HxD Winners
Five finalists in the ACCJ’s digital healthcare competition show that innovation is alive and well in Japan
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As we enter the third year of the coronavirus pandemic, two societal needs have become crystal clear: healthcare and digitalization. These could be seen as distinct domains, and in some respects they are. But the combination of the two could bring some of the most impactful changes to Japan and the world by improving the quality of life, reducing the cost of care, and allowing society to better cope with future crises.
Bringing them together is exactly what the American Chamber of Commerce in Japan (ACCJ) has done with its Healthcare x Digital (HxD) initiative, which began in 2020 and reached new heights in its second year. HxD leaders Torsten Kanisch, Francisco Proaño, Christian Boettcher, and Yasuhiko Iida, with the support of the ACCJ’s Kansai chapter, followed up the very successful inaugural competition by boosting submissions 30 percent.
Ideas Day 2.0
Forty companies submitted entries and 10 were selected to participate in the Pitch Day virtual event on October 14. Five finalists then took part in the HxD Ideas Day on November 11, a hybrid in-person and virtual event with a panel of leading healthcare and pharmaceutical executives—all empowered to initiate business deals and new relationships on behalf of their global brands.
Opening remarks were delivered by AstraZeneca K.K. Representative Director and President Stefan Woxström, who welcomed the more than 300 online attendees and many others who attended in person.
After thanking the healthcare professionals and companies working to develop solutions and care for patients during the pandemic, he shared a bit of Innovation Infusion Japan’s background.
Known as i2.JP, the open innovation initiative connects healthcare professionals, local governments, academia, and private companies, helping them jointly work out collective, practical, and optimal answers to issues in the field of healthcare. The initiative was founded in 2020 and has rapidly grown from seven participants to 130.
“I want to emphasize that this is an open innovation network: anyone can join, it doesn’t matter where you are,” Woxström said. “You don’t have to collaborate with those who started the network, you can collaborate with anyone. That’s the beauty of it, and that’s why it is also starting to produce a lot of solutions for patients.”
He also noted that i2.JP has become a gateway through which startups are entering Japan. “Because they don’t know where to go, who to connect with, they contact i2.JP and find partners who help them come to Japan with their solutions.” He hopes it will flow the other way as well, with i2.JP assisting Japanese startups as they branch out globally.
Setting the stage for the finalist presentations, Woxström said: “What we are going to experience today is what happens when startups, academia, the private sector, and policymakers come together and start working, because that is what is going to create new solutions for the future of healthcare in Japan.”
Goals
Then-ACCJ President Jenifer Rogers spoke next, noting that HxD Ideas Day is “the culmination of a months-long efforts by healthcare leaders and innovators with a shared mission: to solve critical healthcare challenges and improve the lives of patients.”
HxD 2021, she explained, advances the goal of driving innovation in Japan’s healthcare ecosystem by focusing on three areas:
- Overcoming the urban–rural healthcare divide
- Reimagining the hospital of the future
- Empowering patients to own their healthcare
“These areas tie into the digital transformation of society and can help Japan continue to take care of—and provide even better care for—all its citizens,” she added. “Digital transformation [along with] sustainable society and healthcare were two of the ACCJ’s main strategic goals even before the onset of the Covid-19 pandemic, which has accelerated the need for digital and healthcare plans around the world.”
Professor Hiroaki Miyata, of the Keio University School of Medicine’s Department of Health Policy and Management, echoed the belief that the pandemic has driven greater understanding of the need for digital transformation and sustainable healthcare. Speaking after Rogers, he wore a shirt that mirrored the colors of the i2.JP logo, which he said was his way of honoring the diversity championed by the group.
“The pandemic is a turning point for civilization,” he proclaimed. “Particularly in Japan, in terms of digital, the country had ranked 27th or 28th in competitiveness around the world and had to face this situation.”
Noting that Japan, as an island nation, was long isolated from the world, he said that facing these challenges and being forced to embrace a connected world and digital transformation—to grow together in this ecosystem—is important. “In that sense, i2.JP and HxD [represent] growing together in the global environment, so these opportunities are very important for us,” he explained. “And all of you here are going to take a new step that is going to be important for Japan and the world.”
Expert Insight
Saving the finalist presentations—the highlight of the day—for last, the middle section featured a wide range of presentations from experts. Five keynotes followed Professor Miyata’s comments:
- Yoshihiko Izumida—a professor in the Saitama Medical Center’s Department of Endocrinology and Diabetes, as well as representative director of Saitama Medical and chairman of the Life Course Design Association—gave a presentation entitled Global Standardized IoT Platform for Promoting Open Science
- Ryosuke Fukuda—deputy director of the Health Policy Bureau’s Medical Professions Division and director of the bureau’s Planning and Coordination Office for Physician Training in the Medical Professions Division—talked about recent topics in online medical care guidelines
- Jun Miyagawa—general manager of Kansai growth strategy in the Growth Business Development Department of Sumitomo Mitsui Banking Corporation—shared a presentation entitled Accelerating the Formation of a Venture Ecosystem in the Kansai Area: Trends in Innovation in the Run-up to the Osaka-Kansai Expo
- Takeru Yamamoto—board director and chief operating officer at Welby Inc., talked about the current and future prospects for personal health record platforms
- Lei Liu, PhD—innovation partnerships and i2.JP director of commercial excellence at AstraZeneca K.K., recapped the open innovation initiative’s successes in its first year, looked ahead to the future, and introduced HxD and its achievements
After the keynotes, a panel discussion involving the keynote speakers, moderated by Liu, covered current trends in, and future prospects for, digital innovation in healthcare.
Next, the five finalists made their last pitches.
Medii, Inc
First to present was Medii, Inc Chief Executive Officer Hiroki Yamada, a rheumatologist who is himself a patient coping with an intractable disease. His own experience led him to become a specialist treating arthritis and other musculoskeletal conditions and systemic autoimmune diseases, and to search for a way to bring better care to patients and support local doctors across Japan.
Specialist doctors in his field, he explained, may be difficult to find outside of the largest cities. While there are 759 in Tokyo, 32 of Japan’s 47 prefectures have fewer than 75. “In terms of the population, there is a 50-fold difference in the distribution of specialist doctors. We have to do something about this,” he said.
“There are so many undiagnosed patients who are not receiving proper treatment—they are simply overcoming their symptoms. This is the challenge we are facing and that we must overcome.”
Medii would like to create a National Intractable Disease Center so that the latest and most effective treatments can be delivered to patients. About five percent of the people in Japan suffer from such ailments.
The company’s focus is on the issue of doctor’s knowledge about intractable diseases, because supporting local physicians is one of the best ways to help patients.
Medii is offering a service called E-Consult, a digital resource powered by artificial intelligence (AI) that enables the sharing of expertise about rare diseases with doctors who are not specialists.
Doctors in the local community who are trying to diagnose a problem, but who do not possess knowledge of these rare diseases, can be matched with an expert through E-Consult. More than 500 specialists are working with Medii to provide assistance through the service that is a bit like the LINE messaging platform, which is dominant in Japan.
Doctors can be matched on a real-time basis for one-on-one chats and images can be exchanged securely. A response is received within 42 minutes and the level of satisfaction has been as high as 93 percent.
“For instance, in the remote islands, the doctor may be working all on his own, and he has to take care of patients with many diseases,” Yamada explained. “And yet, by using our platform, even though he may be working on a solo basis, all these specialists can support him, and better diagnoses and treatments can be offered to his patients.
“We cannot do this alone, so together with the support of the pharma companies—and for the benefit of the patients and the doctors and the specialists—I would like to further grow this platform,” he continued. “Our team is putting all its efforts into this, and I hope you will all join hands together for this endeavor.”
Immunosens Co., Ltd.
Next, Hirokazu Sugihara, CEO, representative director, and president of Immunosens Co., Ltd., shared his vision for more efficient testing that can close the time gap between diagnosis and treatment.
“Our first target is cardiovascular diseases,” Sugihara said. “As the Japanese population ages, the number of patients with such diseases is on the rise, and treatment accounts for 20 percent of national medical costs.
“When your condition is poor, you go to a primary care physician to find out what is wrong and if there is a risk of disease,” he continued. “Various exams may be performed, and right now tests are outsourced.”
That time lag—typically one to three days—can make a big difference in the outcome for patients. At a minimum, it requires them to make an additional trip to the hospital or clinic and, in some cases, it may prevent the doctor from providing proper treatment.
Immunosens’s solution is a high-performance point-of-care testing (POCT) system that utilizes a technology that the company calls GLEIA, an acronym for gold-linked electrochemical immunoassay.
This lateral flow test technology uses a printed electrode to trap disease markers in the sample by immunoreaction and then sandwich the markers with gold nanoparticles. If a disease marker exists, it will gather near the printed electrode. Ultra-sensitive detection of gold nanoparticles on the printed electrode is achieved through an oxidation and reduction process. This electrochemical measurement can be completed with a single cartridge, enabling quick and efficient measurement with results in just 10 minutes. The easy-to-use, disposable GLEIA sensor is much smaller and cheaper than existing equipment, but detection sensitivity is equal to, or higher than, that of current processes.
The product weighs just 0.1 kilograms and costs between ¥10,000 for a model designed for home use and ¥50,000 for one aimed at clinics. Compare this with existing equipment, which weighs 10–100 kilograms, costs between ¥3 and ¥10 million, and takes as long as two hours to read a sample. Also, current equipment requires a 100–200 microliter sample whereas the GLEIA solution needs just 2–20 microliters.
The device for home use allows patients to measure their condition every four days if they are unstable, or every 23 days if stable. Currently, new measurements are taken once every six months, on average, at a hospital.
Steady development has been underway since 2018 and the first product is scheduled to be launched in the second half of this year. Mass production is targeted for 2025.
Oishii kenko Inc.
With a name meaning “tasty health,” Oishii kenko’s goal is “to contribute to health and healthcare issues through delicious solutions and dietary management,” explained Chief Executive Officer Tetsuya Nojiri.
Scientific evidence has shown that an optimized diet is key to reducing healthcare costs, preventing diseases, and supporting the treatment of existing ailments.
But, as Nojiri noted, controlling one’s diet is easier said than done. He explained that, while 80 percent of Japanese households prepare their own meals every day, it is challenging to plan a nutritionally balanced menu. And if you have dietary restrictions due to illness, doing so becomes even more difficult.
“To whom do you turn for help?” he asked. According to the company’s research, 85 percent of physicians say that they are consulted about diet by their patients, and 90 percent of that group admit that they lack the knowledge and time to provide such guidance. This is where Nojiri feels Oishii kenko can make a difference.
“There is a position called certified dietitian, but 84.4 percent of hospitals in Japan do not have anyone in this role. So, while patients want to improve their dietary life, there is no one whom they can consult,” he explained.
Oishii kenko believes that dietary management is possible in the home, and you don’t need a dietary specialist sitting next to you to make it happen.
“We need to trigger the understanding and desire to eat healthily, and that is what we want to provide through our personalized recipe and nutrition management app, supervised by a registered dietitian,” Nojiri said.
The AI-powered recommendations provide nutritionally balanced meal options, and a shopping list is created automatically. More than 60 health issues can be managed through the 10,000 recipes found on the app.
In addition, the app offers previously unavailable insight into the habits and preferences of people with similar health challenges. This is thanks to Big Data from more than 40,000 users that allows nutritional trends to be surfaced.
As an example, Nojiri shared that, according to the data, female diabetics may have a tendency to like spicy food, while male diabetics eat a lot of meat and dislike fish.
“This is different from the expected behavior of diabetics,
so using real-life data … and based on the preference of the individual, we can suggest good dietary management tailored to each person,” he explained. “Through the app, we hope to change behavior that helps pharmaceuticals to work their best.”
Lanex Co., Ltd.
One example of a traditional practice in Japan that could benefit from digitalization is the maternal and child-health (MCH) handbook. This printed booklet is used to track the results of pregnancy and post-birth health checks.
Lanex software developer and project manager Boubacar Sow shared the company’s electronic version of the process—the E-MCH—explaining that “we empower doctors to manage data generated during pregnancy through virtual consultation, interoperability, and maternal decision support.”
Under the current system, a woman who is expecting visits the doctor and receives a document which certifies that she is pregnant. She then takes this paper to the health center at the ward office and receives the MCH.
Using Lanex’s E-MCH system, she would register during her first visit to the hospital and receive a unique identification number issued by the local government. Login credentials are also provided so that she can download and begin using the system immediately.
At every checkup, data is added to the E-MCH and is accessible via the web portal and smartphone app.
“We believe we have a special system, because it is not simply a pregnancy tracker, but also an ecosystem to digitize maternal and child healthcare,” Sow explained. “We help the local government provide a unique identification number to better track those who are pregnant. It’s special because we have a knowledge base, the contents of which are provided by maternal and healthcare experts from Miyagi University.”
Lanex, founded in 1993, has offices in Japan, the Philippines, Australia, and the United States, and has been developing high-quality software for more than 28 years. It is targeting countries that are unable to meet United Nations Sustainable Development Goal 3: ensure healthy lives and promote well-being for all at all ages, as well as every medical institution that provides maternal and child healthcare in both developed and developing countries.
In May 2021, the E-MCH was adopted by the Japan International Cooperation Agency (JICA) as an innovative product to solve a public problem, and Lanex received financial support from JICA to conduct a survey in African countries.
The web system requires a small payment by the hospital, while the mobile app is free for mothers.
CardioCouple
The final presenter was Ayush Balaji, an 18-year-old from Japan, who is a first-year medical student at the University of York in the United Kingdom. He came up with the idea for a pulsatile percutaneous circulatory assist device for those with heart failure during his last year of high school in Japan.
“I’ve taken inspiration from nature—with animals, such as octopi, which have branchial hearts—and I looked at adopting a resilient network-based solution to heart failure,” he explained.
Cephalopods have two branchial hearts, one located at the base of each gill. The two branchial hearts push oxygen-depleted blood through the gills, thereby supplementing the function of the systematic heart, which pumps the oxygenated blood throughout the body. Similar systems are found in insects and other animal species.
“The biggest issue we have at the moment is heart failure, or cardiovascular-related diseases. There are 64 million cases of heart failure per year [worldwide], and cardiovascular disease is the most common cause of death,” he continued. “The only treatment available at the moment for heart failure is a heart transplant. Between diagnosis and transplant there is an extended waiting period, and during this time the quality of life for patients is significantly reduced.”
Balaji has designed a device called the CardioCouple that focuses on forestalling a reduction in the quality of life between diagnosis and transplant. The aim is to allow patients to lead lives that are as close to normalcy as possible.
He noted five problems with current surgical approaches:
- High rates of infection and complications
- Reduced patient mobility and access
- Hemolysis complications (destruction of red blood cells)
- Lack of resilience
- Foreign material contact and proximity to the heart
How does CardioCouple fix this?
A network-based approach uses small pumps in multiple location around the body to reduce fail rates, provide resilience, and increase mobility. No components come in direct contact with blood, which increases longevity of the devices and reduces the risk of hemolysis-related complications. And, while some surgery is required to implant the devices, major open heart surgery is not needed.
The result is improved quality of life and outlook, more time for physicians to plan further intervention, reduced cardiac afterload and stroke risk, and the ability of patients to resume normal life without the need to manage bulky external apparatus.
In terms of digital healthcare, dedicated software allows data from the device to be utilized, and physicians and patients to control the device in real time. The pump rate can be managed remotely, and physicians can set operational limits so that the patient can adjust the pump rate themselves when needed. Plus, physician access to real-time data on pump performance and patient parameters ensures the maintenance of the device and patient health.
“All these things come together to provide a more reliable, efficient, convenient, and cost-effective device, as it does not rely on significantly new advances in technology and the complication rate is not as high as what exists today,” said Balaji.
“This translates to a lower strain on healthcare budgets, improves profit margins for pharmaceutical companies due to lower complication rates, and provides patients with better control over their health.”
Impressive Breadth of Ideas
Following the presentations, Deloitte Touche Tohmatsu LLC Senior Partner Christian Boettcher moderated a panel discussion during which the five finalists talked with AstraZeneca’s Woxström and Eli Lilly Japan K.K. President and Representative Director Simone Thomsen.
“This year it was very impressive to see the breadth of ideas,” said Thomsen, congratulating the finalists. “I feel the true patient-centric passion is coming through, really making sure that [the focus is on] just one problem and how we can make it better. I think we are seeing an even greater breadth of what digital technology can do to support Japanese patients.
“As always, I continue to applaud you,” she added. “I know there is a lot of entrepreneurship needed, a lot of courage, to make it work. I assume all of you have faced multiple challenges so, by bringing it this far, you continue to impress me.”
Prizes
Ideas Day ended with recognition of the incredible innovation brought forth by the finalists.
Six honors were given:
- Empowering Patients Award and People’s Choice Award: Oishii kenko Inc.
- Hospital of the Future Award: Immunosens Co., Ltd.
- Bridging Urban Health Award: Medii, Inc
- From Japan and Beyond Award: Lanex, Co., Ltd.
- Moonshot Award: Ayush Balaji
The winners received monetary prizes and the chance to meet with senior executives from the organizing sponsors. They will also receive mentoring and support from healthcare professionals and executives of organizing sponsors.
All who took part in the HxD competition benefited from having their ideas reviewed, and the ACCJ thanks everyone who submitted pitches. Yet again, HxD proved that there is boundless healthcare innovation in Japan, and the 2022 competition is sure to reach new heights once more.
Sponsors
President’s Circle Sponsors
Cisco Systems G.K.
Eli Lilly Japan K.K.
Google Japan G.K.
Organizing Sponsors
AstraZeneca K.K. | Bayer Yakuhin, Ltd. | Deloitte Touche Tohmatsu LLC | i2.JP (Innovation Infusion Japan)
Contributing Sponsors
Dentsu | Johnson & Johnson | K&L Gates LLP | Motorola Solutions | NRW Global Business | Omron Corporation | Trilations G.K. | Real Life Sciences | SoftBank Corp.
Supporting Organizations
City of Kobe | Embassy of the United States, Tokyo | Foundation for Biomedical Research and Innovation at Kobe | Global Venture Habitat | LINK-J | Osaka Innovation Hub
Have an idea to pitch? Want to become a sponsor?
Get ready for the 2022 competition with an info packet:
www.accj.or.jp/hxd
