What will the hospital of tomorrow look like? What are the major innovations that will transform, for the better, the relationship between practitioners and patients, whether for greater efficiency or increased acceptance of treatment protocols? Future technologies: how can we identify them, co-create them, and bring them to fruition?
These questions are one of the reasons for the existence of the TransMedTech Institute (iTMT) of Montreal, an institution created in 2017 under the leadership of Professor Carl-Éric Aubin, PhD. On the one hand, iTMT's mission is to develop and implement innovative medical technologies, thanks to the key players in its broad ecosystem, with the aim of meeting existing or emerging needs in the healthcare sector.
To achieve this, TransMedTech relies in particular on TKM's expertise in technology transfer. Its analytical tools enable in-depth techno-economic positioning and feasibility studies to be conducted on projects seeking development within the institute.
A joint perspective on the hospital of the future with Marie-Pierre Faure PhD, Director of Innovation & Living Lab at the TransMedTech Institute, and Christophe Lecante, founding director of TKM.
Marie-Pierre Faure, could you tell us about TransMedTech's approach and mission?
Marie-Pierre Faure: Officially launched in 2017, the TransMedTech Institute is a transdisciplinary open collaboration initiative that brings together entrepreneurs, researchers, healthcare professionals, experts, as well as users, patients, industrialists, and students.
The institute aims to develop innovative medical technologies to meet the needs of the healthcare sector and train the next generation of medical technology professionals. TransMedTech was born from an initiative led by Polytechnique Montréal in collaboration with four other founding institutions: CHU Sainte-Justine, Université de Montréal, CHUM and the Jewish General Hospital of Montreal, as well as some thirty other partners.
Three other institutions joined in 2023: HEC Montréal, the University Institute of Geriatrics of Montreal and the Montreal Heart Institute.
Following the user-centric Living Lab of the TransMedTech Institute, the first step is to conduct a review of the current state of the art, validate market segments, and define the regulatory pathway to ensure the viability of the solution proposed by the team led by the innovators. To do this, we use tools developed by TKM.
To date, more than 140 collaborative projects have benefited from our support by following the TransMedTech method, with nearly $40 million invested.
What are the major trends you are observing in the healthcare sector?
Marie-Pierre Faure : The major trend at the moment is the paradigm shift. The hospital of the future is increasingly integrating the concept of point of care , where care can be delivered more efficiently and directly where the patient is located.
For the patient-citizen, this development will allow for more accessible, personalized and dedicated care and services.
The implementation of the hospital of the future involves the emergence of new technologies, including digital health, with its many issues and challenges such as data sharing, interoperability, security and ethics.
It will be essential to consider the diversity of the population and the environments served, as well as individual characteristics and disparities between communities. It will also be necessary to consider the challenges of the appropriation of these new technologies by the various stakeholders, particularly in terms of training, changes in practices, and adoption.
What is TKM's perspective on these issues and the hospital of the future?
Christophe Lecante: Listening to Marie-Pierre Faure, I can't help but think of a project we did in 2017 on the concept of the "Caring Home" with a Quebec manufacturing company in the construction sector. Its CEO wanted to exponentially increase his company's innovation capabilities and offer innovative solutions to rethink living spaces in service of their occupants.
People's needs evolve over time, sometimes in a temporary way, for example with the arrival of a child, in the event of an accident, or during convalescence, and sometimes chronically with aging. As a result, the scope for innovation is very broad. It's easy to get lost and, ultimately, revert to less innovative solutions.
TKM, by providing a comprehensive overview of this topic, whether in terms of research, public policies, technologies, or start-ups, has highlighted the immediate links with the world of health and, in particular, with the hospital environment for issues such as the link between patient and medical staff, remote monitoring, emergency room overcrowding, and the monitoring of chronic diseases…
It quickly became apparent that this concept of a caring home partly echoed that of a caring hospital, designed and organized around its patients and citizens. This realization, made possible by this "upstream monitoring" work, allowed for the early development of highly exciting collaborative and innovative models that broke with conventional ways of thinking.
In other words, this monitoring has allowed the company to think about its innovation ecosystem in a much more open and effective way, to take a real step aside and to quickly gather expressions of interest, then to initiate collaborations in record time.
The TransMedTech Institute now uses our monitoring and analysis tools to carry out exactly this type of analysis upstream, to validate, de-risk and accelerate the innovation processes proposed to it by the practitioners and researchers who work daily in Montreal hospitals.
Will the hospital of the future be a caring hospital?
CL: Yes, I believe it and I hope so! The hospital of the future is a hospital centered on the patient as a citizen who becomes a partner in their care and in research. It is a hospital that opens itself to the city and prioritizes innovation with a strong societal impact, proven therapeutic added value, and becomes a key player in promoting inclusivity.
This is the ambition that the TransMedTech Institute carries and which it has translated into the heart of its support processes.
Is the technology mature enough to achieve this?
MP F: Today, technology is no longer a problem. The challenge is to use technology to meet needs. We must succeed in integrating these new tools into the healthcare pathway, in a seamless and secure way, for all stakeholders.
That's what we try to do at TransMedTech: we're sometimes presented with incredible technologies, but they're difficult for users to adopt in their current state. That's where we have to make a selection. Hence the idea of integrating patient citizens into the co-development of these innovations as early as possible .
CL: That's why the concept of Value-Based Healthcare —which encompasses developing a healthcare system based on demonstrating added value in the eyes of the patient—is crucial. We can imagine technologies that are wonderful from a technical and scientific point of view, but which might overlook the "use" dimension and prove very problematic for the patient.
How can we ensure that a technology is well suited to the patient's needs?
MP F: For example, we're supporting a project to equip 300 nursing home patients with smartwatches. The major challenge is preventing patients from taking the watches. The project leaders are therefore considering the possibility of using smart clothing instead, which would be more comfortable to wear.
As this example illustrates, the goal is to clearly define the intended use, depending on the type of user. Whether it's a pediatric patient at home with their parents, a teenager wearing a restrictive brace for scoliosis, an adult undergoing post-traumatic rehabilitation using virtual reality, or elderly individuals with dementia cared for by nurses, the realities and needs of patients vary greatly. The approach must prioritize not only therapeutic efficacy but also the ability of a treatment or device to seamlessly integrate into the patient's life. This integration directly impacts the effectiveness of medicine.
All these questions ultimately come down to the issue of the acceptability of the technology…
MP F: There are technological challenges, certainly, but not only that. There are challenges of social transposition, cultural evolution, scaling up, changes in uses and adaptation of devices.
The challenge is to make the devices less invasive, less restrictive and easier for the patient, so that the medical device becomes integrated into the lives of both the patient and the practitioners.
Why is it that the shared medical record is not yet a reality?
CL: The shared medical record is one of the central tools and has been at the heart of debates for many years to enable and facilitate this cross-functionality.
The issues of data confidentiality and security, processing and use, are complex and involve a large number of actors, with significant human, societal and ethical implications.
Paradoxically, people have no problem wearing connected devices for sports, managing schedules, cars, or even owning smart phones. We readily accept giving up some aspects of our private lives if we see an immediate benefit: tracking my performance or training plan, sharing my calendar with my team, greater efficiency in my urban travels, and so on.
But as soon as we touch on the field of health, everything rightfully becomes more complex . There is a real political issue, a real debate to be had to study the benefit/risk balance of connected medical solutions and especially the use made of the data collected.
How does TransMedTech contribute to moving in the right direction?
MP F: In its development work, TransMedTech aims to invent this hospital of the future, this caring hospital, where the patient is an active participant. In partnership with TKM, TransMedTech's mission is to show the right path, since it's possible to detect pitfalls to avoid very early in the innovation maturation process .
What is TKM's contribution to TransMedTech's innovation trajectory?
CL: The tools offered by TKM allow TransMedTech teams to conduct monitoring . This monitoring work helps to validate that each project selected and supported by the Institute is truly relevant and innovative.
The literature review also helps to ensure that there is added value industrial property issues , and this on a global scale.
TransMedTech, in partnership with TKM, is a key player, both operationally and methodologically, in the service of research and innovation for more inclusive precision health.
The collective intelligence approach, with the Living Lab , is a key factor in successfully addressing the issue of translating the invention towards its deployment on the market.
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