Collaboration
Digital Transformation of Healthcare May Bring a World Where Everyone Can Lead a Content Life and Face Death with Satisfaction
Sony Innovation Fund is seeking promising startups every day to create new synergies through collaboration. One of such startups is MICIN, Inc., which is challenging digital transformation of healthcare with its telemedicine service. What kind of potential is there in MICIN and Sony working together? I asked Seigo Hara, CEO of MICIN, and Shinji Omori, a general manager to oversee the biomedical research and development at Sony R&D Center.
Profile
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Seigo Hara
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Shinji Omori
Intent of Starting a Telemedicine Service
──First, could you tell us about your career up to now, Hara-san?
Seigo Hara:After graduating from medical school, I started my career as a doctor. Then, I got involved in establishing healthcare systems and policies, and after studying abroad, I began consulting for medical institutions and pharmaceutical companies from a business perspective. In other words, I have been involved in the medical field, changing my position from a physician, a member of the project to design health policies, and to a business consultant for medical facilities. During these times, I have consistently held a desire to improve the healthcare system. In 2015, I established MICIN to realize this idea.
──Specifically, what aspects of healthcare do you want to improve?
Hara:When I worked as a doctor, I saw various patients every day, and many of them said, "Why did I get this disease?" or "If I knew I would have this disease, I wouldn't have lived like that..." In some cases, however, they could have done something to prevent illness, instead of visiting the hospital after they got ill. If the digitalization of healthcare could eliminate such regrets, that would be a great value. So, I founded a company.
──What you provided first after starting your business is curon, which is a telemedicine service. What is the purpose of this service?
Hara:Normally, doctors and patients see each other face-to-face, and curon is a service that enables this online. It is provided to medical institutions and facilities. Telemedicine is, of course, intended to facilitate patients’ access to medical treatment, but at the same time, it can be an entry point to accumulate health data. We are working on our business from that perspective.
MICIN's vision is “For all to live out their lives with dignity”. This is a very challenging goal, but we are working on our service as one approach to realize this vision. In the future, we’d like to gather medical and health data through digital healthcare, such as telemedicine, which will then allow us to notice any changes before people get ill. We hope that we can contribute to designing each person's own life so that they can live and die accoring to their invididual values.
Change in Awareness after the Coronavirus Pandemic
──Can you tell me what user experience your current telemedicine service can offer?
Hara:curon is an app that is available to patients who use smartphones and to doctors who use computers or tablets. A patient makes an appointment on this app and answers the questionnaire in advance. When the consultation time comes, the doctor and patient communicate via a video call, and the doctor prescribes medicine according to the diagnosis. The patient pays the bill on the smartphone, and the prescription or prescrdibed medication is delivered to the home. That's the flow.
──This might not be limited to online cases, but some people cannot tell their symptoms very well. How do you know whether the patient is describing their condition correctly during the medical consultation?
Hara:That's the difficult part. We have the same issue when seeing patients in person. I think it will be important to develop techniques that draw out what the patient is feeling, while at the same time watching how the patient looks, responds, or talks. I think it is where science and art interact with each other to some extent. In fact, it requires a wide range of techniques as an artisan here. However, interviews using AI have recently appeared, so it is becoming possible to have an efficient way of asking and diagnosing patients based on accumulated knowledge.
──What is a remarkable difference before and after the coronavirus outbreak?
Hara:Before the coronavirus, a certain number of people showed their understanding about telemedicine, but there were also skeptical opinions, saying that unlike in-person visits, telemedicine cannot have sufficient information to conduct medical treatment. We recognized these issues as challenges and worked even harder to change the medical system gradually, but telemedicine did not spread quickly.
After the coronavirus crisis, however, the public awareness and medical system have changed rapidly. I felt this change especiallly when the government declared the state of emergency for April to May as more and more concerns about coronavirus infections were spreading among medical workers. People working at hospitals are largely exposed to the risk of infections when they accept the patients. So, when they felt it difficult to accept patients under the pandemic, curon was adopted as a new way of medical practices. Some hospitals using our service told us that they are actively utilizing telemedicine because it is an invisible mask for the medical staff. I think it truly expresses the value of telemedicine.
What Can Sony Do in the Digital Health Field?
──How did MICIN and Sony build the current relationship?
Shinji Omori:Speaking of myself, I work at the R&D Center of Sony, which performs research and development of technology that can contribute to not only electronics and semiconductors, but also the entire Sony Group, including entertainment and financial businesses. As a general manager to oversee the research and development of biomedical technology, I am working on new technologies in order to support mid- to long-term growth in the medical field.
I met MICIN through the Sony Innovation Fund, which invests in promising startups. In the field of digital health, laws and regulations are changing rapidly, and to cope with that speed, startups have a certain advantage because they can launch their business and grow very fast. Sony, on the other hand, has a broad range of technologies related to digital health. I thought if Sony's core technologies are combined with a pioneering startup like MICIN and create new value, it would be wonderful. That's how we came to work together.
──You mean Sony had a great interest in digital health?
Omori:Yes. We believe that healthcare will become a major pillar in the future. But we won't—and we can't—build the framework of a telemedicine service from scrach. Sony's strength is a long history of making things through open innovation. The compact disc, for example, came from open innovation. Sony now has remote sensing technology, and If MICIN has to create it on their own, it will cost a huge amount of money, so we thought it is a good idea to team up together to create something interesting.
──From the MICIN side, what do you think is the significance of working with Sony?
Hara:Speaking a little bit from a mid-to-long term standpoint, the way we notice subtle changes in a patient’s health and physical condition is important in digital health. For example, if we take images of the body and those images vary depending on the light condition, it can’t be a consistent observation. That situation must be corrected to accurately sense the actual color tones. Another example is a vital sensor like a pulse sensor. It measures vital data when the patient is resting quietly, but how can we measure accurate data when the patient is in active state? Technology that captures various data of the body, such as grasping patient’s condition will become imporant, and we believe that this will be possible when Sony's technologies are linked with what we are working on.
In fact, digitally detecting slightest changes in the body is really important to telemedicine, and it will lead to the future of healthcare where small changes in the health condition can be extracted remotely while a person lives a everyday life and a hosipital can intervene in various ways at an early timing, when changes are detected, before the person gets ill.
──Do you mean that digital transformation of healthecare, such as telemedicine, digital health, and support for medical workers, shows its real value in providing care to people before they get ill?
Hara:Preventing illness and giving medical care at an early stage are important, and many people desire it. But we put more focus on providing satisfaction when facing illness and death. Imagine you say, "I like eating delicious food, so I eat a lot of meat.” If you continue to eat that diet, there may be an increased risk of myocardial infarction and a shorter lifespan, but if you live with satisfactory feeling, that's one way to live. Under the current situation, however, you live without knowing subtle changes taking place in your body, and may suddenly collapse from a heart attack, which makes you regret that it was not supposed to be like this. This is not a happy thing. The advancement of digital transformation in healthcare will enable foreseeing the future health condition of a patient and allow medical facilities to intervene at an early stage, if something happens, so that the patient does not have to go to hospital after getting ill. I think this will help achieve living a content life.
──It's a different way of thinking from other medical startups which aim for longevity and well-being.
Hara:Yes. Conventional medical solutions have basically focused on extending healthy life expectancy. We never deny that, and they are actually showing results. Life expectancy may increase to about 120 years in the future. But I think a process of falling ill and dying does not change for at least several centuries, so we think it is important to seriously consider how to deal with it.
Omori:I think having satisfactory feeling is extremely important. A patient usually has an early symptom, becomes ill, receives medical treatment, and improves prognosis. This consistent process is called a patient journey. Providing a consistent user experience, or a patience experience, for that journey is the key. At present, patients have various complaints: "Why do I have to make an appointment and go to the clinic according to the appointment even though I can't get the service on time?" "Why do I have to wait so long?" "After receiving the treatment, why do I have to go to the pharmacy and wait there again to receive the medicine?" "Why am I a little scared when I tell the doctor that I’d like to ask for a second opinion from another doctor?" For those complaints, they have no choice but to just convince themselves that’s just the way it is in healthcare services. But in the future, digital technology should be used to bring the value and transparencey of what patients pay for, meeting their needs for higher quality, convenience, and usability of healthcare.
3R Technologies Enrich Patient Journey
──What Sony technologies, for example, do you think will be useful in making the patient journey richer?
Omori:Sony is now promoting the concept of “3R Technologies,” which refers to reality, real-time, and remote technologies. “Remote” is what MICIN is doing as their services. “Reality,” in this case, provides a communication mechanism that allows patients to feel as if they were really at hospitals for examination, even via a voice or video call. As Hara-san mentioned earlier, the online practice will be difficult if the color or skin condition of the patient changes depending on the lighting, but Sony has the technology to obtain correct outputs under any light conditions. “Real-time” can be the edge computing technology. Of course, data accumulated in telemedicine will be uploaded to the cloud, and new value will be created through analysis of AI. However, before uploading to the cloud, it is important to process data on the edge and provide information to doctors for assistance in real time during consultation and examination. In this regard, Sony has various sensors, including image sensors, to capture data, as well as the technology to quickly process data on the edge. So, we can provide professional solutions that support healthcare workers in real time.
If we can consume plenty of time on a cloud-based AI system, we can use an extremely large system. But Sony is good at making a small and lightweight machine-learning model to be incorporated into smartphones with ability to output results in real time. So, we are thinking of combining these technologies with telemedicine to create new value.
──What kind of services could be created in the future by linking with those technologies of Sony?
Hara:The technology just mentioned by Omori-san overlaps a lot with the field we are working on. In communication between medical workers and patients, technologies such as color correction and sound source separation can be used to improve examination quality. Personally, I think physical examination, such as auscultation or palpation, will be able to be reproduced remotely, so I hope combining such technologies will be a clue to solve the problems of healthcare support.
Omori:I heard this from a medical worker before. Auscultation, which doesn’t look like a sophisticated examination at first glance, can obtain various information, but there are only a few doctors who can auscultate properly. I believe that this area can be supported by audio technology, which has many elements that can be utilized in telemedicine in the future as well.
Hara:Auscultation is interesting. In this area, there has been no innovation for a long time, so if digital transformation occurs, it may lead to technology that can distinguish various diseases. Traditionally, we've only performed auscultation in the range that we can hear, but sounds actually exist beyond the limits of human hearing, and I think that can be covered digitally. If we can find abnormal health condition from an audio range that was difficult to be heard by humans before, that would bring more advanced diagnosis than in-person auscultation.
In Order to Keep up with the World's Healthcare
──What does it mean for Sony to join the medical field?
Omori:Of course, it's important to focus on evidence-based technology development, but I think patient engagement is also important. For example, patients suffering from lifestyle diseases need to be improved in their daily lives, and software apps to support them are emerging. But in many cases, patients find it difficult to keep doing so for a long time. Also, in the case of a virtual clinical trial, it has merits in that patients do not have to go to hospital, but they’re required to keep records frequently, so there are many cases where they drop out of it. I believe Sony can contribute in those areas to enhance patient engagement, by utilizing technologies Sony has cultivated in entertainment business and combining them with the needs of highly specialized comapanies like MICIN.
──As digital transformation of healthcare advances, people’s biometric data will become more valuable in the future. If there is a system to get rewards in return for providing it, we may be able to get closer to leading a content life and facing death with satisfaction.
Hara:It is very important to have more cases like that. Under the current situation, providing data or being monitored by sensors is difficult to be continued without a clear idea of what benefits can be obtained in doing so. Conversely, if benefits become clearly visible as medical outcomes, the speed of digital transformation of healthcare will surely be accelerated.
Omori:Unfortunately, the speed of digitalization in Japan is slow compared to other countries. Many medical records are still handwritten in Japan. In the United States, by contract, electronic medical records are widely adopted, and they can create the future of digital healthcare based on that. If we do not have more companies like MICIN and gain momentum by promoting the use of digital data to become mainstream, Japan’s healthcare will further lag behind the world’s standard. In that sense, Sony would like to continue to put forward the significance of digitalized healthcare and help bring a better future for both healthcare providers and patients.