Opportunity and challenge of medical electronics industry in Taiwan

1. Opportunity and challenge of medical electronics industry in Taiwan Dr. Pin-tsun, Chao Associate Researcher STB program STPI, NARL 國家實驗研究院科技政策中心

2. Outline • Medical device industry • Global/Taiwan • Opportunity and challenge of medical electronics industry • IT Giants • Traditional Med-Electronic • Taiwan’s role • Myth of Telemedicine • Some Suggestion

3. Medical device industry

4. Background • Aging Society Source: U.S. Bureau ofa the Census；工研院IEK; 張慈映工研院產經中心(IEK)生物科技產業與投資趨勢研習會 醫療器材產業發展現況與趨勢 2008

5. US healthcare cost Source:張慈映工研院產經中心(IEK)生物科技產業與投資趨勢研習會 醫療器材產業發展現況與趨勢 2008

6. Global MD market growing • Annual growth > 8% 資料來源：Espicom Business Intelligence (2006)，工研院IEK (2006/05)

7. Medical device category

8. MD companies on market

9. Opportunity and challenge of medical electronics market

10. Opportunity • Due to the growing aged people, the ME market is also growing!

11. Opportunity for who? • More IT companies want to join this field. • Why IT industry want get in Medical ? • Looking for new application • Medical product • High margin • Longer Product Lifetime • Endless need

12. What other IT giants thinks • Almost all IT giants (HW/SW/IC) declared to enter medical market or initialized medical-related development • Intel • Microsoft • Texas Instrument

13. Intel

14. Intel • World leading CPU/IC manufacturer • Have latest technology for manufacture IC • Moore’s Law • 45nm/32nm

15. Why Intel want to get inmedical market ? • Grow our markets: supply computing and communications technologies to a broadly defined home health & wellness market which is poised for massive growth worldwide • Healthy workforce: insure our own 80,000 employees worldwide have tools, technologies, and training to care for their own aging parents • Healthy economy for business: catalyze new paradigms of health care to head off looming worldwide economic crisis from high-cost, clinic-centric care that cannot scale to meet the needs of the age wave We will never be a healthcare company. We supply technology ingredients. But we continue to lead R&D in new areas. And some new players will shape next generation technologies for the next generation of seniors. Source: Intel

16. Development Strategy • Join policy / standard association • Device interoperability standards • Personal health records • Medical information standards • Intel is committed to understanding the needs of healthcare professionals, as well as anticipating and responding to future needs.

17. Early start • Start from 1999, Intel researchers began focusing on healthcare needs and how technology could address them • In 2002, Intel established Proactive Health Lab, to explore new technologies that will help people to proactively manage their health and wellness, to prevent or delay the onset of disease.

18. 2 focus • IT in healthcare • help healthcare enterprise run more efficiently and effectively • healthcare system, hospital, clinic, biopharma company, payor, government agency, or ministry of health. • Personal telehealth • challenges ahead • Patients remain at home • Patients and clinicians work together to achieve the best outcomes • Patients are viewed in their totality, including their health status, as well as their social network, and their individual capabilities and preferences

19. The evolution of remote patient monitoring http://www.intel.com/healthcare/pdf/RPM6_12.pdf

20. Gotten FDA clearance for a health monitor which can interface with wired or wireless health measurement devices such as glucose meters and blood pressure cuffs in July,2008

21. “Health care is the mother of all big businesses …. this is life and death—some people will get access to this ‘health-care mainframe,’ and everybody else dies.” - Andy Grove Source: “Intel's Andy Grove: The Next Battles in Tech: The IT visionary says tech needs to learn to think bigger,” by Brent Schlender, FORTUNE, Monday, April 28, 2003

22. Microsoft

23. Microsoft + Healthcare is Growing • 1995 Microsoft Healthcare Team Established • 1999 MSN health&fitness releases • 2005Health Solutions Group(HSG) • 2006 Acquisition of Azyxxi* from WHC • 2007 Acquisition of Global Care Solutions, Acquisition of Medstory* • 2008 Amalga*, Amalga hospital IT system (Amalga HIS), and HealthVault launched • Peter Neupert as Corporate Vice President, Health Solutions Group • Azyxxi:醫療（病歷）資料庫軟體，是一種數據瀏覽引擎（外號：醫院的Google）。 • Medstory: 另一個医疗健康类垂直搜索引擎 • Amalga醫療企業系統 : 前身是Azyxxi產品的新版本.

24. Insight Microsoft Healthcare and Life Sciences group • The Microsoft Healthcare and Life Sciences group is 10+ year of service to the industry. • 180 Microsoft employees dedicated to this group. • $6.8 billion in R&D investment annually. • Team members include doctors, nurses, pharmacists, and other clinical staff with experience working for healthcare and life sciences organizations. • The Microsoft Healthcare and Life Sciences group is made up of five subcategories to better address the specific needs of each industry: providers, health plans, pharmaceuticals, biotechnology, and medical devices.

25. Microsoft Health Solutions The platform (Microsoft .NET Microsoft Amalga Microsoft Dynamics Microsoft Office System Microsoft Windows Client Windows Mobile Windows Server System)

26. Microsoft Health Future Vision

27. TI

28. Texas Instruments • Texas Instruments develops analog, digital signal processing, RF semiconductor technologies. • Core technology • Analog: high-performance analog (includes standard power management products, data converters, amplifiers and interface products), high-volume analog & logic • Embedded Processing: DSPs and microcontrollers used in catalog, communications infrastructure and automotive applications • Wireless: DSPs and analog used in basebands, OMAP(TM) applications processors and connectivity products for handsets • Other: DLP(R) products, calculators, RISC microprocessors, ASIC products, royalties

30. TI’s path into medical device • In 90s, they have develop some ICs for medical imaging, ultrasound, etc. • In 2006 • form a medical electronic department • Develop less power consumption, lower cost, smaller size product for medical applications • Focus on SoC (system on chip) and wireless • ISO/IEEE 11073 • Point of Care Medical Device Communication Standards

31. Join Continua Health • Continua Health Alliance • comprised of technology medical device and health care industry leaders dedicated to making personal tele-health a reality.

32. Continua Health Alliance

33. TI’s strategy in medical electronics

34. TI’s Vision for medical electronics

35. Short conclusion of IT giants • All IT giants start from their core competence • Closely cooperate with health care provider—doctor, nurses, physicians • From hospital to home, gradually • What about other traditional medical electronics company?

36. How about GE/Philips/Siemens? • They are not pure IT/electronic companies • All had long history working on medical electronic device • They had key advanced element/ technique • GE invented CT in 1975 • Philips manufacture X-ray tube in 1896 • Siemens had first wholly commercial particle therapy project in Germany • Their vision can be viewed as the next generation of landmark

37. GE vision: Early health • Early health is focused on enabling earlier diagnosis and more effective treatment of disease. • Cancer • PET/CT • Mammography • Cardiac • Ultrasound • High-speed CT http://www.ge.com/innovation/health/index.html

38. Philips Medical More than in hospital or lab • Lifeline • Home Respiratory • Remote Cardiac Services • HeartStart Home Defibrillator

39. Siemens: • Ultimately enhancing patient care • Medical imaging • Therapy • Laboratory diagnostics • Healthcare IT solutions

40. Chance for Taiwan IT?

41. Chances/challenges for Taiwan IT? • What can we do? • OEM? • BP monitor? Thermometer? • Fight directly with Large MD company? • Need too much source • Lack of core technique • Follow IT Giants? • Lack of brand

42. Chance for Taiwan? • Which way? Source:張慈映工研院產經中心(IEK)生物科技產業與投資趨勢研習會 醫療器材產業發展現況與趨勢 2008

43. Capsule endoscope Given Diagnostic Imaging System Approved August 1, 2001 http://www.givenimaging.com/

44. Fetal movement detection • Biopad • Founded in 2004 • Have raised $3 million • provide • (a) the baby's activity is within normal range • (b) fetal movement has declined and that she should see her clinician • Mother will use the disposable pads (up to three times a day) for a period of 20 minutes each time http://www.biopad.com/

45. Learn from Israel • What did they do? • Solve problems that bother doctors or patients • Endoscope vs capsule • Long time measurement of fetal movement • Provide value

46. Another example but not ME: Fitbit • Fitbit automatically tracks your fitness and sleep WEAR SYNC VIEW

47. Fitbit • raised $2 million in 2008 Oct • uses the information it gathers about your movement to help you determine how much exercise you've been getting and how many calories you've burnt. • It can also tell you how many steps you have taken and how well you've slept, all based on its internal motion detector

48. So What can Taiwan IT do? • OEM is easier, familiar, faster to make money • But not a long term choice • Try to solve some “clinical” and “urgent need” problem!

49. Myth of Telemedicine

50. Our Myth ? Telemedicine(TM) =ECG/EEG/BP + PC/cell phone/NB/PDA Source: http://research.microsoft.com/en-us/um/redmond/events/fs2007/presentations/oliver_nuria_faculty_summit_071607.ppt