small foundation shares these same values. Now, it’s our responsibility to go into the field and really engage in this research.
The third annual INNOVCARE forum held in November 2023 opened with a panel introducing practices and research methodologies implemented in Japan. As a springboard for the project’s ongoing work in formulating public health scenarios and policies, faculty of Sophia, Doshisha, and Nihon Universities and a research fellow with Japan’s National Institute of Public Health delivered presentations on measures and challenges related to dementia; medical expenditures for home-visit services versus outpatient, short-stay, residential, and in-facility care options; legal provisions for workplace flexibility with regard to family caregiving responsibilities; and a research methodology that utilizes administrative metadata from insurance-claim records to produce longitudinal projections of healthy or disability-free life expectancies. These talks were followed by a panel on new perspectives offered by early-career French scholars, and a roundtable discussion to map out the research agenda, work methods, and targets of INNOVCARE for the next five years. As the event effectively marked the start of a new stage for the project, with expanded resources and a larger consortium now made possible by its designation as national research program, delegates affirmed their commitment to expanding the established Franco-Japanese collaborations, and to welcoming the wider involvement of researchers from other countries in Europe. INNOVCARE teams are now turning in earnest to the fieldwork that will shape the project’s future proposals on innovative and sustainable care solutions for adults in an aging society.