Disrupting Japan podcast

The Japanese startup killing the nasal swab

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15 Sekunden vorwärts
15 Sekunden vorwärts
Sometimes it seems like Japan just can't figure out medtech startups. In theory, Japan should be one of the most active startup markets for medical technology. In practice, however, there are relatively few success cases. Today we are going to meet one of those success cases and talk with Sho Okiyama, MD and founder of Aillis, who has developed a minimally invasive flu and covid test that is already in widespread use in Japan. Hopefully, no one will ever need to stick another swab up your nose. We also talk about Sho's time as a rural doctor, what's straining Japan's healthcare system, and how to fix it before it breaks. It's a great conversation, and I think you'll enjoy it. Show Notes Why influenza diagnosis has been so resistant to AI You’ll never get another swab stuck up your nose What practicing as a rural doctor taught Sho about Japan's healthcare system Some Japanese still turn to Shamanism for medical advice Starting an AI startup without a technical founder Building a medical training dataset from scratch The challenge Anthropic and OpenAI face in medical tech Aillis's plans for global expansion Why there are so few medtech startup in Japan and how to fix that How to drive meaningful change in Japanese society Links from the Founder Everything you ever wanted to know about Aillis Learn more about Evidence Finder Connect with Sho on LinkedIn Friend him on Facebook Follow him on Twitter @ShoOkiyama Watch Sho's TEDx talk on AI development in modern medicine Leave a comment Transcript Welcome to Disrupting Japan, Straight talk from Japan's most innovative founders and VCs. I'm Tim Romero, and thanks for joining me. Japan has a real problem with life science startups. I mean, there's no shortage of brilliant ideas and patents. There's no shortage of support programs and investors looking to invest in Japanese medtech and biotech startups. Everyone in Japan wants this to happen. Everyone knows this is about to happen. And yet, everyone is also a bit frustrated at just how slow this is happening. But of course, it is happening. So, today we sit down with Sho Okiyama, medical doctor and founder of Aillis, who has developed an AI-powered throat camera that can actually diagnose both influenza and COVID. It's the first device of its kind ever approved as a diagnostic medical device, and it is already in widespread use in clinics and hospitals in every prefecture in Japan. It's really an amazing success story that is just getting started. Sho and I talk about what it really takes to bring a new medical device to market in Japan, what it's like to be the only doctor on a string of remote Japanese islands, and how we're going to get more Japanese doctors to start startups. But you know, Sho tells that story much better than I can. So, let's get right to the interview. Interview Tim: So, we're sitting here with Sho Okiyama, the founder and CEO of Aillis, who is using AI to make medical diagnosis faster and more accurate. So, thanks for sitting down with me. Sho: Thank you for having me, Tim. Tim: I'm really looking forward to this, because I think there's so much innovation going on in biotech and medicine in Japan right now, and what you guys are doing is really interesting. So, you've got two products, and I'd like to kind of cover them briefly. First, you have the Nodoka diagnostic camera. Sho: We produce Nodoka, which is a medical device. This is a pharyngoscope. In other words, it's a throat camera. So, whenever you go to the doctor, the doctor would take a look at your throat, right? You know, find out whether it's reddish, swelling, or something like that. But all those inspections were based on knowledge inside the doctor's brain. So, what we developed was the database of the pharyngeal photo. Tim: So, when a doctor is looking at someone's throat, they're looking for all kinds of different things. But Nodoka, as I understand it, is looking for two very specific things, right? It's able to diagnose influenza and recently COVID as well, right? Sho: Yes. We used to diagnose influenza and COVID using PCR or similar methods. Tim: How accurate is it compared to the PCR test? Because I would be very, very happy if I never have to get another swab up my nose for testing these things. Sho: Yeah. Nodoka has gone through a clinical trial and has proven that it has approximately equivalent accuracy compared to the antigen testing. Tim: That's fantastic. And it's in widespread use already, right? Sho: Yes. It has been introduced to more than 2,000 hospitals or clinics in Japan. Tim: And is the driving factor just patient comfort? Nobody likes getting the swab up the nose? Or is it more accurate? Is it faster? Sho: Yeah, it's faster. And of course, it's less invasive, right? And what's more, Nodoka only has indications for two different diseases as of now, but it has the potential to have more indications, like cancers such as tongue cancer or pharyngeal cancer. And we also wrote a paper that the AI is able to detect signs of diabetes only through the image of the pharynx. Tim: Really? Okay, I want to get back to Nodoka because it's super interesting. But before we do, I want to talk just really briefly, introduce your other product, which is Evidence Finder. Sho: So, this is an LLM-based tool we developed for doctors. There are tons of medical information coming out. There are hundreds and thousands of papers published every day. So, doctors need to keep up, right? But it's a huge burden for doctors. So, what Evidence Finder does, it's a chat-based tool, such as, ChatGPT or Gemini, but it cites scientific papers. We use multiple techniques to prevent hallucination, which is very, very important in the field of medicine. And it also gives the doctors concrete evidence why the AI had said what he has said. Tim: So, is this more of a research tool, or is it something that could potentially be a diagnostic tool? Sho: It could be used in both ways. If the doctor were to use it in clinical settings, it needs to be approved as a medical device, which also could be the case for us developing the medical device version of Evidence Finder in the future. Tim: Well, I understand that getting certified as a medical device is very much on your roadmap at the moment, right? Sho: Yes. Tim: Okay, I really want to dig into that. But before we do, I want to back up a little bit and talk about you. Sho: Thank you. Tim: So, you graduated from University of Tokyo Med School in 2010. And after graduation, you ended up practicing in some very rural areas of Japan, right? Sho: Yes. Tim: I mean, University of Tokyo Medical School is the most prestigious medical school in Japan. Graduates go into top-tier internships and hospitals all over Japan. Why did you decide to go to Okinawa and these rural areas and work as a rural country doctor? Sho: Yeah, I started my residency in Red Cross Hospital in Shibuya. This is a huge hospital. It has like 20 doctors on duty at midnight. And you can perform MRIs, CAT scans 24/7. But the hospital was too developed for myself. And if I were to work there for 10 years, I would end up as a doctor who is only able to work a developed hospital like the Red Cross Hospital in Shibuya. So, I found in myself that I needed to go to rural areas or small clinics to develop my physical examination skills, as well as not ending up as a niche specialist. I wanted to be a generalist. Tim: That makes a lot of sense. So, I mean, I could see that on one hand, going into prestigious hospitals, it's a very smooth escalator. On the other hand, it sounds kind of like the medical equivalent of being a sour man. Sho: Oh, yeah, you could say it in that way. Tim: I mean, things are decided for you. You sort of get pushed into doing one specific track or rotated through. So, how long were you in Shibuya before you made that call? Sho: I was in Shibuya for three years. And then I went to Ishigaki and Hatsuka Islands for one year. And Hatsuka has only 500 inhabitants on the island. And there is, of course, I'm the only doctor on the island. So, you have to be on call for 24/7. If there are emergency patients, I had to call the helicopter and ride the helicopter with the patient to the main island. Tim: Right, right. Because I imagine you're responsible for a number of the surrounding islands. Sho: Yes, yes, we are. Tim: The lack of rural doctors in Japan, it's a real problem now. Do you see technology as being able to kind of address this? For example, the Ministry of Health and Welfare is pushing hard on things like telemedicine and technology sandboxes to allow new technology to be experimented with. Do you think technology is the solution or is it more getting human doctors interested in going? Sho: It's both technology problem and the doctors themselves. But it's less difficult to solve this problem in a technological matter because human beings or doctors don't switch their ways of thinking instantly. But technology, it's changing every day, every week. Tim: Yeah, that's true. You'll certainly make faster progress on the technology front than on the human front. Sho: Yeah, but the decision I made to go to the island, this was 2012 or so, 15 years ago. So, there was less technology, there was no telemedicine at all. So, I had to go there, I went there, and noticed that there's a huge gap between the medicine practice in Tokyo and on the island. But I was taught in the university that Japan is the top one country which has the least discrepancy between the medical level within the nation. Tim: Really? I believe that, I could see that. That's something to be proud of. Sho: But the reality was that there still is a huge gap. So, after going to the island, I want to lessen this discrepancy. And medicine is not for the rich people. It's for the humanity itself. ...

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