Integrating medical Mobility as a Service (MaaS) with the doctor-to-patient with nurse (D to P with N) telemedicine model and pharmacist-supported medication services: Towards mobility-integrated care for Japan's super-aged population

Japan has a super-aged society, where the population age 65 years or older accounted for 29.4% of the total population as of January 2026, and population aging, depopulation, and persistent physician shortages have increasingly constrained access to healthcare. These challenges are particularly evident in rural and remote areas, where mobility itself constitutes a major barrier to care. Although home medical care and telemedicine have been promoted as policy responses, each has inherent limitations when implemented independently. Against this backdrop, the practical integration of Mobility as a Service (MaaS) with the doctor-to-patient with nurse (D to P with N) telemedicine model has emerged as a policy-related approach to delivering multidisciplinary care under conditions of limited medical and transportation resources. In several municipalities in Japan, including early implementation sites such as the City of Ina, medical MaaS-based mobile healthcare initiatives have been implemented to reduce travel burdens while improving accessibility for patients with mobility challenges. From an implementation perspective, these initiatives demonstrate a growing convergence between medical MaaS and the D to P with N telemedicine model. Physicians provide remote consultations while nurses offer on-site clinical support, with telemedicine further linked to pharmacists' online medication counseling and medication delivery services. In practice, this integrated approach, which includes routine consultations, renewing prescriptions, and basic clinical monitoring, is primarily used for the stable management of chronic diseases and is mainly targeted at older patients receiving home-based care. By covering the care continuum from consultation to medication support, this approach aims to reduce patients' travel burden while ensuring the continuity of multidisciplinary care. Despite its potential, key challenges remain, including operational costs, data governance, and emergency response requirements. Overall, integrating medical MaaS with the D to P with N telemedicine model and pharmacist-supported medication delivery represents a significant step towards mobility-integrated care and may serve as a complementary component of community-based integrated care systems.