Future of Healthcare IE - Q1 2022 by Mediaplanet UK&IE

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Ireland is poised to become a global hub for advanced cell and gene therapy An all-island strategy to develop and invest in gene and cell therapy will benefit healthcare and attract multinationals interested in the advanced therapy medicinal products (ATMP).

Image provided by NUI Galway - From Left to Right: Mr Andrew Finnerty, General Manager CCMI; Dr Meadhbh Brennan; Professor Tim O’Brien

here is huge potential for gene and cell therapy to contribute to global wellbeing by developing technologies that can repair or regenerate damaged or aged genes, cells and tissues. Ireland, with its strong advanced manufacturing base, can be a hub of excellence for these activities.

Professor Frank Barry Professor of Cellular Therapeutics, Scientific Director Regenerative Medicine Institute (REMEDI), Co-Director Centre for Cell Manufacturing Ireland (CCMI), NUI Galway

Professor Tim O’Brien Established Professor of Medicine, Director REMEDI, Co-Director CCMI, NUI Galway

Dr Meadhbh Brennan Associate Professor, School of Engineering and REMEDI, NUI Galway

WRITTEN BY Sean Duke

Barry and O’Brien and colleagues at REMEDI, outlines the benefits of having an all-island approach to gene and cell activities and the development of manufacturing and commercialisation infrastructure for ATMPs. Ireland’s advanced manufacturing sector is worth about €140 billion in exports and employs 261,400 people. The strategy can create an ecosystem to accelerate the development of ATMP focused enterprises and increase the attractiveness of Ireland as a place for ATMP related foreign investment. Integral to achieving this is the establishment of a highly skilled workforce. NUI Galway leads the way, with masters and PhD programmes in regenerative medicine and cell manufacturing, training the next generation of researchers to place Ireland at the forefront of advanced therapies.

Paid for by NUI Galway

Developing an all-island strategy The key ingredient is an agreed all-island strategy to develop and invest in the gene and cell therapy industry. This strategy is being driven by two pioneers of the regenerative medicine field in Ireland, Professor of Cellular Therapeutics Frank Barry and Professor of Medicine Tim O’Brien, both based at NUI Galway and Saolta University Healthcare Group. In 2004, they co-founded the Regenerative Medicine Institute (REMEDI) with the support of Science Foundation Ireland (SFI) - a big step for regenerative Ireland’s advanced medicine in Ireland. Funding was also manufacturing sector is secured from the programme for research in Third Level Institutions for the Centre worth about €140 billion for Cell Manufacturing Ireland (CCMI), in exports and employs an advanced facility currently licensed to manufacture cell therapies for treatment 261,400 people. of patients in clinical trials. Challenges facing transformative therapy SFI has awarded over €12 million research funding in areas of gene therapy and cell therapy in the last 10 years. Experts believe these therapies will be the next major innovation to change medicine. Already, gene modified cells are being used successfully to treat blood cancer, where stem cells are modified and delivered back into a patient to target and kill cancers that had previously been untreatable. Medicines based on cells and genes have transformative potential, but they are also complex to develop and manufacture - that’s where Ireland’s challenge lies. Significant government support and investment will be required to overcome these challenges. The strategic position paper, put forward by Professors

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Opportunities in regenerative medicine REMEDI has recruited Dr Meadhbh Brennan, a biomedical engineer who holds a prestigious European Research Council award to study the potential for extracellular vesicles (EVs) - the by-products of stem cell manufacturing – to be developed into medicines with their own therapeutic value. The key is to discover optimal environmental cues to collect EVs, thus developing an off-the-shelf medicine available to patients with damaged tissue. The near future at REMEDI will see COVID-interrupted clinical trials of regenerative medicines for patients with osteoarthritis resuming. A clinical trial in diabetic kidney disease, using a mesenchymal stromal cell product manufactured by NUI Galway spin- out Orbsen Therapeutics, will also continue. These trials and other research has EU support with eight NUI Galway-led consortia supported through the Horizon 2020 programme. The health and economic arguments for Ireland investing in the gene and therapy sector are clear, with patients globally set to benefit.

The ATMP manufacturing strategic position paper is available at nuigalway.ie/ ATMPstrategy

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The first steps to digitally transforming our health service Our healthcare system is lagging in terms of digital health maturity compared to other countries in Europe. To be able to progress medically, we need to transform the health service digitally.

he health service has demonstrated, throughout the pandemic agility, flexibility and innovation. However, we are the fourth lowest in Europe for electronic health record maturity. Our healthcare costs are 20% higher than the European average, despite us having a younger and healthier population than many European countries. To address this challenge, we need to think differently and deliver radical innovation. Digital technology can deliver radical improvements Over the past two years, we have been working within the health system to co-design and test new digital solutions with managers, clinicians and patients in a network of over 40 Digital Living labs. Collaboration across all of government, civil service, industry and society is required to address the significant challenge to transform the health service to become more digitally enabled. Our goal is to leapfrog in Digital Health maturity and we have made significant progress through the pandemic– according to the OECD, we are now fourth in Europe for Teleconsultations, up from last. We now have a world leading respiration measurement solution in 23 hospitals which gives much earlier notice of a patient deterioration to allow early intervention. Ireland is now rated as a faster follower in Europe for Digital Therapeutics regulation. These are important first steps.

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Professor Martin Curley Director of Digital Transformation and Open Innovation, HSE

Key principles for moving forward • We will leapfrog from a health system that is primarily paper, presence, clinician and acute centred to one that is digital, home/communitybased, cloud-based and, most importantly, patient-centred. • We will move towards a healthcare system where the primary improvements in life expectancy and health outcomes will be enabled by digital technology, data-driven care and innovation, enabled by disruptive technologies such as the internet of things and artificial intelligence. • Stay Left, Shift Left is our digital health innovation strategy which aligns very closely with Sláintecare. Stay left is about keeping people well, or if a citizen happens to have a chronic condition that he/she can be managed best of all from home. Shift Left is about moving patients as quickly as possible from acute care to community to a home setting. We have a strong alignment amongst key stakeholders in the health ecosystem and by partnering with a shared vision, we can drive a breakthrough improvement in our health service. With the collective power of the country behind this initiative we cannot fail, nor can we afford to fail as it is just too important. Let’s do this!

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How personalised healthcare uses resources in a targeted and effective way other industry partners, health and academic institutes, governments and organisations is a way to find innovative new solutions to complex problems. The ambition of the MTB is to improve the standard and the practice of precision oncology in Ireland and bring all physicians up to speed on new and emerging topics at the same pace.” During the MTB pilot, a number of attendees — including 16 institutions, plus patients, physicians and pathologists — discussed more than 30 complex tumour cases. Of the cases reviewed, 80% of presenters revealed that the discussions helped to confirm, modify or change the treatment plan for at least one of their patients.

Treatment that is tailored to an individual patient’s needs leads to a smoother healthcare journey and enhanced outcomes.

Personalised healthcare enhances outcomes for patients and builds efficiencies into the healthcare system. To be effective, however, deep partnership and collaboration is needed.

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ata-driven personalised healthcare is an exciting development where partnership and collaboration leads to greater insights, better decision-making and enhanced patient outcomes. Moving away from a ‘one-sizefits-all’ approach to medicine is important for various reasons, says Maeve McGrath, Roche’s Head of Healthcare Innovation. “Treatment that is tailored to an individual patient’s needs leads to a smoother healthcare journey and enhanced outcomes,” she explains. “Plus, using resources in a more targeted and effective way builds efficiencies into the entire healthcare system.” Personalised healthcare relies on interpreting data and insight from a variety of sources, such as genomic sequencing of tumours. Yet there is a danger of overload here because of the vast amount of constantly changing data now available. “In 1980, medical knowledge

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was doubling every seven years,” notes Deirdre Poretti, Personalised Healthcare Lead, Roche. “Today it’s doubling every 73 days. Take a fast-moving area like oncology, where it’s difficult to keep up with the latest information. If all this specialist knowledge could be pooled, discussed, interpreted and made available to local clinicians, their most complicated cases could be offered more appropriate treatments.” Partnership and collaboration That’s why Roche has been working with registered charity Cancer Trials Ireland to deliver the first nationally accessible educational molecular tumour board (MTB), following a successful pilot programme. The MTB is made up of multidisciplinary oncology experts who discuss complex genomic analysis of their cancer cases. “We operate in a landscape where partnership and collaboration is critical,” says Poretti. “Collaborating globally with

Better digital infrastructure Cancer Trials Ireland is now taking over the management of the MTB. It is also planning to create a national registry of consolidated knowledge to help local physicians offer more personalised oncology treatment and the participation in a clinical trial. “The registry will be a vital resource for those in the oncology field,” says Verena Murphy, Head of Research & Business Development, Cancer Trials Ireland. “A doctor in Dublin dealing with an unusual tumour mutation can receive input from the MTB panel, who will discuss it and make suggestions for treatments and suitable open trials. Later, if a doctor in Galway is dealing with the same type of complex case, the information about the best path to follow will be available from the registry.” The possibilities of the MTB are limitless, enthuses Murphy. “If we could link up with other MTBs around the world, expert information would be available from every country, resulting in better treatment for cancer patients.” Health ecosystem of the future Yet, currently, the Irish health system lacks the digital infrastructure to support the convergence of different data streams. That needs to change, insists McGrath. “Creating the health data ecosystem of the future means being able to combine, say, genomic insights from the MTB with real-world clinical insights from electronic health records and outcomes from remote patient monitoring,” she says. “If we could pool rich, multi-sourced, contextualised data — and then apply technologies such as AI to interpret it — it would improve efficiency, accelerate drug discovery and help people live well for longer.”

Maeve McGrath Head of Healthcare Innovation, Roche

Deirdre Poretti Personalised Healthcare Lead, Roche

Dr Verena Murphy Head of Research & Business Development, Cancer Trials Ireland

WRITTEN BY Tony Greenway

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Digital data is driving research and empowering patients Digital health systems, in particular the use of data, are enabling better diagnosis, treatment and management of neurological disease.

he traditional medical model has been that patients visit a doctor when unwell. The doctor offers treatment options, which can include behavioural solutions, some of which patients would comply with. However, in 2007, with the birth of electronic records, the Institute of Medicine in the USA suggested a new approach – called a learning health system. It automatically aggregates digital information which doctors collect from thousands of patients in real time and allows rapid learning from data to persuade people to change behaviour. This dynamic system could improve neurological care, says Professor Colin Doherty, Professor of Epileptology, Trinity College Dublin and Principle Investigator for Digital Health at FutureNeuro – a Science Foundation of Ireland Research Centre for neurological disease. It is hosted by RCSI University of Medicine and Health Sciences with over 80 multidisciplinary researchers across seven leading Irish universities.

Supporting research projects in personalised medicine We have an ambition for Ireland to become a global innovation leader through further development of our excellent research base and talent. This will deliver positive benefits for Ireland, making a difference for our society and economy.

ne of the areas of significant opportunity for Ireland is personalised medicine, an approach whereby physicians try to predict the most appropriate and effective treatment, or disease prevention approach, for an individual based on their genetic makeup and lifestyle. We are now supporting research projects that are delivering outstanding science in the area of personalised medicine. These projects bring the skills and talent from different sectors together and have the potential to make a real impact on patient outcomes. Motor neurone disease research Precision ALS is an ambitious academic, clinical and industry research programme that will provide new insights in our understanding of motor neurone disease (MND), also known as amyotrophic lateral sclerosis (ALS). It involves two SFI Research Centres - ADAPT and FutureNeuro - bringing together researchers in clinical science, data science and artificial intelligence (AI). The researchers will work in partnership with TRICALS, an international consortium of leading ALS experts, patients and patient advocacy groups. Precision ALS will combine applied clinical research with cutting-edge data science to realise the power of AI towards new drug development in motor neuron disease.

Moving to new research models FutureNeuro is embracing research into the learning health model to improve patient outcomes. The Centre’s mission is to enable people with neurological disease to live fulfilled lives. Its scientists and academic clinicians conduct advanced, impactful research in epilepsy, motor neurone disease, MS, Parkinson’s and other chronic and rare neurological diseases. The team works in partnership with national and international companies to identify faster diagnostics, personalised treatments and patient-centred care. For the latter, collaborative research with industry and other SFI Centres explores the power of innovative data analysis when applied to the wealth of patient data. FutureNeuro applies a rigorous approach to safe governance of data and is pioneering patient-engaged and patient informed models of research. Effective use of data Professor Doherty believes that by adopting a data science approach, researchers can discern patterns in disease, which can help to unlock future treatments. For epilepsy, the clinical network has gathered valuable data for over 10,000 Irish patients out of 40,000 people living with the condition here. The more effective use of data will also help clinics to run more efficiently and facilitate people with epilepsy and other neurological diseases to take control of the day-to-day management of their disease.

We are now supporting research projects that are delivering outstanding science in the area of personalised medicine.

Professor Colin Doherty Professor of Epileptology, Trinity College Dublin and Principle Investigator for Digital Health at FutureNeuro WRITTEN BY Sean Duke

Paid for by SFI FutureNeuro Centre Find out more at futureneurocentre.ie

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Dr Siobhan Roche Director, Science for Economy, Science Foundation Ireland

A new cancer consortium Cancer affects more than 45,000 people in Ireland annually. In this area we are researching how genetic and other biological information is being used to develop new tests to diagnose cancer patients based on personal molecular cancer signatures. The results of which can inform individual treatment approaches. Precision Oncology Ireland is a unique consortium of five Irish universities, six Irish cancer research charities and seven international companies, who have joined forces to tackle the challenge of developing personalised cancer treatments. This consortium is similarly using a combination of biological, clinical and data science technologies to accelerate the development of new cancer diagnostics and treatments. The ultimate goal is to improve healthcare outcomes through more effective, tailored treatment approaches. Increacing capacity in personalised medicine The shift towards personalised medicine will require the health sector to increase capability in areas such as data science, bioinformatics, computational biology, artificial intelligence and machine-learning. We have considerable opportunities as a country to create fusion across our sectors such as life science, drug development, medical devices, tech, AI, etc. and shape the future of healthcare not only in Ireland, but internationally.

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Identifying the best care for cancer patients Immunotherapy is offering a new dimension to cancer treatment but a major challenge facing scientists and clinicians is knowing which patients will respond well to it.

T Paul Murray Professor of Molecular Pathology, University of Limerick

WRITTEN BY Mark Nicholls

Paid for by University of Limerick

he fight against cancer is constantly evolving with rapid developments in treatment underpinned by ground-breaking research. A more recent innovation has been immunotherapy, a technique which helps the human body stage its own fightback against disease, in contrast to chemotherapy which introduces toxic elements to kill cancer, often with significant side effects. While being used more frequently in clinical settings, it remains unclear which patients will, and will not, respond to immunotherapy.

Noting that the tumour microenvironment is dynamic with cells flowing through it, she says: “That means it can be very difficult to take a snapshot in time and use that to predict the presence of something at a timepoint in the future.”

Predicting responses Professor of Molecular Pathology Paul Murray’s team is using patient samples to look at changes in the tumour microenvironment to predict responses to immunotherapy. He says there are different types of immunotherapies, such as immune checkpoint inhibition, The Health Research Institute at the which reactivate the immune University of Limerick supports this response that has been silenced in the cancer. ground breaking new research which “We can use drugs to unleash has real potential to improve treatment a pre-existing immune response effectiveness for people with cancer. to the cancer cells. The problem ~Professor Alan Donnelly, Director, Health Research Institute is that we do not know why some at the University of Limerick patients respond well,” he adds.

Utilising the immune system That challenge is being addressed by research at the Health Research Institute at the University of Limerick in Ireland where immunologists are focussing on cells in the immune system and how they function. Immunologist Dr Elizabeth Ryan explains that immunotherapies are about reactivating the patient’s own immune system but emphasised that tumours in different organs - whether melanoma, lung cancer or colon cancer - have different mutations. Working on colon cancer and why some tumours are richly infiltrated with immune cells and others have no immune cells, she adds: “By understanding what drives the different immune profiles in the microenvironment we can begin to sort these patients into groups to stratify them into potential responders to different types of therapies.”

Elizabeth Ryan Lecturer in Immunology, University of Limerick Health Research Institute

No one size fits all What is clear is that there is not a single immunotherapy that is effective for all patients. The holy grail is to identify biomarkers for drugs but even when you have a drug which targets a particular protein, it is still not clear which patients will respond well, says Professor Murray. Boosting the team’s chances of success is the use of CODEX technology, which allows researchers to map the different components of the tumour microenvironment.

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How do EMEA countries compare in digital health technology adoption? A new study examines the role of digital technology in health systems across countries and explores success factors and areas that need improvement.

T Gwynne Morley General Manager, IQVIA

he role of digital technologies in health systems has deep roots: from the early development of structured medical records through to telemedicine, which was so vital in continuing healthcare operations during the COVID-19 pandemic. However, the adoption of digital technologies has not been uniform across countries. IQVIA examined the state of digital health across EMEA, creating a maturity framework comprised of 12 elements that accounted for the wide-ranging nature of digital activities in health systems. The 12 scored elements were grouped into three categories: • Initiatives (policy, funding, data governance, institutions) measures the foundations from which a country can begin its digital journey. • Infrastructure (electronic health records [EHRs], data standards, omics, interoperability) examines how a country creates a backbone of interconnected systems and high-grade data. • Implementations (telehealth, artificial intelligence, information use, virtual studies) captures a country’s ability to abstract the data to make a real impact in population health management.

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Outcomes of the study We observed a positive correlation between the maturity score and GDP per capita, implying that richer nations score higher due to the resources at their disposal. Large scale digitisation requires strong cultural, political, economic and regulatory foundations.

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Estonia, England, Sweden and Denmark are the largest positive outliers in the study. We identified the elements that have set them apart are wide-scale national genomic programmes, advances in decentralised trials and the use of national health data to make evidence-backed decisions. Areas of increased focus The highest GDP per capita nations, Switzerland and Ireland, are outliers in terms of low digital maturity relative to GDPR per capita. The reason for the lower scores for these two countries revolve around underdeveloped EHR networks. In Ireland, this is also coupled with its exceptionally high GDP growth driven by a low tax environment attracting many large multinational corporations. Neither country has rolled out state-of-the-art projects such as the whole genome sequencing of large parts of their population, use of artificial intelligence at a national level or running large decentralised clinical trials. The ever increasing burden of demand on health systems, addressed by limited resources with little or no growth, makes continued digital expansion an attractive proposition to generate savings by driving large efficiencies at scale. However, the real excitement comes from the promise to provide superior population health management from better data and deeper insight, for example by improving patient outcomes and avoiding later complications.

Aurelio Arias Engagement Manager, IQVIA

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AI-driven healthcare: unlocking the power of data for precision medicine Strong synergies between healthcare and research are crucial to develop new eHealth models.

he last two years have proved that digital technology is a critical enabler of all aspects of society, including healthcare. Artificial intelligence (AI) is transforming digital healthcare, leading to exciting opportunities for screening, decision making support, disease treatment and personalised or ‘precision’ medicine delivery. Data-rich era Increasingly our world is driven by data. A major challenge for precision medicine is developing and deploying innovative and agile solutions that can unlock the data needed for precision medicine. At the ADAPT Centre, our goal is to have AI used by clinicians in a way that augments their abilities to make better, more accurate decisions and faster, more informed diagnoses. With access to large reams of medical information from different sources, clinicians can get a more holistic picture allowing them develop individual treatment pathways for patients. Evolution of medicine One such example that we are leading on from a data-science perspective is ‘Precision ALS’. It is an ambitious academic, clinical and industry research programme that will provide new insights in our understanding of motor neuron disease, also known as amyotrophic lateral sclerosis (ALS). The pan-European programme will result in advanced data-driven prediction models for progression of the disease in patients and next-generation data analysis that facilitates clinical insights and treatment. New opportunities to arise The Irish team will lead the development of metadata management tools for advanced integration of real-world clinical data sets, including remote monitoring. The development of a whole illness model of disease within the wider healthcare ecosystem opens up the opportunity for new products and services, new therapeutics and diagnostic tools and the framework can be easily adapted to other diseases such as cancer. Expectations are high for the future of AI-driven healthcare. Close collaboration between researchers and industry will help us unlock real-world data in an ethical way. This is the key to realising true ‘precision medicine’ and providing the most suitable, personalised medicine.

Professor Vinny Wade Director, ADAPT Centre

Paid for by SFI ADAPT Research Centre For enquiries please email: info@adaptcentre.ie

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Why Ireland is well placed to capitalise on advances in healthcare technology As the medical devices sector evolves rapidly, Ireland’s medtech industry has all the necessary components to build on next-generation manufacturing, product development and digital innovation.

reland has a long tradition in medtech: 14 of the top 15 global companies have operations here. We are Europe’s largest medtech employer per capita and a magnet for skilled talent from within Ireland, the EU and beyond, working on cutting-edge technology, research and product development. Ireland’s wider life sciences ecosystem also includes strategic operations for nine of the top 10 biopharma companies. A test for health advancements This places Ireland at the centre of trends shaping the future of healthcare, such as the move to provide greater levels of care outside of acute hospital settings, as set out in the HSE’s digital transformation strategy agenda, ‘Stay Left, Shift Left’. Ireland has the potential to become an exciting digital and connected health hub: a test-bed for innovating, developing, piloting and rapidly commercialising next-generation medical devices and related digital services. Greater medtech collaboration Capitalising on this opportunity will require even closer collaboration between three pillars in Ireland’s medtech ecosystem: domestic SMEs, academic research facilities and medtech multinationals – 75% of which already carry out R&D in Ireland. Irish medtech start-ups have an excellent global reputation. LetsGetChecked recently gained ‘unicorn’ status with its USD 1 billion valuation. Others, like BlueBridge Technologies and S3 Connected Health, partner with global multinationals to enable connected devices and disease management solutions. Our globally respected research centres focus on multiple areas within connected health disciplines – from materials and microelectronics to software and AI. The Insight Research Centre is recognised for its work in data analytics while Tyndall

Our globally respected research centres focus on multiple areas within connected health disciplines – from materials and microelectronics to software and AI. National Institute has research contracts with four of the world’s top 10 medtech companies to develop intelligent medical devices and systems. The third element is the FDI base with its manufacturing, innovation and engineering excellence. For example, in Galway, Johnson & Johnson-owned Cerenovus develops advanced medical devices to treat strokes. It is investing a further €30 million in the site, which has a stroke simulation lab, prototype development and testing facilities and collaboration spaces. 3M’s new Digital Science Community is its first R&D centre committed to optimising its global technical, data security and privacy operations to solve challenges facing the global healthcare system. Continued government support Ireland’s size and infrastructure means that all three groups have easy access to each other. Furthermore, there is Government support in the form of R&D grants, the 25% R&D tax credit and the €500 million Disruptive Technologies Innovation Fund (DTIF), designed to drive collaboration across the ecosystem. We have the means to connect and collaborate; now is our moment.

Rachel Shelly Head of Medical Technologies, IDA Ireland

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iStock Photo ID number 6366530206

Future healthcare and healthcare research will be more person-centred. In MTU, our multi-disciplinary approach to supporting healthcare transformation is underpinned by our community-engaged, practice-led research, that will assure the continued relevance of the knowledge and skills of our future graduates as well as the outputs from collaborative research. Professor Maggie Cusack President, MTU

Food, nutrition and physical activity innovations keep us heathy What we eat and how we exercise can significantly improve improve the quality and longevity of life. At Munster Technological University (MTU) scientists are developing novel products, therapeutics, policies and interventions for healthier lives for everyone. This work aligns with Ireland’s Primary Care Strategy for a more cost-effective health service with enhanced promotion of preventative health, screening for disease, diagnosis and treatment, in a socially inclusive manner. Discover, design, deliver BioExplore, a life science research centre in MTU’s Bishopstown Campus in Cork, aims to improve detection and management of infectious agents in the medical, veterinary and agricultural sectors. The research centre monitors the prevalence of antibiotic resistance in clinical and healthcare settings. They have established strong collaborative links with industry and academic partners, both nationally and internationally. The centre’s research is funded by the Irish State, the EU, Industry and philanthropy. BioExplore scientists have published more than 500 high impact peer-reviewed papers and given keynote presentations at international conferences. Much of the research leads to patents, licences and clinical interventions. One aspect of the research is on antibiotic resistance in pathogenic bacteria. Campylobacter, associated with poultry, can lead to human illness with an economic burden of €2.4 billion annually in the EU. BioExplore researchers in collaboration with Teagasc, the Department of Agriculture, Food and the Marine, the Food Safety Authority of Ireland and University College Dublin aim to reduce this burden through enhanced farm biosecurity, processing prerequisites and HACCP based interventions.

Professor Aidan Coffey Senior Lecturer/PI BioExplore, Munster Technological University

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Nutrition research and innovation NutRI research group at MTU Bishopstown Campus has expertise in expertise in nutrition science, agriculture, biomedical science, and microbiology. This multidisciplinary group collaborates on food innovation, food microbiology and public health nutrition. The research group engages with local, national and international industry and experts in computer and exercise science to deliver innovative solutions to global challenges in food, nutrition and health. People are living longer. NutRI scientists are working to ensure our older life years are spent in good health through reformulating existing foods, developing new food products, designing interventions to support wellbeing and optimising health throughout life. Recent evidence from NutRI suggests that the diet of older Irish adults is poor and associations with frailty exist. Scientists at the research group have now designed a frailty intervention in collaboration with the Health Service Executive (HSE). Meanwhile, Project OptimA in collaboration with Kerry Group and Teagasc Moorepark aims to design novel plant protein products for older adults to optimise quality of life as we age.

Dr Aoife McCarthy Senior Lecturer/PI NutRI, Munster Technological University

No one left behind UNESCO Chair is based in MTU’s Kerry Sports Academy in Tralee and works collaboratively with research, education, health and human rights partners for sustainable development. The Chair advances social inclusion and wellbeing of marginalised groups globally using physical activity and sport, which are recognised enablers of optimal health, wellbeing and social inclusion. The OECD predicts that healthcare will be unaffordable by 2050 and calls for a new healthcare vision, where people are empowered to optimise their own health. The Chair advocates for the role of physical activity and sport for positive wellbeing outcomes for all. The Chair worked with the World Health Organisation to produce the 2020 Guidelines on Physical Activity and Sedentary Behaviour. The key message #EveryMoveCounts is critical for people with disabilities and enduring mental illness. The Chair, HEx-Spo and NIMBUS centres are currently working with HSE Cork mental health team and service users to promote physical activity, nutrition and digital technology, as facilitators of better outcomes for people with schizophrenia and bipolar disorder. The research takes a human rights-based approach, advocated globally by the UN and embraced here in Ireland by the Mental Health Commission.

Catherine Carty UNESCO Chair Manager, Munster Technological University

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WRITTEN BY Sean Duke

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Innovations in healthcare can create a better future for all In modern healthcare, few fields are delivering such rapid innovation or improving patient outcomes as substantially as surgical robotics.

Mr Patrick O’Malley Consultant Urologist, The Galway Clinic

Dr Ian Fraser Clinical Director of Radiation Oncology, Hermitage Clinic

Mr Niall Hogan Orthopaedic Surgery Consultant, Blackrock Clinic

ince first emerging in the 1980s, surgical robots have transformed the way surgery is performed. In the past, even the most skilled surgeons could not be expected to perform surgeries of even moderate complexity without making large incisions in patients. As the motion control technologies have advanced, surgical-assistance robots have become more precise than any human being, helping surgeons to perform complex microprocedures in a minimally invasive fashion, while carefully avoiding nerves and other obstacles. Delivering clinical excellence As the country’s newest private hospital group, Blackrock Health, comprising Blackrock, Galway, Hermitage and Limerick Clinics, is at the cutting edge of robotics developments, and their hospitals’ pioneering work in the field goes back well over a decade. In November 2007, for example, Mr Patrick O’Malley, consultant urologist at the Galway Clinic, established Ireland’s first robotic assisted surgical programme for the treatment of prostate cancer. Today, the group continues to invest heavily in cutting edge robotics to stay ahead of the curve in delivering clinical excellence. Introduction of precision robotics As part of this shared effort, Blackrock Clinic recently introduced a new precision robot for joint replacement surgery.

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The Mako Robotic-Arm Assisted Surgery device offers many advantages over traditional surgery. The robot warns the surgical team if there is even a minor deviation from the pre-operative plan, while also helping to ensure there is less dissection to the soft tissue. Similar equipment is already used extensively in the UK and the patient experience here has been very positive. Patrick O’Connor was the first patient treated using the robot in late 2021. After experiencing severe difficulty in walking, his total knee replacement - and the post-op care in Blackrock Clinic’s Physiotherapy Department - has had a very positive impact. “The recovery is going very well, and I can now walk further than I did prior to the surgery. I am going to build on this progress and I look forward to getting back into walking and cycling,” Patrick says. Greater precision and personalised care In the future, more surgical procedures are likely to be robotassisted, providing for greater precision and the increased possibilities of personalised care. A similar innovation has been taking place at Hermitage Clinic, the CyberKnife System, is used to treat a variety of cancerous and noncancerous problems. The treatment works by sending multiple beams of high dose radiation from a wide variety of angles using a robotic arm. X-ray cameras monitor the patient’s movement and breathing and reposition the radiotherapy beam

Brain scan images courtesy of CUBRIC & Siemens Healthineers. With support from EPSRC, The Wolfson Foundation and The Wellcome Trust ©Cardiff University Brain Research Imaging Centre, Great Britain

in order to minimise damage to healthy tissue. Improving patient outcomes This accuracy means it can also be used in place of surgery in some cases and minimises damage to healthy tissue, delivering significantly better outcomes for patients. Dr Ian Fraser, clinical director of radiation oncology at Hermitage Clinic, believes the machine should be used to help many more patients. “For a very small lung cancer, this is all you need. The patients feel nothing. They don’t lose their hair. Don’t get sick. No chemo. Its accuracy is within less than a millimetre and it’s the most accurate machine of its type on the island,” he says. Cyberknife technology is so non-invasive, that the Hermitage’s 1000th patient, Keith Killeen of Mornington, Co Meath, remained awake throughout his painless treatment and was able to drive home immediately after every session. More innovation to come While what has been achieved thus far in the field of surgical robotics has been impressive, it will likely pale in comparison to what is just around the corner. As Mako expert and Blackrock Clinic consultant Mr Niall Hogan put it: “What we are witnessing now is the beginning of a new era in surgical technology, one where patients will benefit from technological advances, bringing with it a reduction in patient pain and a reduction in hospital stays.”

Paid for by Blackrock Health

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How digital and personal technology are helping patients One of the most important developments in modern healthcare is the use of digital technology. Hospitals at the cutting edge of Irish healthcare need to ensure their patients benefit from the exciting changes that are taking place.

t its heart, the ongoing technological revolution in healthcare is about streamlining the work of medical practitioners to ensure they spend less time on ancillary tasks, such as record keeping and note taking, and more on delivering person centred care. Where in the past, these timeconsuming practices had to be carried out manually, today digital healthcare technologies ensure that doctors, nurses and consultants have all the information they need about a patient to hand, at every stage throughout their hospital journey. The availability of these innovative technologies and treatments is enhancing the relationship between doctors and patients by giving clinicians the tools they need to provide the best care. All of this is vital in achieving Blackrock’s Health’s goal of raising standards and improving patient outcomes. Linking up medical records Examples of this can be seen across the group, including in Galway Clinic, where the combination of patient monitoring systems linking to the clinic’s electronic medical record system means doctors can securely access patient’s vital signs on their smartphones. Galway Clinic’s commitment to the adoption of electronic medical records (EMRs) led to it achieving HIMSS Level 6 accreditation in 2017. In 2019, Galway Clinic’s nursing team created a unique but transferable electronic record and

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were later awarded the Kate Grainger European Award. The Director of Nursing Ms Sinead Hanley says: “We want our patients to experience a world-class standard of care which has compassion at its heart.” Similar moves are afoot in Blackrock Clinic, which in 2020 began to participate in the Irish National Orthopaedic Register (INOR) electronic system which monitors elective hip and knee joint replacement procedures and tracks implant performance and patient outcomes, while providing continuous feedback to patients. Utilising personal technology A vital part of the group’s ‘Patients First’ approach involves preparing patients for treatment and assisting in every way with the recovery process. Here too, personal technology is of huge assistance. Hermitage Clinic recently became the first hospital in Ireland to use the mymobility care management system which works with wearable devices such as iWatches or iPhones. The system tracks patients’ movements and provides guidance in how to perform pre-op and postop exercises, while also allowing surgeons to stay abreast of their patients’ progress. Patricia Connerton recently had a hip replacement in Hermitage. She says that mymobility was vital in aiding her recovery, as it provided “a whole programme of exercises and reminders and trackers for me, which helped me to build up my walking again.”

Providing better, faster, cheaper care According to Dr John Sheehan, Clinical Director of Radiology in Hermitage Clinic and a Consultant Radiologist in Blackrock Clinic, the early adoption of improved technologies involving the Cloud, artificial intelligence (AI), augmented reality (AR) and mixed reality (MR) will yield significant benefits, thus allowing for better, faster and cheaper delivery of care to patients. Thanks to advances, radiologists will be able to benefit from increased precision and reduced inter reader variability, when interpreting complex medical images. A combined example of the transformation is in the use of cloud-based AI and AR. Dr Sheehan will soon be demonstrating on stage how the new Microsoft HoloLens / ApoQlar technology and Siemens Healthineers “AI Rad Companion” can be used to examine various aspects of the brain in stunning interactive mixed reality 3D. These transformations in how robotic, digital and personal technology are being implemented are just the beginning. They offer a real prospect of improving patient outcomes and quality of life across the board. Blackrock Health will officially launch on March 31st. In the coming years, the developments taking place will get exponentially better, faster and cheaper. This will help deliver more personalised care and better outcomes for patients.

Sinead Hanley Director of Nursing, The Galway Clinic

Dr John Sheehan Clinical Director of Radiology, Hermitage Clinic and Consultant Radiologist, Blackrock Clinic

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Saving lives by ensuring patients get the best test first A new technology platform is helping to ensure the right tests are administered to patients quicker, avoiding unnecessary radiology scans.

he US Food and Drug Administration has highlighted that up to 50% of radiology scans are unnecessary and do not benefit the patients that they are performed on. This can result in long waiting lists and poor patient outcomes, including delayed diagnoses, missed diagnoses and unnecessary radiation exposure. It costs health systems the substantial sums of money spent annually on unnecessary radiology scans. In early 2021, a new smart radiology referral platform was created by xWave Technologies. xRefer has been developed in partnership with the world’s largest radiological society, the European Society of Radiology and uses market-leading evidence to support clinicians in ordering the most appropriate radiology scan for their patient. Reducing referral times The company has already demonstrated the positive impact of xRefer through working in partnership with the Royal Victoria Eye and Ear Hospital where it has reduced the average time taken to create, send and have a referral reviewed by a radiologist from 7.5 working days to just 14 minutes, a reduction of 99.6%. Importantly, use of xRefer’s clinical decision support system has also resulted in 96% of referrals being considered appropriate for the patient. The support of the HSE Digital Transformation Team has been absolutely vital to the success of the platform to date. The HSE Digital Transformation Team’s “Stay Left, Shift Left” strategy perfectly encapsulates the benefits delivered by the platform, in the areas of improving patient and clinician experience, improving patient outcomes and quality of life and reducing costs. Mitchell O’Gorman, CEO at xWave Technologies, says: “There is huge momentum to move Ireland into a leadership position in global health technology. The supports that we have received have enabled us to build on our successes in Ireland by moving into overseas markets, including the UK and Northern European countries. “Our mission of ensuring that patients always get the best test first will be enhanced by our on-going AI and machine learning research as we build the next generation of medical diagnostic referral tools, with a greater focus on personalised and predictive medicine.” Find out more at xwave.ie

Mitchell O’Gorman Chief Executive Officer, xWave Technologies

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Can collaboration between public and private improve healthcare?

The pandemic has demonstrated that when governments, organisations, regulators and the healthcare industry work together it is possible to adopt new ways of providing effective healthcare products and services rapidly and safely.

he question of what is possible from our healthcare system, and how we achieve it through collaboration and innovation, is more at the forefront of healthcare than ever before, and a key theme through the recent Health Summit.

What needs to be done for the advantages of digital health to be seen? We in the sector know the future for health transformation is bright for Ireland. HealthTech Ireland members know that for patients to see the benefits of digital health and transformative medtech products and services, funding and How has the pandemic helped create a shift in effective collaboration is key. The HSE Digital healthcare? Transformation Team with collaborators is The pandemic has highlighted the need for change facilitating this need to think differently. Martin and transformation in healthcare systems globally. Curley, Director, Digital Transformation HSE It has also demonstrated the collaboration and describes ‘How the National Digital Health work across organisations Strategy ‘Leap Frog – Stay to develop and roll out the Left, Shift Left’ acts as a vaccinations, and is evident compass to drive coherency in the delivered medtech amongst the radical How do we continue to bring the and digital solutions, digital innovations so they e.g. contact tracing, and combine so that the whole is value of health products and national rapid upscaling greater than the sum of services to the system and patients far in diagnostics to meet PCR the parts’. testing demand. He explains how research in a collective way? Healthcare organisations demonstrates that digital have demonstrated how, when given the technologies create the opportunity to deliver 10x opportunity, we can be dynamic and collaborative improvements. With public and private sectors in delivering solutions. We have demonstrated working together we can capitalise on digital resilience and drive and have had to ask hard technology and deliver radical improvements. questions - how do we best deliver patient solutions It will be more important than ever, as we emerge in this complex ecosystem? How do we continue from the pandemic to build on this momentum to to bring the value of health products and services become a leader in healthcare. to the system and patients in a collective way? These are important questions as global demands on healthcare systems continue to grow. Ireland’s healthcare costs are 25% higher than the European Susan Treacy average despite us having a younger and healthier Chief Executive Officer population than many European countries, and we HealthTech Ireland are ranked joint last for telehealth maturity along with Serbia and Romania.

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Collaborations and quality control shape future nursing curriculum Paid for by TUS

focuses attention on caring for people as close to their homes as possible. For TUS student nurses dealing with patients with mental illness, this means sharpening their diagnostic skills to recognise in the shortest of consultations any deterioration in a patient’s health and to decide the most appropriate level of care.

The Department of Nursing and Healthcare has almost 450 students and is part of the Faculty of Science and Health on the Athlone Campus of TUS. As well as a suite of undergraduate Healthcare Programmes and Postgraduate Nursing Programmes; the Department offers Nursing and Midwifery Board of Ireland (NMBI) accredited, BSc. (Hons) Degree programmes in General and Mental Health Nursing. These programmes are delivered in partnership with the HSE facilities across the Midlands in Longford Westmeath and Laois/Offaly. Image provided by TUS

Dr Des Cawley, Head of Department of Nursing and Healthcare Department of Nursing & Healthcare,TUS Technological University of the Shannon: Midlands Midwest

The experiences of nursing students who found themselves on the frontline of pandemic care are defining a new era in nursing education.

Ms Olivia Corcoran Lecturer and Programme Coordinator for the BSc (Hons) in Mental Health Nursing, Department of Nursing & Healthcare, Technological University of the Shannon: Midlands Midwest (TUS)

Dr Laura Dempsey Lecturer and Programme Coordinator for the BSc (Hons) in General Nursing, Department of Nursing & Healthcare, Technological University of the Shannon: Midlands Midwest (TUS)

he COVID-19 pandemic put healthcare workers, amongst others, under untold pressure as they helped care for those in need. Many nursing students found themselves on the front line of care, at a very early stage of their career, often managing acutely unwell and even dying patients with the support of their superiors. TUS’ (Technological University of the Shannon) nursing students found themselves in this position. The university prides itself on producing nurses who can infuse their clinical judgements with a higher level of critical thinking and reasoning, never has this been so important. Dr Laura Dempsey, Lecturer and Programme Coordinator for TUS’ BSc (Hons) in General Nursing, describes these students as incredible. She says: “They experienced so much that wouldn’t ordinarily have happened as early in their training.”

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Maintaining patient connections During their placements student nurses quickly identified the importance of infection control measures, such as handwashing and correct use of personal protective equipment (PPE). Critically, they also identified the importance of connecting with patients, particularly those negatively affected by visiting restrictions. Dr Dempsey explains: “Students understood that human interaction was missing. They took up the family role: they were the ones facilitating Zoom calls and window visits; they were at bedsides, holding patients’ hands in their last hours of life. Even though it was a pressured time, they learned the importance of sitting and talking with patients and really getting to know them.” Emerging mental health need As the country recovers from the pandemic, these critical skills remain in demand and nowhere more so than in the field of mental health. Ireland’s new health strategy

Treating all mental health problems According to Olivia Corcoran, Lecturer and Programme Coordinator for the BSc (Hons) in Mental Health Nursing at the TUS, this field of nursing is physically, as well as intellectually demanding which is why the university prioritises the development of quality assurance methods and collaborations with organisations at the coalface of emerging mental health need. One of these, Jigsaw, which specialises in the mental health of young people under the age of 18, gives the university a better understanding of the skills future nurses will need. Corcoran explains: “There are major shortages of mental health professionals throughout Ireland. “As an educational facility, we need to be able to educate our students to be able to treat any kind of mental health problem. For example, having COVID-19 or the impact of being a refugee or asylum seeker could result in developing a mental health condition from traumatic experiences. We need to be able to look at what’s current and ensure our students have the skills to care.” Adapting the future curriculum To shape the future curriculum and its student support services, the unique experiences of TUS students during the pandemic have now been captured in research. The concept of ‘compassion fatigue’ has been coined to inform the development of support and advice for nursing students in areas such as selfcare, resilience training and stress management. Dr Dempsey explains: “Nursing is a very rewarding career but, by definition, it is also very dynamic and very demanding. That is why we felt we need to look after our undergraduate students and integrate those types of fundamentals into the curriculum going forward.” WRITTEN BY Ailsa Colquhoun Find out more at ait.ie/faculties/ departments/ nursing-healthcare/

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Collaboration with Europe will accelerate Irish healthcare innovation When considering the direction healthcare will take, Ireland’s future looks promising.

reland supports a vibrant health innovation community and has solidified its impressive position as the second biggest exporter of medical device technology globally. Ireland also plays host to burgeoning educational programmes that produce successful health tech entrepreneurs. However, a unique idea and a qualified team isn’t enough to ensure success. Those at the forefront of health innovation can find the Irish market to be too small for testing and validation. In these cases, entrepreneurs need only look to our European neighbours for collaboration opportunities to test in larger markets and draw on a wider pool of resources. The pandemic hit the accelerator on ground-breaking innovation. In 2021, USD 44 billion was raised globally in health innovation. This represents a 20-fold increase in 10 years, and is double the 2020 amount. These investments affecting healthcare for Irish and European citizens will prioritise and optimise patient experience. The aim is that those VC-backed datadriven technologies being developed will: 1. Bring care home Technologies that bring interactions away from reality and into the virtual world mean improved efficiencies in healthcare settings and enable greater attention to be paid to patients that require face-to-face care. 2. Use AI to improve patient care London-based start-up Abtrace has developed a unique AI tool, which acts as an intelligent layer on top of the electronic health record. Abtrace’s software scans the EHR and proactively suggests to GPs and clinicians which treatments are required, empowering them to make data driven decisions. 3. Move from treatment to prevention Predictive analytics can provide models for early diagnosis, thereby avoiding preventable diseases or delaying their onset. A panEuropean innovation project underway is the Alzheimer’s Disease Prediction Service (ADPS). At EIT Health in Ireland, we have enabled over 70 entrepreneurs, start-ups and SMEs to scale into Europe. With our support these medtech, biotech and digital health start-ups have gone onto raise €129 million in investment with more than €73 million of that occurring in 2021. If you want to know what the future of healthcare in Ireland will look like, look no farther than Europe.

Irish digital health firms help to shape the future of global healthcare Ireland is recognised as a leading global medtech hub, with our community of pioneering leaders playing a pivotal and transformative role in digital healthcare around the world.

esponsible for €13 billion in exports to over 100 countries, Ireland is the second largest medtech exporter in Europe. The industry employs over 45,000 people across 350 companies and over 200 of these are indigenous Irish firms working in a number of areas, including digital health, diagnostics and research.

This support from the HSE and the network of Digital Living Labs are important factors in the ecosystem which fosters the development of these cutting-edge digital health solutions in our medtech sector.

Impactful Irish Innovation Global healthcare leaders are increasingly turning Working with the HSE to the Irish medtech sector for solutions and our In an era when unprecedented demands to indigenous companies are trusted by many. deliver rapid solutions were placed on healthcare Some of these firms includes HealthBeacon, systems, Enterprise Ireland is proud to support which develops smart tools for supporting patients firms working in the area in managing medication of digital and connected through their Injection health that are playing a Care Management System. pivotal role in shaping the They recently published a The development of connected future of global healthcare. study which showed a 26% The HSE’s ‘Stay Left, Shift improvement in medication and digital health solutions can Left’ strategy aims to move amongst patients have a number of potential benefits adherence some supports and care using this system. required by patients from Another example is for the health service, the primary acute environments to the Swiftqueue, a patient goal being to improve patient home or community-based portal which enables outcomes. settings. Digital health the management of solutions are at the heart appointments and results, of this and the HSE is partnering with companies, and this drove efficiencies during the COVID-19 universities and researchers to utilise their crisis by supporting test centres in managing innovations to drive this change. appointments. Enterprise Ireland is committed to nurturing Fostering an innovative eco-system Irish talent and will work with the HSE to foster The HSE and Enterprise Ireland have a strong trackthe growth of these potentially transformative record of collaboration. The partnerships fostered innovative digital health solutions. by our High Potential Start-Up team and the HSE’s Digital Transformation Unit have had a number of successes. Alan Hobbs The development of connected and digital health Manager, solutions can have a number of potential benefits High Potential Start Ups (Lifesciences and for the health service, the primary goal being to Industrial), Enterprise improve patient outcomes. Others include the Ireland capacity to drive efficiencies, cut costs and to reduce pressures on the system.

Leslie Harris Managing Director EIT Health Ireland-UK

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An academic health science system to revolutionise health in the Mid-West A coordinated partnership between academics and health and social care practitioners aims to create the evidence base for more ambitious and cost-effective healthcare in Ireland’s Mid-West.

A Paul Burke Chief Academic Officer / Vice Dean (Health Sciences), University of Limerick & UL Hospitals Group

Paid for by University of Limerick & UL Hospitals Group

n ambitious programme is underway in Ireland’s Mid-West region to transform the area into a “living lab” of research-based clinical practice. A coordinated partnership with the local health system (UL Hospitals Group and Mid West Community Healthcare), the University of Limerick are supporting the development of a local Academic Health Science System (AHSS). This is an initiative – supported nationally by the Chief Academic Officer Group - to help deliver the aims of the 2018 Sláintecare vision of one universal health service for all. Improving standards and investment Like their counterparts in the UK and wider afield, the AHSS will play a key role in improving standards of healthcare delivery and a return on investment in clinical care. Research, innovation and the sharing of best practice, education and training across a region are considered the foundations of developing new evidence-based models of care that deliver more cost-effective services as close to people’s homes as possible. It is also an environment designed to stem the ongoing and costly emigration of health professions talent from Ireland by providing home-grown talent with a more professionally satisfying career path. Flexibility in clinical research The University of Limerick sees itself as an ideal stakeholder in this initiative due to its recent heritage

in medical research and training, as well as its location in the Mid-West. Paul Burke, Chief Academic Officer and Vice Dean (Health Sciences), says the university’s relative ‘youth’ in health sciences education is a positive advantage, in terms of its flexibility to advance frontiers in clinical research. The Mid-West’s established coordinated approach between its hospital and community services provide an advantageous backdrop in which to break new research ground.

Rose Galvin Associate Professor in Physiotherapy, University of Limerick

Increased academic research profile For the university, the incentive of improving the local healthcare economy is boosted by the prospect of an increased profile in academic research nationally and internationally. For Rose Galvin, Associate Professor in Physiotherapy at the University of Limerick, AHSS participation is already bearing fruit. A recent research initiative into redesigning health and social care for older people to reduce unnecessary hospital admissions has already transformed service delivery across the region and it is fast becoming standard practice for GP referrals. Professor Galvin explains: “We are focused on building a body of empirical evidence that is rigorous and that can help build capacity among clinicians and explains to government the financial benefits of change. For us, that’s what we mean by applying science on a day-to-day basis.”

WRITTEN BY Ailsa Colquhoun

Find out more at ul.ie

Fuelling the pharma talent pool: Innovation through collaboration An innovative academic-industry research collaboration in Ireland is developing new technologies for medicines and transforming the next generation of young scientists.

atient treatments for a range of diseases and conditions are changing, with a shift towards a more personalised approach to care. Yet underpinning this is a complex research process to develop innovative technologies to address key challenges facing the pharmaceutical industry.

Dr Sarah Hayes Chief Operations Officer, SSPC WRITTEN BY Mark Nicholls

Paid for by SSPC

Providing in-depth research Playing a pivotal role is SSPC (the Science Foundation Ireland Research Centre for Pharmaceuticals), which delivers scientific and engineering research expertise to companies in need of tailored solutions to bespoke challenges. Led by the University of Limerick, it involves academics (or investigators), Higher Education institutes, PhD students and post-doctoral researchers from across the country and brings them together with industry and specialist research institutes. Professor Anne Marie Healy, SSPC Co-Principal Investigator at Trinity College Dublin, says: “We are looking to improve our understanding of all facets of the drug product development pipelines - from the molecule to the medicine - not just on manufacturing, but also on performance and clinical effectiveness to ultimately improve patient outcomes.” Establishing industry links Rather than focusing on specific disease states, SSPC looks at developing products and solutions with a multidisciplinary approach involving material scientists,

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engineers, pharmaceutical chemists and mathematic modellers. Professor Healy adds: “By being so closely connected with industry we see the problems they are facing in terms of developing and improving the manufacturing processes and of addressing the needs of patients.” SSPC Chief Operations Officer Dr Sarah Hayes explains that the wider collaborations are developing people with the skill sets required of industry and providing opportunities for students to become the next generation of scientists.

Professor Anne Marie Healy Medicine Theme Lead at Trinity College Dublin, SSPC

Creating a greater talent pool The SSPC is fuelling the talent pipeline for the pharmaceutical sector, putting young people at the forefront of product development in the biopharmaceutical space. Dr Hayes says: “We are the largest producer of PhD graduates in Ireland transitioning into the pharma industry. The interdisciplinarity is unique and that filters down, so PhD students get full exposure to all aspects of pharmaceutical work. “That is important in preparing students for that transition from academia to industry. In industry, you are an expert in a particular area, but you need to have that full breadth and understanding of how a medicine comes all the way through the pipeline.” Professor Healy concludes: “A lot of the work we are doing is very applicable; it ends up making a difference to industry, and ultimately to patients.”

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Developing the workforce for biopharma success Since the first biologic therapeutic was authorised by FDA in the early 1980s, the biopharma industry has experienced exponential growth and the global sales of biologics now exceed USD 300 billion in 2021. Killian O’Driscoll Director of Projects NIBRT

he forecasts for the future growth of the industry remain strong, though there are considerable complexities and challenges to be navigated.

Digitisation has potential to be a key enabler of a manufacturing competitive advantage, though significant barriers remain. More diverse and complex product pipelines Monoclonal antibodies (mAbs) are predicted to remain the dominant modality in biopharma by some margin. However, there is a fast emerging, unprecedented diversity in therapeutic pipelines driven by excellent fundamental science including more complex mAbs and cell and gene therapies. Future manufacturing investments for advanced therapies will increasingly be co-located with R&D operations. Advanced manufacturing This pipeline diversity is driving fundamental changes in facility design, operations and supply chain with a focus on flexible and agile facilities with the ability to manufacture multiple products. Digitisation has potential to be a key enabler of a manufacturing competitive advantage, though significant barriers remain. To remain competitive there

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is continued demand for new efficiencies, improved quality and cost reductions in manufacturing processes. Global challenges As always, there are multiple external factors that will potentially impact on biopharma manufacturing including COVID-19 variants, international monetary and fiscal policies, supply chain challenges and geo-political developments. In particular, developing vaccine capacity for lower to middle income countries is a key challenge. The fight for talent Access to a diverse talent pool with a broad range of multi-disciplinary skills will be a key determinant of future success. In 2021, the Financial Times working with Cytiva published the inaugural Global Biopharma Resilience Index, access to talent was identified as the primary weakness in the resilience of the global biopharma industry. Indeed, the UK’s Bioindustry Association estimates the UK alone will require 133,000 skilled life scientists by 2030. This is not a new problem but one that has persisted for many years. To address these challenges and to further develop the biopharma sector in Ireland, NIBRT recommends a continued focus on workforce development with a longterm strategy to develop appropriate solutions across all levels and demographics.

The future of healthcare must focus on new models and priorities As we emerge from the pandemic, we must watch emerging healthcare trends closely and their potential impact across the globe.

Kelly McCain Head of Healthcare Initiatives, World Economic Forum

Around the world, the status quo is shifting - mounting consumer expectations, and widespread staffing shortages and burnout continue to make headlines. The healthcare sector’s time, resources and attention have been dominated by an ongoing global pandemic which is now entering its third year. The future of healthcare hinges upon how leaders can rapidly adapt to the much-needed industry transformation and for everyone to consider new solutions to how, where and by whom care is delivered. Across the sector, the World Economic Forum is watching three trends that showcase how the future of health and healthcare is already taking shape:

Increaced investment in digital technologies Digital is at the core. The rapid shift to digital tools during the heights of the pandemic opened pathways to reach more patients in new ways. From at-home visits on smartphones to remote screenings, the industry saw it could unlock more inclusive and accessible care. Fourth industrial revolution technologies such as AI and machine learning continue to speed the discovery of new drugs and therapeutics to support better patient outcomes. Early-stage screenings and diagnoses for many types of cancer and finding new treatments for previously incurable conditions offer new frontiers for patients and their families.

New opportunities for collaboration and partnership The widespread collaboration from the scientific community, coupled with government support for financing and private sector investment, provides lessons learned on how to support swift responses and solutions to global health crises. Similar partnerships can continue to take shape to solve many of the other barriers, from supply chain challenges, to equitable vaccine distribution, to providing care in the face of migration crises. The growing interconnectedness of our systems require actors to come together and for those from outside of the health and healthcare sector to think about the role they play in finding solutions.

A renewed focus on sustainability and new models of care Health systems globally buckled under the pressures of the pandemic and pre-existing weaknesses were further exposed. Over 90% reported disruptions to essential care and services globally. New thinking and investments are required to move away from fee-based services models to an outcome-based system that ensures longer-term benefits to both patients and providers. This requires continued focus on strong policies and partnerships between delivery systems and governments for better care and outcomes for individuals.

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Transformation and innovation in health and biomedical education and research cohort of IT Sligo’s online part-time students are industry-based, working for public sector, medtech and pharmaceutical companies. The courses they are studying will help them upskill and progress in their careers.

Image provided by IT Sligo

A more flexible approach to third level education, along with industry and public access to high-quality evidence-based research, will be key to the transformation of Ireland’s healthcare system.

Paid for by IT Sligo

urrently, Ireland’s fragmented healthcare system is under reform. Yet for real change to occur, two key challenges must be solved. Firstly, crucial skills gaps must be filled in areas such as health and medical information science to facilitate the digital transformation of the sector. Secondly, high quality, evidencebased research is required to support the changing landscape of healthcare innovation, delivery and outcomes. IT Sligo, a third-level education institute who will join with LYIT and GMIT, and become Atlantic Technological University on April 1st 2022, is on a mission to address both of these issues. By addressing the skills deficit, it has developed a number of full-time and part-time online undergraduate courses giving students more learning flexibility. This includes the pilot of a full-time online, three-year Level 7 degree in Health and Medical Information Science, funded by the Higher Education 4 All initiative, developed in partnership with IT Sligo, the

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Mayo, Sligo and Leitrim Education and Training Board (ETB), Donegal ETB, Disability Federation of Ireland and Family Carers Ireland. Online learning promoting Higher Education 4 All “It is vital that we address the problem of social exclusion in third level education,” stresses Dr Richéal Burns, Programme Chair of the Health and Medical Information Science Programme at IT Sligo. “Being physically unable to attend campus — because of disability, mental health issues, caring responsibilities or geographical reasons, for example — is a huge barrier to education. When models of learning incorporate live lectures and practical’s delivered online, students can more flexibly acquire sought after skills and qualifications, which the healthcare sector is crying out for.” The University also provides collaborative degree programmes such as the BSc (Hons) in Biomedical Science with the University of Ulster offering flexible options for specialisation and awards. It’s not just school-leavers who are taking advantage of these flexible educational programmes. A large

Training the researchers of tomorrow Focusing on developing the research capacity, Dr Burns notes that training “the researchers of tomorrow” is key to Ireland’s healthcare transformation. This is one of the aims of IT Sligo’s Health and Biomedical (HEAL) Strategic Research Centre, which launches this month and features a wide spectrum of expertise across four main research pillars: population health and clinical research; biomedical research; digital health technologies; and health analytics, evaluation and policy. “These four pillars have been identified as the future of multidisciplinary research in north-west Ireland,” explains Professor Suresh C. Pillai, Director of the Health and Biomedical Strategic Research Centre, IT Sligo. “Apart from upskilling individuals, the HEAL Centre will serve as a point of contact for healthcare research within the region, supporting biomedical and health-related companies with their innovation strategies. HEAL will also continue to strengthen and further develop collaborations and partnerships with industries.” Collaborating with industry The HEAL Centre’s current research projects include developing digital technologies to assist persons with type 1 diabetes with more efficient self-management, the development of wearable devices for better healthcare monitoring, the use of nanotechnology to improve access to clean water and the design of a self-management programme to support people living with a brain tumour. “All these ongoing projects, and others like them, will now emanate from the HEAL Strategic Research Centre,” says Dr Konrad Mulrennan, Associate Director for Digital Health Technologies, Health and Biomedical Strategic Research Centre, at IT Sligo. “We have more than 20 researchactive principal investigators — but they don’t just collaborate with industry. They also work with public services, charity organisations and NGOs across the healthcare sector, nationally and internationally. The range of expertise, and the integrative and collaborative ethos of HEAL will provide more effective support to Ireland’s future healthcare system going forward.”

Dr Richéal Burns Associate Director of the Health and Biomedical Strategic Research Centre, Programme Chair of the Health and Medical Information Science Programme, IT Sligo.

Professor Suresh C. Pillai Director, Health and Biomedical Strategic Research Centre, IT Sligo

Dr Konrad Mulrennan Associate Director for Digital Health Technologies, Health And Biomedical Strategic Research Centre, IT Sligo

WRITTEN BY Tony Greenway

For more information visit itsligo.ie/heal-2

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Non-contact hospital thermometers are improving lives Non-contact digital thermometers are better for patients because they are less disruptive and remove the risk of infection. They are also more efficient, economic and sustainable.

igital transformation is bringing exciting innovation into Ireland’s hospitals, which is benefitting patients and clinicians alike. Take digital thermometry for example, a technology which one medical device company has set out to improve. “In older digital contact thermometers a disposable plastic cover has to be placed over the probe every time a temperature reading is taken,” explains says Roisin Molloy, CEO and Co-Founder of medical technology manufacturer, TriMedika. Reducing risk of infection “As the thermometer makes contact, a cover is necessary to protect the patient against infection; but apart from increasing plastic usage, it’s also expensive, because each cover costs four cents,” she says. When you think about how many times patients have their temperatures taken, you can see how this mounts up, both economically and environmentally. However, the latest thermometers are noncontact and use infrared technology. To take someone’s temperature, you simply point at a patient’s forehead and click. “Because it doesn’t touch the patient it’s less invasive and disruptive for them,” says Molloy. “They can have their temperature taken while they are asleep, for example. As 80% of hospital infections are passed through contact, it removes that risk. Plus, it’s time saving for clinicians and more sustainable because no plastic consumables are needed.” Implementing new technology Molloy’s company has been working in partnership with HSE’s Digital Health Living Labs initiative to accelerate the creation and adoption of their own non-contact thermometers in more hospitals. This fits in with Ireland’s Digital Health Strategy and Action Plan, Stay Left, Shift Left, which aims to utilise the power of digital applications so that more patients can be treated at home with improved levels of care. “The HSE is very open-minded and supportive of new companies developing new technology,” says Molloy. “Improving the patient experience — while helping clinicians — is at the centre of this.” TriMedika is also developing a Bluetooth digital thermometer which sends patients’ temperature readings directly to their medical records, making it easier for clinicians to monitor patients in remote settings. Dr Roisin Molloy CEO and Co-Founder, TriMedika WRITTEN BY Tony Greenway

Ireland’s ambition to shape the future of global health Ireland is already home to approximately 200 companies engaging in digital health. To help the industry here achieve its potential we are calling for a national strategy.

reland is a popular base for life sciences Advocating for an ambitious national strategy companies, it is home to 450 medtech To help Ireland achieve its potential, the Irish companies including nine of the world’s top 10, Medtech Association, along with Technology more than 100 pharma companies including all Ireland and BioPharmaChem Ireland are of the top 10 and more than 900 tech companies, advocating for the Government to develop a again including all of the top 10 having a base here. national industrial health tech strategy, led by the With sales of €15.7 billion forecast in digital health Department of Enterprise Trade and Employment. alone by 2024, and strong growth projections year It needs an appropriate appointee put in place in on year, it’s an attractive area to drive competitive the department to oversee and implement this advantage for Ireland. strategy which would The value of adopting operate in a similar fashion a more holistic approach to Ireland’s Industry 4.0 to healthcare has been Strategy 2020-2025. highlighted over the course Research on international trends of the COVID-19 pandemic Equipping Ireland’s world class in digital health reveals that with rising spending talent to compete pressures and greater To ensure sustainable governments are aggressively demand for international progress not only do we investing in innovation to not only to collaboration between need the right policies, but both governments and compete, but also to tackle emerging Ireland also needs world businesses to provide access class talent that can stay healthcare needs. to vital care. ahead of both the latest technology and business Learning from leading economies in digital health trends. That is why the Connected Health Skillnet Research on international trends in digital health has led the development of a first-of-its-kind reveals that governments are aggressively investing ‘Future Skills Needs Analysis of the Digital Health in innovation to not only to compete, but also Sector in Ireland to 2025’ which will be launched to tackle emerging healthcare needs. In Europe, this year. France has is investing €7 billion in an impressive innovation strategy for 2030. The aim is to make it a global destination for digital health R&D. Sinead Keogh Further afield, Israel has grown its lead as a Director of Medtech location of choice for digital health with supportive and Engineering, policies to ensure that the right business Irish MedTech Association, IBEC environment is in place to bring key stakeholders together to develop disruptive technologies.

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Building a resilient, leading healthcare system with technology Over the last two years, we have seen a significant acceleration of digital transformation and the adoption of new technologies in healthcare spurred on by the challenges of the pandemic.

he pandemic disruption within healthcare has created a renewed need for digital services and solutions. For the HSE, at the height of the pandemic, and in the absence of in-person capacity, the need for these timesaving services became even more apparent.

Kieran McCorry National Technology Officer, Microsoft Ireland

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A catalyst for change “The COVID-19 emergency has acted as a catalyst for increasing digitalisation across all sectors, but especially in the public sector” says Kieran McCorry, National Technology Officer, Microsoft Ireland. “According to our research report, Digital Ireland – Inclusive Recovery, leaders in healthcare are more likely to say they are only at beginning of their technology journey. What is now clear is that the acceleration of digitalisation has exposed differing needs and challenges across healthcare provision. We are only at the start of a lengthy process of adjustment to the new realities of a post-pandemic economy and society in Ireland.” Fair, equitable access to healthcare “At Microsoft, we believe that every Irish citizen deserves the best healthcare services on a fair and equitable basis. Our healthcare strategy is centred on three pillars; to focus on enhancing patient engagement, empowering collaboration among healthcare teams and improving clinical and operational insights.

“Since the launch of Microsoft Cloud for Healthcare, we’ve been helping to solve some of healthcare’s greatest challenges. These include enabling virtual health and remote patient monitoring to managing health data at scale to provide a 360 view of the patient.” The HSE has embraced several new digital tools that not only provided flexibility, scale and responsiveness, but also helped the organisation to process and derive insights from significant amounts of data through the use of digital-based systems. Supporting the healthcare system The roll-out of these digital solutions assisted in delivering insights, facts and data in real-time in order to enable decision making, as well as support resourcing planning and the dissemination of information to the public. Pre-existing eHealth tools such as e-Prescribing, eReferrals and telemedicine were increasingly adopted and used over the pandemic period. New health technologies such as cloud-based data lake platforms were used to collect COVID-19 data in real time. AI-based technology was implemented through the COVID-19 triage Health Chatbot. The adoption of these innovations shows what our health system is capable of implementing in a short time. Now is the time to further strengthen these improvements and successes to build a resilient, leading healthcare systems for future generations.

Offering patients all the healthcare information they need in one easy-to-access place can help them better manage their own care and recover quicker.

D Tom Coleman CEO & Co-Founder, Zendra Health WRITTEN BY Mark Nicholls

igital technology can have massive benefits in bridging the gap between patients and healthcare professionals to improve health outcomes. This can range from helping patients to become more engaged in their healthcare, better adhering to medication and rehabilitation regimes through to care teams having better visibility of people they may not be able to physically visit on a regular basis. Patient-centric care Digital health expert and Zendra Health CEO Tom Coleman explains that digital health can make healthcare more accessible and

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By putting all the patient information – which can often be fragmented - in one place digitally and available on laptop, PC, tablet or smartphone and tailored to that cohort, it enables patients to have what they need close to hand and cuts down the time healthcare professionals spend doing admin tasks with patients.

Digital health is bridging the patienthealthcare gap

support patients with more than one condition, in their own home. “It is about delivering personalised care to their needs,” he says, “and moving care away from the acute setting into more community-based setting and at home.” Navigating pathways The idea for the company emerged from seeing their mother, who had rheumatoid arthritis, struggle with navigating her way through the care pathway. “She would have reminders on her phone to take her meds, educational leaflets scattered under her footrest and a plastic bag for all of her appointment letters,” says Coleman.

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Healthcare visibility Zendra Health’s solution can also give healthcare staff visibility of how their patient is doing, highlight whether they need additional care such as a social worker visit, or cut down on routine face-to-face visits. “For patients, it empowers them and they can feel comfortable that a care team can see how they are doing in between clinic visits,” Coleman adds. Patients, caregivers and care teams can rapidly co-create a digital health solution using Zendra’s Health’s technology in just one day. With the tremendous support of HSE Digital Transformation team and Sligo Living Lab, Zendra Health is helping healthcare services in the US, UK and Ireland transform from a diseasedcentred model to a truly patientcentric and integrated model. Zendra Health is a Dublin-based medical technology company that works with healthcare services to provide turnkey digital health platforms, with the aim of helping with patient engagement and care optimisation. The company recently achieved ISO 13485 certification by the NSAI to develop medical-grade software. Find out more at zendrahealth.com

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If more patients were treated at home, it would free up hospital beds for those who most desperately need acute treatment.

Technology that allows patient care to be managed at home The latest advanced sensor technology enables some patients to be cared for in their own homes. That’s better for them — and it frees up resources in the healthcare system.

I Sarah Jane O’Dwyer CEO, HaloCare WRITTEN BY Tony Greenway

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t’s an interesting time to be working in healthcare technology — especially in Ireland, which has become a fertile ground for disruptive innovation in recent years. A great example of this is personalised care at home, says Sarah Jane O’Dwyer, CEO of HaloCare, a company which uses advanced contactless technology to enable people to live longer healthier lives in their own homes. Meeting the needs of patients HaloCare provide a holistic model of care supported through three pillars safety, social/wellness and clinical. They use state-of-the-art technology and clinical excellence to ensure they meet the needs of their clients or patients. Before a client or patient is onboarded, a full assessment of their needs is performed by a multidisciplinary team. If a safety issue is identified, they can provide a network of digital sensors (such as fall, activity and door sensors), detectors (such as water and smoke detectors) and alarms can be unintrusive installed in their home. These are personalised to their requirements and connected to a state-of-the-art care hub. “The sensor technology is discreet, wireless and contactless so clients can just forget about it and go about their daily lives, in the knowledge that HaloCare are there in the background should there be an issue, this gives peace of mind to the client and their family,” explains O’Dwyer. Personalised care based on respect and dignity Patients are also able to connect with a member of the 24/7 care hub team via a voice-activated panel; and — depending on their dexterity — can be given an easy-to-use tablet with an age-friendly design to access video calls with the care specialists or with their clinicians. Meanwhile, family members or care givers can keep up to date with the patient’s progress — and be connected to them — via an app on their phone. Now the technology is beginning to move into the clinical space to enable remote patient monitoring. “Depending on the medical procedure

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a patient would normally recover in a hospital until the clinical team deem it safe for them to be discharged — now these patients can be discharged early and return to the comfort of their home — safe in the knowledge they are still receiving the same level of care had they stayed in the hospital” says O’Dwyer. This type of patient-centred care in the community means that people will spend less time in hospital,” says O’Dwyer. “The use of this type of service will reduce their risk of exposure to hospital-acquired infections and able to spend more time in their own surroundings, where they are more comfortable. It’s care that gives them independence and dignity.” A new and advanced way of delivering care This support is better for patients, but it’s also a boon for the healthcare system. “If more patients were treated at home, it would free up hospital beds for those who most desperately need acute treatment,” says O’Dwyer. “That would make the acute setting more efficient. This technology will not replace a hospital setting, but it is a way to support hospitals and patients.” O’Dwyer believes that holistic virtual care using innovative disruptive technology and clinical excellence is the future. “People are more tech savvy and want to be in control of their health and to be able to receive the same level of care at home rather than in a hospital will create a measurable impact in the lives of people and improve outcomes for the better.” Over the last two years COVID-19 has created delays in treating patients especially with chronic conditions, we now need a new way of treating people and a new way of delivering care.

Find out more at halocaregroup.com

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