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China is leapfrogging the U.S. in using AI in medicine. These five companies are leading the way

In the race to deploy artificial intelligence in medicine, China has surged ahead of the U.S. and other countries, spawning technology companies that are using algorithms and novel software tools to help treat millions of patients and relieve pressure on the country’s overwhelmed hospital system.

One company, WeDoctor, uses a combination of AI and telemedicine to conduct 90,000 online consultations a day and screen patients for cancer and chronic diseases. No company with anywhere near such reach exists in the U.S.

Another AI firm, Infervision, has stockpiled more than 1 million patient scans from Chinese hospitals and is working with medical centers to detect lung cancer and diagnose stroke, collapsed lung, and other conditions. U.S. tech firms typically train medical imaging algorithms with thousands, or tens of thousands, of scans from a single institution. Infervision says it is collaborating with more than 300 hospitals where its software is helping to make more than 33,000 diagnoses per day.

China’s government has been crucial to the early growth of these companies: It has set a goal to become the world’s leader in AI and build a $150 billion industry by 2030, with a particular focus on health care as a way of addressing a national shortage of physicians. China has only 1.8 doctors per 1,000 people, compared to 2.6 in the United States and 4.2 in Germany.

“One thing that differentiates China from the U.S. is how the government, smaller startups, and big tech companies are working toward one agenda,” said Deepashri Varadharajan, lead artificial intelligence analyst for CB Insights, a business research firm. She noted that Tencent Holdings, a China-based technology company that operates the giant social media platform WeChat, was hand-picked by the government to lead the development of AI products in health care.

Some business leaders have fretted that the U.S. risks falling behind in the development of artificial intelligence, which could cause business opportunities, and investment dollars, to flow to Chinese companies. At a national health technology conference earlier this year, the influential tech investor John Doerr said the U.S. may be in a losing fight, given China’s lack of privacy restrictions and the extent of the government’s investment in AI.

Hype surrounding Chinese AI companies is rampant, as it is in the U.S.,  and it remains unclear how use of the technology is affecting patient outcomes. But there’s no doubt that the development of medical artificial intelligence is progressing faster in China. The government support helps, but AI companies have other advantages, including fewer privacy regulations and other hurdles, and access to much larger data sets that facilitate the training and refinement of algorithms.

With a population of 1.4 billion, the country is more than four times the size of the United States, and its hospitals treat and collect data on many more patients.

“China is a great example of how AI can expand access” to care, said Terri Bresenham, chief innovation officer of GE Healthcare, which has a business relationship with Infervision. “The incredible unmet need in China is motivating the provider community to work on these solutions and address the uneven distribution of health care resources.”

GE is among many U.S. companies with a large presence in China. Apple has major business operations there, and Amazon recently opened an AI lab, although the ability of U.S. companies to grow may be impaired by the Trump administration’s trade war with China.

Likewise, it may be difficult for Chinese companies to gain access to U.S. patient data needed to train their algorithms for use in America, an issue highlighted by the recent flap involving the company PatientsLikeMe, which the U.S. government forced to unwind a Chinese company’s investment.

Still, many of China’s digital health companies are already working with hundreds of hospitals to build and test their products. Here is a look at five businesses at the forefront of the effort.

If you go by patient visits, WeDoctor is one of China’s largest medical providers — and it operates primarily online. It sees about 90,000 patients a day, providing diagnostic services, online chats with doctors, and prescriptions.

The company started in 2010 as an online appointment booking portal to help navigate a badly broken system in which Chinese patients pay middlemen to get access to doctors or wait in long lines outside hospitals. Since then, it has expandedto provide direct consultations with doctors. Its AI software helps diagnose patients and screens them for diseases like cervical cancer.

It also sells a $600 smart speaker, called WeDoctor Tong, that serves as a physician hotline and can connect users to services at 2,700 hospitals and 20,000 pharmacies across the country. The company sends patients automated reminders of checkups and can help them arrange services, including surgeries and drug purchases.

“This is an example where you see China leapfrogging the world,” said Nisa Leung, managing partner of Qiming Venture Partners, a Hong Kong-based venture capital firm that is an investor in WeDoctor.

She told STAT that, in addition to helping wealthier patients through its smart speaker, the company is improving access for people of lesser means. “By using the internet, patients from rural villages can get access to the top doctors,” Leung said. “It’s really quite transformative.”

WeDoctor, which also sells insurance and data management capabilities to hospitals, is backed by Tencent Holdings and has attracted investments from the insurance company AIA Group and Shanghai Fosun Pharmaceutical Group. It was valued at $5.5 billion in advance of an initial public offering expected by the end of this year.

Infervision

Many of the world’s largest technology companies are using AI to analyze medical images. But few, if any, have the volume of data that Bejing-based Infervsion has amassed.

The company is ingesting tens of thousands of CT scans, MRIs, and other images per day through its partnerships with hundreds of hospitals across China. Its InferRead CT Chest product analyzes patient scans for lung nodules, bone tumors, emphysema, and the early signs of arterial disease. It has also developed algorithms to detect bone fractures and the onset of stroke.

Infervision is seeking FDA approval to begin selling its AI services in the U.S., where it is testing its products with Stanford Children’s Hospital and a handful of other providers. The company’s CEO, Kuan Chen, is a frequent visitor to medical conferences, where he emphasizes that the practical benefits of AI are just beginning to be realized.

“When we get enough data to [replicate] the techniques of the best doctors at the top hospitals, we might be able to provide this expertise for rural areas and smaller hospitals,” he said during a panel discussion at the recent World Medical Innovation Forum in Boston.

The company still has plenty of work to do to demonstrate the effectiveness of its products, but its ability to collect imaging data through the Chinese health care system is unsurpassed: So far, it has assisted doctors in analyzing images on 4.5 million patients.

Ping An Good Doctor

Ping An Good Doctor has showcased one of the most novel creations of China’s digital health sector: A tiny, unstaffed medical “clinic” in which patients can get advice from an “AI doctor.”

The company, backed by Ping An Insurance Co., has declared its intention to open hundreds of thousands of the 3-square-meter clinics across the country over the next few years.

The clinics are designed to be a one-stop shop: Patients can give a short medical history, get a diagnosis, and then chat online with an in-house doctor from Ping An. The booth even includes a medicine cabinet to supply patients with more than 100 drugs.

The company boasted 265 million registered users at the end of last year, giving it a large supply of data it can use to refine its algorithms and build new products. Its average daily number of patient consultations has surpassed 535,000, an annual increase of 45 percent.

Yidu Cloud

Established in 2013, Yidu Cloud is using artificial intelligence to analyze hundreds of millions of electronic medical records of patients across China. The company converts the records into a standard format that can be used by doctors and researchers to examine patient outcomes. Its software is also being used to help predict the path of patients’ diseases and suggest treatment options, according to its founder, Rujing Gong.

“The machine can calculate on a real world dataset the possibility of certain treatment outcomes or the choices of medicines for that particular patient,” Gong said during the World Medical Innovation Forum.

Gong added that the company is working with the China Food and Drug Administration and other regulators to evaluate the effectiveness of certain drugs. “That research can be done by our system much cheaper and much faster,” she said, before adding a crucial caveat: “It may not be the most accurate, but it can give a quick perspective to the researchers and the scientists.”

Gong said Yidu Cloud has spent $100 million to build its software and employs about 850 people, including 200 physicians, a number that would be cost prohibitive in the United States. The company has also begun to reach out to clients beyond China’s borders, including the U.K.’s National Health Service.

Yitu Technology

Not to be confused with Yidu Cloud, Yitu Technology has developed AI software that analyzes medical images, pathology slides, written records, and other data to help diagnose and treat cancer patients.

The Shanghai-based company got its start in security products using facial recognition software and has built a health care business over the past several years. It showcased its products last November at the annual conference of the Radiological Society of North America. It is focused on diagnosis and treatment of lung and breast cancer, the two most common forms of cancer in China.

Yitu said it employs more than 400 physicians to help with the development of its technology, which also includes a 4D chest scanning system that shows moving, real-time images of lung nodules and other lesions.

The company is led by Leo Zhu, who studied at UCLA and the AI lab at the Massachusetts Institute of Technology. It has announced research partnerships with large hospitals across China, including a collaboration on lung cancer with West China Hospital in Chengdu, giving it access to tens of thousands of images.

“Data collection is a lot faster in China because we have so many patients going into each hospital,” said Leung, the managing partner at Qiming Venture Partners. “That’s really the key.”

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