Category: Insights

Our opionin, idea,

26 May 2020
PUBLIC HEALTH AND INNOVATIONS

2020 WMIF INSIGHT – PUBLIC HEALTH AND INNOVATION

Dr. Gregg Meyer,  professor at Harvard Medical School and Chief Clinical Officer of Partner Healthcare, says in the 6th World Medical Innovation Forum (2020 WMIF) that the unsolicited new coronavirus (Covid19) has changed everything. The routine right now is changes happening every day. I summarize some of the insights to this month’s newsletter and hope we learn and grow, especially in the tremendous transformation of the global healthcare landscape. 

A new coronavirus (Covid19) attacks indiscriminately. The synergy of the global healthcare community should be strengthened rather than fragmented. On public health, AI and big data should play a role in enabling real-time interaction between doctors and patients and networking with home care. Meanwhile, the implementation of Care Delivery based on reducing physical Contact between doctors and patients should continue to innovate and transform the existing hospital physical space. The trend towards de-globalization does not affect the global healthcare collaboration system that has emerged. 

  1. According to Dr. Karen DeSalvo, chief health officer of google health, people are willing to provide their personal information in secure and encrypted ways to the public health system, thus enabling the public health sector to obtain more sufficient data to establish various monitoring models and algorithms for epidemics. While AI currently works only for known diseases, Bayer’s senior vice president Dr. Mike Devoy says there seems to be a natural consensus among different organizations around the world to open up data, innovate and collaborate to develop new drugs and vaccines.
  2. In the new normal of coexistence with the virus, we have to innovate our care delivery routine to reduce physical contact between medical staff and patients. For instance, the waiting area of the hospitals and clinics should be redesigned to perform initial screening for cross-infection prevention. We also consider various technologies to implement bed to bed, ward to ward communications, which ultimately reduce face to face contact.  Tele-medicine, internet hospitals are effective ways to reduce the frequency of outpatient.
  3. In the future, digital home care will become an essential part of public health. Families will adopt consumer devices to extract the health and vital signs data automatically. And automatically connect with care delivery institutions to complete the diagnosis, health warning, and risk evaluation, and completing the Internet medical treatment process. Among them, the chronic disease population will be the focus of public health.
  4. In the face of growing anti-globalization sentiment, Thermo Fisher Scientific chairman and chief executive Marc Casper said the product could not be delivered without 20,000 employees‘ teamwork in different countries and different functions. Now is the time to strengthen global cooperation, such as in small countries such as Cambodia. They can not localize medical products, some middle-sized countries in Europe, but also need participation from other regions to complete medical services.

The ”Disruptive Dozen” results from interviews of one hundred Mass General Brigham senior Harvard faculty followed by a rigorous selection process to identify the twelve mostly likely to have significant impact on healthcare by the end of 2021.

#1 | Battling COVID-19: Maps, Technology, and AI

Mapping the spread of infectious diseases within communities is more important than ever as the novel coronavirus continues to sweep across the globe. Researchers are harnessing AI, technology, and advanced data analytics to map the spread of COVID-19 and identify those infected with the virus.

#2 | Harnessing Technology to Reduce Health Disparities

Health is determined not just by genes, diet, and exercise, but also by the environments where people live, learn, work, and play. New technologies are emerging to help reduce health disparities and improve health outcomes.

#3 | Digital Management of Chronic Disease

Chronic diseases are a major challenge for patients and health care systems alike. In 2016, the U.S. spent over a trillion dollars caring for patients with heart disease, diabetes, cancer and other chronic conditions. Find out how technology could help improve care for these patients — and lower costs.

#4 | Solving the Problem of Infection in Total Joint Replacements

Total joint replacement is an increasingly common procedure. For most patients, recovery is uneventful and lasts a few months, but some experience a much more complicated and painful journey due to infection in the artificial joint. Find out how researchers are harnessing technology to help address this problem.

#5 | New Tools to Help Aging Eyes and Ears

Like many parts of the body, the eyes and ears can deteriorate with age, making them vulnerable to disease and loss of sensory functions. Find out how new technologies and treatments could help patients and clinicians better protect these organs from age-related decline.

#6 | Gene Therapies Transform Treatment of Rare, Devastating Diseases

The emergence of the first gene therapies for clinical use signaled a watershed moment in the history of medicine. This treatment modality will do ever more in the coming year for patients, especially those with rare genetic conditions.

#7 | New Therapeutic Options for Sickle Cell Disease

Millions of people worldwide suffer from sickle cell disease. While the cause of this debilitating blood disorder has been known for half a century, only two drugs are currently available to treat it. New developments are on the horizon that could help transform the management of a disease that has too often been overlooked.

#8 | Keeping Transplant Organs Fresher for Longer

Over 120,000 people in this country are now waiting for an organ transplant. What if it were possible to increase the time that organs can be safely stored outside the body prior to transplantation? Scientists are working to drive innovation in this area in an effort to expand the pool of donor organs available for those who need them.

#9 | First Disease-Modifying Therapy for Alzheimer’s Disease

The world lacks a meaningful treatment for Alzheimer’s disease, a progressive, debilitating neurodegenerative condition that affects millions across the globe. But that could change later this year, when the FDA is expected to weigh in on a novel drug that targets clumps of protein in the brain known as amyloid plaques. If approved, the drug would mark the first disease-modifying therapy for Alzheimer’s disease.

#10 | Making Cells Larger to See Them More Clearly

Visualizing cells at high-resolution is a cornerstone of modern biology and medicine. For more than a century,  as scientists yearned to observe biological structures with greater power and clarity, they built more advanced microscopes. Yet today, even those sophisticated tools have limits. See how researchers are developing a innovative new approach to cell visualization.

#11 | Video Games for Stroke Patients

Each year in the U.S., some 800,000 people suffer from a stroke. For those who survive, recovery often includes intensive physical and cognitive therapy to help regain functions that have been lost or impaired. But this can be a long, difficult journey that tests patients’ fortitude — and their wallets. See how clinicians are looking to help increase patient motivation and compliance as well as increase access to rehabilitation services. In the below video, Ross Zafonte, DO provides perspective on the technology.

#12 | Reducing the Burden of Prior Authorizations

A widely used administrative tool in U.S. health care, which is meant to control costs while ensuring quality, is getting a major overhaul. The tool, known as prior authorization, requires physicians to first obtain approval from insurance companies for certain treatments in order for them to be covered by patients’ insurance plans. See what could save clinicians time as well as some $450 million for the health care industry. In the below video, Marcela del Carmen, MD provides perspective on the technology.


Authors

ANDY YU |Bio| Andy@tmfox.com

Mr. Yu founded TMFOX VENTURE PARTNERS in Shenzhen in 2009. He has been committed to building an innovative investment banking business platform that integrates incubation, acceleration, and investment to enhance the growth of high-tech companies, and has actively participated in it. To the construction of the science and technology service system of the Guangdong-Hong Kong-Macao Greater Bay Area Regional Government. In 2015, TMFOX’s virtual incubation model was promoted nationwide by the Policy Research Office of the State Council as a representative institution. In 2017, he cooperated with the School of Management and Engineering of Central University of Finance and Economics to set up an entrepreneurial innovation experimental class and acted as a technical innovation course tutor. In 2018, the experimental class became a demonstration project of university education reform by the Ministry of Education. In 2018, TMFOX’s professional virtual incubation system was established as the technology incubation industry standard by Guangdong Province. Mr. Yu has been working on North American healthcare research and collaborative implementation of project resources in China since 2015. Currently he focuses on managing Worldiscoveries (North American Medical College Alliance), UW (University of Washington) School of Life Technology, UBC (University of British Columbia) ) Collaborative R & D and technology marketization of medical schools.

29 Apr 2020

COVID19 –SURVIVAL IN AN ERA OF GLOBAL TURMOIL

 In 2019 we were talking more about how to deal with the uncertainty of the next ten years, but apart from the Sino-US trade dispute, we could not define what this topic was. A global pandemic of the Covid 19  is questioning our ignorance and contempt for nature. It also unveils the essence of the competition between the great powers in the context of economic globalization over the past decade, and the new multilateral trading system is emerging.  Healthcare restructuring becomes a national strategy for every country. The restructuring of the global industrial chain is underway. The value of cutting-edge technological innovation will be enhanced, but the risks will increase accordingly. The digitization will further transform the management  of business for a low margin. I want to share with you the above trends, and I hope we work together for the future.

After the outbreak, we will face a volatile and protectionist prevailing global market, similar to the warring States period 475 BC 221 BCin Chinese history. The new regional trade zones dominated by the United States, China, the European Union, and the United Kingdom respectively will formalize. The new rules will affect product sales, logistics, pricing, market access, culture, and value. Therefore, They also increase the complexity of market expansion and product costs.

  • Stephen Schwarzman, CEO of Blackstone Group, said during an interview by Yahoo financial in October 2019 that the central issue in the Sino-US trade dispute was the United States to change China’s system, which happened to be the fundamental guarantee of China’s development as an emerging economy. Europe has realized that it can not choose sides between China and the United States any longer. It is not its interest as the birthplace of modern industrial civilization in the history.
  • In 1999, the proportion of the global population living in extreme poverty was 28.65%. The number had fallen to 9.98 % by 2014. The decrease of the extreme poverty population means 1.2 billion people worldwide were out of poverty as a result of globalization. In terms of the export value to the GDP over the same period, China’s share varied between 20% and 40%, while the United States remained between 7% and 9%. Bilateral trades (including the number of bilateral trade agreements and total trade volume) of developing countries accounted for 60% of the global total, and developed countries were only about 30% of developing countries.
  • Developed-country-led rules set by the World Trade Organization (WTO) have gradually lost balance in the rise of emerging economies. The inability of developed countries to absorb the loss of value from their trade surpluses through other economic instruments has been a source of increased trade friction between developed and emerging economies in recent years. Bilateral or multiple trade agreements have been mainstreamed, particularly in the last five years.

After the outbreak, we will face a volatile and protectionist prevailing global market, similar to the warring States period (475 BC – 221 BC)in Chinese history. The new regional trade zones dominated by the United States, China, the European Union, and the United Kingdom respectively will formalize. The new rules will affect product sales, logistics, pricing, market access, culture, and value. Therefore, They also increase the complexity of market expansion and product costs.

From 2010 to 2019, it is a decade of rapid expansion of artificial intelligence(AI) and mobile internet in China’s healthcare market, and a golden decade of transformation of the patient conduct into consumer behavior. The continuous innovation of mobile healthcare or Internet healthcare in the traditional healthcare system has made patients more mature when dealing with health consumption. According to TMFOX survey: In the area that is densely populated and economically developed, approximate 43% of newly diagnosed patients will study related health conditions or diseases through the Internet or reference books before making a doctor appointment; about 12% of i patients who are prepared to see the doctor will make a tentative diagnosis through a virtual doctor on the Internet; about 8% of the patients will make comparison of the doctor’s diagnosis to confirm that the decision is reliable and the costs are reasonable.

We are saying goodbye to the consumer market before 2020 and gradually entering the minimalist era. Consumers will regard cheapness and convenience as the main factors in their purchase decision, and they will no longer be loyal to any brand and habits. Family-based health sports will become the main entertainment consumption.

The outbreak of the Covid19 lead the consensus cultivated over the past 30 years with technological innovation gives way to the individualists Maybe the individual never changes as we think they would.

The product’s market attributes, such as price , and convenience become the core of consumer concern. The social attributes of products will be diluted in the future.

We need to coexist with the virus for a long time in the future, aggregate mass entertainment will no longer be the first choice for consumers, and healthy sports and entertainment, including online and offline, in family units, will be developed.

In the future, families will be as cautious about their investments and cash flows as businesses do, and families will deal negatively with long-term investments (more than 12 months).

Case Study: Challenges of Primary Medical in ChinaThere is no doubt that the Covid19 has forced the reconstruction of health care systems to become a national strategy. The state- or state-capital-based public health care system will play a major role in the future. They will work with the private sector to extend the healthcare coverage to the  Point of Care (POC). China will be the pioneer and the largest market for future global health reform. Medical and health technology innovation will become a measure of national strength.

From 1949 to 1978, China’s population doubled, and life expectancy doubled – from 35 to 68- mainly because the rural cooperative medical model (Barefoot Doctor Model) pushed health education for all, disease prevention, and treatment of common diseases to the forefront of demand (rural). And the failure case of Suqian (a city of Jiangsu Province) privatized healthcare reform has left 5 million citizens without medical options (American model).

China has become the only country in the world to push the fight against epidemic disease and healthcare system reform at the same time:

2020- 2-14, China issued guidelines for the reform of the health care system.

2020-2-22, China issued opinions on the details of the implementation of the health care reform.

2020-4,  8 public medical institutions and health insurance participated in the construction of Internet hospitals in China.

As a large savings-based consumer country, with the promotion of China’s investment scale of 300 billion (RMB) per year, China will become the main market for health care in the future. At the same time, the strain of the epidemic on the global health system will prompt the landing of primary healthcare-based (POC) programs that began in 2015 (countries already in operation include Germany, Canada, the United States, and China).

Countries will implement national security controls on key biotechnology in the future. The competition for medical innovation talent and technology will become extremely hot.

Although the global industrial chain ecosystem takes time to complete the reorganization, the collaboration mechanism will be broken by the Covid19. Economies will re-engineer industrial collaboration systems along the lines of technology and industrial safety, which will undoubtedly either increase the cost of products or force firms into low-margin times.

Although most companies are reluctant to make changes to the existing industrial chain collaboration, regionalized logistics and production centers will no longer be just a matter of discussion but of when to start, according to Joe Zidle, the Chief Investment Officer of Blackstone group, in a client newsletter in April.

If the end user price of the product can not be increased effectively, the company will no longer be as generous to the industrial chain system as before. They will reduce the cost as much as possible and limit the profit space of raw materials, production, and logistics through large-scale procurement.

The proposition put forward by the epidemic situation to the managers of small and medium-sized enterprises is: in the future, what are the main elements that affect the operation safety? How can we reduce costs and increase efficiency? How to apply digital strategy to enhance the core competitiveness of businesses.

Although we have gradually adapted to the virtual (online) working environment during the epidemic period, there are two problems that have not been solved: one is the problem of communication; the other is the problem of trust and authorization. In the future, small and medium-sized businesses will gradually establish a business and decision system with blockchain technologies, which can visualize the efficiency of each process and can connect with external information and analysis tools to improve the decision making.In considering low profits, businesses are no longer willing to spend 3-5 years as in the past to do train the team. The talent strategy focus on how to improve the output of individuals. In the future, Digital software will be more effective in helping businesses to manage and maintain core resources. Digital assessment tools will help managers to objectively evaluate the cultivation of core competencies. Businesses will gradually modularize business functions and outsource non-core business functions.

The pessimist is right, and the optimist is successful. While we are optimistic, we should also think about the way forward. The year 2020 is a year of great change, and the first year we enter the new world together. Let us think objectively and move forward optimistically, carry the beginning of this new world on our shoulders, work together, and move forward together.


Authors

ANDY YU |Bio| Andy@tmfox.com

Mr. Yu founded TMFOX VENTURE PARTNERS in Shenzhen in 2009. He has been committed to building an innovative investment banking business platform that integrates incubation, acceleration, and investment to enhance the growth of high-tech companies, and has actively participated in it. To the construction of the science and technology service system of the Guangdong-Hong Kong-Macao Greater Bay Area Regional Government. In 2015, TMFOX’s virtual incubation model was promoted nationwide by the Policy Research Office of the State Council as a representative institution. In 2017, he cooperated with the School of Management and Engineering of Central University of Finance and Economics to set up an entrepreneurial innovation experimental class and acted as a technical innovation course tutor. In 2018, the experimental class became a demonstration project of university education reform by the Ministry of Education. In 2018, TMFOX’s professional virtual incubation system was established as the technology incubation industry standard by Guangdong Province. Mr. Yu has been working on North American healthcare research and collaborative implementation of project resources in China since 2015. Currently he focuses on managing Worldiscoveries (North American Medical College Alliance), UW (University of Washington) School of Life Technology, UBC (University of British Columbia) ) Collaborative R & D and technology marketization of medical schools.

30 Mar 2020

RETHINK YOUR GROWTH STRATEGY

We know we all are on the path of the global recession. The questions remain how worse the economy will be and how soon we together could work out. The Chinese market is recovering but still waiting for the lights of hope of Europe and the North American market, which we all are struggling to reach the peak of COVID19, respectively. The meeting of G20 this month discussed many things in a very political way, which are significant, sounds good, but none is practical to save lives. We have to protect ourselves. We have to survive during this historical human and economic crisis, here are my thoughts:        

Check working capital

Today is the end of the first quarter of 2020. You need to review the 2020 budget with your chief financial officer and. Whatever you are burning investors’ money, or it is a mixture of the investment and the revenue, you need to carefully look at your monthly paid out and paid in, 12 months working capital is minim.You need to discuss with investors and bankers on possible continuing investment and loans and actively engage with the current economic stimulus plan. Please also re-examine Inventory “turns,” customer credit policy, administrative expenses carefully.  

Plan for market changes

If you already have operations outside your home, do not lose control during the period; what is happening here does happen there. We should believe that the outbreak of coronavirus and incoming recession change national governance, market, business environment fundamentally. Therefore, we have to stick with the changes mentioned above. For instance, after China released the aggressive healthcare reform plan in February, the US and Canada are planning the same thing as well. 

Stay focus on R&D

Do not cut R&D expenses; stay focus on the core technologies, outsource non-core R&D activities. One possible and welcome change would be a reversal in the decline of government-led investments in critically essential sectors of the economy. The decrease in spending on healthcare and biotech R&D as a percent of GDP put the US at a noticeable disadvantage to the competitors globally. New programs should be funded to increase preparedness for future disease outbreaks.  

Re-examine supply chain

Joe Zidle, Chief Investment Strategist from Blackstone, notes that the US-China trade dispute started to pressure companies might be forced to choose between efficiency and supply chain security. The decision could result in higher-paying manufacturing jobs, but at the expense of lower profit margins or higher prices. We will see what’s going on very shortly. However, the urgency is that make sure the supply chain is still working, changes in component price and transportation costs, whether the cost structure affects price and quality. The alternative should be prepared. 

Eventually, scientists will produce a breakthrough vaccine, and the frozen global economy will thaw out. However, meantime, stay safe, wash hands, wear mask and glove, reduce costs, stick on changes, be well prepared.

Gene Seq -200 – Open to Collaboration in US and Canada Market

TMFOX is happy to partner with GenePlus Technology(Gene+), a Beijing based biotech company, with its 30 million USD fundraising and business development to the US and Canada market. Gene+ was founded by the ex-chief operation officer of BGI, a leading life science and genomics company in the world.

Gene+Seq 200 sequencer  is designed for tumor-related applications, which featured as accurate, fast, and safe detection. Gene+Seq 200 sequencer has over 30 hospitals and lab installations in Asia and is now looking for partnerships in the US and Canada. Please contact me directly if you have any interests.

15 Mar 2020

The Opportunities and Challenges of China Pilot Demo Area (SHENZHEN) for International Hi-Tech Business

Practical Approaches to alleging growth strategy with the world-leading innovation driver(Great Bay Area of China)

In early August, China’s State Council and the Central Committee of the Communist Party of China issued a new guideline outlining an ambitious plan for the future of Shenzhen. In this plan, Shenzhen, as a core driver to Greater Bay Area (that would integrate Hong Kong, Macau Dongguan, Foshan, Guangzhou, Huizhou, Jiangmen, Shenzhen, Zhaoqing, Zhongshan, and Zhuhai), which account for approximately 12% of China’s national GDP and a combined population of 70 million people, will become a leading city in the world in terms of economic strength and development quality, specifically focusing on research and development, industrial innovation, emerging industries, public services, and ecological environment. In considering China to US trade tension and Global economic downturn, we present opportunities, challenges and how to strategy for global Hi-tech startups and business access to this oriental innovation engine for healthy growth.

The outline of the new economic system and key industries

#1 Plan: Enhance basic science and application-level research which targets key technologies research such as chip, new material, etc.

Action: Establishing a national science center in Shenzhen and establishing 10 global basic science research academies with over 15 billion funding in the next five years.

#1 Plan: Enhance basic science and application-level research which targets key technologies research such as chip, new material, etc.

Action:

Establishing a national science center in Shenzhen and establishing 10 global basic science research academies with over 15 billion funding in the next five years.

#2 Plan: Innovation sectors include 5G, artificial intelligence, cyberspace technology, and biomedical technology.

Action: 

  • Funding research labs, engineer facilities, establishing the Innovation center for the great bay area of China.
  • Establishing 20 global Innovation Center within major research areas around the world.
  • Establishing a Comprehensive Medical School and research center in Shenzhen.

#3 Plan Developing Ocean Economy which including deep-sea exploration equipment, ocean ecosystem research, and development.

Action:

Establishing National Ocean Bank and China Ocean University in Shenzhen.

#4 Plan Both Nation and city-level policies, funding, industrial chain optimization are priority to support Shenzhen to develop Smart manufacture, digit economy, big data, cloud computing, AI, advanced communication components, digital currency, advanced medical device, health care management system.

Action:

  • Establishing Manufacture Innovation Center in Shenzhen.
  • Establishing an experimental area of digit economy.
  • Establishing a big data center for the great bay area.
  • Encouraging and funding Chinese companies to set up oversea R&D facilities. Encouraging and developing international research institutions in building partnerships with locals in Shenzhen.

The changing of local laws and regulations

Action #1. Release policy-making power to Shenzhen, give Shenzhen the most power to decide which is the best to build a national model as an innovation driver.

Action #2. Encouraging foreign startups and businesses to set up their company as a local company with Chinese citizen treatment.

Action#3, Simplify Visa processing procedure to foreigners for business purposes.

Action#4, Allowing foreign medical experts such as doctors, healthcare professionals to practice without to be a Chinese certificate.

Action#5, Allowing city administrative to approach import medical device, also allowing production permit and device permit has not to be in one place.

Action#6, Allowing foreign currency to flow via Qianhai without an additional procedure.

Challenges and risks

The facts of recent economic figures of China have confirmed that the once export-orientated powerhouse is now much more internally focused, creating ample opportunities for companies looking to expand abroad. As the economy continues to grow (expected to expand by 6% this year), we assess some of the main risks and challenges encountered by overseas firms doing business in China. 

#1:Market access

Local distribution networks, buying habits of local consumers and regulatory requirements can make China a very difficult market to access. What’s more, the market environment is completely detached from most other economies in the world, making it difficult to take the first steps.

Tips:

  • Direct selling to China is no longer a workable approach to most Hi-tech startups and business unless you are only choice (China-US trade tension also should be considered), therefore, doing business or starting a business in Shenzhen may be a realistic approach. As one of the successful economic and innovation raw model, Shenzhen has built-in the past 40 years. Once you position yourself as Shenzhen business, it is much easier to sell to the rest of China.
  • Doing market research is another necessary step you have to take, a big number in market size is easy to understand, but the big number always confuse you into some rules as mentioned above.  

#2 Consumer preference

There has been a sizeable class shift in China over the past few decades, and the consumer environment is far more diverse than it once was. It is also completely detached from markets elsewhere in the world, and many companies have sunk in China because they failed to take into account consumer preference. 

Tips:

  • Copying to China has been dead mode for decades. Consumer preference study is mandatory. Listening to what target consumer say is more important than you follow the pattern big companies does.
  • The economic way to do consumer study is to visit area of Qianhai street. Not only over 50 Hi-tech IPO companies such Tecent locate there, but also many maker spaces, incubators, accelerators, venture capital funds, University labs locate there. Looking at what they do and listening to what they think about market and consumer is valuable.

#3 Bureaucracy and Administration

Overseas firms often struggle with laws and regulations in China, bureaucracy as their number one concern when expanding into the country. Most common complaints revolve around obtaining the required licenses and permits, the laborious processes is boring, sometimes even nowhere to go. Administration, licensing, product approvals and much more laborious operating tasks can leave managerial desks flooded in paperwork. For many firms, overcoming the bureaucratic hassle is the biggest task of successfully breaking the Chinese market. 

Tips:

  • Honest to say, Shenzhen is much better than other places in China. Even Shenzhen have the same difficulty when they expand out of Shenzhen. ”Small government, big society” is one of the key principles Shenzhen rules itself. As we can see over 200 administrative procedures have been suspended in the last 5 years.
  • Hiring local service experts to deal with the government, do not do it by yourself.
  • Treating both yourself and your company as a local, not a foreigner (LaoWai), make sure your business is inline of government support scope, establish local entity with Hi-tech certificate, software certificate, and many other things, they are not paperwork, they help you to get government funding, applying tax return, enable governmental and industrial allowance which ultimately reduce operation costs, R&D costs.
  • Both central government and local governments have certain programs to support Hi-tech R&D, outsource annually, build a Pro-forma financial statement to outline each component, they are not just free space, land use, etc.

#4 Intellectual property

Intellectual property rights are an area that has been notoriously difficult in China, although recent reports suggest this is an area that is improving the most. Every foreign company calling for stronger IP protection, more Chinese companies are calling for the same.

Tips:

  • The most important thing is you have to admit this is a changing fact, we wish it will be better. However, we have to take the risk. Intellectual property is not a key factor in our decision making process of doing business or not doing business in China.
  • Plan you IP framework before you go there, Ask investment banks, lawyers, and related expert to draw a clear picture of your innovation roadmap, Do an IP research on who is doing and what is not doing. Establish a routine check and review mechanism on assumed competitors. Most Chinese companies are not likely to release their inventions in the first place because of the worry of copying.

#5 Competition

Many Chinese companies are looking to improve the quality of their products and services so they can sell them abroad, which has increased competition as a result. Additionally, consumers can, in some cases, give preference to native companies over those from abroad. The government can also give preference to domestic firms, which makes disrupting the market rather difficult. 

Tips:

  • Secretly but not seriously secret, the government gives preference to domestic firms, especially government contracts with health care, aerospace, railway, water, gas, telecom, etc. In the past, foreign firms enter these kinds of business via Chinese middle man (Firm). However, with anti-corruption campaign have gone further, we would think there should be some transparency.
  • Start your business as a local brand, this is a kind of business immigration as we have seen very much possibility happened very shortly.
  • Look at the capital structure of your firm both in the motherland and in China. Build a father-son and son-father relationship, and ensure outside in and inside out cash flows as needed.
09 Mar 2020

China Healthcare Reform 2020

China is recovering from the historical shutdown although the CVOD-19 is still spreading into many countries. Farmers start their year routine as usual and the lonely cities are getting busier. The single-digit of new cases of CVOD-19 in the last two weeks gives Beijing confidence to restart the economic engine, that is said, 6% of GDP growth and buying more farm products from President Donald Trump are still goals and promises of China’s 2020. The chance is that China released an aggressive guideline for healthcare reform two weeks ago and estimated USD 30 billion governmental investment is going to spend on primary healthcare infrastructure and new technologies, the confusion is that how healthcare innovators in North America, such as you, could catch them up and make difference in there?

Healthcare Reform 2020

Beijing released 2020 healthcare reform guideline on Feb 14; each of them has long term impact not just for healthcare industry, but also for wellbeing of people in China. The move of this reform is not a one guy show, it requires global collaboration. The estimated investment is over USD 30 billion each year and primary care is key, I sum as following, for details, please refer to my article on linkedin “China’s reform on public health and healthcare system after coronavirus epidemic”:

  1. Build China’s own “biological shield “to safeguard national security.
  2. Promote “efficient and seamless convergence” between public health and medical services.
  3. Shift its focus to primary care; focus on strengthening the community public health forces, so as to enable general practitioners to play the role of prevention and treatment.
  4. Strengthen scientific research, disease control, and clinical treatment coordination anti-epidemic mechanism, strengthen information sharing and ensure that the three fronts of health care are highly coordinated and mutually supportive.
  5. Improve the classification, stratification, diversion, and treatment mechanism to ensure that the epidemic response orderly.
  6. The scientific and technological innovation mechanism should give full play to the role of advanced digital technologies such as big data, artificial intelligence, and cloud computing in epidemic surveillance and analysis, virus traceability, and resource allocation, so as to promote the modernization of epidemic prevention through information technology.
  7. The mechanism of emergency medical assistance and the mechanism of exemption of medical expenses for special groups and specific diseases should play the role of State financial and social security to reduce the burden of public visits and hospital treatment.

Strategic Confusion to China Market?

In February, I talked to 19 founders or CEO of healthcare clients from coast to coast, they are definitely outstanding both in technologies innovation and market development in U.S and Canada. However, the capital market does not say the same story, many of their stocks are devalued for a period of time. Over ¾ of CEOs think the potential of China market is three times more but fear of uncertainties to a new market may keep them in here. The most concerned 3 questions are:

  1. Pro or Con of Distributing to China market or selling to China?
  2. How intellectual property can be well protected?
  3. How to use cross-border capital to support local R&D while exploiting a new market?

I recommend all of you to read my article on linkedin “The Opportunities and Challenges of China Pilot Demo Area (SHENZHEN) for International Hi-Tech Startups and Business”, this is updated guideline and help you understand some new things and approach to grow in China market, I also encourage all of you write to me anytime for specific concerns.

09 Mar 2020

Coronavirus

The unexpected outbreak of coronavirus has caused fear of uncertainty for future and I am sure the outcome will shape many respects of the world No.2 economy. However, the nature of being smart, hardworking, and kindness Chinese just as described as personality of being rate in Chinese lunar book. Therefore, we should continue.. In January, TMFOX released report on POC (Point of Care) of China and I welcome global innovators and investors to work with TMFOX for value investing and better wellness to people. I also congratute our  client Sonic Incytes Medical based in Vancouver finalized its later seed fundraising and the success of this round definitely fuel the company to FDA process and early market access in both U.S and China.

Coronavirus Impacts

The outbreak of coronavirus in China is not a casual crisis,but a outcome of problems unsolved in past 40 years. It is a time to re-think root causes and solutions for future:

  • I can not predict how much worse the conronavirus damage the GDP of China at moment, but in general, the worsest the economy could be, the greatest potential it could re-bounced;
  • Policies makers in China will re-examine governmental spending and regulatory, especially health care system, public safety, and national R&D ecosystem. Some polit projects such as integrated healthcare system, electronic medical records, primary care will complete validation and execute at nation level.
  • Many small and medium business in high tech will be out of market in next 3 months, especially those are in low profit margin (less than 6%) and low rate of capital turnover .
  • Entrepreneurs are likely to suspend their long term stratety and concentrate suvivial plan at moment, this means they refocus on cash cow product, eliminate management process and headcount.
  • 80-90s Employee will encounter the most fierce competition in job market due to foreseen umployment rate, they have to rebuid their knowledge, skills, and re-define imployment relationship.
  • People will re-examine their relationship to nature, social value, government, community in terms of social responsibilities.

Research Highlights: China POCT Investing in 2020-2030

  • In the future, market forces such as retail, insurance, internet, community service and other organizations will bring consumers together to participate in the innovation of the primary medical system. These forces will drive traditional medical institutions and regulators to make concessions and get involved in innovation.
  • In the next 10 years, the global economic will be in turmoil, relative to the short lifespan of new technologies and the weakness of fixed income investments, investments based on POC and POCT will provide safe returns and lead a growth trend (CAGR greater than 10%).
  • POCT’s technological innovations (artificial intelligence, automation, biosensors, biochips) can completely replace some of the human labor in the medical system. We have every reason to believe that machine learns faster than human does, and that machines are not affected by emotions and physical limit.

POC should be on the front line of healthcare and bear at least 80% of the outpatient volume. As long as the quality is guaranteed, the service is convenient, and the price is affordable, there will be no doubt that patients are willing to accept the proximate primary medical service.

The complete report is downloadable from https://www.tmfox.com/the-value-of-poct-point-of-care-technology-investing-in-2020-2/  (English Version), and http://club-vc.com.cn/index/2020-02-06/28.html (Chinese 中文).

Sonic Incytes Medical completed last seed fundraising

Prof. Robert Rohling and Prof. Tim Salcudean started Sonic Incytes Medical at their lab at the University of British Columbia and later was incubated by Hatch Accelator at UBC. Sonic Incytes Medical focus on 400 million liver disease in U.S and China market and empowers POC (point of care) via accurate, portable, and costs saving diagnosis and paitent care technologies. With completion of this round leading by industry partner and venture capital globally, the client is in fast pace of FDA,early market validation, team building.

08 Mar 2020
POC insight

The Value of POCT (Point of Care Technology) Investing in 2020

China’s POC market and investing research -Issue  2020-1

The shortage of high-quality medical resources and people’s increasing demand for healthcare is a global challenge. In this report, TMFOX Healthcare team objectively conducted an analysis and demonstrated the innovation path and investment value of Point of Care Technology (POCT), and provided case suggestions for POCT to empower primary care. This study is based on 1) multi-dimensional changes of patient needs; 2) distribution of high-quality medical resource, and 3) real cases analysis.

More than 70% patients already have consumer characteristics

  • Patients will be better at using Internet information tools than doctors. They no longer trust doctors unconditionally as they did in the past; but demand full transparency in treatment process;
  • Information technology has never reach such a level that has allowed patients to use various convenient tools for self-management of health and disease. They already obtained basic medical knowledge and strong desire for preventing disease, and wish to collaboratively interact with medical providers on an equal basis;
  • In the past 10 years, with the inconsistent adjustment of various regulatory policies in China’s healthcare industry, patients have become more sensitive to prices and outcomes. They want to have “reasonable cost and explicit results”.

From 2010 to 2019, it is a decade of rapid expansion of artificial intelligence(AI) and mobile internet in China’s healthcare market, and a golden decade of transformation of the patient conduct into consumer behavior. The continuous innovation of mobile healthcare or Internet healthcare in the traditional healthcare system has made patients more mature when dealing with health consumption. According to TMFOX survey: In the area that is densely populated and economically developed, approximate 43% of newly diagnosed patients will study related health conditions or diseases through the Internet or reference books before making a doctor appointment; about 12% of i patients who are prepared to see the doctor will make a tentative diagnosis through a virtual doctor on the Internet; about 8% of the patients will make comparison of the doctor’s diagnosis to confirm that the decision is reliable and the costs are reasonable.

Deloitte’s 2019 Global Health Industry Consumer Behavior Survey Report [1] states that in Singapore, 38% of patients are likely to question the diagnosis of doctors, compared with 27% of similar data in the United States.  While doctor ’s decision is completely disagreed by 23% of patients in the United States, 6% in Singapore and 22% in Denmark.

TMFOX survey data shows that although more than 78% of doctors in China are more inclined to suggest patients avoid being too superstitious in the diagnosis or recommendations of from internet, doctors are unable to reject patients’ requests for transparency in medical treatment. This tendency will not be altered in the next 10 years.

Data from Deloitte shows that 40% of consumers worldwide are using various health technology tools, 60% of which are using home health management tools to monitor their physical conditions. Although Apple’s hardware sales are declining, Market Realist Analysis [2] points out that revenue from service will reach 21% of its overall revenue in 2019. Based on Apple ’s own innovations in medical devices and acquisitions of personal health devices companies (Fitbits, Gliimpse), Business Insider predicts that Apple ’s revenue from the health sector will reach $ 300 billion by 2027 [3]. CBINSIGHTS quotes FDA Commissioner Scott Gottlieb as saying [4] : “New medical devices empower consumers to better understand their health and better manage their own healthcare.”

TMFOX research indicates that compared with 10 years ago, more than 76% of Chinese patients are more sensitive to medical expenses and output. There are more channels to compare the quality of hospitals, doctors and medical services, from price, satisfaction, word of mouth, etc., and related discussion can be carried on many social media interactively. Similar figures are 53% in the United States and 45% in Singapore. Meanwhile, according to the National Bureau of Statistics of China, from 2014 to 2018, the annual growth rate of personal medical expenditures of Chinese residents exceeded 11%; whereas the government’s medical expenditures decreased at 2- 3% annually [5].

Therefore, healthcare institutions should reposition their relationship with patients from a macro perspective; and optimize the service procedure and service quality. This is the foundation for ensuring medical services quality and improving patient satisfaction.

Case Study: Challenges of Primary Medical in China

According to national policy and healthcare ecology, at least 80% of healthcare services should be provided at primary care institutions, but the fact is that more than 60% of outpatients are shared by only 33,000 large general hospitals in China.

The lack of medical equipment, information platforms and high-quality medical care staff is the main shortcoming of primary healthcare institutions in China.

From 2014 to 2018, although the annual growth in the number of primary medical institutions(We usually think they have same function to point of care in China) was only 0.71%, the overall quantity was still more than 30 times that of general hospitals in China. According to data from the National Bureau of Statistics [5], during this period, the number of outpatients undertaken by primary medical institutions was less than 40%. Excluding the number of visits that are general health services such as vaccines, the actual number of outpatient clinics undertaken by primary medical institutions is estimated to be around 30% (as shown in Table-1).

Table-1 Comparison of General Hospital and Primary Care Institute (Data source: Statistic China)

Data includes community hospital, community clinics, family clinics, community healthcare provider and general hospital.

We take a community health hospital as an example, which is located in the center of Shajing Street, Baoan District, Shenzhen, Guangdong Province, to analyze the current situation of primary care. This community covers an area of 3.08 square kilometers and has a permanent population of more than 60,000 people. The hospital was established for more than 20 years, with functional area of 3,500 square meters, and its service radius is generally within 1 km. Currently, there are 8 departments including general internal medicine and general surgery, as well as specialties such as emergency department, traditional Chinese medicine and rehabilitation physiotherapy, which basically cover the diagnosis and treatment needs of common diseases in the community. The hospital has one day-operation room; two auxiliary departments for inspection and imaging. The hardware is equipped with electrocardiogram, colour ultrasound, and X-ray. It is possible to perform routine inspections inside the inspection room and cooperate with third-party inspection agencies to deliver services. There are about 1 to 2 full-time physicians in each department, most of who are less trained and educated for medicine compared to registered doctors. The average daily visits of this hospital in 2019 are 480 person-times, 50% of which are general public health services in the health department, such as vaccination, child health, women’s census, etc., and chronic disease management is only 500 person-times throughout the year. ECG examinations are about 4 times a day, colour Doppler ultrasound examinations are about 12 times a day, and laboratory examinations (including delivery inspections) are about 49 times a day. The workload of medical technicians is not saturated, and the doctors mobility is high. In terms of recruiting, it is difficult to hire assistant staff in the department and full-time medical technicians. Lack of a regulated training system makes it difficult for doctors to improve their skills, and difficult for them to promote to a higher position. The hospital information system is backward and prone to malfunction. There is lack of appointment system and doctor-patient interaction platform.

professional technicians has reversely constrained the deployment of medical equipment in primary medical institutions. Without conventional medical equipment and timely diagnosis, the types of diseases that can be diagnosed and treated in primary clinical departments are limited, which leads to low volume of visits. Low salary and benefits make the recruitment even harder. Failure to provide quality medical services further leads to even less visits, forming a vicious circle. Patients with common and chronic diseases prefer large general hospitals than community based primary care. According to preliminary statistics of a triple A (first class) hospital in Futian District, Shenzhen, at least 70% of the outpatient visits are for common or chronic diseases, which unnessicerily occupies the workload that should have been used for more urgent and more severe diseases.

Global POCT market analysis and prediction

Point-of-care testing (POCT) is uniformly named by the POCT Equipment Technology Committee of the Chinese Medical Equipment Association. In 2012, it was defined as: a detection method performed at the sampling site, using a portable analytical instrument and its supplementary reagents to quickly obtain test results [6].


Users of Point of Care

German scholar Dr. Sandeep Kurmar Vashit defined POCT as a technology that can provide real-time detection, monitoring, and health management at the point of implementation of medical care; and is characterised as being real-time, rapid, and cost-efficient [7]. Although Chinese research institutions tend to classified POCT as a branch of in vitro diagnostics (IVD), a manuscript that is published on the international medical journal Point of Care in September 2019 believes that as the development of artificial intelligence and next-generation detection technology, patients behavior shift, as well as increasing pressures of healthcare system and continuous health policy adjustment in many countries, China, the United States and other large countries have launched Point of Careology as an independent program in post-secondary education. Through technology innovation, policy adjustments, the community based clinics will be gradually transformed into the primary forces for providing medical and health services [8]. And the users of POCT are defined as community hospitals, critical care unit, family doctors and third-party laboratory testing institutions.

In the future, the global POCT testing, diagnosis and health management market will grow at a compound annual growth rate of 9.6%, with emerging markets represented by China and India growing at a compound annual growth rate of more than 14.2%

The aging of the population and chronic disease epidemics make POCT technology particularly prominent in primary care clinics;

User experience has become a guideline for POCT innovation

The global POCT market in 2018 is $18 billion. It is predicted that by 2026, the size of the global POCT market will reach approximately $50 billion, with a compound annual growth rate (CAGR) of 9.6%. Emerging markets such as China and India have a conservative CAGR of 14.2% due to a weaker starting medical infrastructure. Factors that drive the growth are listed below:

Scientific and technology innovation: Through constant investment in research and development, the diagnostic devices is made more compact (convenient), laboratory automation and artificial intelligence technology are continuously improved (time efficient), and low-cost high-quality medical solutions are emerging (cost efficient), all of which will be the driving force behind the rapid market growth.

Market demand: The prevalence of chronic diseases and the growth of the elderly population have boosted the market demand. According to the International Diabetes Federation, approximately 425 million adults worldwide have be diagnosed diabetes in 2017-18, and this population is expected to rise to 629 million by 2045 [9]. The POCT blood glucose meter and hemoglobin A1C instrument has been clinically proven to increase the medical compliance of diabetic patients and make blood glucose management more convenient and effective.

Capital market: Growing funding available from multiple public foundations is also driving the growth of the POCT market. In November 2018, the Massachusetts Medical Device Development Center, has received a  $ 7.9 million funding from National Institutes of Health (NIH) that is designated for advancing Point-of-Care Technologies. Many private entities such as Dartmouth College, California Polytechnic, and global organizations have also participated in the POCT development program. In August 2018, the American Society of Clinical Chemistry announced a certification program for POC testing professionals to improve their diagnostic testing outside the clinical laboratory.

Application: With the better understanding the advantages of POCT by doctors and patients, who are more inclined to use POCT devices. POCT operation does not require much professional skills, thus small clinics and medical department can use this type of devices for diagnosis without hiring senior staff, which is one of the key driving forces to the market. Patients hope that the POC service can create better customer experiences and the doctors hope the medical procedure can be empowered. Therefore, they will be eager to share data with trusted partners, and they want their own health data to create an harmonious eco-system, which allow them to view and access numerous services anytime, anywhere, and not be hurdled by the obscure management system.

Case study: Siemens POCT and service solution

On November 7, 2016, Siemens Healthineers announced the acquisition of Conworx Technology GmbH, a German provider of POC data and open connection system, which kicked off Siemens’ own POC ecosystem.

According to the official introduction of the Siemens Health Department, Conworx Technology GmbH’s POC-based service solution is integrated into two subsystems: 1) data that focuses on the redesign of primary medical workflow and 2) POCcelerator Data Management System; a data management system based on intelligent operation efficiency, which can connect and manage all types of POC devices on a single platform, or scale up with UniPOC Data Management System [10].

Once the integration was accomplished, Siemens Health Department formed a POC product series with data management system as the foundation; chronic disease management and intensive care as the application scenarios; and blood, urine, blood glucose, heart, and blood coagulation as the final testing product, which are compatible with 2,800 types of diagnostic devices world-widely, as shown below:

Siemens product family at POC

POCT innovation direction

In the past 5 years, international giants such as Siemens, Abbott, Roche and Johnson & Johnson have continuously expanded their penetration into the POCT market through internal R & D, mergers and acquisitions, though this area was not appreciated by them back to 5 years ago. Representative startup companies such as iHealth Lab, Cellmix, and Alere also continue to make breakthroughs in subdivided fields. However, through the research and analysis of related technologies by the TMFOX medical team, we believe that: no matter it is medical equipment empowered by artificial intelligence, such as early screening and diagnosis of cancer, or detection equipment based on molecular technology, such as diagnosis of infectious diseases, or the detection products based on biosensing or biochip technology, the ideal POCT must be combined with the following functions in order to effectively integrate with primary medical care:

Empowerment for health management and compatibility with related data platforms;

Test or diagnosis can provide timely results, and no secondary technical confirmation is needed if possible;

Ability to continuously monitor changes in human condition and perform health assessments and early warnings;

Can provide therapeutic effect to some extent

At the same time, the accuracy requirements of POCT technology innovation exceed the ethical requirements for the quality of doctor services, which is the biggest problem of POCT technology innovation at present. Work efficiency and consumer costs are two other innovation indicators that must be considered.

POCT empowering health care will be the trend

In the future, market forces such as retail, insurance, internet, community service and other organizations will bring consumers together to participate in the innovation of the primary medical system. These forces will drive traditional medical institutions and regulators to make concessions and get involved in innovation.

In the next 10 years, the global economic will be in turmoil, relative to the short lifespan of new technologies and the weakness of fixed income investments, investments based on POC and POCT will provide safe returns and lead a growth trend (CAGR greater than 10%).

POCT’s technological innovations (artificial intelligence, automation, biosensors, biochips) can completely replace some of the human labor in the medical system. We have every reason to believe that machine learns faster than human does, and that machines are not affected by emotions and physical limit.

POC should be on the front line of healthcare and bear at least 80% of the outpatient volume. As long as the quality is guaranteed, the service is convenient, and the price is affordable, there will be no doubt that patients are willing to accept the proximate primary medical service.

In September 2019, a global retail giant Walmart opened its 10,000-square-foot clinic to public in Dallas. At the same time, Amazon care has completed its one year trail operation and officially opened to its three million employees in Seattle.

Similar to its main business positioning, Wal-Mart targets consumers within the radius of its own supermarket coverage, provides patients with diagnosis and treatment of acute and chronic diseases, and preventive services such as immunizations, physical examinations, health education, and other health check with low and transparent charges [11]. In addition to hiring full-time healthcare workers, Wal-Mart encourages its employees to participate in health education and support.

Similar to Wal-Mart’s original intention, Amazon also entered the field of health care in order to overcome the high medical costs of employees and the poor quality of medical services, and has become the second cross-border robber. Amazon uses a combined service of physical clinics and virtual diagnosis and treatment. Communication between patients and doctors can be achieved through the network, and it is equipped with medicine delivery or direct home delivery services.

Elise Amez-Droz, the director of healthcare policy at the Mercatus Center at George Mason University comments on Wal-Mart clinic: Wal-Mart Healthcare indicated that private institution can provide high-quality, transparent healthcare services without government intervention. And the best way to meet up patients’ changing medical needs is to give patients the final authority in making healthcare decisions.

Endnotes

Deloitte’s 2019 global health care consumer survey finds that the future is now:

Why Apple’s Services Segment Is Critical to Its Growth

Apple Is Going After The Healthcare Industry, Starting With Personal Health Data

How Apple could generate $313 billion from healthcare in 2027 — and why it won’t

http://www.stats.gov.cn/

https://baike.baidu.com/item/POCT

< Point-of-Care Technologies Enabling Next-Generation Healthcare Monitoring and Management> by Sandeep kurmar Vashit, 2019

《The creation of point-of-careology》, point of care Journal 2019.9

https://www.idf.org/aboutdiabetes/what-is-diabetes.html

https://www.siemens-healthineers.com/en-ca/point-of-care-testing/featured-topics-in-poct/informatics-featured-topics/open-connectivity

https://www.pwc.com/gx/en/healthcare/case-studies/making-a-difference-global-health-usa-case-study.pdf

Acknowledge

We thank those who have provided comments and suggestions in this research work, and pay tribute to their enthusiasm and responsibility for promoting primary-level medical innovation (regardless of ranking):

Yu Huang –Chair, royal capital , shenzhen| Bio

Liang xing Wu – Chair, Shenzhen Jifu Medical| Bio

Dr. Liang Xiao – Director, Cancer department, Shenzhen N.2 Hospital | Bio

Dr. Dahai Zhang – Post Doctor fellow, BC Child &women Hospital| Bio


Authors

ANDY YU |Bio| Andy@tmfox.com

Mr. Yu founded TMFOX VENTURE PARTNERS in Shenzhen in 2009. He has been committed to building an innovative investment banking business platform that integrates incubation, acceleration, and investment to enhance the growth of high-tech companies, and has actively participated in it. To the construction of the science and technology service system of the Guangdong-Hong Kong-Macao Greater Bay Area Regional Government. In 2015, TMFOX’s virtual incubation model was promoted nationwide by the Policy Research Office of the State Council as a representative institution. In 2017, he cooperated with the School of Management and Engineering of Central University of Finance and Economics to set up an entrepreneurial innovation experimental class and acted as a technical innovation course tutor. In 2018, the experimental class became a demonstration project of university education reform by the Ministry of Education. In 2018, TMFOX’s professional virtual incubation system was established as the technology incubation industry standard by Guangdong Province. Mr. Yu has been working on North American healthcare research and collaborative implementation of project resources in China since 2015. Currently he focuses on managing Worldiscoveries (North American Medical College Alliance), UW (University of Washington) School of Life Technology, UBC (University of British Columbia) ) Collaborative R & D and technology marketization of medical schools.

Dr. XIAOJIA XIONG|BIO| 784314077@qq.com

Dr. Xiong graduated from the Medical College of Sun Yat-sen University (PhD), and is a practitioner and innovator of Chinese medicine. For a long time, Dr. Xiong was engaged in front-line medical service work at Peking University Shenzhen Hospital, including serving as the chief physician and resident chief physician. Dr. Xiong has successively held senior management and strategic planning work in several doctor groups and primary clinics, and has extensive clinical experience and innovation and planning experience in primary medical systems.