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.

Ireland is a popular base for life sciences companies, it is home to 450 medtech companies including nine of the world’s top 10, more than 100 pharma companies including all of the top 10 and more than 900 tech companies, again including all of the top 10 having a base here. With sales of €15.7 billion forecast in digital health alone by 2024, and strong growth projections year on year, it’s an attractive area to drive competitive advantage for Ireland.

The value of adopting a more holistic approach to healthcare has been highlighted over the course of the COVID-19 pandemic with rising spending pressures and greater demand for international collaboration between both governments and businesses to provide access to vital care.

Learning from leading economies in digital health

Research on international trends in digital health reveals that governments are aggressively investing in innovation to not only to compete, but also to tackle emerging healthcare needs. In Europe, France 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.

Further afield, Israel has grown its lead as a location of choice for digital health with supportive policies to ensure that the right business environment is in place to bring key stakeholders together to develop disruptive technologies.

In Europe, France is investing €7 billion in an impressive innovation strategy for 2030.

Advocating for an ambitious national strategy

To help Ireland achieve its potential, the Irish Medtech Association, along with Technology Ireland and BioPharmaChem Ireland are advocating for the Government to develop a national industrial health tech strategy, led by the Department of Enterprise Trade and Employment. It needs an appropriate appointee put in place in the department to oversee and implement this strategy which would operate in a similar fashion to Ireland’s Industry 4.0 Strategy 2020-2025.

Equipping Ireland’s world class talent to compete

To ensure sustainable progress not only do we need the right policies, but Ireland also needs world class talent that can stay ahead of both the latest technology and business trends. That is why the Connected Health Skillnet has led the development of a first-of-its-kind ‘Future Skills Needs Analysis of the Digital Health Sector in Ireland to 2025’ which will be launched this year.

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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.

It’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 is there in the background should there be an issue, this gives peace of mind to the client and their family,” explains O’Dwyer.

This technology will not replace a hospital setting, but it is a way to support hospitals and patients.

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 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.

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One 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.

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

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.

Increasing 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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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.

The 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.

Our healthcare costs are 20% higher than the European average, despite us having a younger and healthier population than many European countries.

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/community-based, 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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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.

The 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.

How has the pandemic helped create a shift in healthcare?

The pandemic has highlighted the need for change and transformation in healthcare systems globally. It has also demonstrated the collaboration and work across organisations to develop and roll out the vaccinations, and is evident in the delivered medtech and digital solutions, e.g. contact tracing, and national rapid upscaling in diagnostics to meet PCR testing demand.

Healthcare organisations have demonstrated how, when given the opportunity, we can be dynamic and collaborative in delivering solutions. We have demonstrated resilience and drive and have had to ask hard questions – how do we best deliver patient solutions in this complex ecosystem? How do we continue to bring the value of health products and services 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 average despite us having a younger and healthier population than many European countries, and we are ranked joint last for telehealth maturity along with Serbia and Romania.

With public and private sectors working together we can capitalise on digital technology and deliver radical improvements.

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 effective collaboration is key. The HSE Digital Transformation Team with collaborators is facilitating this need to think differently. Martin Curley, Director, Digital Transformation HSE describes ‘How the National Digital Health Strategy ‘Leap Frog – Stay Left, Shift Left’ acts as a compass to drive coherency amongst the radical digital innovations so they combine so that the whole is far greater than the sum of the parts’.

He explains how research demonstrates that digital technologies create the opportunity to deliver 10x improvements. With public and private sectors working together we can capitalise on digital technology and deliver radical improvements.

It will be more important than ever, as we emerge from the pandemic to build on this momentum to become a leader in healthcare.

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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.

The 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.

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.”

What is now clear is that the acceleration of digitalisation has exposed differing needs and challenges across healthcare provision.

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.

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

The 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 chronic and rare neurological disease. It is hosted by RCSI University of Medicine and Health Sciences with over 80 multidisciplinary researchers across seven leading Irish universities.

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.

By adopting a data science approach, researchers can discern patterns in disease, which can help to unlock future treatments.

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.

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Dr John Sheehan

Clinical Director of Radiology, the Hermitage Clinic and Consultant Radiologist, the Blackrock Clinic

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.

At 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 time-consuming 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 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.

We want our patients to experience a world-class standard of care which has compassion at its heart.

Sinead Hanley

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 post-op 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.

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Dr Ian Fraser

Clinical Director of Radiation Oncology, the Hermitage Clinic

Mr Niall Hogan

Orthopaedic Surgery Consultant, the Blackrock Clinic

In modern healthcare, few fields are delivering such rapid innovation or improving patient outcomes as substantially as surgical robotics. 

Since 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 micro-procedures 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.

What we are witnessing now is the beginning of a new era in surgical technology.

Mr Niall Hogan

Introduction of precision robotics

As part of this shared effort, Blackrock Clinic recently introduced a new precision robot for joint replacement surgery.

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 robot-assisted, 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 non-cancerous 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 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.”

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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.

Digital 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 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.”

For patients, it empowers them and they can feel comfortable that a care team can see how they are doing in between clinic visits.

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.

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.

For patients, it empowers them and they can feel comfortable that a care team can see how they are doing in between clinic visits.

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 diseased-centred model to a truly patient-centric and integrated model.

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