Healthcare Trend is changing from Medical to Healthcare. Trend is changing from supplier-centered to consumer-centered, from treatment-centered to prevention management-centered.
Recently, medical companies under hospitals, medical foundations, and general trading companies in Japan have also changed their overseas expansion, and I will introduce specific changes to those companies. (In particular, while telemedicine services are attracting attention due to the recent spread of COVID-19, the medical, digital, and mobility industries are working to develop healthcare mobility services that have upgraded existing telemedicine services to the next level.)
Japanese medical institutions support early stabilization of inpatients and return to society by promoting ‘smart hospital’ in cooperation with digital companies to strengthen predictability and accuracy. (Smart Hospital: It refers to a hospital operated by a fully automatic system that identifies and treats patients’ conditions using AI and IoT.) Since 2017, NEC, a large Japanese company, has been working with KNI Medical Group (Kitahara International Hospital Group) to develop a system to detect inpatients’ anxiety behavior or risk of misleading pneumonia. They analyzed electronic medical record information and vital data with AI and detected 71% accuracy about 40 minutes before inpatients’ insecurity behavior, enabling preemptive response by medical staff. As a result of KNI’s AI analysis, about 34% of elderly inpatients showed anxiety behavior, and in this case, discharge was extended by about 19 days compared to ordinary patients. In addition, they determined 87% accuracy of high-risk patients with misleading pneumonia, which frequently occurs in elderly or stroke inpatients, and nurses were able to focus on preventive management from the beginning of hospitalization. As a result of KNI’s analysis, misleading pneumonia occurs in about 10% of inpatients, and 70% of inpatients lead to long-term hospitalization for more than 1 month. In addition, they developed a system that analyzes nurse’s voice input data with AI, labels them based on nursing knowledge, and automatically classifies and stores them. As a result, 58% of the nursing record work (one hour per day per nurse) was reduced, and the effect of replacing the face-to-face handover work (30 minutes) was obtained. In addition, Japan’s Kitahara International Hospital focuses on treatment of chronic diseases centered on diabetes and rehabilitation, and has entered China to provide healthcare services. They offer low-sugar menus in hospital restaurants, along with healthy food ingredients, food, and healthcare products.
Japanese general trading companies, which focused on resource projects, are discovering and expanding healthcare businesses. In the past, bio-investment by large companies began in the 1980s, but technology limitations and markets were immature, and in the 1990s, starting with the detoxification of the human genome, they were activated as universities, research institutes, and ventures, but profits were low even after 10 years. In the 2000s, due to the breakthrough in biotechnology and the government’s deregulation of regenerated drugs, approval of drugs was also made easier. Japanese general trading companies have experienced the risks of resource businesses that rely on the market, and since then, they have found their main profitable businesses in bio-healthcare, a non-resource business.
Mitsubishi Corporation, a leading general trading company in Japan, directly participated in the operation of Tokyo Komagome Hospital until 2028 as a PFI business. Komagome Provincial Hospital (800 beds) is a hospital that had strengths in cancer and infectious diseases among Tokyo Provincial Hospitals, and Mitsubishi Corporation participated in the bidding for 186 billion yen, including a large remodeling of the hospital, securing the right to operate the hospital for 20 years from 2008. Japan promoted the PFI (Development of social capital by utilizing private funds) project for the purpose of improving the management of local hospitals, and in addition to design companies, construction companies, and IT companies, ASO groups operating large-scale hospitals in Fukuoka participated in the Komagome hospital project.
Mitsubishi Corporation has also entered the pharmaceutical manufacturing sector by taking advantage of the strengths of general trading companies in addition to hospitals and medical devices. Mitsubishi Corporation, along with Fuji Film, established FDBK and FDBT, biopharmaceutical joint ventures in the UK and the United States, respectively. Originally, Fuji Film acquired a biopharmaceutical CMO company from Merck in the U.S. in June 2011, and transferred shares to utilize Mitsubishi Corporation’s business experience in the bio sector. (Fuji Film makes up 80% of shares and Mitsubishi Corporation makes up 20% of shares.)
Meanwhile, Mitsubishi Corporation established the Bio Business Development Department in April 2000 when Bio Medical was selected as a new business area in its mid-term management plan. Currently, it is the healthcare department under the Life and Distribution Headquarters and is in charge of domestic and Asian businesses. (Headquarters for Living Distribution includes the Food Distribution Department, Paper and Packaging Department, Healthcare Department, and Asia Healthcare Business Development Office.)
A key subsidiary of Mitsubishi Corporation’s bio-health business is ‘MC Healthcare’, a business outsourcing and medical material distribution company of hospitals under the Ministry of Healthcare.
MC Healthcare is a company founded in April 2010 by integrating three companies : Hospital Service (established in 1995; supply of medical equipment), Apprecia (established in 2001, procurement and repair services of medical devices) and MC Medical (established in 1989; import and sale of medical devices). They achieved Japan’s largest sales of about 243 billion yen in 2017 by aggregating the functions of the three companies, including the JIT system of salespeople, to respond to the advanced demands of medical institutions. In April 2019, MC Healthcare consolidated its three food-related subsidiaries to seek further business diversification. (Three food-related subsidiaries: MC Food Specialties Inc. (Manufacture and export/import, sale of sweeteners, condiments, confectionery and baking ingredients), MC Foodtech Co., Ltd. (Manufacturing and selling glucose, fruit products, marine products, additives), KOHJIN Life Sciences Co., Ltd. (Manufacture and sale of yeast, food, feed, fertilizer, and medicines)
Mitsubishi Corporation established Good Life Design in 2002 in collaboration with TOYOTA Motors, and started Aichi-Ken’s local healthcare business. Good Life Design supports management improvement and mutual linkage of local medical institutions as an outsourcing project. In addition, it is a company that provides healthcare products and services to patients and local residents, and consists of 51% of TOYOTA Motors and 49% of Mitsubishi Corporation. Medical services for patients are handled by local base hospitals, and Good Life Design provides testing agencies, IT work support, joint purchase of medicines for local hospitals and pharmacies, and nursing facilities for discharged patients, rental and sales of care products, and renovation of homes for the elderly.
The Japanese pharmaceutical industry is pushing for the development of digital treatments, breaking away from the simple business model of selling drugs to medical institutions. (Digital Therapy: Advanced software medical devices that provide therapeutic intervention to patients to prevent, manage, and treat diseases or disorders. Mobile applications, games, virtual reality, chatbots, artificial intelligence, etc.) Otsuka Pharmaceutical Co., Ltd. has developed a digital pill for the treatment of schizophrenia/bipolar disorder, and it has a built-in special sensor that responds to stomach acid, allowing users to identify medication information and dosage patterns through wearable devices and mobile apps. Eisai Co., Ltd. is developing a preventive medical app by analyzing data accumulated as dementia treatment drugs with AI. SHIONOGI & CO., LTD. is developing a video game for treating childhood ADHD (AKL-T01) and a video game for treating autism spectrum disorder (AKL-T02). Takeda Pharmaceutical Company Limited is developing medical devices to treat digestive problems.
Japanese startups are leading the way, developing telemedicine systems and providing mobile-based services to improve user convenience. Japan’s Nipro began selling “NIPRO Heart Line” in 2018, and remote doctors diagnose mild COVID-19 infections in self-isolation, and hospitals (which can monitor body temperature and blood oxygen concentration data) provide online prescriptions to pharmacies. Japan’s Medley operates an app that enables Second Opinion consultation with 18 medical professionals at Tokyo University Hospital through the “CLINICS” online platform, and is affiliated with about 800 medical institutions nationwide.
Focusing on large Japanese companies, it is promoting ‘healthcare mobility service’ that combines telemedicine and next-generation mobility service (MaaS). (MaaS (Mobility as a Service): A service that combines the operation information of various means of transportation, such as railways, buses, and taxis, and suggests an optimal route for users.) Toyota Motor Corporation and SoftBank Group Corp. established MONET Technologies in February 2019 to provide various mobility-linked services such as logistics, medical care, and finance in cooperation with companies and local governments to promote the MaaS business. Philips Japan is working with MONET Technologies to promote “delivery of healthcare” through a “mobile clinic” service that has upgraded telemedicine services to the next level. (Philips Japan is a healthcare total solution company that sells products and services for each process of healthcare such as prevention, diagnosis, treatment, and home care for a healthy life.) In December 2019, Philips Japan tested the commercial Van (9seats) called HiAce of TOYOTA in Nagano-Ken, Ina-City, equipped with a monitor capable of remote diagnosis, a vital data meter such as blood pressure, body temperature, weight, and blood sugar, and an automatic heart shock device (AED). The “mobile clinic” provides remote and face-to-face treatment services regardless of physical location by moving mobility to where patients want it. It is a system in which a nurse visits a patient with a healthcare facility, a doctor in a hospital treats the patient through a video call, and then the nurse examines and prescribes the patient under the doctor’s direction. This is what the ‘mobile clinic’ provides by synthesizing the three concepts of ‘remote treatment + home treatment + mobility’.
Large companies and startups are all speeding up the development of AI image diagnosis technology to respond to healthcare services. NTT Data demonstrated an AI image diagnosis system developed by the University of Miyazaki in 700 patients, and measured the accuracy of detecting gastrointestinal abnormalities, showing 90% accuracy in cancer diagnosis. In October 2019, it began developing an algorithm that identifies the disease name from abnormalities found by the AI image diagnosis system, and in 2020, it verified to what extent the system could reduce the burden on doctors in actual diagnostic tasks. Hitachi’s U.S. subsidiary Hitachi Consulting has signed a partnership contract with the British medical group Northern Care Alliance to realize Digital Transformation. By introducing data analysis and IoT technology for Salford Royal Hospital under Hitachi, it is seeking countermeasures to flexibly deploy beds, operating rooms, and medical devices to patients and reduce waiting time. There are also many R&D startups such as lpixel in the field of image diagnosis, and lpixel, a venture company at the University of Tokyo, developed an image diagnosis support procedure using artificial intelligence and recently unveiled a cloud-type image analysis platform called ‘IMACEL’.
Fitness Center provides healthcare services such as health data measurement and health counseling due to high customer accessibility. RIZAP Group (the No. 1 company in sales at Japan’s Fitness Center) was originally centered on diet and beauty businesses, but recently, in partnership with 183 medical institutions nationwide, doctors have started health care services (rehab and dementia prevention, depression treatment, etc.) RENAISSANCE (the fourth-largest company in Japan’s Fitness Center sales) is promoting a healthcare project for senior citizens aged 60 or older to prevent cognitive decline such as exercise guidance, meal and sleep support. In addition, Renaissance established a joint venture in Vietnam and a subsidiary operating the fitness center and swimming school. In cooperation with their own design know-how and Japanese construction companies, they reorganize the swimming pool and open a Japanese-style swimming class to conduct swimming method training and water quality management consulting projects. In addition, it sought to enter Vietnam through a step-by-step approach such as sports center construction and operation of sports centers. Prior to the COVID-19 outbreak, Japanese companies’ healthcare services had melted into Vietnam, with more than 1,000 visitors a day despite the same high price as Japan. The Japanese food industry is releasing healthy foods such as sugar-restricted foods and menus, and selling various types of health supplements. (Sugar-restricted diet is a diet that consumes less sugar and lowers blood sugar with a diet focused on fat and protein. It has a weight-loss effect and consequently inhibits the possibility of diabetes.) Convenience store company FamilyMart has launched low-sugar foods in cooperation with sports center group RIZAP, and LAWSON has introduced low-sugar confectionery, lunch boxes, and noodles. Originally started as a medical device manufacturer that made Japan’s first scale and the world’s first body fat scale, TANITA expanded its business to the restaurant industry as a health food restaurant that provides healthcare services. TANITA expanded from the concept of measuring weight and body fat to the concept of measuring health, and it became famous throughout Japan when it provided healthy menus to employee restaurants with the aim of taking care of employees’ health first. Since then, it has published a recipe book and opened the restaurant “Marunouchi Tanita Shokudo” for the general public. It conducted free health counseling and events based on restaurants expanded nationwide, and developed a lifestyle coaching app to prevent diseases.
As such, Japanese companies are promoting links between different industries with the goal of realizing innovations that strengthen ‘convenience’, ‘accuracy’, and ‘accessibility’ of healthcare. Not only Japanese domestic companies, but also companies from neighboring Asian countries and companies from all over the world are expected to be linked in more detail to these Japanese innovations, namely, these TRENDs.
MIKE CHOI
ASIA JOURNAL
