Sustainable Growth in Connected Health and the Economy

‘Sustainable Growth in Connected Health and the

Economy’

Wednesday 8th May 2013 at 2pm

‘Sustainable Growth in Connected Health and the Economy Workshop’ Wednesday 8 May 2013 at 2pm (registration and buffet lunch from 1.30 pm),

at the Loughview Suite, Jordanstown Campus (University of Ulster). 1.30pm Registration and Buffet 2pm Professor Jim McLaughlin (Chair) Introduction

2.05 Guest Speaker George MacGinnis – Continua Health Alliance/PA Consulting Group – ‘What role will Connected Health play in driving our economy?’ 2.30 Professor Jim McLaughlin (NIBEC): ‘Connected Health at Ulster and Growth in the NI Economy’ 2.45 Professor Chris Nugent (SERG): ‘Smart Environments and Ambient Assisted Living’ 3.00 Professor Johnny Wallace (Comp & Eng.): ‘Growth in Collaborating with Healthcare Providers’ 3.15 Mr Stephen McComb (CHIC): ‘The Role of Innovation in Growing NI Connected Health’ 3.30 Guest Speaker Professor Brian Caulfield (UCD): ‘A New Connected Health Infrastructure in the Republic of Ireland’ 3.40 Discussion and Wrap-up

4pm -5pm There will also be a tour of the SERG and NIBEC Laboratories

(www.eri.ulster.ac.uk)

Director: Professor Jim McLaughlin

£200 m annual income

£40-60m per annum research income

4 campuses; 3000 staff and 25,000 students

127,000 alumni

Distance learning through Campus One

17 research institutes

6 Faculties: Computing & Engineering; Life and Health Sciences; Arts; Social Sciences; Art, Design and the Built Environment Ulster Business School

The 2008 Research Assessment Exercise confirmed the strength and quality of our research and the advances that we are continually making.

Facts in Figures about Ulster

Ulster is a university with a national and

international reputation for excellence,

innovation and regional engagement.

We make a major contribution to the economic,

social and cultural development of Northern

Ireland and play a key role in attracting inward

investment.

Our core business activities are teaching and

learning, widening access to education, research

and innovation and technology and knowledge

transfer.

Overview of Ulster

Life and Health Sciences in Northern Ireland – Need for Strategy

Randox LaboratoriesHSC Innovations

Almac

lmac Diagnostics

Fusion Antibodies

Gambro

MDS Pharma Services

Norbrook

Perfecseal

Warner Chilcott

BootRooms.com

Intelesens

James Leckey Design

Blue Scope Medical Technologies

Diabetica

Tomcat Systems

Health Tek

Quality Healthcare at Home

Universities

Hospitals

Of over 900 companies in Northern Ireland’s vibrant ICT sector, more than 100

are international investors, including SAP, Fujitsu, Openwave, Microsoft,

Cybersource (VISA) and BTI Systems.

Combined turnover - £500m

5000 jobs

DRIVERS

• Business •Business Models, Economic Assessment

• Nursing •Biomedical Science

•Sports Science

•Personalised Medicine

• Computing Science

• AAL, Big Data, Cloud

• Engineering

• Sensors, Wireless, Integrated Point of Care Systems, Embedded Systems

Engineering Computing

Science

Business Nursing (And Life Sciences)

Professor Jim

McLaughlin: Ulster

Lead

Healthcare Lifestyle

Technology Sweet spot

Connected Health at Ulster (Executive): Will include 3 other representitives

Prof. Chris Nugent: Computing

Science/Intelligent Algorithms and

Connected Health; Large Grant holder

(£5M) and major experience in human

sensor based trials

Prof Jim McLaughlin:

(Physicist) Medical Sensors; Micro

and nanodevices; NIBEC Director

Large Multi-million projects (£23M);

17 patents and founder of ST+D Ltd

Professor Brendan McCormack (Nursing) research work

focuses on gerontological nursing, person-centred nursing

and practice development and he serves on a number of

international editorial boards, policy committees, and

development groups in these areas

Since 2008

Over £15M into

Connected

Health

A

Dr Abbes Amira

B

Mr Mark Beattie

Professor Norman Black

Dr Raymond Bond

Dr Adrian Boyd

Mr William Burns

Dr Tony Byrne

C

Dr Darryl Charles

Dr Liming Chen

Professor Vivien Coates

Dr. Damien Coyle

D

Mr Richard Davies

Dr Dorian Dixon

Dr Mark Donnelly

E

Professor Omar Escalona

F

Dr Dewar Finlay

G

Dr Brendan Galbraith

Dr Leo Galway

H

Dr Leane Hoey

K

Professor George Kernohan

L

Dr Briege M Lagan

M

Prof Paul Maguire

Dr Suzanne Martin

Professor Tanya McCance

Dr. Paul McCullagh

Professor Sally McClean

Professor Brendan McCormack

Professor James McLaughlin

Professor Helene McNulty

Prof Brian Meenan

Dr Vidar Melby

Liz Mitchell

Dr George Moore

Dr Anne Moorehead

N

Dr Peter Nicholl

Professor Chris Nugent

S

Professor Bryan Scotney

Professor Marlene Sinclair

Dr Paul Slater

Dr Eamon Slevin

T

Dr Laurence Taggart

Dr Maria Truesdale-Kennedy

W

Professor Eric Wallace

Professor Jonathan Wallace

Dr Haiying Wang

Dr Mary Ward

Dr Alan Webb

Z

Dr Huiri Zheng

Connected Health at Ulster:

(Main Academic Members - 50):

Education: Postgraduate

Below are a range of our most promising Post Graduate courses and modules which form part of the Connected Health-Ulster’s offering. We also over numerous PhD’s in the Area

Health Informatics (PgCert/PgDip/MSc)

Health and Wellbeing (PgDip/MSc)

Health Promotion and Public Health (PgCert/PgDip/MSc)

Human Nutrition (PgDip/MSc)Non-Medical Prescribing (PgCert)

Psychology (Health)

(PgDip/MSc)Nursing Credit Bearing ModulesRespiratory Health (PG Certificate)

Sport and Exercise Nutrition (Postgraduate Diploma/MSc)

Biomedical Engineering (PgDip/MSc)

Dean of Computing and Engineering

Professor R. Millar

Engineering Research Institute

Director :

Professor Jim McLaughlin

NIBEC

Director Professor Jim McLaughlin

ECRE

Acting Director :

Dr Alistair McIlhagger

AMFo0R

Group Leader Dr Alan Leacock

Computing Science Research Institute

Professor Bryan Scotney

The ERI Faculty Dr Dorian Dixon

Nanocomposites

and Polymer

drug Delivery

Systems

Prof James

Davis: Bio

sensing and

diagnostics

Dr Patrick Dunlop:

Biosensors

Prof. Brian

Meenan:

Biomaterials and

Tissue

Engineering

Prof. Paul Maguire:

Nanofabrication and

Plasma Technology

Prof Jim

McLaughlin:

Nanotechnology

related to carbon

and nano-sensor

fabrication

Prof Pagona

Papankonsta

niou:

Nanotubes

and

Nanodevices

Dr Patrick

Lemoine:

Nano-tribology

and nano-

microscopy

Dr Tony

Byrne:

Photocatalysi

s and Clean

Technology

Dr Adrain Boyd

Nano based-

biomaterials

Alan Brown:

Microfluidics

Dr George

Burke: Cell

Biology

Dr Davide

Mariotti:

Nanoparticle

s and

Plasma

Physics

Dr Abbess Amira

Embedded

Systems in

Connected Health

Dr Alistair

McIlhagger:

Composites /

NIACE

Dr Alan

Leacock:

Metal

Forming /

NIACE

Dr Edward

Archer:

Composites /

NIACE

NA

MR

I

NIBEC

NA

MR

I

ECRE

NA

MR

I

AmFOR

Engineering Research Institute www.eri.ulster.ac.uk

Infrastructure (Nanofab and Characterisation): £17M (since 2001) £7M SRIF/RCIF £8M Government and Industry £3M EU

Major Projects £13M (since 2001) £5 M EU £4M EPSRC £4.8 M Industry/Government

Staff 5 Professors 3 Readers 6 Senior Lecturers 5 Lecturers (ECR’s)

Technology Transfer/Proof of Concept £1.6M (since 2001)

Nanotechnology and Integrated

Bioengineering Centre (NIBEC)

Nanotechnology and Integrated Bioengineering Centre (NIBEC)

Engineering Research Institute

£33million funding since 2001

EPSRC;

INI;

DEL;

Wellcome

Trust;

EU;

NSF (US Irl

Partnership)

BIS;

HEA;

SFI;

MRC;

Leverhulme;

R&D Office;

Industry;

Philanthropic

Multi-disciplinary research centre applying nanotechnology and bioengineering to the following thrusts:

Our CH History: NIBEC founded in 1985 by Professor John Anderson Traced back to Professor Partridges idea of mobile coronary care New building in 1994 and 2004

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THE DISTRIBUTION OF ACUTE CORONARY DEATHSMc NEILLY (BELFAST), 1965-66, 818 DEATHS

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2020

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The Acute MIThe Acute MI

Myocardialpreservation %

Myocardialpreservation %

Average patient

response time

Average patient

response time

Hrs. from symptom onsetHrs. from symptom onset

History of Success in CH

• M Health

• Clinical Trials

• Adoption Models

• Economic Assessment

• Spin Outs

• Electrode Fabrication and Characterization

• Carbon Nanotube & Graphene Growth

• Nanoparticles

• Telemetry: Bluetooth, Wi-Fi and Propriety RF

• Electronics

• Embedded Systems

• Pattern Recognition

• PlasmaTechnology

• Microfluidics

• Microfabrication

• Nanofabrication

• Surface Analysis

• Microscopy

• Chemical Analysis

MEMS and Nanodevices

Smart Diagnostic Devices

Smart Systems

Connected Health Solutions

Fully Integrated systems for Chronic Health; Lifestyle and Pharma Monitoring

Nanosensors

ECG, EMG, EEG, Temp, Resp. Rate,

SpO2, PWV, Biosensors, E Nose

The NIBEC Capability

CH Infrastructure

NIBEC: Nanotechnology, Microfluidics; Cell- /Micro- Biology Laboratories; Microfabrication Cleanrooms

SMART WARD

SMART Doctors Surgery

SERG (SSRI): Ambient Assisted Living

Data Analysis/DSP/Labview Project Laboratories

Patient Testing Laboratories

Terrace House and Playing Field Testing

Plans for new Innovation Centre (Manufacturing)…Rapid Proto typing

Connected Health Themes at Ulster

Wireless Vital Signs Monitoring

Point of Care Diagnostics Systems

Sensor Technology

M-Health

Ambient Assisted Living

Clinical Trialing

Economic Assessment and Valuation

Technology Transfer…spin outs and licensing

Personalized Medicine (BSRI)

CTRIC and UUM (ISRC)

Sensor Technology

ECG, EMG, EEG

SpO2 (Reflective)

PWV (piezo)

Accelerometers (MEMS- Motion)

Respiration Rate

GSR

Cardiac Mapping

Biosensors: Glucose and Cardiac Enzymes via IDE’s

Micro- SPR

Micro-Raman

Micro-E-nose (plasma)

Impedance

Micro-E-nose (plasma)

Connected Health Themes at Ulster

All about higher sensitivity &specificity – less false alerts

Key current research topics

AF sensing/pattern recognition

Sleep Apnoea early warning

Smart MEWS based multi-sensing Algorithms

De-hydration Sensing

NIBP systems

Cardiac Mapping

Multiple data analysis – MVA, Big Data analytics

Pulse Wave Velocity

Remote Foetal monitoring

Hypo- detection in Diabetics

Non-Invasive Glucose Monitoring (IR)

Novel Wearable Electrode Systems

Point of Care Diagnostics – Microfluidic Systems

Key Underpinning Materials Areas

Major nanotechnology laboratories

Plasma Technology

Graphene, CNT’s and DLC

Metal Oxides

Nanoceramics and nanoparticles

Si nanoparticles

Microfluidics – Integrated Optics/Impedance

Nanomaterials Characterisation: TEM, SEM. FIB, TOF SIMS, AFM, XPS, Raman, Nanoindentor etc.

Electrical Characterisation of Materials

Electrode and antenna design

The NIBEC POC Cardiac

Enzyme Impedance

Microfluidics – Integrated optical and impedance

platforms; nanoparticle (CNT/Graphene/Si

amplification); and pattern recognition with

wireless communication systems.

CH Enabled AF Treatment for Patients with

a Passive Implantable Atrial Defibrillator

Regional Cloud Hospital

WAN Support

Mainframe Computer

Centre for

Connected

Health

Minimal Critical Care

Setting

AF Patient with an

Implanted PIAD

CH Assisted Cardioversion

with a Passive Implantable

Defibrillator (PIAD) PIAD

Interventional

Cardiology Experts

Public Access Defibrillation Reliability and

Effectiveness Enhancement by Connected Health

Key issues to address:

- AED device automatised regular maintenance/supervision by CH while in the emergency

box; AED could be used only once in 5 years or more.

- AED embedded knowledge based algorithms performance can be enhanced if supported

by a CH centre mainframe computer.

- Soft paramedic assistance from an emergency CH service, while live monitoring patients

vital signs and CPR parameters, would en enhance safety and effectiveness of CPR.

Centre for

Connected

Health

AED with

Embedded Internet Cloud Emergency Services

AED

Maintenance

& Supervision CH Assisted

CPR

CH Assisted PAD for the

AED Knowledge Base and

Live Expert Advice

Mainframe Computer

CH Enabled Cardiac Mapping for Early MI Detection

(within 90 minutes)

Cloud Emergency Services

WAN Support

Mainframe Computer

Centre for

Connected

Health

Patient with Chest Pain at His Home

Current Portable 28-Lead

Cardiac Mapping System

and Disposable Harness

Experts at the

Cardiac Centre

CH Assisted 28-Lead Cardiac Mapping

Smartphone Application for Live MI

Authorised Diagnosis

Clinician Trust/Hospital Hospital/GP/Care Home

Specialising

Dr Ganesh Manoharan / Prof J Adgey

Belfast Health and Social Care Trust

Hospital Cardiology

Dr Hubert Curran

Senior Primary Care Advisor to the Performance

Management and Service Improvement

Directorate of the HSCB

Primary Health Care Primary Health Care

Dr David McEneaney South Eastern Health and Social Care Trust

Hospital Cardiology

Dr Roy Harper South Eastern Health and Social Care Trust

Hospital Diabetics

Sharon Foster (Clinical Nurse)

McElwaine Industry Telehealthcare

Engagements with possible inclusion Dr Paddy Donnelly (Ulster); Dr Maurice O Kane CTRIC; Dr David McCance (RVH)

CLINICAL LINKS

Employing around 35-40 staff directly

Wireless Vital Signs Platforms

Intelesens has developed its

platform as the basis of OEM

products

Short range or cellular telemetry

Range of vital signs possible

Respiration

Blood oxygen (late 2007)

Temperature

Motion, activity and falls

Cardiac output

ECG

Compact, light, easy to wear

ecg

respiration rate

temperature

SpO2

accelerometer

3. Innovation

Ubiquitous surveillance monitoring system

Full ambulation

Wi-Fi connectivity

Simple, easy, unobtrusive, low-cost

Alert management

Smart: ECG Pattern Recognition

Bradyarrhythmia

Ventricular Tachycardia

Supra Ventricular Tachycardia

Self-terminating Ventricular Fibrillation

Asystole

Atrial Flutter

Atrial Fibrillation

1st Degree Heart Block

2nd Degree Heart Block

3rd Degree Heart Block

Clinical Study complete with Ulster Hospital:

Dr Roy Harper and currently undergoing one at

UI and Dublin

•Congenital heart defects

•Congestive heart failure

•Heart muscle disease

•Heart valve disorders

•Other diseases, such as lung conditions

•External forces such as electric shock or severe

chest injury

Atrial Fibrillation captured with Aingeal device

Example of CSR captured: Cheyne-Stokes respiration

Employing around 60-70 staff directly

Heartsine

Corporate Headquarters: HeartSine Technologies, Inc. 940 Calle Amanecer Suite E San Clemente, CA 92673

United States

Phone: 1.949.218.0092 Fax: 1.949.218.0093 Toll Free: 1.866.HRT.SINE European Office: HeartSine Technologies, Ltd. Canberra House 203 Airport Road West Belfast, BT3 9ED Northern Ireland

Phone: +44 (0)28 9093 9400 Fax: +44 (0)28 9093 9401

http://www.heartsine.com

The 1970’s NIBEC Vision

Recently purchased by Verathron

employed 60 staff directly (at one stage

over 100)

80-Lead Technology Benefits:

Features:

1. J Elect rocard.

Heartscape, the Heartscape symbol, Verathon, and the Verathon Torch symbol are trademarks of Verathon Inc. © 2011, 2012 Verathon Inc.

for a complete view of the heart

Touchscreen color monitor

80-Lead Vest:

58 anterior leads

12 lateral leads

10 posterior leads

A 360º ECG

Non-U.S. Only

Recently acquired by Verathron

The Vision – Self Care Model

Sensor – analysis – diagnostics – feedback – immediate therapy

Vital signs alert and immediate worn therapy

For example – heart attack and possible patch based TPA delivery

Or respiration rate and dosage feedback for therapy

Require POC diagnostics and improved drug delivery techniques

Worn Drug Therapy

Feedback

Cloud Analytics

Worn Vital

Signs Detection

Founder and Managing Director: Dr. Suzanne Roghieh Saffie-Siebert Professor Jim McLaughlin Director and CSO John Hartnett and Tim Brundle (Investors and Directors) Scientists: Drs. Nessim Troabi-Pour; Mukhtar Ahmed; Jeremy Hamill

SiSaf scooped a major prize – for development of an innovative drug-delivery system at the Irish Technology Leadership Group’s

(ITLG) annual awards ceremony in Silicon Valley, California.

The SiSaf Difference

Solubility – Improved up to 40%

Biocompatibility – Organic Solid

Nanoparticles

Active Delivery – Self beneficial

compound

Control Release – Tailor made

release profile

Penetration – Into and through skin

Absorption – Improved through

localization and SR

Localization – High concentrated

molecule

Headed up by Stephen McComb

Connected Health in Northern Ireland Industry led research with global relevance

What is it?

CHIC is an Industry-led group which is

focused on collaborative research to

support the growth of the connected

health market. Funding is largely from

state aid.

Emerging Focus Areas

1.Integrated community care – joining

together existing and new technology

and process.

2.Point of Care Diagnostics – moving

diagnostics closer to the patient.

3.Vital Signs monitors - technology

development to support sign

identification, analysis and

communication.

“Delivering leadership for the development of Connected and Mhealth markets and practice across Europe and beyond”

Joint MOU between DETI and DOH in Northern Ireland (better health and jobs)

Setting up of a NI CH Eco System – Clinicians- Business- Academia Strong links with Boston – Finland – Catalonia – Manchester – NIMAC ECHAlliance Ecosystems – Manchester, Northern Ireland and more to be

announced.

ECH - Alliance and the new Northern Ireland Connected Health Eco System

EU-US eHealth Business

Marketplace – Boston USA 2012

35 patents, 3 companies and many licences

Created over 120 industry jobs across all 3

Connected Health spin-outs; Trained over research

100 staff for CH industries

Saved lives, improved the quality of life and cut

costs - MATCH.

Technologies are used by the Wellcome Trust,

CIMIT and various companies as exemplars of the

future of healthcare.

The concept of Connected Health in Northern

Ireland was derived from much of our early work.

Their more recent work, with over 35 patents, has been commercialised to companies such as Heartsine Inc., Samsung, Intelesens Ltd. Heartscape Inc., Tyco, SHL Telemedicine, Phillips and Air Products. These companies’ products have now been well established and include the world’s best selling disposable ecg electrode, telemedicine based 12 lead electrodes, the most compact AED marketed and a smart wireless chest based ecg, respiration rate, temperature and SpO2 monitor.

Professors McLaughlin, Anderson and McAdams have a 25 year history of developing successful patent exploitation in the area of medical sensors and electro-stimulation devices, following the impact that Pantridge, Adgey and Anderson had on mobile coronary care in Northern Ireland.

Impact of Connected Health @Ulster

This has inspired many initiatives such as the:

BEST Centre, CHIC, ECHCampus (2009-2012) and now the European Connected Health Alliance (2011-); Northern Ireland Connected Health-ECO; culminating with NIMAC which joint agreement between USA, Finland, ROI, Northern Ireland, the Manchester and Catalonia; Northern Ireland DHSSPSNI & DETI signing a strategic and joint Connected Health MOU

The recipe for Connected Health Device Innovation

Good Product design – from concept to scale-up

User needs – cost reduction (evidence) – regulatory

Accurate and flexible business model

A good users based - ECO system (smart market analysis)

Miniaturised and robust technology

Portable – Cloud based solutions – still some security issues

High quality data analytics

Early warning with clear patient & clinical benefits

Smart Back-end systems

And most of all functional & well designed (intuitive) and meets all FDA – CE approvals and easily validated

Conclusion

History of Success

University of Ulster Capability and experience

Strong Clinical Integration

Technology Transfer – spin-outs – CHIC’s future Role

ECHA- The Northern Ireland CH Eco System

Finally - We need a systems and design approach to adopting this new form of delivering Healthcare – with sensors, diagnostics, communications, software, clinical specifications, health economics, regulatory drivers and business models all playing a key role to drive our Healthcare Provision and Economy