At least at the current stage, the main force to promote the development of smart medicine is still information technology. From the perspective of information technology, especially electronic semiconductor technology, what are the current development directions for smart medical (or digital medical)?

Wen︱ Luo Yi

Figure︱Omida

Healthcare is a big market. According to data from the market research organization Frost & Sullivan, the global healthcare industry will reach 2 trillion U.S. dollars in revenue in 2020, and the future growth rate is also very gratifying. Large water raises big fish. The global medical equipment is hundreds of billions of dollars in scale, and the domestic market is also hundreds of billions of yuan. Although not all equipment is related to electronics, new medical solutions represented by digital medicine are the growth of the medical equipment market. The main driving force is wearable devices and the medical Internet of Things. According to data from Juniper Research, the medical wearable device market will reach 60 billion U.S. dollars by 2023, and Allied Market Research (Allied Market Research) It is estimated that the global medical Internet of Things market will reach 136.8 billion U.S. dollars.

Digital medicine (or smart medicine) is reshaping the pattern of the medical and health industry, and under the background of continuous innovation in information technology, the meaning of digital medicine itself is constantly being subverted. From early electronic prescriptions, digital cases, and medical collaboration platforms, to smart medical and remote diagnosis based on artificial intelligence and network communication technology, surgical robots and networked operating rooms that combine the most advanced sensors, artificial intelligence technology and motion control technology It is also gradually becoming practical, and personal precision medicine based on big data will become more and more common.

Five Trends of Smart Healthcare

According to the analysis of consulting firm McKinsey, the development of global smart healthcare reflects five major trends.

Trend one is full-cycle health management. Consumer demand is extending from "medicine" to "health", requiring full-cycle services including health management, healthy living, disease prevention and rehabilitation care. Taking Singapore as an example, the government established the Health Promotion Board to promote knowledge of evidence-based medicine and disease prevention to encourage residents to develop healthy living habits, thereby reducing the incidence of disease and the risk of progression. In addition, the Singapore Health Promotion Agency also focuses on promoting patient care pathways in non-medical institutions to reduce the number of visits to residential hospitals.

Trend two, high-quality clinical results. Medical errors and over-medical treatment cause huge waste of resources. American studies have shown that the misdiagnosis rate in outpatient clinics can be as high as 5%, and about 10% of patient deaths are caused by misdiagnosis. The World Health Organization estimates that even in developed countries, 7% of hospitalized patients have medical infections every year. Due to excessive medical treatment, more than 210 billion US dollars of medical resources are wasted every year in the United States alone. The above data shows that the medical service system urgently needs to improve the quality of diagnosis and treatment, and the hospital as the main body of medical services needs a fundamental change.

Trend three is retailing health services. In mature markets, the model of a single hospital providing all services to all patients is gradually being replaced. Hospitals and other medical service providers (such as family doctors, clinics, pharmacies, rehabilitation centers, etc.) are continuously integrated to form an interdependent ecosystem. For example, in the United States, leading retail pharmacies can provide a variety of routine testing and treatment services. In China, the government is promoting the decentralization of medical services by vigorously developing family doctor services, community health centers and third-party service agencies.

Trend four, active patient participation. Today, patients around the world have more medical knowledge and actively participate in the medical decision-making process. They actively asked for information and began to clearly express their preferences for treatment and payment options. At the same time, technological innovation has made new medical models such as online consultation and multidisciplinary diagnosis and treatment more accessible, and promoted the development of hospitals to a patient-centric operation model.

Trend 5: Refined expenditure management. The ever-increasing medical expenses have made the payer and hospital's need for cost control more urgent. Health expenditures in major countries around the world have continued to grow: US medical expenditures accounted for more than 17% of GDP; China's medical expenditures accounted for about 6% of GDP, and it has been increasing year by year. Many provinces and cities are facing medical insurance budget pressure. Medical systems in various countries are promoting the reform of value-based payment methods, prompting medical institutions and payers to share risks, such as the introduction of "Episode of Care" (Episode of Care) in the United States, and China's trial of payment by disease diagnosis-related grouping (DRG), etc. .

McKinsey also pointed out that the realization of smart healthcare requires five elements, namely, inter-agency interconnection, automated and efficient operation, full-process reshaping experience, big data-driven decision-making, and a continuous innovation mechanism.

Most of these five elements are related to electronic information technology. For example, inter-institutional interconnection needs to build an information system that supports real-time data connection and sharing. This requires hospitals and various institutions to establish a unified data standard and structure, and establish specifications for data collection, storage, transmission, and use, to ensure that data is safe and private. Under the premise of reasonable use; automated and efficient operation requires the use of IoT perception technology to optimize the hospital's internal asset management process, supporting personnel and materials in real-time identifiable, traceable, and traceable; the whole process of medical experience is inseparable from reshaping Electronic technology, whether it is smart appointments and uploading records, or the use of wearable devices for real-time monitoring and reminders, as well as automatic triage, portable examinations, medication reminders and remote follow-up, etc., must be supported by hardware devices.

Of course, McKinsey also pointed out that although information technology is essential, smart hospitals are not just an information project. On the contrary, a smart hospital is a systematic project involving managers, doctors, nurses, etc., and it is necessary to establish a continuous open cooperation mechanism in order to find problems faster, propose innovative solutions, and pilot and promote solutions in the hospital to improve medical care. Quality and patient experience, optimize clinical procedures, and effectively control costs.

Figure: Classification data of medical electronics applications

Three directions for the development of medical-grade electronic components

But at least at the current stage, the main force to promote the development of smart medicine is still information technology. From the perspective of information technology, especially electronic semiconductor technology, what are the current development directions for smart medical (or digital medical)?

First, low-power, high-precision sensor technology and sensor fusion. With the development of wearable medical equipment and implantable medical devices, the requirements for portable or miniature medical and health sensors are mainly focused on three points, namely higher accuracy, smaller size and lower power consumption. As an important branch of sensors, the design and application of medical-grade sensors must consider the influence of human factors, the particularity and complexity of biological signals, and the biocompatibility, reliability, and safety of biomedical sensors, such as the shape of the sensor. The structure should be adapted to the anatomical structure of the tested part. When used, the damage to the tested tissue should be small, and the sensor will have less impact on the tested object, will not bring burden to physiological activities, and will not interfere with normal physiological functions. Because the sensor is worn or implanted in the body, the size requirements are extremely strict. Generally, the smaller the better, the use of more advanced semiconductor processes to manufacture sensors is the current focus of research. Power consumption is also a big issue. Wearable devices or implanted devices are all battery-powered, or even battery-free, which poses a severe challenge to the low-power design of sensor systems. In addition, there are various parameters that need to be detected and monitored in medical health. Therefore, sensor fusion will also become a research focus of medical equipment.

Second, extensive connection. Medical Internet of Things will become more and more popular, and the Internet of equipment information will become a necessity. Especially with the new coronavirus pandemic, patients are more inclined to realize the diagnosis, treatment and rehabilitation monitoring of common diseases at home, and remote diagnosis and virtual care have seen unprecedented growth. Even if you see a doctor in a hospital, the automated operation and smart diagnosis process of the hospital will also introduce more and more medical and health networking equipment, which will help doctors obtain real-time data from patients, so as to better monitor their health. More suitable for personal rehabilitation treatment plan. On March 16, 2019, Ling Zhipei, the chief neurosurgery physician at the Hainan Hospital of the People's Liberation Army General Hospital, used high-definition video images transmitted in real time through China Mobile's 5G network to remotely control the operation for 3 hours. One patient completed the implantation of a "brain pacemaker". It is reported that this is the first 5G-based remote human surgery in the country. In the future, remote diagnosis, remote care and remote surgery will become more popular, and medical care scenarios require a more reliable, complete, real-time, and efficient network environment.

Third, the deep integration of artificial intelligence and big data. There are three main applications of artificial intelligence in the field of smart medical care: one is a virtual assistant system that helps doctors, nurses, and technicians do diagnosis and care; the other is the integration and mining of big data, how to use medical health safely and without infringing on personal privacy Data is a problem that needs to be solved urgently; the third is the rapid development of artificial intelligence diagnosis represented by intelligent images. According to IDTechEx’s "Artificial Intelligence in Medical Diagnosis from 2020 to 2030: Image Recognition, Player, Clinical Application, Prediction" report, by 2030, because artificial intelligence can analyze data more efficiently than humans, medical imaging will recognize artificial intelligence. Usage will grow by nearly 3,000%. By simplifying the image analysis process, the technology is expected to improve the diagnosis plan and minimize the treatment time.

Long-term growth of medical electronic components can be expected

According to market research firm Omida, the 2020 epidemic has triggered a surge in sales of ventilators and medical imaging equipment, which has driven the sales of related electronic components, making medical semiconductors in 2020 an increase of nearly 10% compared to 2019, but this will happen in 2021. The growth momentum may not be sustained. However, the long-term momentum of medical semiconductors is optimistic. The main reasons are as follows: the rapid development of telemedicine health applications; equipment replacement-new equipment uses much more semiconductors than old equipment; artificial intelligence in the field of medical and health growth; portable and wearable medical health The growth of equipment; and the increase of medical functions in personal health equipment.

Chart: Revenue data by category of medical electronic devices

MarketsandMarkets is more optimistic. This market research organization believes that the global medical electronic components market will reach US$8.8 billion in 2026, with a compound growth rate of 6.9% from 2021 to 2026. Among them, sensors will account for the largest share of the market segment (Omida separates optoelectronic devices from other sensors, and the combined market share of the two in the Omida report is about 22%, which is also the largest share).

However, from the statistics of MarketsandMarkets, the top 15 medical electronic component manufacturers are all foreign manufacturers. Although domestic manufacturers have participated at the component level, they are generally in the signal chain processing part, the core sensors and processing There is very little involvement in devices and dedicated ASICs. But with the gradual rise of domestic equipment manufacturers, the domestic supply chain of medical electronic components will gradually mature.