A 12-year-old girl living in Detroit, Michigan, usually wore a smartwatch on her wrist. One day last year, a warning sound suddenly rang on the clock. This is because the heart rate was abnormally high. The girl's mother visited the hospital with her daughter, and decided to undergo surgery after being diagnosed with appendicitis. However, what doctors who entered the operating room found was a malignant tumor growing in the appendix. Adolescents were appendicitis, a rare cancer that rarely develops. The girl's mother, who immediately underwent cancer removal surgery and regained her health, said, "Without the warning of the smartwatch, it would have taken a long time to take my daughter to the hospital, and my daughter's life would have been in jeopardy."
The digital healthcare industry, which manages individual health and diseases by combining medical care and information and communication technology (ICT), is developing remarkably. AI (Artificial Intelligence) can determine in advance whether there are symptoms of dementia just by listening to the voice, and technology is also being developed to determine whether cancer is caused by shooting light without touching the body. Research on digital treatments (DTXs) that treat diseases through digital devices such as mobile apps, wearables, and virtual reality (VR) instead of drugs or surgery is also active. How is digital healthcare changing the world?
(Picture from Unsplash)
Diagnosing depression
The most active area of technology development is the diagnostic field that identifies early whether there is a disease or a possibility of occurrence. One of the biggest reasons for the existence of digital healthcare is to reduce medical costs, said Kim Chang-hoon, CEO of Macrogen, a genetic company. "Because the cost of disease treatment is much higher than the cost of prevention, investment in technology to diagnose diseases in advance is being actively made."
Among them, diagnostic technology using voice has recently been in the spotlight. Equipment that can utilize voice technology such as smartphones, AI speakers, and wireless earphones has been widely distributed, and non-face-to-face treatment has increased due to COVID-19. AI listens to the patient's voice, breathing, and cough patterns to determine whether he has depression, dementia, or Parkinson's disease.
"Sonde Health" in the U.S. has developed an AI program that analyzes voice strength, height, and vocal cord movements to identify physical conditions and analyzes them to determine if there is a disease. To this end, 1.2 million negative samples were collected from 85,000 people living on four continents, including Europe and the Americas. Currently, this technology is being used to diagnose depression and respiratory diseases. For example, if you enter a six-second voice, you can determine whether you have asthma. The company explains that if you enter a 30-second voice into AI, you can also find out whether you are depressed. Currently, this technology is being applied to apps developed by health-related companies in Denmark. The company is also developing a technology that determines whether dementia or alcoholism is present through human voice. As this technology became popular, KT also invested $2 million (about 2.5 billion won) in the company last year. Lim Seung-hyuk, head of KT's digital and bio-health business, said, "We are considering introducing this technology for the mental health of call center employees. We expect it to be applied to monitoring various diseases with artificial intelligence speakers in the future."
The app developed by the U.S. startup "Kintsugi" also determines how depressed and anxious users are with only their voices. When a user regularly talks about his or her feelings, it is a method of determining the degree of depression in steps '0 to 21'. The company explains that it can find out with 80% accuracy whether someone is suffering from depression or anxiety just by talking for 20 seconds. Grace Chang Kintzugi, CEO, said, "Because we continue to store and track app users' records, we can measure them much more accurately than we can judge based on stories that patients improvise."
Identifying breast cancer
Domestic and foreign companies have also jumped into the development of technologies that can diagnose cancer early. Olive Healthcare, a domestic startup, has developed a technology to identify breast cancer by shooting near-infrared rays on the skin in the chest. When light is absorbed and reflected by the body, AI analyzes it to determine the concentration of hemoglobin in the blood in the body. AI diagnoses that there is a high possibility of breast cancer because the level of hemoglobin in the blood increases if there are cancer cells. Currently, the first clinical trial has been completed, and the company's goal is to conduct the second clinical trial within this year and commercialize it from 2024. Han Sung-ho, CEO of Olive Healthcare, said, "Cancer varies greatly depending on the doctor's ability to judge, and it is difficult to accurately judge by ultrasound."As I see it, patients are also anxious, he said. "It is a representative field where digital technology can be developed and applied."
In Japan, a technology is being developed to predict the risk of cancer with a few drops of blood. The technology, which is being developed by Japanese healthcare company "NEC Solution Innovator," captures thousands of proteins in the blood, investigates the amount, and AI determines whether there is a possibility of cancer. It aims to provide a service that determines six types of cancer, including breast, colon, and prostate, within a few years.
A mirror (smart mirror) that can detect skin conditions by reflecting a person's face has already been developed and sold on the market. Developed by a domestic company "Lulu Lab," this mirror takes a picture when a user touches it and analyzes it with AI. It comprehensively judges six items such as pores, wrinkles, trouble, pigmentation, dark circles, and redness, scores skin, and recommends cosmetics or care methods. For example, it is recommended not to apply essence on oily skin, and if the score of wrinkle items falls, cosmetics containing a lot of anti-aging ingredients are recommended. An official from Lulu Lab said, "We developed it based on more than 2 million skin data and have been selling it on the market since June last year."
Smart pill
Beyond diagnosis, 'digital therapy (DTX)' for disease treatment is also being actively developed. It is a method of treating diseases through technologies such as "smart pill," wearable devices, and virtual reality (VR) instead of surgery to put a knife on the body or traditional drugs.
Researchers at the University of San Diego in the U.S. are developing a "smart pill" that goes into the stomach and checks internal health. The pill is 2.6cm long and 0.9cm in diameter with a wireless biosensor. In an experiment on pigs last year, it succeeded in measuring glucose levels for about 2 to 5 hours every 5 seconds. A separate battery is not required because it operates in a "biofuel cell (BFC)" method that obtains energy through glucose when passing through the digestive tract instead of a chemical cell. The San Diego Union Tribune said, "This technology can be used to detect and treat various gastrointestinal diseases such as bowel disease and diabetes in the future."
Smart pills are also used for athletes and others to grasp their physical condition and maintain their best condition. Smart pills made by France's BodyCap enter the body and measure organ temperatures in the body, such as the heart and stomach. Even if your body temperature is normal on the outside, taking smart pills can help you check and treat your body condition accurately because your long-term temperature can be low if you are not in good condition or get sick.
In addition, "electrochemicals" have been developed for a relatively long time and are used to treat depression, dementia, cancer, diabetes, and dry eyes. Electronic drugs refer to products that treat diseases with electrical signals such as electricity, ultrasonic waves, and magnetism, not chemical or biological drugs such as drugs or injections. "Wybrain," a domestic company, has developed a product that treats depression by applying electrical stimulation to its headband. It received marketing approval from the Ministry of Food and Drug Safety in April 2021, and began selling it in June last year. This product is only available with a prescription from a psychiatrist. So far, about 24,000 prescriptions for this product have been made at more than 70 hospitals. A Y-brain official said, "When a patient is treated with this product, information such as the intensity, stimulation time, and frequency of the current will be delivered to the doctor 30 minutes later."
Digital treatments to relieve pain are also being developed. MSK Solution, developed by U.S. startup "Kia Health," functions to alleviate musculoskeletal pain and provides customized exercise and physical therapy programs by measuring patients' exercise performance. In clinical treatment, the medical bill for patients who exercised and treated under this program was 80% lower than for patients receiving general standard treatment.
Digital Heart
In addition to diagnosis and treatment, the field of "wellness" related to personalized health care is also emerging. This field is linked to wearable devices such as smartwatches. When an individual's heart rate, electrocardiogram, and blood pressure are identified through a smartwatch, digital devices identify the individual's lifestyle and physical condition and set nutrition, exercise, sleep, and rest time. In the case of Korean life insurance company "Shinhan Life," it has launched an app that improves users' health habits using Apple Watch. Using the Apple Watch purchased from the app, it identifies physical fitness based on maximum oxygen intake and weight, and suggests activity goals such as "burn 500 calories (Kcal) three times a week." An official from Shinhan Life said, "When customers become healthy, customers and insurance companies are good," adding, "As the global insurance industry is increasingly difficult, domestic and foreign life insurers are scrambling to enter the healthcare sector."
Research to combine virtual worlds such as metaverse with medical care is also active. A typical example is 'digital twin' technology that digitally replicates the real world. French 3D software company 'Dasso System' has developed a technology that designs human organs and cells equally on digital with 3D replication technology. For example, Living Heart is a high-performance 3D simulator that embodies the human heart in the virtual world. It is designed to respond to electricity or blood flow, so it is possible to determine what reactions or results come out when a part of an organ is cut or a drug is injected. Currently, doctors at large U.S. hospitals, including Harvard Medical School, use this technology when performing simulated surgery before actual surgery.
Digital healthcare is growing rapidly with the government's policy support, especially in the United States and Europe, because it can significantly lower medical costs and dramatically increase accessibility for the underprivileged.
According to market research firm GIA, the U.S., which accounts for 41% of the global digital healthcare market, is expected to grow at an annual average of 19.3% to reach $215.6 billion (about KRW 78 trillion) by 2027. In Europe, the market size of $41.7 billion is also estimated to grow 16.1% annually to reach $118.5 billion. The Korea Development Institute (KDI) said in a report, "The U.S. is pursuing various medical innovation policies centered on big data construction and regulatory reform in line with global trends, and Europe is also actively promoting digital healthcare that combines health care and ICT."
On the other hand, Korea remains on the periphery, with only 0.7% of the global digital healthcare market as of 2018. Telemedicine, which has entered the universal stage in China as well as the United States and Europe, remains illegal in Korea. It has been a long time since the government vowed to "create digital healthcare as a new industry," but it has not been speeding up related regulatory reforms as it has difficulty narrowing differences among stakeholders. "In the U.S., companies such as Amazon, Telidak, and Amwell are developing telemedicine-related systems one after another, and Samsung and SK are jumping in, but companies are looking for opportunities in overseas markets compared to advanced countries," said Kim Hyun-soo, managing director of Olive Healthcare.
Writer: Yeyoung Jeon