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 better efficiency or greater acceptability of therapeutic protocols? Technologies of the future: how to detect them, co-construct them and bring them to reality?
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, the iTMT's mission is to develop and implement innovative medical technologies, thanks to key players in its large ecosystem, with the aim of meeting existing or emerging needs in the health sector.
To achieve this, TransMedTech relies in particular on TKM's expertise in technology transfer. Its analysis tools make it possible to carry out in-depth technical-economic positioning and feasibility studies on projects that are candidates for maturation within the institute.
Crossed perspectives 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 present to us the approach and vocation of TransMedTech?
Marie-Pierre Faure: Officially launched in 2017, the TransMedTech Institute is a transdisciplinary initiative of open collaboration, which brings together entrepreneurs, researchers, health professionals, experts, but also users, patients, and even industrialists, and students.
The institute aims to develop innovative medical technologies in order to meet the needs of the health sector and train the next generation of the medical technology sector. TransMedTech was born from an initiative led by Polytechnique Montréal in collaboration with four other founding institutions: the CHU Sainte-Justine, the University of Montreal, the CHUM and the Jewish General Hospital of Montreal, as well as around thirty others partners.
Three other institutions will also join in 2023: HEC Montréal, the University Institute of Geriatrics of Montreal and the Montreal Heart Institute.
By following the user-centered Living Lab of the TransMedTech Institute, a first step consists of taking a state of the current art, validating the market segments, defining the regulatory path in order to ensure the appropriateness of the solution proposed by the team led by the innovators. To do this, we use the tools developed by TKM.
To date, more than 140 collaborative projects have benefited from our support 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 big trend at the moment is the paradigm shift. The hospital of the future increasingly integrates the notion of point of care , in French this would translate into point of service, where care can be provided more efficiently and directly where the patient is.
For the patient-citizen, this development will allow more accessible, personalized and dedicated care and services.
The implementation of the hospital of the future involves the emergence of new technologies, notably digital health, with its many issues and challenges such as data sharing, interoperability, security and ethics.
It will be essential to take into account the diversity of the population and environments served, as well as individual specificities and disparities between communities. It will also be necessary to consider the challenges of appropriation of these new technologies by the various stakeholders, particularly in terms of training, change of practices and adoption.
How does TKM view these issues and the hospital of the future?
Christophe Lecante: Listening to Marie-Pierre Faure, I can't help but think of work that we did in 2017 on the concept of “Maison Bienveillante” with a Quebec manufacturing company in the field of construction. Its manager wanted to increase his company's innovation capabilities tenfold and offer innovative solutions to rethink the living space to serve its occupants.
People's needs change over time, occasionally, for example with the arrival of a child, in the event of an accident, or convalescence, or even chronically during aging. As a result, the scope for innovation is very broad. Easy to get lost and, in the end, to return to less innovative solutions.
TKM, by providing a complete inventory on this theme, whether in terms of research, public policies, technologies, or start-ups, has enabled the highlighting of immediate links with the world of health and , in particular, with the hospital environment for questions such as the link between patient and medical staff, remote monitoring, emergency room congestion, monitoring of chronic diseases, etc.
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 awareness, made possible by this “upstream monitoring” work, made it possible to imagine collaboration and innovation plans , breaking with usual thinking patterns.
In other words, this monitoring allowed the company to think about its innovation ecosystem in an infinitely more open and effective way, to take a real step aside and very quickly collect signs of interest, then to initiate collaborations in record time.
The TransMedTech Institute today 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 practitioners. s and researchers who work on a daily basis in Montreal hospitals.
Will the hospital of the future be a caring hospital?
CL: Yes, I believe so and I hope so! The hospital of the future is a hospital focused on citizen patients who become partners in their care and research. It is a hospital that opens up to the city and is primarily interested in innovation with a strong societal impact, verified therapeutic added value and which becomes an essential player of inclusiveness.
It is this 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 manage to integrate these new tools into a care pathway, in a fluid and secure manner, for all stakeholders.
This is what we try to do at TransMedTech: we are sometimes presented with incredible technologies, but which are difficult to adopt as is by a user. This is where we need to make a selection. Hence the idea of integrating patient citizens into the co-development of these innovations as early as possible .
CL: This is why the notion of Value Based Health Care — which covers the fact of developing a care system based on the demonstration of added value in the eyes of the patient — is crucial. We can imagine wonderful technologies from a technical and scientific point of view, but which could miss the “use” dimension and prove very problematic for the patient.
How to ensure that a technology corresponds to patient use?
MP F: We are supporting, for example, a project aimed at equipping 300 patients in retirement homes with connected watches. The big difficulty is to prevent patients from snatching up this watch. Project leaders are therefore wondering about the possibility of opting instead for connected clothing, which is more bearable.
As this example shows, the objective is to clearly define the use, depending on the type of beneficiary. Between a pediatric patient — at home with his parents — a teenager wearing a restrictive corset for scoliosis, an adult in post-traumatic rehabilitation equipped with virtual reality, or elderly people suffering from dementia and cared for by nurses... The reality and the needs of patients are very different. It is not only therapeutic effectiveness, but also the ability of a treatment or a device to best integrate into the patient's life that must take precedence in the approach. This integration has an impact on the effectiveness of medicine.
All these questions ultimately come together to that of the acceptability of the technology…
MP F: There are technological issues, certainly, but not only that. There are challenges of social transposition, evolution of cultures, scaling up, changes in uses and adaptation of systems.
The whole challenge is to make the devices less invasive, less restrictive and easier for the patient, so that the medical device blends into the life of the patient and the practitioners.
How come the shared medical record is not yet a reality?
CL: The shared medical record is one of the central tools and at the heart of debates for many years to enable and facilitate this transversality.
The issues of confidentiality and security of data, their processing and their exploitation, are complex and involve a large number of actors, with significant human, societal and ethical issues.
Paradoxically, people have no problem wearing connected objects to play sports or to manage diaries, cars or even owning connected phones. We agree to abandon part of what concerns our private life if there is an immediate interest in it: monitoring of my performances or my training plan, sharing of my agenda with my teams, greater efficiency in my urban trips, etc.
But as soon as we touch on the field of health, everything legitimately becomes more complex . There is a real political subject, a real debate to be had to study the benefit/risk balance of connected medical solutions and especially the use that is made of the data collected.
How does TransMedTech contribute to moving in the right direction?
MP F: In its development work, TransMedTech wants to invent this hospital of the future, this caring hospital, where the citizen patient is a stakeholder. In partnership with TKM, TransMedTech aims to show the right path, since we can detect very early the pitfalls to avoid in the process of maturation of innovation .
What is TKM’s contribution to this TransMedTech innovation trajectory?
CL: The tools offered by TKM allow TransMedTech teams to carry out monitoring on a global scale. This monitoring work makes it possible to validate that each project selected and supported by the Institute is truly relevant and innovative.
The literature review also makes it possible to ensure that there is added value to the project and to verify that there is indeed a possibility of exploitation, by removing any doubt in particular on questions of industrial property , and this on a global scale.
TransMedTech, in partnership with TKM, is a key player, both from an operational and methodological point of view, serving research and innovation for more inclusive precision health.
The collective intelligence approach, with the Living Lab , is a key factor in properly addressing the question of the translation of the invention towards its deployment on the market.
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