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National Science Council, Taipei, Taiwan


                     A Fantastic Journey
of Learning Innovative Medical Devices in
    Stanford University and Silicon Valley


               John Tsung-Chun Lee, M.D.
                                                           Staff Physician
                                                       Clinical Instructor
                                    Gastroenterology, Internal Medicine,
                                     National Taiwan University Hospital


                                             2012/04/11
                            E-mail: johnlee0212@gmail.com
                             www.linkedin.com/in/johntclee
國科會報告 , 台北 , 台灣

    一位台灣醫生走出象牙塔外之
美國史丹福大學與矽谷高階醫療器材產
           業的奇幻旅程

                         李宗錞醫師
                 內科 胃腸肝膽科 消化內視鏡專科
                             主治醫師
                          教育部部定講師
                     台灣大學醫學院 台大醫院

                          2012/04/11
       E-mail: johnlee0212@gmail.com
       www.linkedin.com/in/johntclee
Outline
 •   One-year journey at Stanford and Silicon Valley
 •   Biodesign Program
 •   Ecosystem of medical device industry
 •   What we can do in Taiwan
 •   Alumnus’ view on STB program
       – Recruit, in-program, afterwards
 • National Architect to replicate Silicon Valley!

 • D isclosure

2012/04/11                copyright John Tsung-Chun Lee   3
Stanford University
             (established since 1891)




2012/04/11              copyright John Tsung-Chun Lee   4
Stanford-Taiwan Biomedical (STB)
program
• Since October 2008, 2 batches per year
• A group of physicians, engineers
• Duration: one-year
      – 2010/10/01 – 2011/09/30
• Hosted by Prof. Peter Fitzgerald
      – Cardiovascular Medicine, School of Medicine, Stanford
      – Engineer, Interventional cardiologist, Inventor, Venture Capitalist
• Office at
      – Center for Cardiovascular Technologies (CCVT)
      – Stanford University Medical Center (SUMC)
• Status
      – Visiting Scholar of Stanford University
      – Audit classes of interest (medical, engineering, business schools)
2012/04/11                    copyright John Tsung-Chun Lee                   5
Where do innovation come from?




2012/03/09    copyright John Tsung-Chun Lee   6
My journey- 3 essential credits




2012/04/11    copyright John Tsung-Chun Lee   7
2012/03/09                   copyright John Tsung-Chun Lee   8
http://www.siliconmaps.com/silicon_valley.html
The Silicon Valley Way (mindset)
•   Dream Big !
•   Change the world !
•   Dare to dream
•   Dare to try
•   Rapid prototyping
•   Fail fast then try another one
•   Rapid iteration
•   Lean startup
•   Partnership between
    entrepreneur and venture
    capitalist
•   “The StartUp Game”
    (William H Draper III)
2012/04/11                     copyright John Tsung-Chun Lee                       9
                                                               http://www.amazon.com
Design thinking (d.school at Stanford Univ)
      "Human–Centered Design"

How to conduct an high-impact brainstorming:
•Warming-up
•Empathy: prime sub-consciousness
•Focus – problem
    – Status quo and Specifications
•Explore four quadrants for insights
    – X-axis: Logics & Emotion
    – Y-axis: Spoken & Unspoken
•Creative within constraints
       • Time; Resources
•Forget all the rules, Let’s brainstorm!
•Think by prototyping; Try by prototyping

2012/04/11             copyright John Tsung-Chun Lee   10
Design thinking crash course at d.school,
2012/03/09   Stanford Univ., 2011/01/08
             copyright John Tsung-Chun Lee               11
Snapshot at d.school




2012/04/11
                         Design thinking crash course at d.school,
             copyright John Tsung-Chun Lee                           12
                         Stanford Univ., 2011/01/08
Creativity
 comes with child-like excitement




2012/04/11
                              Design thinking crash course at d.school,
                  copyright John Tsung-Chun Lee                           13
                              Stanford Univ., 2011/01/08
Dialogue between MD and
             Engineer
             雞同鴨講?
             非也 , 異中求同 - 同中求創新 !
             Apprenticeship; Different tracks


                                                                                                  Vall
                                                                                          Silicon Valle

                                                   CBA: Biotech, Life Science Organization in Bay Area, California - A Biotech




                                                                 ORGANIZATION                                     MEMB
2012/03/09         copyright John Tsung-Chun Lee     HOME      AB OU T U S       EVENTS   NEWS     MEMBERS      14
                                                                                                                CONTACT

                                                     Board Members    Advisors
Biodesign thinking process
                           -new thinking, forget about SCI !
 • Identification                (Disease insight)
             • Solid unmet clinical need
             • Large market potential; Back-of-envelop analysis
 • Innovation                    (Device insight)
             • Design thinking
             • Rapid iteration
 • Implementation (Business insight)
             • Three hurdles to overcome: Intellectual Property,
               Regulatory, Reimbursement
             • Clinical adoption, Sales and Marketing, Channels
             • Business model
             • Exit strategies


2012/03/09                       copyright John Tsung-Chun Lee     15
P. G. Yock, T. J. Brinton, S. A. Zenios, Teaching Biomedical Technology
2012/03/09   copyright John Tsung-Chun Lee Discipline. Sci. Transl. Med. 3, 92cm18 (2011). 16
                              Innovation as a
                              DOI: 10.1126/scitranslmed.3002222
Essence of Bio-design

• Design: purposeful invention for the good of patients
• Patient – first; Patient – centered; Patient - oriented
• Disruptive innovation, not incremental improvement or cost-down
  approach (although affordable medicine is the trend)
• Market-driven (global market, emerging market, niche market)
• Reasonable anticipated return
• Therapeutic device better than diagnostic
• Multi-disciplinary approach/team from beginning to end
• Rapid iteration
• Industrial feedback (instant, timely, practical)
• Business project, not scientific project for SCI academic publications

2012/03/09                copyright John Tsung-Chun Lee              17
Secrets of successful innovation for
entrepreneurs
•   Find solid, data-proven unmet clinical need
•   Passion about it
•   Follow you heart
•   Dive deep, Know everything about it
•   Find the best professionals to form a complimentary team
•   Form hypothesis along the way, test and revise
•   Rapid iteration
•   Intellectual property (IP) portofolio protection as the most
    early and important task



2012/04/11               copyright John Tsung-Chun Lee             18
Eco-System of medical device industry

 •   Entrepreneurial team
 •   Venture capitalist, Angel investor
 •   Design and prototyping companies
 •   Pre-clinical testing companies
 •   Attorneys (IP, Legal, Accounting, M & A, IPO)
 •   Consultants (regulatory, manufacturing, reimbursement)
 •   Doctors, Scientists, Hospitals
 •   Contrast Research Organizations (CRO, trialists)
 •   Businessmen (Salesforce, Marketing, Channels)
 •   Experienced entrepreneurs, mentors

2012/04/11                   copyright John Tsung-Chun Lee    19
Importance of networking
 • “Silicon Valley is built on “Merit”( 成人之美 ) (Trust)
 • “Merit rules out” (John Roos, CEO of WSGR)
 • Proximity within Silicon Valley area: work & life together
 •   We need to
       – Learn from them about “Insider’s know-how”
       – Get involved
       – Tap into the US medical device value chain




2012/04/11                    copyright John Tsung-Chun Lee     20
Building connections …
         LinkedIn, Tweeter
         Medical Device conferences
         Starbucks coffee, Peet’s coffee, …




2012/04/11                 copyright John Tsung-Chun Lee   21
Cross-Pacific Strategy
 -- Rooted in Taiwan, Leveraging Silicon Valley




2012/04/11              copyright John Tsung-Chun Lee   22
Strategies to design and build EcoSystem of medical
 device industry in Taiwan
 • Bottom-up and Top-down approaches
 • What resources do we have ?
 • Incentives for stakeholders inside and outside Taiwan ?




2012/04/11              copyright John Tsung-Chun Lee        23
Taiwan’s advantages




                                                                  Precision
                                                                  manufacture




                              P. G. Yock, T. J. Brinton, S. A. Zenios, Teaching Biomedical Technology
2012/03/09   copyright John Tsung-Chun Lee Discipline. Sci. Transl. Med. 3, 92cm18 (2011). 24
                              Innovation as a
                              DOI: 10.1126/scitranslmed.3002222
What are missing?




                              Entrepreneurs, Job-shifting Talents,
                              Experienced Executives




                              P. G. Yock, T. J. Brinton, S. A. Zenios, Teaching Biomedical Technology
2012/03/09   copyright John Tsung-Chun Lee Discipline. Sci. Transl. Med. 3, 92cm18 (2011). 25
                              Innovation as a
                              DOI: 10.1126/scitranslmed.3002222
What can we do in Taiwan ?
 • Biodesign innovation workshops
       – Educate physicians, engineers, and investors
 • Clinical shadow observation in the hospital
       – Source of unmet needs and new ideas
 • Prototyping services for medical devices
       – Rapid iteration, proof-of-concept testing
 • Early-stage investment in medical devices
       – Government or Corporate seed funding
 • First-in-man trials in Taiwan
 • Close and continuous connection with Silicon Valley



2012/04/11                     copyright John Tsung-Chun Lee   26
Important professionals in Silicon Valley




Dr. Paul Yock   Dr. Peter               Dr. Jay Pasricha              Mark Deem            Jim Swick
                Fitzgerald,
CV, Biodesign                           GI, Innovator                 CTO, Foundry         Ex-CTO, LyChron
                CV, VC


                              Dr. Yue-Teh Jang                                       Dr. Joseph Yang
                              Entrepreneur, VC                                       TECO, San Francisco




  2012/04/11                          copyright John Tsung-Chun Lee                                    27
Taiwan
             -- innovation starts from here!

             Conceived in Taiwan
             First-Trialed in Taiwan
             “ 台灣發想 矽谷設計
              台歐認證 行銷全球 ”
2012/04/11             copyright John Tsung-Chun Lee   28
居廟堂之高 ,則憂其民
       范仲淹 岳陽樓記



   替未來的年青學子
  謝謝國科會的長官們

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Stb Tsungchun Lee 20120411 S S

  • 1. National Science Council, Taipei, Taiwan A Fantastic Journey of Learning Innovative Medical Devices in Stanford University and Silicon Valley John Tsung-Chun Lee, M.D. Staff Physician Clinical Instructor Gastroenterology, Internal Medicine, National Taiwan University Hospital 2012/04/11 E-mail: johnlee0212@gmail.com www.linkedin.com/in/johntclee
  • 2. 國科會報告 , 台北 , 台灣 一位台灣醫生走出象牙塔外之 美國史丹福大學與矽谷高階醫療器材產 業的奇幻旅程 李宗錞醫師 內科 胃腸肝膽科 消化內視鏡專科 主治醫師 教育部部定講師 台灣大學醫學院 台大醫院 2012/04/11 E-mail: johnlee0212@gmail.com www.linkedin.com/in/johntclee
  • 3. Outline • One-year journey at Stanford and Silicon Valley • Biodesign Program • Ecosystem of medical device industry • What we can do in Taiwan • Alumnus’ view on STB program – Recruit, in-program, afterwards • National Architect to replicate Silicon Valley! • D isclosure 2012/04/11 copyright John Tsung-Chun Lee 3
  • 4. Stanford University (established since 1891) 2012/04/11 copyright John Tsung-Chun Lee 4
  • 5. Stanford-Taiwan Biomedical (STB) program • Since October 2008, 2 batches per year • A group of physicians, engineers • Duration: one-year – 2010/10/01 – 2011/09/30 • Hosted by Prof. Peter Fitzgerald – Cardiovascular Medicine, School of Medicine, Stanford – Engineer, Interventional cardiologist, Inventor, Venture Capitalist • Office at – Center for Cardiovascular Technologies (CCVT) – Stanford University Medical Center (SUMC) • Status – Visiting Scholar of Stanford University – Audit classes of interest (medical, engineering, business schools) 2012/04/11 copyright John Tsung-Chun Lee 5
  • 6. Where do innovation come from? 2012/03/09 copyright John Tsung-Chun Lee 6
  • 7. My journey- 3 essential credits 2012/04/11 copyright John Tsung-Chun Lee 7
  • 8. 2012/03/09 copyright John Tsung-Chun Lee 8 http://www.siliconmaps.com/silicon_valley.html
  • 9. The Silicon Valley Way (mindset) • Dream Big ! • Change the world ! • Dare to dream • Dare to try • Rapid prototyping • Fail fast then try another one • Rapid iteration • Lean startup • Partnership between entrepreneur and venture capitalist • “The StartUp Game” (William H Draper III) 2012/04/11 copyright John Tsung-Chun Lee 9 http://www.amazon.com
  • 10. Design thinking (d.school at Stanford Univ) "Human–Centered Design" How to conduct an high-impact brainstorming: •Warming-up •Empathy: prime sub-consciousness •Focus – problem – Status quo and Specifications •Explore four quadrants for insights – X-axis: Logics & Emotion – Y-axis: Spoken & Unspoken •Creative within constraints • Time; Resources •Forget all the rules, Let’s brainstorm! •Think by prototyping; Try by prototyping 2012/04/11 copyright John Tsung-Chun Lee 10
  • 11. Design thinking crash course at d.school, 2012/03/09 Stanford Univ., 2011/01/08 copyright John Tsung-Chun Lee 11
  • 12. Snapshot at d.school 2012/04/11 Design thinking crash course at d.school, copyright John Tsung-Chun Lee 12 Stanford Univ., 2011/01/08
  • 13. Creativity comes with child-like excitement 2012/04/11 Design thinking crash course at d.school, copyright John Tsung-Chun Lee 13 Stanford Univ., 2011/01/08
  • 14. Dialogue between MD and Engineer 雞同鴨講? 非也 , 異中求同 - 同中求創新 ! Apprenticeship; Different tracks Vall Silicon Valle CBA: Biotech, Life Science Organization in Bay Area, California - A Biotech ORGANIZATION MEMB 2012/03/09 copyright John Tsung-Chun Lee HOME AB OU T U S EVENTS NEWS MEMBERS 14 CONTACT Board Members Advisors
  • 15. Biodesign thinking process -new thinking, forget about SCI ! • Identification (Disease insight) • Solid unmet clinical need • Large market potential; Back-of-envelop analysis • Innovation (Device insight) • Design thinking • Rapid iteration • Implementation (Business insight) • Three hurdles to overcome: Intellectual Property, Regulatory, Reimbursement • Clinical adoption, Sales and Marketing, Channels • Business model • Exit strategies 2012/03/09 copyright John Tsung-Chun Lee 15
  • 16. P. G. Yock, T. J. Brinton, S. A. Zenios, Teaching Biomedical Technology 2012/03/09 copyright John Tsung-Chun Lee Discipline. Sci. Transl. Med. 3, 92cm18 (2011). 16 Innovation as a DOI: 10.1126/scitranslmed.3002222
  • 17. Essence of Bio-design • Design: purposeful invention for the good of patients • Patient – first; Patient – centered; Patient - oriented • Disruptive innovation, not incremental improvement or cost-down approach (although affordable medicine is the trend) • Market-driven (global market, emerging market, niche market) • Reasonable anticipated return • Therapeutic device better than diagnostic • Multi-disciplinary approach/team from beginning to end • Rapid iteration • Industrial feedback (instant, timely, practical) • Business project, not scientific project for SCI academic publications 2012/03/09 copyright John Tsung-Chun Lee 17
  • 18. Secrets of successful innovation for entrepreneurs • Find solid, data-proven unmet clinical need • Passion about it • Follow you heart • Dive deep, Know everything about it • Find the best professionals to form a complimentary team • Form hypothesis along the way, test and revise • Rapid iteration • Intellectual property (IP) portofolio protection as the most early and important task 2012/04/11 copyright John Tsung-Chun Lee 18
  • 19. Eco-System of medical device industry • Entrepreneurial team • Venture capitalist, Angel investor • Design and prototyping companies • Pre-clinical testing companies • Attorneys (IP, Legal, Accounting, M & A, IPO) • Consultants (regulatory, manufacturing, reimbursement) • Doctors, Scientists, Hospitals • Contrast Research Organizations (CRO, trialists) • Businessmen (Salesforce, Marketing, Channels) • Experienced entrepreneurs, mentors 2012/04/11 copyright John Tsung-Chun Lee 19
  • 20. Importance of networking • “Silicon Valley is built on “Merit”( 成人之美 ) (Trust) • “Merit rules out” (John Roos, CEO of WSGR) • Proximity within Silicon Valley area: work & life together • We need to – Learn from them about “Insider’s know-how” – Get involved – Tap into the US medical device value chain 2012/04/11 copyright John Tsung-Chun Lee 20
  • 21. Building connections … LinkedIn, Tweeter Medical Device conferences Starbucks coffee, Peet’s coffee, … 2012/04/11 copyright John Tsung-Chun Lee 21
  • 22. Cross-Pacific Strategy -- Rooted in Taiwan, Leveraging Silicon Valley 2012/04/11 copyright John Tsung-Chun Lee 22
  • 23. Strategies to design and build EcoSystem of medical device industry in Taiwan • Bottom-up and Top-down approaches • What resources do we have ? • Incentives for stakeholders inside and outside Taiwan ? 2012/04/11 copyright John Tsung-Chun Lee 23
  • 24. Taiwan’s advantages Precision manufacture P. G. Yock, T. J. Brinton, S. A. Zenios, Teaching Biomedical Technology 2012/03/09 copyright John Tsung-Chun Lee Discipline. Sci. Transl. Med. 3, 92cm18 (2011). 24 Innovation as a DOI: 10.1126/scitranslmed.3002222
  • 25. What are missing? Entrepreneurs, Job-shifting Talents, Experienced Executives P. G. Yock, T. J. Brinton, S. A. Zenios, Teaching Biomedical Technology 2012/03/09 copyright John Tsung-Chun Lee Discipline. Sci. Transl. Med. 3, 92cm18 (2011). 25 Innovation as a DOI: 10.1126/scitranslmed.3002222
  • 26. What can we do in Taiwan ? • Biodesign innovation workshops – Educate physicians, engineers, and investors • Clinical shadow observation in the hospital – Source of unmet needs and new ideas • Prototyping services for medical devices – Rapid iteration, proof-of-concept testing • Early-stage investment in medical devices – Government or Corporate seed funding • First-in-man trials in Taiwan • Close and continuous connection with Silicon Valley 2012/04/11 copyright John Tsung-Chun Lee 26
  • 27. Important professionals in Silicon Valley Dr. Paul Yock Dr. Peter Dr. Jay Pasricha Mark Deem Jim Swick Fitzgerald, CV, Biodesign GI, Innovator CTO, Foundry Ex-CTO, LyChron CV, VC Dr. Yue-Teh Jang Dr. Joseph Yang Entrepreneur, VC TECO, San Francisco 2012/04/11 copyright John Tsung-Chun Lee 27
  • 28. Taiwan -- innovation starts from here! Conceived in Taiwan First-Trialed in Taiwan “ 台灣發想 矽谷設計 台歐認證 行銷全球 ” 2012/04/11 copyright John Tsung-Chun Lee 28
  • 29. 居廟堂之高 ,則憂其民 范仲淹 岳陽樓記 替未來的年青學子 謝謝國科會的長官們

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