In recent years, municipalities across Japan have been focusing on promoting healthy life expectancy to solve one of the problems arising from two societal issues: a super-aging society and a declining birthrate. Maintaining a healthy mind and body that allows for an unimpeded daily life leads to curbing medical costs and revitalizing local communities. Regardless, being healthy is something most people desire, as it allows them to live and work without anxiety.

Spinometer, developed by GET BACK Inc., a startup from Tohoku University's Department of Orthopedic Surgery, is a posture estimation app aimed at improving and preventing chronic stiff shoulders and back pain caused by poor posture. Using proprietary technology, it estimates the condition of the spine and posture from just a webcam video of the face, encouraging continued use through real-time poor posture alerts, stretch suggestions, and posture visualization. It's a business perfectly suited for our times, supporting a long and healthy life from our daily routines.

The company's representative, Dr. Isao Hashimoto, is a medical doctor who serves as an Associate Professor and Chief of Spine Surgery at Tohoku University's Department of Orthopedic Surgery. He has accumulated knowledge and experience in the medical field for about 25 years. Even now, he is a leading clinical physician for the "spine," handling over 100 highly difficult spinal surgeries annually, while also being personally involved in software development and its real-world application, leveraging his deep understanding of medical devices and AI technology.

We spoke with Dr. Hashimoto, who is developing software while also being an entrepreneur and working in the medical field, about his motivation, the goals he aims for, and the details of his business.

The Precision of the Software Before Medical Verification Gave Me Hope: "This Might Just Work"

    Could you tell us how you came to develop software while working in the medical field?

    Hashimoto: The idea for Spinometer itself wasn't mine; it was brought to me by a member from the engineering department at Tohoku University. About five years ago, I was asked if I could help verify a prototype of the Spinometer, an app that could determine posture from the angle of the head and the distance between the eyes and the PC screen, from a medical standpoint. The reasoning was that "without medical verification, its credibility is low," and the request came to my boss at the time. He then said, "Since it's about the spine, Hashimoto, you should handle it." So, the beginning was really a matter of fate and luck. Some of the members who brought the idea are still involved with GET BACK today.

    What was your first impression of the software?

    Hashimoto: The software was from a team member who had won an award at a global student app development contest. When they brought it to me, they also consulted me about commercialization, saying, "'We want to make it something like, 'Using this device will cure stiff shoulders.'" However, linking it directly to symptoms is quite difficult, so I replied, "That's probably not possible right away" (laughs). So, we decided to start by conducting motion analysis experiments for verification.

    How were the verification results?

    Hashimoto: I considered what could be done with the two variables—the tilt of the head and the distance between the eyes and the PC screen—and it seemed possible to estimate the shape of the back itself. So, when we conducted the experiment, we were able to estimate it with quite high accuracy, which made me feel like, "This might just work."

    Were the results better than you imagined?

    Hashimoto: They were better than I expected. We estimate the angle and inclination of each part of the spine from the two variables of head tilt and eye-to-screen distance, and I was surprised by the very high correlation and coefficient of determination. We wrote a paper based on that estimation formula, which was published in an international scientific journal this year.

A Clinician's Perspective on the Importance of 'Preventive Medicine' and Business Potential

    What was the reason for you, as a doctor, to participate in the commercialization of Spinometer?

    Hashimoto: In the field of ergonomics, research shows that poor posture while sitting is a major cause of back pain, and by extension, lower back and shoulder pain. Since the COVID-19 pandemic, a survey found that the time spent in front of digital devices like computers and smartphones has increased by 5.5 hours per day. Lower back and shoulder pain caused by poor sitting posture has become a global issue. As surveys by the Ministry of Health, Labour and Welfare show, Japan originally has a very high number of people complaining of lower back and shoulder pain. It is said that Japanese people have some of the longest sitting times among OECD countries, which is likely related.
As a doctor, I treat lower back pain, stiff shoulders, and neck pain in the clinic, but many people already have fully developed symptoms when they come to the hospital. I had a desire to do something before it gets to that point, and I was already involved in preventive medicine, so I saw great potential in the Spinometer.

    So, your motivation was both your conviction as a doctor and the market need.

    Hashimoto: There are various health devices and services out there aimed at improving posture, but it's questionable whether they are truly effective, and many haven't been properly verified for accuracy. In that respect, I believe Spinometer's credibility can be guaranteed because doctors like us are directly involved. Also, many health devices need to be physically worn, which can be a hassle. Some people can't continue because of that. But with Spinometer, as long as your computer is on, it monitors you automatically in the background. You can set it to start automatically when the computer boots up. Things that are a hassle tend not to catch on, so the fact that Spinometer is effortless is a major advantage. As I mentioned earlier, in the world of ergonomics, it's recognized that alerts from apps and such are also effective in improving posture.

    So, in terms of reaching more people, Spinometer has its strengths.

    Hashimoto: As a doctor, I want to provide something that helps "prevent people from getting sick" and "prevents their condition from getting worse," preferably to as many people as possible. With that in mind, I have been engaged in clinical practice and surgery for many years, but for example, a single doctor can perform surgery on at most about 10,000 people in a lifetime. However, an affordable app has the potential to contribute to tens of millions of people. Also, most research by doctors ends with publishing a paper, but I wanted to see it through to social implementation and give back to society. That was another factor that led me to participate in the business.

    So, app development leads to improving the symptoms of more people as a doctor. Considering that people all over the world could potentially become users, it seems like a viable business.

    Hashimoto: Yes. That's why we are also working on multilingual support for Spinometer. With English, Spanish, and Chinese versions, we can cover roughly 40% of the world's population. The theme of an upcoming international medical conference on the spine that I will be attending is "The Impact of Prolonged Sitting on the Spine." With the spread and evolution of digital devices, spine and posture issues have become a global problem. Presenteeism, the state of being at work but having reduced productivity, is one indicator of a company's productivity decline due to health problems, and neck and back pain are major causes. From that perspective, I feel there is high demand for Spinometer not just for B2C, for people who want to improve their back and shoulder pain, but also for B2B. If we can further increase the accuracy of Spinometer, I believe it could become a global platform for posture improvement.

Creating a 'Third Option' for a Doctor's Career: A Challenge in the Business World

What motivated you to apply for the ICT Startup League?

    Hashimoto: Of course, the reliability of it being a project backed by the Ministry of Internal Affairs and Communications and the financial aspect were appealing, but the hands-on support in management was a major attraction. While doctors who open their own clinics or manage hospitals are sole proprietors or managers, doctors have very few opportunities to learn about management or finance. I think it's quite risky to run a business that way, and in fact, some get deceived. I also wanted to do something about my own naivety when it comes to business and management.

Were you originally interested in entrepreneurship?

    Hashimoto: People outside the industry might not be familiar with a doctor's career path, but to put it simply, there are two options: continue as a salaried doctor in a hospital or become a private practitioner. In reality, most doctors follow one of these two paths. I questioned why a doctor's career is practically limited to these two choices, and I have a desire to break new ground with a different career path. When I was a young doctor just starting out, I didn't think much about it, but later I went abroad to study for basic research. There, I got a glimpse of various companies and the business world, and from my mid-30s, I started to think more about my career as a doctor.

    Specifically?

    Hashimoto: Doctors tend to live in a bubble, and it's possible to function entirely within the medical industry. But I didn't want to end there. I wanted to learn the mindset of business professionals. Conversely, I thought my knowledge and experience as a doctor could be useful in companies in other industries. Since I was doing research related to preventive medicine, I thought it would be great to have interactions like developing services or products that "prevent illness." The establishment of "GET BACK" is, in a way, me putting that into practice.

    You are a doctor and researcher at a university. In recent years, there has been a lot of movement toward establishing university-based ventures, and Tohoku University, where you are affiliated, has always been proactive in supporting industry-academia collaboration and the creation of university-launched startups. Was that environment also a driving factor?

    Hashimoto: Yes. Tohoku University is a national university, and we are also considered quasi-public servants, so there are restrictions, but the university has been fundamentally supportive.

    What are your impressions after actually trying your hand at management?

    Hashimoto: Since Spinometer has not been fully commercialized during its development phase, I haven't yet encountered severe management problems. However, when thinking about it as a business, I've come to strongly feel that "just because it's a good product doesn't mean it will sell" and "just because its reliability is proven doesn't mean it will sell." Marketing is essential to break through that barrier, but it's tough and difficult. Even managing social media, I suppose doing it blindly won't work. That's why I'm encouraged by the prospect of receiving advice from marketing professionals at the ICT Startup League.

Improving Posture by "Praising to Encourage Growth": A Future Partner That Supports Its Users

    Please tell us about the future development, challenges, and vision for Spinometer.

    Hashimoto: Spinometer is software with a strong "preventive" aspect, but prevention is not a burning need—it's not something that people who are in trouble will jump at to solve immediately. As a business, I feel we need to address that part. This relates to the marketing I mentioned earlier, and it will be important to raise awareness and highlight its necessity in the media. On the other hand, I think it's also important to further advance social implementation experiments.

    Having it used in society and daily life?

    Hashimoto: Yes. In February 2025, Spinometer won both the Grand Prize and the Approach Award at the "MATSUE Tech-Product Award 2025," a business contest for IT-related technologies hosted by Matsue City, Shimane Prefecture. At that time, the mayor of Matsue, who was a special judge, suggested, "It seems useful for labor management, so why don't you try an implementation experiment at the city hall?" Through such experiments, I want more people and companies to use Spinometer and experience improvements in neck and back pain, a better quality of life, and increased work productivity. To achieve that, the software's specifications will need to be refined with more attention to detail.

    Specifically?

    Hashimoto: For example, with the real-time poor posture alerts, I want to focus on "Good" rather than "No Good." People tend to lose motivation and get annoyed when they are criticized, right? (laughs). So, rather than just warning, I want to emphasize conveying "Good job" when their posture improves. I want to send out positive messages as much as possible, like "You did great today, that's good," to skillfully boost the user's motivation. The visual representation of the spine's condition is currently just a stark skeleton, but we could change it to a cute character avatar. How should I put it... make improving posture a more upbeat and fun experience? (laughs).

    Given the nature of the service, it's more like a partner that accompanies you in life rather than just a product, so those aspects are probably important.

    Hashimoto: From that perspective, we don't know how long humanity will continue to sit in chairs and face computers. Changes will be necessary according to new devices, so in the long term, we should also be conscious of responding quickly to problems that arise from changes in the times.
The appeal of being a doctor is being able to directly help people. One of the reasons I chose orthopedics was the high degree of direct connection between the treatment results and the patient's recovery. It's rewarding to provide direct value to patients and see them heal and improve. I want Spinometer to be a service where users can always feel that kind of value. I also get the impression that business is something that will eventually blossom if you keep at it, so I want to continue working with the mindset that there is significance in continuing.