While countries around the world grapple with COVID-19, the disease caused by the novel coronavirus, Japanese startups are accelerating the deployment of telemedicine and clinical trials, important tools to overcome the pandemic as well as future disease outbreaks.
Legacy healthcare procedures and regulations have slowed the development of more efficient ways to provide medical care and perform clinical research. The coronavirus pandemic is speeding the transformation of conventional medicine into digital health, comprising everything from telemedicine to diagnoses supported by artificial intelligence. Japanese entrepreneurs are seizing this opportunity to provide unique solutions in Japan and overseas.
Delivering healthcare in a pandemic
Over the past few months, Tokyo-based MICIN has seen unprecedented demand for Curon, its telemedicine solution, as patients and healthcare providers try to minimize coronavirus infections. The service is helping popularize telemedicine in Japan. Curon is an app from MICIN that lets users fill out health questionnaires, schedule appointments with doctors, consult with them over video, and pay for services. They can also arrange for prescriptions to be sent to pharmacies and have medicine delivered. The cost is as little as 300 yen ($2.79) per session.
“What we wanted to do is help patients and physicians use telemedicine easily and painlessly,” says Hara Seigo, cofounder and CEO of MICIN. “For patients, the entire experience, from booking a consult to medicine delivery, is seamless. The app can also gather important healthcare data from medical devices, such as blood pressure monitors, for review by doctors. For healthcare providers, adoption is as easy as possible because patients pay for the telemedicine service.”
Curon was launched in April 2016, about five months after Hara founded MICIN along with Kusama Ryoichi and Shiohama Ryushi. Hara began his career in medical practice, working as a hospital physician before moving to a Japanese think tank to do health policy research and recommendations. After graduating business school in the United States, he took a job in a consulting firm with clients including pharmaceutical companies and medical device makers.
“I’ve been involved in healthcare in various capacities, but my passion has always been to help the healthcare system in Japan,” says Hara. “When I was a doctor, patients diagnosed with disease or facing death often voiced regret about not knowing earlier. I want to eliminate this kind of regret through entrepreneurship. That’s why our vision is that everyone lives their life with dignity. I also enjoy creating value from scratch with my trusted colleagues.”
MICIN applied for and received approval to use Japan’s sandbox deregulation scheme in 2018, when the government began telemedicine-related reimbursements. Users suffering COVID-19- or influenza-like symptoms have been able to use MICIN’s Curon platform for consultations without fear of spreading infection by visiting clinics. Hara also believes telemedicine apps like Curon can improve access to medical care, even in countries like Japan that have advanced, universal healthcare systems.
With the surge in interest due to the pandemic, Curon has been used by tens of thousands of patients in Japan and at more than 4,000 hospitals and clinics nationwide. Meanwhile, MICIN is focused on adding features such as predicting disease from symptoms, promoting telemedicine with patient platforms such as Japan’s MedicalNote, and collaborating with academics to gather evidence of the benefits of telemedicine.
“We’re hoping telemedicine will be a game changer in Japan,” says Hara. “There will be a new normal where more patients and doctors can use telemedicine as a matter of course.”
Less paper, more productivity
Before a vaccine can be developed for the new coronavirus, therapeutic drugs will continue to play a critical role, and clinical trials are vital in evaluating both vaccine and therapeutic drug candidates. But clinical trials require time and money and are prone to delays. They also involve multiple stakeholders in different locations and a complex array of regulations.
Agatha is a Tokyo-based startup that’s taking some of the pain points out of clinical trials by providing automated processes for creating, managing and tracking clinical trial documents. Agatha offers a cloud-based system that connects all participants, allowing them to share documents, communicate and collaborate. This is a huge advantage because a single clinical trial can involve over 100 hospitals, multiple manufacturers and thousands of patients.
Traditionally, this has been a paper-driven process involving trial protocols, consent forms and monthly reports up to 300 pages long. Agatha’s system is compliant with regulations in Japan, the U.S. and Europe relating to health records, clinical trial regulations and rules relating to long-term storage of records.
“Our solution is to remove the paper and put everything online,” says Agatha cofounder and CEO Kamakura Chiemi. “What makes us unique is that we can offer this solution for both hospitals and pharmaceutical companies, while most other companies serve one or the other.”
Kamakura became an entrepreneur through a chance discovery. After earning an MBA at Rice University in Texas, she returned to Japan and was working in business development at a Japanese conglomerate when she visited a group hospital and came upon big stacks of paper being used for a clinical trial. Intrigued, she learned that hospitals were going through two tons of paper annually, but only drug makers could afford the $2 million software solutions offered by her company.
In 2015, she established Agatha to deliver on her vision of a cloud-based solution at a price more than 100 times less than that of her former employer. Agatha now has about 200 clients, of which approximately half are hospitals and half are pharmaceuticals and medical device makers.
Agatha has seen increased demand amid the COVID-19 epidemic in Japan, as pharmaceutical firms and research organizations have become reluctant to dispatch workers to hospitals. Building on its success, Agatha is now aiming to add artificial intelligence features to its services while expanding its business outside Japan. With offices in France and the U.S., a French COO and a new head of North American operations, Agatha is well positioned to build its business abroad. New overseas customers include companies such as Mablink Bioscience, a French firm specializing in immuno-oncology, and Agatha has built partnerships with firms in countries such as Spain, Italy, Germany, Russia and China.
“Our system is very quick, very cost effective and can be used right away,” says Kamakura. “We’re meeting the needs of small biotech, pharma, and medical device companies as well as system integrators in various countries that want to offer Agatha as part of their consultation services. This is all part of our broader mission, which is to contribute to healthier lives everywhere around the globe.”
Note: All Japanese names in this article are given in the traditional Japanese order, with surname first.
To learn more about MICIN, click here (website in Japanese).
To learn more about Agatha, click here.
To learn more about Japan’s regulatory sandbox scheme, click here.
Japan is changing. The country is at the forefront of demographic change that is expected to affect countries around the world. Japan regards this not as an onus but as a bonus for growth. To overcome this challenge, industry, academia and government have been moving forward to produce powerful and innovative solutions. The ongoing economic policy program known as Abenomics is helping give rise to new ecosystems for startups, in addition to open innovation and business partnerships. The Japan Voice series explores this new landscape of challenge and opportunity through interviews with Japanese and expatriate innovators who are powering a revitalized economy. For more information on the Japanese Government innovations and technologies, please visit https://www.japan.go.jp/technology/.