Whats Behind Japans Collaborative And Sustainable Medical Innovation Ecosystems – Forbes

Japan has among the best healthcare systems in the world, yet it is looking to make major changes to spur innovation in this field so as to adapt to a new demographic reality.

The country leads the global trend of aging societies: more than 1 in 5 Japanese citizens are 65 years or older. By 2060, the ratio is expected to hit 2 in 5. Still, rather than accepting it as a burden, Japan decided to turn the problem on its head: Use its demographics as a test-bed to pioneer fresh social and industry solutions, and lead global discussions on future medical care.

The 2nd Well Aging Society Summit Asia-Japan was held in October 2019. Approx. 650 global leaders from academia, business and governments came together to find ways to collaborate on innovative solutions for aging societies.

Building on the countrys strength in medical research, many of its cities have begun to create new physical and intellectual spaces that promote open innovation, data analysis, wider use of technology, and a commercial mindset. Such actions, coupled with Japans troves of medical data, have also ignited a boom in medical-tech startups and with it interest from global venture capital.

One example of how this is working out in practice is Japans comedic heartland, the Kansai region. If laughter is the best medicine, Kansai has been in the business of curing people for centuries. So, perhaps its only natural that the area that includes Osaka and Kobe is also emerging as the countrys engine for innovation in healthcare.

In both cities, innovation ecosystems are being created via collaboration projects and spaces that cut across traditional business, private-public, and academia lines. Importantly, these collaborations are not just about sharing know-how and ideas. The focus is on results: In other words, producing the tools, services and people to revolutionize todays healthcare.

Partnership Creates Leading Global Hub for Healthcare

Before winning global fame as a beef producer, Kobe developed as a port city. Its economy was based around heavy industry such as shipbuilding, steelmaking and chemical products. An earthquake in 1995 and its recovery process, though, persuaded Kobe City to foster an entirely new industry, that of health tech, around its port area.

The effort drew together all sides: industry, government, academia and the medical community. This union resulted in the creation of what is known today as the Kobe Biomedical Innovation Cluster (KBIC). Today it ranks as Japans top hub for R&D in biomedicine. The power of KBIC, and the nearby laboratory of the Institute of Physical and Chemical Research (RIKEN), have transformed the city into an engine for innovation in healthcare.

Located on Port Island, KBIC accommodates about 360 advanced medical institutes. Among these is the RIKEN and two other organizations, which pioneered the transplant of retinal pigment epithelium sheet grown from a patients iPS cells in 2014.

KBICs resources and status make it a vital connector to bringing domestic and foreign talent and know-how to Kobe City. This, in turn, helps the municipality to explore new solutions in medical care for its citizens.

The areas fluidity of ideas and skill transfers are what allow for open innovation, helping also to translate research into actual medical treatment, said Shigenori Tanabe, who has a doctorate in informatics and is Director of the Business Promotion Division at Kobe City.

With KBIC we have an immense pool of talent working in close proximity that acts as a strong source of innovation for the medical industry.

From Cluster to Capital

The presence of KBIC and its willingness to engage with new ideas and startups has lured one of Silicon Valleys most prestigious investment and incubator organizations, 500 Startups, to open a program in Kobe City in 2016.

Each year, the 500 Kobe Accelerator project accepts around 20 companies for an intensive, 6-week course that teaches key skills, including the art of communication, price-setting, fund-raising, and what is needed to attract partners and backers at home and abroad.

US know-how gives the program a very practical platform when coupled with the KBIC, and makes it easier to bring in venture capital, said Dr. Tanabe. In the end, this motivates yet more people and companies to settle in Kobe, he said.

This years program focused on health tech and had 174 applicants, with almost two-thirds from outside Japan. Many see this as a way to enter the Japan market and to connect with KBIC, Dr. Tanabe said.

Though only three or so years old, the Accelerator program is already bearing fruit.

Among the first successes of the 500 Startups Kobe program is T-ICU Co., Ltd., which provides hospitals with remote support for patients in intensive care. It won the Excellence Award in the Japan Healthcare Business Contest 2019.

Dr. Tomoyuki Nakanishi, an emergency physician and board-certified intensivist, spotted that 70% of Japanese hospitals had no ICU specialist. This made their intensive care less effective and many patients had repeat health problems. After research, he saw that the solution lay in remote tele-ICU centers, which enable off-site specialists to interact with bedside staff via video link, exchanging health information electronically in real-time.

Dr. Nakanishi set up T-ICU Ltd. in 2016 to be the first company to provide such services in Japan, but he could only score a single hospital contract. Even that came only in June 2018 and via a friends connection.

The team at T-ICU took part in the Kobe Accelerator course in 2018. It was very intensive, said Dai Ogura, COO of the company. Every single day, we were asked to describe our business in just one sentence.

What left the most impression on Mr. Ogura was not the technical parts of the course, but the focus on forging the right mentality for the business to succeed.

Just a year later, T-ICUs client roster is in double figures and the startup has raised 153 million yen from investors. The company now counts 25 doctors and nurses, and is starting to get calls from potential clients in South East Asia, Mr. Ogura said.

After updating T-ICUs interface, Mr. Ogura sees potential for the company to enter the U.S. market, which has a longer history of using tele-ICU. The low-cost nature of T-ICUs system should be attractive, he said.

Academics Channel Local Merchant Spirit and Connect Stakeholders for Success

The birth of Osakas medical ecosystems owes much to the citys independent, merchant spirit, as exemplified by its top university.

Osaka University traces its root back to a private academy founded in 1838 by Ogata Koan, a samurai and a scholar of Western medicine in the late Edo period. Many of its alumni went on to play an important role in modernizing Japan. This willingness to embrace progress and a boisterous, free spirit is what defines Osaka and makes its initiatives unique, said Osaka University Professor Yoshiki Sawa, a top specialist in iPS cell treatment for heart disease.

Ogata Koan (right; 1810 1863) was a leading figure in introducing Western medicine to Japan. His private academy, Tekijuku, evolved into Osaka University (left), which ranks 3rd in Japan, according to the 2020 QS World University Rankings.

Traditionally, weve been good at the science part, but not the next step, Prof. Sawa said, noting the wealth of Nobel prizes awarded to scientists from the Kansai region. To help promising medical minds in Osaka tap into the citys merchant spirit, Prof. Sawa saw the need to create a new program more focused on commercial results.

It was also a way to expand on Japans nationwide strategic initiative to promote translational research, which was launched in 2007 to bridge basic medical research with clinical practice. This helped plug academia more directly into efforts to create innovative drugs and medical devices.

The shift at government level encouraged a triumvirate of Osaka University, The University of Tokyo, and Tohoku University to seek out Stanford University and discuss a collaboration in setting up a Japanese version of the Biodesign program.

The result was the launch in 2015 of a 10-month Japan Biodesign course. Its concept is to mold talent that can grasp patient and healthcare worker needs and marry them with the medical devices and services being developed by industry and academia. Taking on research projects with an eye for commercial potential from an early stage is key, said Prof. Sawa. The goal of Japan Biodesign is to sculpt an ecosystem that continuously delivers medical device and service innovation to meet the needs of Japans aging society.

Now, were creating cadres that are also entrepreneurial and can deliver results on an industrial scale, said Prof. Sawa, also chairman of the Japan Biodesign Association. It is a chance for people to create new industries in medicine, he said.

One of Japan Biodesigns first successes is Remohab Inc., a venture that develops remote cardiovascular care by monitoring patient rehabilitation through exercise.

Heart disease is the second most-common cause of death in Japan and heart failure is often the cause. The latter affects 1.2 million people in Japan alone, yet cardiac rehabilitation in hospitals is tough for elderly patients because of the need for frequent visitations. After a while, many stop going or do not receive the right care.

Remohab developed a home system, using IoT, which helps patients continue rehabilitation under remote real-time monitoring by healthcare professionals. Should Remohab succeed, it will be the first company of its kind globally, CEO Dr. Tatsunori Taniguchi said.

Before attending the Japan Biodesign course, Dr. Taniguchi, who worked as a cardiovascular physician after graduating from Osaka University, admits he did not even know what the letters CEO stood for. What he did know, however, was that research and study were not enough. He had to find a solution for the elderly that could work as a business.

Dr. Taniguchi was one of the first to attend the intensive course, learning how to link research with the commercial phase, how to evaluate markets and build a strategy around medical insurance, and other skills. It gave me a great amount of confidence to acquire so much different information and know-how in a practical and systematic way, suited for entrepreneurship.

Since launching Remohab in 2017, Dr. Taniguchis firm has gone from strength to strength. It attracted 50 million yen in venture capital and in its second year won the Excellence Award in the Japan Healthcare Business Contest 2019 conducted by the government.

It makes me so happy to hear that elderly patients who took our course have managed to return to a more active lifestyle and got a smile back on their face, Dr. Taniguchi said.

As many elderly patients find frequent hospital visits to rehabilitate heart problems difficult, Dr. Tatsunori Taniguchi (right) found a solution by designing a remote rehabilitation system, which formed the basis of his company Remohab Inc.

Organizing for Future Innovation

To promote further space for learning and idea-exchange in medical innovation, Osaka has created a X(cross)-Innovation Initiative to bring all stakeholders (private, public and academia) to discuss issues under one roof. Another key space for innovation is the

Nakanoshima-4 intersection in northern Osaka, which is due to house from 2021 a two-building complex dubbed the International Center for Future Medicine. The center will unite hospital, research, clinical trials, and commercial medical facilities, concentrating on further breakthroughs and bringing innovation to markets.

In a country where so much attention is placed on Tokyo, the initiatives of Kobe and Osaka show that Japans efforts to create the right environment for medical innovation are spread out much more widely and find support on both the national and local levels.

Thats an extremely important and often overlooked part of stimulating innovation, said Erwin Bttinger, Professor for Digital Health and Personalized Medicine at the Hasso-Plattner-Institute in Potsdam. We need organizational frameworks, so that they can give a perspective to all these activities and initiatives.

The leading German academic attended the Well Aging Society Summit (WASS) in Tokyo in October and had a chance to speak with the people driving medical innovation in Japan, including Prof. Sawa of Osaka University.

When you look at what is happening in Japan, a sense of progress does come across, Prof. Bttinger said.

To learn more about 500 Startups Kobe, click here.

To learn more about T-ICU, click here.

To learn more about Japan Biodesign, click here.

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Whats Behind Japans Collaborative And Sustainable Medical Innovation Ecosystems - Forbes