Experts agree that the top five technology trends in Healthcare are: Telemedicine, Artificial Intelligence, Robotics, IoT and the use of the Blockchain. Starting with AI, we will analyze what the most promising approaches and startups in Asia that will shape the future of Healthcare are. Artificial Intelligence and Machine Learning are the current buzzwords. Everybody is talking about the singularity which was already envisaged more than 14 years old. Accenture recently analyzed the ratio of financial resources invested in AI depending on the industry. With only 1.5 percent, the Healthcare sector was one of the laggards. Massive opportunities still exist for the use of AI in Healthcare. Opportunities will somehow need to be supported by clear frameworks on how the regulatory authorities will evaluate and approve new AI medical products.
Frost & Sullivan estimates that AI has the potential to improve the outcomes by as much as 40 percent while reducing the costs by 50 percent. AI can also be used in a variety of ways from analyzing the lifestyle of individuals to helping in medical diagnosis, checking the massive quantity of data generated by medical imaging, and helping in decision making. This is just the tip of the data iceberg. When DNA sequencing will be routinely used, the data generated will increase exponentially. Only AI robust algorithms will then have the ability to extract meaningful and synthetic information from these tsunamis of data. According to The Institute of Medicine at the National Academies of Science, Engineering, and Medicine, diagnostics errors contribute to approximately ten percent of patient deaths. In China, a diagnostic competition took place in 2018 between top 15 radiologists against the BioMind AI. In 30 minutes, AI achieved 87 percent correct diagnoses compared to 66 percent for the physicians. This is a fantastic achievement when realizing that DeepBlue beat Garry Kasparov just 23 years ago.
Drug discovery, preventive and personalized medicine are also significant growth avenues for AI. More than one-third of the Healthcare AI market is linked to Drug Discovery. Using open innovation strategies, Big Pharmaceutical companies are opening themselves to AI. GSK is, for example, partnering with the startup Insilico Medicine and Merck with Atomwise.
According to CBInsights, Venture Capitalists invested more than $2 billion in healthcare AI startups in 2018. A dramatic rise when compared to the $100 m invested just five years ago. In the UK, BenevolentAI which focuses on using AI to accelerate drug development has recently announced a massive series C funding round of $207 m. This amount could appear as modest when compared to the $620m raised by Chinese Computer Vision and Deep Learning company SenseTime. AI is receiving a massive amount of interest will it be for Deep Learning, Natural Language Processing
When compared to $2 billion in 2018, the global market for AI in Healthcare is expected to reach over $35 billion by 2025. It is a staggering CAGR of 50% on the period. Deep Learning and its applications in medical imaging and diagnostics are expected to hold the major share of the market. Even if the US keeps its position of the dominant market, the Asia-Pacific region and China are expected to register the highest CAGR during the forecast period
HEALTHCARE AND AI IN KOREA
In Korea, technology and innovation are part of the mindset. According to the Bloomberg’s Innovation index, 2018, South Korea ranked as the world’s most innovative country. No doubt than AI and Healthcare are considered as very serious business will it be by the Government, the medical or startups communities. The ambition in for Korea to be one of the world leader in this field.
The Korean government has decided to finance up to $33 million the development of a medical AI system “Dr. Answer” in the course of the next three years. This software will target eight pathological fields: breast cancer, colorectal cancer, prostate cancer, cerebrovascular disease, heart disease, epilepsy, dementia, and pediatric rare refractory genetic disease. Coordinated by Seoul’s Asan Medical Center, this system will involve 25 Hospitals and 19 AI software developers. The ultimate goal of this project is to help physicians in establishing the best treatments based on personalized medicine. In December 2018, the Korean government went one step further and announced that AI-based new drug development and healthcare innovation would be regarded as national tasks for the Fourth Industrial Revolution.
Founded in 2013 and selected in 2017 as one of the world’s top 100 AI startups by CB Insights, Lunit entered in 2018 in a partnership with the Samsung Medical Center. Lunit specializes in using deep learning technology to detect nodules in chest radiography with a standalone accuracy of 97%. When used in conjunction with a radiologist, the diagnostics were improved up to 20%. When analyzing mammography for breast cancers, the standalone accuracy was close to 96% when human usually reaches to 87%.
Meanwhile, in the city of Yongin, an agreement was signed between the local Government and the Severance hospital with the objective to build by 2022 a medical AI center that is expected to attract startups and pharmaceuticals companies. The goal is to create close to 4,000 jobs.
In August 2018, The Korean Ministry of Food and Drug Safety also announced the approval of two AI systems: Lunit’s Insight and JLK Inspection’s JB-01K. JLK Inspection offers a universal AI assisted image analysis software with the potential to be used in more than 30 medical conditions. This AIHuB can analyze images from different sources: MRI, CT, X-ray and mammography imagery. JLK raised more than $17 million and is, like many other AI Korean startups, planning for an IPO on the KOSDAQ in the second half of 2019.
HEALTHCARE AND AI IN JAPAN
After a slow start when compared to China and the US, Japan is now fully realizing the potential of AI. In March 2017, the “Artificial Intelligence Technology Strategy” was published insisting on the importance of Healthcare. One year later, in June 2018, AI was included in Japans’ Integrated Innovation Strategy. Supported by the Government, numerous startups are now on the move. Multiple collaborations between the major technology players and universities are being established. Regarding Healthcare, the development of AI is directly linked to the shortage of doctors and the increase in the number of patients suffering from chronic conditions mostly due to the aging population problem.
The Japanese Government is planning to invest $100 m in the next five years to boost the development and adoption of AI technologies in Hospitals. Japan is part of the top 10 largest diagnostic imaging exporters. AI is a natural fit both to help manage issues linked to the evolution of the society and to boost the economy. The target is to open 10 AI hospitals by the end of 2022. The goal being for the doctors to concentrate on the patients and for the AI to analyze the data and managing the paperwork. AI will help for analyzing blood tests, vitals, EKG, DNA parsing and imaging. The ultimate diagnostics being ultimately left to the physicians which open more doors for AI systems to be developed to help in the diagnosis. The Japanese authorities expect AI to improve treatments and reduced the costs linked to unnecessary medical examinations. This could also constitute an opportunity for foreign companies to enter the Japanese market.
Lots of Startups and more mature companies are now engaged in Telemedicine and AI in Healthcare in Japan. NEC the Tech Giant is partnering with Japan National Cancer Center on using an AI online analysis of polyps during a colonoscopy. In an Open-Innovation approach, Olympus, Fujifilm, and Cyberdine have recently invested more than $27m in the Tokyo-based medical imaging analysis startup LPixel.
For patients who have dementia, Exawizards has developed a new approach based on analyzing unstructured nursing data. Videos of the interactions between the caregivers and the patients are recorded and analyzed using AI specific algorithms to improve how the caregivers will interact with the patients. By improving the patient/nurse relationship, Exawizards hopes to reduce nursing care costs by as much as 20%.
In order to ease the registration process, the Government decided in 2018 to set new rules to govern how AI could be used in medical equipment. Clear guidelines should also be established by the Ministry of Health on how to evaluate the efficacy of AI in Healthcare related products.
All of the components for success are now present. Academic research quality is high. Government is paving the regulatory pathway and offering incentives. Big Tech players have the financial resources to invest heavily in their future and Startups are being incorporated and financed. AI startups are part of the investment strategy of Realtech Fund, one of the major Venture Capital Fund in Japan. No doubt that in the coming years, interesting outcomes will emerge from Japan in Healthcare AI startups and collaborative projects.
HEALTHCARE AND AI IN CHINA
The changes in a society are often followed by technological evolutions which in turn will induce a shift in policy. China is a perfect example of this domino effect. According to the Organization for Economic Cooperation and Development (OECD), China has 1.8 doctors per 1,000 inhabitants, compared to 2.6 per 1,000 inhabitants in the US. It is dramatically insufficient especially when considering that with 147 million people over 65 years old China is aging rapidly. In 30 years, China’s population over 65 will roughly be the same as the current total population of the US. With age often come chronic diseases which already impact more than 300 million Chinese. Healthcare costs are soaring, and AI is part of the strategies to be used by the Government to limit the strains on the state insurance system.
Seeing a doctor is difficult in China. Patients have to queue for long hours, and those living in the suburbs often choose to travel to big cities hospitals which are considered of higher standards. In China, there is a significant resource gap between urban and rural area. Technology is increasingly being used to bridge the gap between urban health centers and remote parts of the country with limited access to doctors.
The Chinese Government ambitions regarding AI are obvious. In July 2017, a “New Generation Artificial Intelligence Development Plan” was released with the goal for China to be by 2030 the leading AI power. The government is conducting concrete actions and have partnered with national tech companies to develop research, and industrial leadership in AI and a $2.1 billion technology park for AI research in Beijing will be built.
Venture Capital money is flowing freely in China. In 2017, Chinese AI startups raised $5 billion in VC backing overtaking their US counterparts by more than $600m. China is going fast as exemplified the more than 131 AI Healthcare companies presented by the Beijing Consulting company Yiou Intelligence.
Intelligent robots and Chatbots have being developed and show great promises to resolve the shortage of doctors. iFlyTek built in partnership with Tsinghua University is now famous for being the first robot to successfully passed the Chinese medical licensing exam. In May 2018, WeDoctor an online consultation and doctor appointments platform raised $500 million with a valuation of $5.5 billion. WeDoctor aims at becoming the one-stop medical solution for Chinese. The app connects with 2,700 hospitals, more than 260,000 doctors and 20,000 pharmacy outlets. WeDoctor goes even further and has developed two AI-powered diagnosis platform. The first one called “RealDoctor” for Western medicine and the other one “Huatuo AI Doctor” for those more inclined to Chinese medicine.
IBM researchers estimate that medical images make up more than 90% of all existing medical data available today. In China, being a radiologist is tough. In average, each doctor will have to read at least 20,000 images per day. This is 2 to 3 times more than the average workload of a US-based radiologist. This might explain that most of the Startups in China focus on medical imaging systems., VoxelCloud is on a winning track and is the perfect example of the collaboration between China and Silicon Valley. Initially founded in Los Angeles in 2016 VoxelCloud has now offices in Shanghai and Suzhou offers solutions to analyze coronary arteries, lungs, and the retina. They obtained FDA and CE approval for clinical use. They submitted CFDA applications. In two years, they received more than $78m. Tencent, the owner of WeChat, being part of the latest $50m December 2018 round.
Founded in late 2015 and located in Shenzhen, iCarbonX already went through two rounds of funding totaling more than $200 million. As one of the founders of the biggest Genomics company, BGI, Jun Wang was no beginner to biotechnology. With a first round of $154m and a valuation of $1 billion, iCarbonX became an instant unicorn. By aggregating aggregate health data from a multitude of sources, from medical records to IoTs the ultimate goal of iCarbonX is to unlock the doors of personalized medicine fully.
When compared to other sciences, Artificial Intelligence is still in its infancy. 50% of the patents were published in the last five years. AI is a science that is still trying to find itself. According to a recent article from the MIT Technology Review, some research fields that are currently very popular, such as Deep learning, might disappear in the coming years. Another ethical and legal question that will arise as one point will be to clearly define who will be responsible in case of AI misdiagnoses. The last country that has also realized the potential of AI in healthcare to address the resources gaps they are facing in India. No doubt that in the coming years, India will be the country where the potential of AI in Healthcare could induce the most significant changes in the health of the population.