Taiwan: Small Island, Big Potential
Intelligent bedsheets and insulin pens with universal connectors; a glimpse at the medical startups who are joining Taiwan's burgeoning startup ecosystem.
What is it that motivates a startup to take a leap of faith and relocate to another country? Is it access to a larger pool of talent, proximity to their target market, increased funding opportunities or maybe they’re looking for manufacturing partners? Through initiatives supported by the government, Taiwan is working towards creating a startup ecosystem which ticks all the boxes.
A key component in creating a competitive startup ecosystem in Taiwan was the creation of two ‘ecosystem builders’, Taiwan Startup Stadium (TSS) and Taiwan Tech Arena (TTA). Founded in 2015, TSS have played a key role in connecting Taiwan to international startup ecosystems and never fail to catch the eye with their bright yellow in-your-face design. Launched in 2018 as a government-subsidized project, TTA operates as a co-working space for startups and accelerators, and supports startups in.
One organisation currently flaunting the benefits of Taiwan’s startup ecosystem is the relatively new BE Accelerator. Located inside Taiwan’s self-proclaimed ‘innovation and entrepreneurship hub’, TTA. The team at BE Accelerator have already completed 3 batches, accelerated 29 startups and raised over $50M USD.
“Most people never really think of Taiwan, but we really have a lot to offer, especially in healthtech and medtech”, says Anton-Philip Kannemeyer, Program Analyst at BE Accelerator. “Everyone knows about the manufacturing capabilities of Taiwan. For companies just starting up that need to build prototypes efficiently and at a relatively low cost, Taiwan is a good place to start. For those at the next level, looking to scale up, this is a great place to come and find your manufacturing partner”.
BE Accelerator was created to bridge the gap between ICT, healthcare and business. They have found early success through their partnerships with two hospital groups in Taiwan, Taipei Medical University and Show Chwan Healthcare System.
Partnerships within Taiwan’s healthcare system is vitally important if startups are likely to succeed in what can be a very challenging industry. “I do believe that it is the toughest startup industry to be in, and that’s why BE Accelerator started. It is also probably why healthcare innovation is lagging behind. There is a lot of innovation in healthcare but it’s just so much more challenging to succeed” says Kannemeyer. “In healthcare, companies typically have to go through hospital groups, insurance providers or even a group of private physicians. This means it’s not just about who has the best marketing but who has the best concept, who’s going to fit their workflow and then you need to build up trust”.
Taiwan’s Science and Technology Minister, Liang-Gee Chen told EE Times in a previous interview that Taiwan hopes to change its image through hardware-based artificial intelligence (AI) services. It’s here, in AI, where Taiwan is likely to lure startups from overseas due to its treasure trove of data. “One of the biggest trends in Healthcare at the moment is AI, and AI requires massive amounts of data for it to function properly. Taiwan has collected roughly 25 years’ worth of patient data through its National Health Insurance system, this is a single payer system which is all digitised. This is a fantastic opportunity for startups to come into Taiwan and leverage all that data to help test their solutions”, says Kannemeyer.
Capturing the right data to fight diabetes
Diabnext, a French telehealth startup, relocated their R&D to Taipei in 2016 to leverage Taiwan’s manufacturing prowess and develop IoT devices.
They have created a series of universal connectors which retrieve data from devices used by diabetics, such as insulin pens, and send that information to your device via Bluetooth. The goal is to replace the manual process of logbooks with an automated system. Doctors have access to an online platform which enables them to review your results and remotely assist patients.
“The solution is simple, it allows doctors to see how much sugar is in the patients’ blood, how much insulin they have injected and the food they eat”, said Richard Binier, Chairman and Co-Founder at Diabnext. He added: “If you have too much or too little sugar in your blood, then you are slowly destroying your body. Usually around the ages of 40-50yrs, your condition will become more exacerbated and you’re more likely to have problems such as heart disease”.
Treating the Diabetes pandemic is of vital importance to governments around the globe who are developing reimbursement programs to incentivise companies. According to the International Diabetes Federation (IDF), Diabetes is a chronic disease which currently afflicts 463 million people worldwide and resulted in at least a USD 763 billion dollars health expenditure in 2019.
One of the biggest challenges in treating diabetes is keeping a diabetic’s blood glucose levels within a target range, commonly referred to as ‘time-in-range’ (TIR). Traditionally, doctors will rely on their patients to regularly monitor their condition and keep a record of their data in a logbook. Whilst there are apps available which try to make this process more convenient, many lack the discipline to keep their logbook up to date. Poor record keeping can lead to patients administering the wrong levels of insulin. This often results in symptoms such as loss of sight, amputation, heart disease and kidney failure occurring later in life.
Prior to their move to Taipei, Diabnext had a team in China but were disillusioned with the results they were seeing.
“We were in Shenzhen and we had a lot of quality issues, especially with components. We had horrible surprises such as some products not working in the hands of patients, so it was a very simple decision to move to Taipei”, said Binier. After 1.5yrs in Shenzhen, Diabnext packed up their operation and moved to Taipei to start work on prototyping and manufacturing.
Quality issues became a thing of the past for Diabnext who have seen a marked increase in both quality and reliability.
Since moving to Taiwan, Diabnext have been able to prototype much faster and Binier tells us they have already developed four generations for each of their connectors in the last two years. “In Taiwan, the engineers are at a higher level than their counterparts in China, they are much more faithful and more engaged in their work. They are also more stable; Shenzhen can be a bit of a cowboy city”.
It hasn’t all been plane sailing for Diabnext since arriving in Taipei as Binier explains that they originally chose a luxury ‘San Francisco style’ open plan office but found it to be isolating to the point that it impacted on the team’s productivity. “When you’re a startup with your own office space, you can become isolated, your engineers don’t learn or share and it’s just not in their culture to ask for help”. Faced with this challenge, Diabnext chose to move their team to the TTA’s co-working space. “Just this morning we had a coding problem, we posted the problem in TTA’s Slack group and you ask for help from the community, this is wonderful”, says Binier.
Is your bedsheet smart enough?
Another company operating out of TTA is smart textiles startup, Studio 1 Labs. The Canadian startup are currently developing an intelligent bedsheet which can monitor a patient’s physiological signals using smart textiles.
Coming to Taiwan through one of the various soft-landing programs on offer, they had arrived in pursuit of finding manufacturing partners.
Oliva Lin, Executive Director and Co-Founder at Studio 1 Labs, explains that despite early support in Canada, it was necessary to look overseas for partners. “In Canada we had a lot of support initially through grants and cooperation with research institutes but once we needed to focus on production, the support tapered off. Production is a real strength in Taiwan, and there was a lot of support to find corporate partnerships”.
But it wasn’t just hardware manufacturing that attracted Studio 1 Labs to Taiwan, “one of the primary reasons for coming to Taiwan was the reputation for functional textiles”, said Lin.
Studio 1 Labs are working to combine the textile and electronics industry to create what they’re calling ‘smart fabric’. This concept isn’t new, and in fact, Levi’s have already launched ‘connected clothing’ products through their collaboration with Google’s ‘Project Jacquard’. While innovative, Google’s technology can only register gestures and is limited to a small surface area.
Edward Shim, Managing Director and Co-Founder at Studio 1 Labs explains that “companies are using conductive textiles but finding limitations in the distance the electrical charge can travel as the formfactor changes”. He theorises that this could be a reason Levi’s connected clothing limited the sensors to a sleeve.
“In smart textiles, your skin becomes an electrode when it comes in contact with your skin, it passes a signal through your body to measure something. A key limitation is that there’s so much noise that if there’s any slight movement or bend it collects that noise and requires filtering. We’re filtering on the sensor level; this means if the sensor bends or folds you can still take accurate measurements”. Shim elaborates further: “Normally pressure sensors and vibration sensors are two separate sensors but we combined ours so it’s a continuous active sensor which is able to measure dynamic range of voltage”.
Though once limited to a baby sheet, they have extended the operational area of their smart fabric to fit a hospital bed. “We’ve since progressed beyond this limitation and even developed a sheet for a horse, this was just to see how big we could build”, says Shim.
Now that they have solved the surface area quandary, they plan to attain medical certification and use their intelligent bed sheet in healthcare. Shim said that they plan to “address one of the biggest challenges in long term care which is the health deterioration which occurs after a patient takes a fall”.
“Our competitors are using a binary system so they can only monitor if someone is on or off the bed. The other system is a high gradient of a capacitive type which allows you to model the body when its transitioning. As we monitor dynamic high voltage, we can tell the difference between a person slowly getting up or if they’re springing up”.
Trying to find additional value for caregivers, Lin explains that it’s more than just detection. “We want to correlate detection with cognitive functions and see if a patient’s health trends can indicate their future wellbeing”.
A key element to the intelligent bedsheet is that it allows for non-invasive monitoring of a patient. Lin, who has a background in cognitive psychology, describes how it was important to develop a technology which wouldn’t force patients to change their habits. Lin added, “we wanted to bypass this necessity by embedding our technology into your daily life”. This will also be a kindness for some as the plethora of cables and electrodes associated with long term care can often be a dehumanising component of healthcare.
Part of the second batch to complete BE Accelerator’s 4-month program, Studio 1 Labs are now looking to develop the partnerships they have made with local hospitals and start beta testing.