Healthcare Technology Innovation in Singapore and Japan – Interview with Shingo Tsuda from INDEE

With more than a decade of experience investing in medical and healthcare-related technology companies, Shingo Tsuda – Founder of INDEE – sheds some light on the current state-of-play when it comes to technology innovation in Singapore and Japan’s healthcare sector.

Thank you for joining us in this interview Shingo-san! To kick things off, could you tell us a bit more about INDEE?

Essentially, INDEE is a venture capital investment and innovation consulting firm that was founded in Japan in 2011. And in 2019, we set up our presence in Singapore at SPECTRUM – so it’s been a good four years that we’ve been in the country!

As for what we do, INDEE invests in, and mentors medical and healthcare-related companies that are mostly from Japan. An example of one of these companies is Ubiea healthcare Artificial Intelligence (AI) app that currently has about seven million users every month. Developed with input from doctors and medical professionals, Ubie enables users to get advice about what to do if they feel unwell. If a user feels a bit under the weather, all that she or he has to do is answer some questions in the app. The app will then give the user information about how severe the illness is, possible causes, as well as care options – which also includes which doctor or hospital they should go to. This helps users lessen any anxiety they’re feeling about their symptoms, and equips them with information that they can convey to a medical professional should they choose to consult one. Whilst the app might not be so relevant in Singapore where the healthcare system is quite advanced and well-established, users in developing countries will reap the most benefits.

Besides venture capital investment, INDEE also serves as a consultant for Japanese companies – assisting them with the expansion of their presence and operations into Asia in general, using Singapore as a testbed. Japanese companies have developed lots of good technology, but these haven’t been exposed beyond the country’s borders. Where we come in is to help these companies navigate new markets, understand what the challenges are, and assist their management in making informed decisions for the future.

That certainly sounds like an interesting market sector to have a presence in. Could you give us some insight into your journey towards co-founding INDEE?

It began when I was a research engineer at IBM’s disk drive business. During my time there, IBM had the best technology for disk drives. However, it was a different story when it came to the business side of things. When I left IBM, the big question on my mind was: “If it isn’t technology that decides the winner, then what is?”

This was the question I took with me into my next role as a management consultant. In this role, I learned that winning isn’t about management either. It was then that I realised that innovation – not technology nor management – was the key. This was back in 2011, and a few of my colleagues and I decided to start a consulting firm dedicated to innovation. More specifically, it was about teaching managers what innovation actually is.

This was a time when no one was talking about innovation. In fact, most people couldn’t even define innovation. So, we had to break down what innovation means – explaining that innovation isn’t only about invention, but also about getting people to adopt a product, use it in the real world, and become product champions who take real ownership of the product. And this whole innovation journey is what we now help Japanese companies with.

Now that INDEE has a presence in both Japan and Singapore, what differences have you noticed between the two country’s technology and innovation landscape?

I think that the most significant difference is that in Japan, there are many privately-owned companies that are publicly listed.

In contrast, a lot of the economic structure in Singapore is government owned. This makes sense because all the government organisations are structured to drive the research that’s necessary for innovation. However, there aren’t many companies looking for – and wanting to commercialise – these innovations coming out of Singapore.

This is why I think that there needs to be more collaboration between Singapore and Japan.

Could you elaborate on the kind of collaboration you’d like to see between the two countries?

Moving forward, I’d like to see more Japanese companies use Singapore as a springboard for their products.

And I think one of the reasons we’re not seeing this is because the Japanese economy and market is big enough such that their companies tend to stick to the domestic market and shy away from the global market. However, this hasn’t stopped us from telling them that they should try out their products in Singapore because it’s a good market to start from.

We see Singapore as the perfect place for that starting point for many reasons. The first reason for this is that Singapore is one of the nearest developed countries to Japan. Secondly, Singapore and Japan have good political relationships as well as populations that share many cultural similarities. And last but not least, Singapore has a business-friendly environment and a populace that speaks both English and Mandarin. This means that if Japanese companies can establish a base in Singapore, the country can then be a springboard to the United States, China, and the other countries in ASEAN. All these factors make Singapore a good entry point for access to a huge market.

Besides Singapore, are there any other countries in the region that you think Japanese companies can operate in?

I think Indonesia would be one such country. Their GDP has been growing at a rate of more than 5% for decades, and their population has also been growing. In contrast, Japan has been struggling with a stagnant economy and an ageing population. This is why I’m personally interested in exploring what Indonesia has to offer Japanese companies, and I think that Singapore represents a good gateway to do so.

We saw that INDEE conducted an Eldertech Tour earlier this year. As Singapore and Japan both face the issue of an ageing population, could you share more about this tour?

The tour was an interesting one that surfaced lots of learning points. One of these learning points stemmed from the difference in each country’s approach to caring for its elderly.

Singapore’s approach is a structured one with various government bodies such as the Housing & Development Board (HDB) and the Ministry of Health working together with respect to housing and hospitals – both of which are innovative and well-organised.

In contrast, many things in Japan are done by private organisations. Whilst their technologies may be advanced, the solutions may be non-systematic. Hence, the structured approach that Singapore takes with respect to caring for the elderly is something that the Japanese can learn from.

In fact, during the tour, some of our Japanese guests found opportunities to bring their technologies into Singapore and collaborate with counterparts in the country to test these technologies.

In your article Healthcare, Behaviour Change, and the Canvas, you shared about “The Healthcare Canvas” – a tool that you developed. Could you share more about this tool and its applications for businesses?

For the majority of healthcare products on the market today, their efficacy depends on repeated use by patients. Take medication for example. Patients will need to take their medication consistently in order for the medication to be effective. This highlights the need for a method of engaging a patient – or customer – so that the medication or product achieves the intended result.

I created the Healthcare Canvas as a tool and framework to help businesses succeed at delivering their product to new patients and customers, and also to keep them engaged. In other words, the Healthcare Canvas helps in services that require developing a habit to lead to a desired outcome.

One example is the habit of losing weight. Did you know that all it takes to lose weight is to weigh yourself every day? This is because weighing yourself forces you to be mindful.

In contrast, if your doctor tells you that you should eat fewer sweets in order to lose weight, you’d tend to forget that piece of advice. Moreover, if a delicious piece of cake was placed in front of you, you’d probably prioritise eating that piece of cake over your doctor’s advice. However, if a patient frequently measures her or his weight, then there’s a level of engagement with how much they weigh, and they’d end up losing weight anyway. That’s the kind of engagement that the Healthcare Canvas drives.

Another example that illustrates my point has to do with brushing your teeth. For adults, it’s a habit to brush your teeth. You don’t do it with the main intent of preventing cavities. You do it because it’s refreshing, and you don’t want others to be bothered with your bad breath. For kids, none of them want to brush their teeth. So, parents will say “you’ll get cavities if you don’t brush your teeth.” But that threat doesn’t work too, right?

What we’re trying to do with the Healthcare Canvas is to make the consumption of healthcare products fun, engaging, and measurable. It provides a framework to guide you through the design of a process that – for instance – gets people to measure their weight or take their temperature every day, or even wear their smartwatch everywhere.

You also mentioned wearables – such as the Apple Watch – versus traditional medical devices in your article…

Yes, my wife wears a smartwatch. But when she goes for walks, she forgets to wear it… and then comes back from the walk and says, “darn it”. This sentiment arises because of the notifications you get from the watch. These notifications act as a form of reward and keeps you dependent on the watch. And this is how Apple is disrupting the healthcare industry, and traditional medical devices in particular.

In what other ways do you see technology and innovation impacting the healthcare industry?

I think that Artificial Intelligence (AI) is definitely something that will impact the industry.

Take Ubie for example. They’re using AI to replace consultations with a doctor. To illustrate, let’s say you have a stomach ache and you visit a doctor. The doctor will probably get you to press your stomach, ask you how it feels, and give you a diagnosis. The same things happen on Ubie – but with the use of AI to generate the questions asked, as well as the diagnosis based on your responses. You might be able to find the information you need on Google, but probably only after going through lots of other irrelevant information.

As for the other startups that we invest in, most of them incorporate some sort of AI – such as image recognition or deep learning – in their business. And they use these technologies to detect illnesses such as eye or lung diseases.

All of what I just mentioned is why I think that AI is definitely going to be a propellant for the future.

With innovation and technology constantly evolving, how will INDEE continue to adapt?

That’s a good question!

When humans confront technological changes, we’re often overwhelmed by information – about new products and new terminologies such as AI and deep learning. However, the impetus for all these changes is constant. At the core, you need a customer who has a problem. Then you need to provide a better way – compared to the status quo – to solve the problem.

At INDEE, we help people and organisations go back to the core. What’s the problem that their customers are facing? What do they want to do? What can be done better? These are the questions that we ask, and help them find the answers to.

To us, innovation isn’t just a novelty. Innovation and technology need to have a place in the world – a place where people practice it and use it on a daily basis. If not, we run the risk of forgetting about innovation altogether.

That’s a great point about how it can be overwhelming with all the new technology that’s coming out, and the resultant information that we need to absorb…

That’s right! You can be overwhelmed – and lots of companies are overwhelmed.

Actually, lots of companies are either overwhelmed or they sort of sweep it under the rug and forget about it. This is because they don’t know what they should be doing. And this is why INDEE helps our clients to achieve a good ratio of innovation and modernisation so that they can thrive.

To round things up… We’re always glad to see you in SPECTRUM whenever you’re in Singapore. What has your experience in SPECTRUM been like each time you’ve visited us?

As a business owner , I’ve visited quite a few coworking spaces around the world. Out of the many that I’ve visited, SPECTRUM definitely stands out, not only because of the space but also because of the staff, who all contribute to the overall ambience of the place.

Although, when we were first looking for a space, I thought that we should consider One-North – where lots of research and innovation organisations are located. However, I thought that SPECTRUM was a really nice space when I first visited it… So here we are.

The only thing on my wish list is to see SPECTRUM in more locations! Perhaps a SPECTRUM in One-North, which is home to several research and innovation organisations or even a SPECTRUM in Changi where there’s a good hospital and quite a few research centres!

Thank you for joining us in this interview!

You can connect with Shingo Tsuda via LinkedIn to know more about INDEE and the work he does.