Smart Gate: Contributing to the Next Generation of Society

Innovation can be defined by many as a curious beast that most organizations righteously struggle with. For Japan and elsewhere in the world, innovation is key to survival in any business. With information technology and communications forming the foundation of the digital era, Japan has been quietly churning out a string of innovations to keep up with the technological advances. However, while the Japanese ICT industry is well established and holds a global reputation for excellence, ICT innovation has been limited to large organizations, failing to penetrate the society that has been challenged with inefficient work and living conditions for close to three decades.

This industry narrative is precisely what a couple of former managers of the product localization department in Japan, who also handled Cisco Webex, had decided to change in 2010. Drawing on their decades of rich experience in the IT industry, these professionals set out to realize the impact of the IT revolution and AI on the society by laying the foundation of Smart Gate—a company that is collaborating with the world’s largest web conferencing system, Cisco Webex Meetings for remote medical care system— Smart Cure.

Smart Gate’s remote medical care system, Smart Cure, enables remote medical institutions and patients around the world to connect with medical institutions in Japan. Embedded with great frequency characteristics such as an excellent electronic stethoscope and the JRCS model JPES-01 on a smartphone, Smart Cure is bringing in online auscultation that can greatly increase the number of diseases targeted by physician telemedicine and can be applied from emergency care to home care.

With Smart Cure, a doctor can back up a visiting nurse or visiting pharmacist through online auscultation—thus effectively changing the way doctors, nurses, and pharmacists work and contribute to improving medical quality. Innovating the future of online medical treatment and online medical services, Smart Cure can be telemedicated to China and Asia, which was earlier not possible. “Through the ICT revolution and AI, we will accurately grasp the impact and change on our lives and propose the ideal form of the future. Our mission is to contribute to the next generation of society,” says Yukio Hanatani, representative director at Smart Gate.

The existing telemedicine systems in the Japan market have a poor frequency specification in a mobile communication environment, and fail to meet the required quality for medical examination, cannot support online auscultation. The sound of the heart murmurs have frequencies below 100 Hz and cannot be heard correctly by other telemedicine systems. As a result, electronic stethoscopes cannot be used in real-time with these telemedicine systems. “They also lack post-codec communication function for video data and demand a large bandwidth for telemedicine,” stresses Hanatani. As an answer to these challenges, Smart Gate has customized and incorporated Cisco Systems Webex, which excels in data communication application technologies (for example, encoder paging function), and has improved frequency characteristics by suppressing bursts and bandwidth.

The company’s telemedicine system presents frequency characteristics of 50Hz or more, enabling the use of a real-time electronic stethoscope in the system, which allows identifying more than 130 diseases through auscultation sounds. Moreover, Smart Gate has implemented a function that displays an alert when the communication environment deteriorates and allows you to reconnect immediately if the connection is lost. At the core, Smart Cure promises an improvement in medical quality by presenting a telemedicine solution for doctors with auscultation skills.

For the first time in Japan, this telemedicine system is introducing a way to reduce ER visits by assisting doctors in conducting online auscultation to perform online triage, avoid emergency transport, and respond to nurses and caregivers at the facility. Besides, it can also eliminate unnecessary or too late consultations. Combining online auscultation solutions with face-to-face medicine can centralize the information for nursing care, home care, and emergency care, which is extremely beneficial for improving unnecessary or too late consultations. “According to Dr. Kimura—who has obtained a doctoral degree from Osaka University and has served as director of emergency services at Osaka Koseinenkin Hospital—as a result of analyzing the past about 4,500 cases of emergency transport at night at a facility for the elderly, if there is a system that allows doctors to have an online auscultation, 40 percent of emergency transport can be easily avoided, and probably 82 percent in the future,” adds Hanatani.
The uniqueness of Smart Gate’s Smart Cure stems from its ability to communicate the same video with approximately 50 to 60 percent data volume in the mobile communication environment in Japan. As a result, compared to competitors, it has less noise, high-resolution video, better frequency characteristics, less delay, and allows communication with China as well. Undoubtedly, Smart Cure is broadening the horizon of telemedicine. The company has currently facilitated accessing medical treatment at a depopulated area with online auscultation by using Smart Cure. “Patients with stable medical conditions while visiting a nurse will bring an electronic stethoscope (JRCS: Model JPES-01), and a doctor will remotely perform auscultation online. In this way, we will try to improve the efficiency of doctors and nurses,” says Hanatani. While the operation of electronic prescriptions is scheduled to begin in 2020 in Japan, small dispensing pharmacies are examining the possibility of collaboration between a home physician and a visiting pharmacist. That said, Smart Cure is well-positioned to become an innovative solution for enabling doctor-pharmacist cooperation.

Smart Gate’s Smart Cure has a strong value proposition in place. Now, it is only a matter of penetrating society and contributing to the next generation of society. As per Hanatani, Japan’s healthcare system is likely to undergo a significant transformation in the next few years.
In an ambitious bid to tap into this trend, the company is considering an expansion of its business scale, including the overall system cooperation in Japan. In case the country’s healthcare space is developing at a slower pace, Smart Gate prioritizes the development of overseas services. “We are planning to incorporate AI-based diagnostic functions and face authentication with electronic medical records (EMR) and image interpretation,” concludes Hanatani.