2013 HTX Annual Report
2013 HTX Annual Report
2013 HTX Annual Report
www.htx.ca
INSIDE
Vision & Mission
HTX: Team, Board of Directors, Observers,
Business Advisory Committee 04-05
Messages
This report reflects work completed or in progress between April 2012 and early 2014.
Materials in this report may be reproduced with the written consent of htx.ca The Health Technology Exchange.
This is to ensure an awareness of the manner in which these materials may be used for other purposes.
Health Technology
Commercialization Program 10
Medtech RISE 34
Copyright 2014
Highlights
Additional copies of this report in book form are available upon request.
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HInext
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26
28
30
Sensory Technologies
I N V E N T | I N N O VA T E | I N V O I C E
HTX TEAM
JOHN SOLONINKA
President & CEO
Rob Hall
Vice President,
Finance
NORMAN PYO
Senior Director,
Business Development
CHERYL VERSCHEURE
Executive Assistant/
Office Coordinator
Shahira Bhimani
Manager, Strategic
Initiatives
Damian Lamb
Co-Founder & Managing
Director, Genesys Capital
DAVID SHINDLER
Former CEO of
BioDicovery Toronto
Peter Goodhand
Board Chairman,
Executive Director (Acting),
The Global Alliance for
Genomics and Health
Gary Hodgins
President, Pharmax Ltd.
Ken Lawless
President, Epitope
Capital Corp.
Michael Sefton
University Professor, Institute
of Biomaterials & Biomedical
Engineering, University of
Toronto
PHIL SPENCER
Life Sciences Counsel
HTX OBSERVERS*
BILL MANTEL
Assistant Deputy Minister,
Research, Commercialization
& Entrepreneurship Division
ALLEN PAUL
Life Science Programs
Mark Roseman
Manager, Innovation
Strategy and Programs
Dimitri prokopiev
Senior Policy Advisor
Frank Baylis
President, Baylis
Medical Canada
Jeremy Bridge Cook
Senior Vice President,
Assay Group, Luminex
Molecular Diagnostics, Inc.
John Buckingham
Founder & Partner,
Buckingham
Alliance Partners
Ted Hewitt
Former Vice President,
Research & International
Relations, The University
of Western Ontario
Frederic Lachmann
CTO, Medipattern
Damian Lamb
Co-founder & Managing
Director, Genesys Capital
Genevieve Lavertu
Director, Legal Affairs,
Business Development
& Clinical Research,
Medtronic of Canada
John MacRitchie
Regional Director, Central
Region, Ontario Centres
of Excellence
to International Invoice,
mission
HTX supports the growth of a dynamic,
prosperous Ontario medtech sector
that aligns with and advances world
class healthcare, enabling enhanced
healthy living for its citizens.
HTX aims to generate the
following results for Ontario:
Vision
Kieran Murphy
Vice Chair & Chief
of Medical Imaging,
University of Toronto
Kris Shah
Vice President, Technical
Division Manager, Baylis
Medical Canada
Thomas Reeves
President & CEO,
Interface Biologics, Inc.
Bill McClean
Former GM, IBM Canada
Cheryl Reicin
Partner, Torys LLP
LifeScience M&A
Practice Lead
Doug Tessier
Former Acting Senior
Vice President of Development
& Implementation, eHealth
Ontario
marketing companies;
I N V E N T | I N N O VA T E | I N V O I C E
Follow-on financings:
Infonaut Expanding the footprint of this Hospital Acquired Infection monitoring
technology into US markets customers.
Profound Medical Pursuing the next phase of clinical trials in Ontario, the US and Germany
of a novel technology for prostate cancer the entire prostate gland can be ablated from inside
the urethra, in one treatment session, destroying cancer while sparing surrounding tissue.
SensoryTech Implementing their mobile care management platform into US Hospice and
palliative homecare provider customers.
We continue to be impressed by the disruptive potential of these world-class medical technologies
38 Medtech Financings
$86M in Total Project Value 4x Leverage
Over this last year we reviewed 36 applications and selected another 11 projects to finance,
bringing our total to 38 funded projects for the last 4 years. We have committed approximately
In addition to our financing, HTX is very pleased to support and drive creation of medtech
$21.4M into strategic medtech commercialization and ecosystem projects, which was matched
commercialization capacity in Ontario. We collaborate with a large number of public and private
by $65M from private sector companies, their investors and strategic public and private-sector
partners. The companies have been aggressively hiring and advancing their products to market.
MaRS EXCITE As a founding member of EXCITEs Management Board, HTX is very pleased to
HTXs project-based funding is designed to help companies de-risk both their business models
see EXCITEs portfolio grow to 15 companies undertaking field evaluations and health technology
assessments in the pre-market space. HTX is also working in collaboration with EXCITE in providing
funding support to two EXCITE projects; the first one being with Rna Diagnostics in supporting field
studies and clinical trials with leading cancer centers in Ontario and Quebec, and the second with
ApneaDx, described above.
Harmony A collaboration with Hull and Associates and an international advisory board,
Harmony will enable medtech companies to select attractive export markets for their technologies
and to reduce the cost, time and risk of evidence development supporting global market access.
Our related Soft-landing initiative has identified a roster of highly qualified regulatory and
reimbursement consultants internationally to assist companies achieving global market access.
CORTECHs HTX led the creation of a 40-organization neuro-imaging, simulation, navigation,
surgery and assessment consortium, capitalizing Canadas strong global positioning in
neuroscience research. HTX and the Ontario Brain Institute are now exploring further funding
potential for the CORTECHs initiative.
Medtech RISE A coalition of 12 organizations across the country coming together to create
a single, comprehensive registry of over 3000 medtech innovators, suppliers and exporters.
Medtech Working Group and Innovation Procurement Initiatives public-private
collaborations aimed at improving Ontarios ability to speed adoption of beneficial technologies.
New Horizons for Medtech - Last year we reported creating a collaboration between HTX,
MEDEC and FEDDEV to provide $1M to support Ontario companies pursuing global markets.
technology has the promise to dramatically reduce side effects of current drugs, reduce cost
We are very pleased to report that 29 companies were awarded funding for global market
development initiatives that will increase export sales for Ontarios medtech companies.
I N V E N T | I N N O VA T E | I N V O I C E
HTX has developed deep experience in medtech company creation, financing, evidence
generation, market access and adoption issues facing medtech companies. Our tag line
As the Chair of the Board, it is hard not to sound repetitive: we have completed yet another
is from Invention through Innovation to International Invoice: our early years incented
outstanding year, driving towards the completion of the HTCP mandate. As we approach this
final year of the current HTCP funding program, its helpful to take stock on just how far the
through the HTCP program; and now we have entered our phase focused on adoption,
Ontario Medtech Ecosystem has progressed since 2002, and the impact HTX has had.
Whats Next?
Medical and Assistive Technologies Consortium (MATC). Its goal: to understand why we were so
good at medical research, and yet so poor at commercialization, adoption and export of medical
technologies compared with other industrial clusters around the world. An industry cluster analysis
was conducted and recommendations made which included the creation of an entity like HTX, and
a focus on breaking down the silos dividing providers, innovators, financiers, regulators, and payers.
My enthusiasm for the creation of HTX was so strong that I became the founding Managing
Director and have stayed fully engaged for more than a decade as the Chair of the Board.
Again, this outstanding year would not have been possible without
the contributions of many:
Our extremely capable and experienced colleagues and staff at HTX;
Our Board and Business Advisory Committee;
Look at the Ontario medtech ecosystem now: the commercialization awareness, processes,
supports and funding we now have in place would have seemed unimaginable in the medtech
climate of 2002. And with the creation of the Ontario Health Innovation Council, a government/
health system/industry collaboration with a specific mandate to accelerate evidence-based
adoption of beneficial technologies, we have all of the necessary players and infrastructure
engaged. But there is still work to do. We have built the infrastructure, but now we need to use
it to ramp up private sector investment levels, commercialization and adoption rates of Ontario
medical technology, increasing exports and reducing our trade deficit. When we move the
needle on those, we have accomplished our goals from 2002.
Our President and CEO, and his team have again performed extremely well, and made the Boards
Our partners at the Ministry of Research and Innovation, the Ontario Brain Institute, MaRS
job very easy. It is indeed a pleasure to see the level of commitment, engagement, collaboration
EXCITE and CIMTEC; my colleagues on various national and provincial medtech working
and accomplishment, all within a lean, professionally managed team. But I must equally say that
groups, the Canada Israel Industrial R&D Foundation (CIIRDF); and most importantly
the unstinting commitment and creative vision of Bill Mantel and the team within the Ministry of
Research and Innovation, supported so strongly by Minister Moridi and Deputy Minister Tilford,
has been critical to HTXs success.
team, its external reviewers and the Business Advisory Committee. The continued discipline and
rigour of the due diligence and investment management gave the Board great confidence in the
process. The Board appreciates and thanks all involved for their efforts.
On behalf of the HTX Board I am pleased to be supporting HTXs CEO, the team and the Ontario
Medtech ecosystem in their continued success with a model that has demonstrated its value.
I N V E N T | I N N O VA T E | I N V O I C E
Health Technology
Commercialization Program
Launched in the spring of 2010, the Health Technology Commercialization Program (HTCP)
80,000,000
70,000,000
completed its fourth year of operation in December 2013. HTCP runs for a total of five
years to December 2014.
50,000,000
As of early 2014, HTCP has committed all of its funding for disbursements to companies
40,000,000
HTX Disbursements,
Operations and
Ecosystem Support
($14.25M). There are a total of 37 projects with small/medium-sized Ontario companies and
1 project with a multinational company. 23 projects have been successfully completed to date.
30,000,000
Over the five-year life of HTCP, HTX is on-track to disburse $14.25M to its recipient companies
20,000,000
and to spend $7.15M on operations and ecosystem support. Recipient companies and their
partner organizations will spend more than $65M (in addition to HTX funding) on the 38 projects.
Overall, the total value of HTCP, including all recipient and partner spending, will exceed $86M.
10,000,000
0
FY 2011
10
FY 2012
FY 2013
FY 2014
FY 2015
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Baylis Medical
Colibri Technologies
Interface Biologics
Medworxx
Infonaut Inc.
LifeLike BioTissue
OtoSim Inc
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PatientOrderSets.com Ltd.
Qvella
RoweBots
Segasist
Rna Diagnostics
Scisense
Sensory Technologies
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Spartan
Xagenic
XLR Imaging
ApneaDX
Harmonic Medical
Ultrasound Therapy
Total Project Value: $2,081,555
HTX VALUE: $489,270
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Vascularix
HInext
Imagistx
Huron Technologies
GE Healthcare
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MyndTec Inc.
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HInext Inc.
HInext Inc.
Providing a high quality of care
for our clients whose array of
needs is complex has been made
Ricardo Santiago,
Chief Information Officer,
Village Care of New York
manually, and diagnosis and treatment are based largely on subjective personal analysis rather
Partners from the mental health community play a key role in contributing to TREATs continued enhancement. A prototype for the typical standalone,
community-based mental health organization, for example, is Manhattans Village Care, with 30 psychologists and psychiatrists treating outpatients.
The mental health department of New Yorks Maimonides Medical Center (MMC), a large acute-care hospital, is a prototype for the use of TREAT
in a typical Accountable Care Organization. MMC is part of a cooperative organization of 50 healthcare providers comprising a network called the
Brooklyn Health Home. This network is responsible for the care and management of about 25,000 people with Bipolar Disease and Schizophrenia.
MMC is particularly excited about TREATs Metabolic Monitor, a sophisticated software algorithm that uses data from standard medical monitors and
measuring devices to calculate a patients risk of developing one of the metabolic disorders that often arise as a side effect of their medications.
HInexts strategy is to offer TREAT as a fully hosted, Web-based application based on the Software-as-a-Service (SaaS) delivery model in
more than 30 provider organizations, achieved Meaningful Use Certification in the U.S. in August, 2013.
which customers pay a monthly subscription fee to access the application via the Internet, using any standard Web browser. The SaaS value
The enhancement project, expected to be completed by the end of Q1, 2014, includes patient and
resource scheduling, and patient billing. As a result, TREAT will be a fully integrated, market-ready
solution that meets U.S. regulatory requirements. Equally important, it will meet the needs of
fast start-up and little or no upfront costs; and regular, predictable subscription fees. This deployment model will facilitate greater adoption
of TREAT across a broader geographic area.
standalone mental health organizations and large community organizations, such as those
As part of the healthcare ecosystem, HInexts goal is to help mental health patients get their disorders addressed and move them out of
high-cost, acute-care into community- or home-based care, where they can live and function like other members of society. As a business,
TREATs unique value proposition is based on key differentiators, such as scientifically designed,
best-practice diagnosis and screening assessment tools. TREATs screening assessment tools take
the determination of a patients mental condition from being a subjective, personal analysis to
one that is based on objective measures. HInext has spent years researching and refining these
tools with the help of medical experts. Another differentiator of TREAT is its focus on the Recovery
Model the idea that, through a multi-disciplinary treatment plan, a person with behavioral
health issues can achieve a level of recovery that is coordinated, managed and measured.
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proposition is widely accepted and field-proven anywhere, anytime user access; no IT infrastructure for customers to buy and maintain;
HInexts goal is to grow the company as an Ontario-based entity, adding new jobs and new investment in Ontario. At this point, just prior to
full commercialization of TREAT, HInext has 22 staff, with a target of 30. Executive management is grateful for the HTX funding assistance,
particularly because it is difficult to raise money in a secondary, stigmatized, underserved and under-funded niche market such as mental health.
And with TREAT live in numerous provider facilities in the U.S., including a large, nationwide insurance company, HInext has a viable foothold
and has begun to establish credibility in the U.S. market. Completion of the enhancement project will yield a product that is positioned strongly
against any competition and uniquely meets the needs of U.S. mental healthcare providers.
I N V E N T | I N N O VA T E | I N V O I C E
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develops prostate cancer, and one in every 28 dies from the disease. Although advances in early
detection and treatment have dramatically improved survival rates (99%) for those diagnosed with
this disease, the side-effects commonly associated with current treatments can severely undermine
quality of life for survivors. Loss of healthy bladder, bowel and erectile function are often part of the
treatment outcome, along with fear of recurrence and long recovery periods.
Profound Medical has developed a safe, accurate, minimally-invasive and non-surgical treatment
for localized prostate cancer that potentially eliminates complications and long-lasting side-effects.
The treatment uses an innovative Ultrasound Applicator (UA) to ablate an entire prostate gland
from inside the urethra, in just one treatment session. This novel technology, combined with
state-of-the-art MRI image guidance, delivers highly accurate and precise treatment, destroying
cancer while sparing surrounding tissue.
The procedure takes place with the patient inside an MRI scanner, which provides image-guidance
for the UA positioning, treatment planning and live monitoring of the prostate being ablated.
During treatment, the UA is inserted into the prostate and rotated 360 degrees, emitting
ultrasound energy toward the prostate boundary, heating and killing the prostate tissue. Real-time
temperature images from the MRI are used to automatically adjust the energy intensity and rate
of rotation of the UA, resulting in precise conformal targeting of the prostate tissue, while sparing
surrounding structures. The actual ablation takes only about 30 minutes, and early trials show
that subjects are regaining urinary function very quickly.
Following successful completion of a pre-clinical canine study conducted at the University of
Western Ontario, a Phase 1 trial was approved for Canada, U.S. and Germany. The trial is being
conducted at London Health Sciences Centre in Canada and William Beaumont Hospital in the U.S.,
as well as at Heidelberg University Hospital in Germany to facilitate subsequent commercialization.
Partnerships continue to be a key success factor in the development of Profounds technology, which grew out of early work by two scientists
at Sunnybrook Research Institute in Toronto. Of particular note is Torontos York University, which has been very accommodating and flexible
in making its research MRI scanner available at a very reasonable cost for initial concept validation and testing. Siemens Medical has also been
very helpful, providing technical support and facilitating introductions to the German hospitals where trials are taking place. The project is also
benefiting from the ongoing advice and guidance of leading experts in urology and radiology at such prestigious institutions as the Cleveland
Clinic, Vienna University Medical School, Harvard Medical School and Sunnybrook Health Sciences Centre.
In addition to Genesys Capital, the Business Development Bank of Canada and the MaRS Investment Accelerator Fund, HTX has provided
substantial early funding and support for Profound Medical, and management at Profound has been taking full advantage of HTX partnerships
and resources. The firm hopes to provide a return through job creation, the potential for local manufacturing and by helping other emerging
firms learn about clinical trial design, sourcing of complex manufacturing and navigating the FDAs Class 3 approval process. Perhaps most
Following successful completion of the Phase 1 trials in early 2014, a Phase 2 trial of the efficacy of
important of all, Profound is poised to make a ground-breaking contribution to a new standard of care for men with prostate cancer and to
the Trans-Urethral Ultrasound Ablation (TULSA) procedure in treating cancer is expected to begin.
The 30 patients from the Phase 1 study will be enrolled in the Phase 2 trial and monitored for up to
five years to ensure they remain cancer-free.
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I N V E N T | I N N O VA T E | I N V O I C E
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Therapeutic
Monitoring Systems
Therapeutic
Monitoring
Systems
CIMVA technology offers a novel
approach to help me take care
of our institutions critically ill
patients, and I look forward to
its further development and
eventual commercialization.
Dr. Frank Jacono,
Assistant Professor of Medicine,
Division of Pulmonary, Critical
Care & Sleep Medicine, Case
Western Reserve University
School of Medicine, Cleveland
CIMVA consists of two components: 1) the CIMVA Universal software platform, which is the
Currently, critical-care vital signs monitors in hospital intensive care units (ICUs) only have cursory
The first clinical application CIMVA Extubation Advisor helps the care team better determine
analytical capability, and as a result offer little, if any, point-of-care clinical decision support for
when to take patients off mechanical ventilation (by removing their breathing tube) prior to their
physicians and nurses facing difficult decisions. Despite round-the-clock vital signs monitoring for
release from the ICU. In the U.S. alone, 1.4 million ICU patients annually are on ventilation and
the critically ill patient, hospitals commonly resort to a wait and see approach to assess how a
about 15% of these patients fail the extubation procedure, resulting in increased risk of death and
almost $7 billion of avoidable cost. Other CIMVA applications in the development pipeline include
leads to thousands of unnecessary deaths annually, longer hospital stays and billions of dollars
one for assessing the risk a patients will deteriorate rapidly from infection (sepsis), and another
for determining when to decrease the level of sedation in critically ill patients.
Therapeutic Monitoring Systems (TMS) is addressing this critical problem with CIMVA clinical
A key partner for TMS has been the Ottawa Hospital Research Institute, which has been very
decision support (CDS) software that incorporates novel predictive analytics that can determine
supportive and its three associated hospitals have been CIMVA software study sites. Other
noteworthy Canadian and U.S. teaching hospital sites supporting CIMVA testing to date include:
engine for the complex mathematics and predictive analytics; and 2) individual CIMVA clinical
applications running on top of the platform that address specific clinical interventions and
procedures. The CIMVA Universal platform received U.S. FDA clearance in 2013.
St. Michaels Hospital (Toronto), Mount Sinai Hospital (Toronto), London Health Sciences Centre,
CIMVA technology was conceived by TMS founder Dr. Andrew Seeley, a practicing ICU clinician
University of Michigan Hospital, Columbia University in New York City, the Billings Clinic in
and thoracic surgeon at The Ottawa Hospital. Development has been funded by angel and venture
Montana and the University Hospital of Case Western Reserve University in Cleveland.
investors and timely strategic funding from agencies such as the Health Technology Exchange and
the Federal Economic Development Agency. The strategic funding has enabled TMS to leverage
CIMVA Extubation Advisor recently completed a 12-hospital U.S./Canada clinical study involving
700 patients. Comparison of predicted outcomes with the subsequent real-life outcomes showed
that using CIMVA may lead to a 75% reduction in extubation failures. A second study is in the
Using data collected from patient monitors, CIMVA employs complex mathematics to illuminate
planning stages to confirm the results seen in the initial study, and once the results data is
hidden information in patient vital signs and predict the outcome of a patient undertaking a risky
complete, an application will be filed with the FDA for clearance to market CIMVA Extubation
procedure that may result in increased harm and a costly increased length of hospital stay. Presented
to a doctor using a tablet at the patient bedside, CIMVA calculates a risk score that, when used in
combination with other clinical metrics and the care teams judgement and experience, enables
CIMVA will be initially deployed on an OEM basis, as software embedded within monitors, ventilators
better treatment decisions that can improve patient care and cut hospital costs. TMS envisions
and electronic medical records (EMR) systems from leading healthcare product vendors. This will
physicians invoking CIMVA episodic CDS applications similar to the way physicians currently order
give TMS a strong, well-established and far-reaching channel into the marketplace, which, in the
patient lab tests. CIMVA transforms patient data into actionable information for use by doctors
U.S. alone, includes more than 3,500 acute-care hospitals and almost 70,000 ICU beds. In mid-2013,
and nurses at the point-of-care to improve decision-making and the delivery of patient care.
TMS signed a device integration partnership agreement with Cerner Corporation, a leading vendor
of EMR systems to acute-care hospitals.
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Cocoon
Automated
bioreactor systems overcome
living implant production barriers and accelerate
adoption of regenerative medicine
Regenerative medicine the use of cell therapy and tissue engineering to treat trauma and to stop,
and even reverse, the progression of disease is not new, and is becoming increasingly successful
in neurology, cardiology, orthopaedics and numerous other areas.
In orthopaedics, for example, where hip and knee cartilage degeneration leading to joint replacement
has become common, regenerative medicine can be especially effective on two fronts. The
introduction of new cells can stop degeneration by repairing cartilage lesions early, following
detection, thereby delaying or even eliminating the need for full-joint replacement using implants.
Even severe cartilage disease affecting the underlying bone can be successfully treated using
advanced living implant technology incorporating cells and scaffolds to form repair tissue that
The patients entire cell production process, including all inputs (donor cells, reagents, stimulatory
chemicals) and outputs (waste products, resulting new cell population), is managed via the patients
single-use cassette, in which the patients cells are nurtured, grown and directed in terms of their
biological function.
The use of automation and bioreactors not only provides greater control over production, thus
enabling greater cell performance, but also reduces production cost significantly by eliminating
a lot of the manual labour previously required for the production of cells and tissue. Use of small,
portable and relatively inexpensive Cocoon bioreactors also allows cell production to be dispersed
geographically. As a result, the manufacture of living implants can take place closer to the point
of care, thus eliminating transportation problems and related costs associated with a centralized
manufacturing model.
large, multinational regenerative medicine companies that have cell therapy and living implant
products on the market or in development but are struggling with manufacturing scalability.
The Cocoon technology and cell production process is incorporated by those companies into
their manufacturing process.
For example, the Israeli company BrainStorm Cell Therapeutics is using the Cocoon platform to
unlike conventional metal or polymer hip and knee implants that have a limited lifetime.
grow, and enhance the performance of, an expanded population of stem cells that can be used
therapy and living implants, manufacturing is a major barrier to widespread clinical and commercial
adoption. Cell production, which traditionally takes place in a specialized clean-room environment,
is very complicated and expensive. It also requires an extremely capital-intensive infrastructure to
to stop further neurologic degradation for those suffering from ALS (a.k.a. Lou Gehrigs Disease)
clinical areas being addressed by Octane partners include diabetes, blood-related diseases such
as leukemia, and a host of orthopaedic applications.
While all the product development activity on the Cocoon platform is undertaken in-house,
In addition, todays centralized approach to manufacturing cells and implants creates considerable
Octane fosters close collaborations with numerous academic partners, including the Centre for
transportation complexities and cost associated with delivering living implants to the point of care
in a timely fashion.
Excellence for Cell Therapy based at Hpital Maisonneuve-Rosemont in Montreal, the University
manufacturing barriers to the adoption for cell/tissue therapy and living implants.
Cocoon Instrument
of Basel in Switzerland, KU Leuven University in Belgium, the University of Zagreb, the University
of Bristol, and the University of Genoa and the Rizzoli Institute in Italy.
Apart from the obvious clinical benefit of Cocoon technology for patients across Canada and
28
Sterile Cassette
by repairing and re-establishing key neurological processes interrupted by the disease. Other
efficiently make cells in sufficient number typically hundreds of millions to be clinically effective.
With funding assistance from HTX, Kingston, Ontario-based Octane Biotech has overcome these
OCTANE
Bioreactor
Technology
Octanes primary channel to market for the Cocoon platform is through partnerships with
integrates with the surrounding cartilage. These biological solutions avoid further medical intervention,
Although clinical trials throughout the world continue to demonstrate the medical efficacy of cell
Cell Source
Octanes innovative Cocoon bioreactors allow the automated production of large populations of
throughout the world, Octane is also bringing value to Ontario and the local economy in the form
cells and tissue outside of a traditional clean-room facility. The patented Cocoon technology provides
of job creation (the company has grown from eight to 24 employees) and local manufacturing
a complete environment for cell and tissue growth, while protecting the cells from any external
(the firm has recently expanded its production footprint from 17,000 square feet to 50,000).
hazards that may be present due to the bioreactor location. Provision of support resources required
Octane also provides a significant amount of training for summer/co-op students and is involved
to maintain a living environment inside the container is fully automated and software controlled.
Part of the innovation is in the use of bioreactors within a disposable cassette for processing the
Octane has taken Cocoon from functional prototype to a pilot production run of roughly 20
cells and allowing the entry/exit of support resources. The cassette, which sits inside the Cocoon
complete systems that have been successfully tested internationally. The company is currently
preparing its marketing launch package, and plans full commercialization by mid-2014.
Automated Production
of Allograft and
Autograft Implants
Versatile
Automated
Economical
Standardized
I N V E N T | I N N O VA T E | I N V O I C E
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Sensory Technologies
Transitioning to eShift
Transitioning to eShift
1 Nurse
1 Nurse
Southwestern Ontario, for example, hospitalizations for palliative care patients were reduced
from 50% to 2%, which is a significant impact on health system cost as well as patient satisfaction.
In the US, eShift can deliver even greater value, given the higher cost of healthcare. This is especially
true under the recently enacted Accountable Care Act, whereby Accountable Care Organizations
(ACOs) that create efficiency and process improvements that save money for the health system
receive significant incentive bonuses, which is a significant driver of innovation adoption. Using
1 Patient
1 Patient
eShift to reduce expensive hospital stays through better home care allows ACOs and their partners
desire to manage more patients at home and prevent admissions (& re-admissions) is a growing
and necessary trend for health systems. However, home care delivery today follows an extremely
Delegating
Nurse
Delegating
Delegating
Nurse
Nurse
Nurse
Aide
Nurse
Aide
With the continually increasing costs of healthcare, whether from economics or demographics, the
Nurse
Aide
inefficient human resource model. While a hospital may be expensive, it is relatively resource
With this strategy in mind, Sensory Technologies has entered the U.S. through its relationship
efficient because varying levels of medical skill (specialist, GP, nurse, allied health) are available
with Hospice of Michigan (HOM) headquartered in Detroit. HOM is a member of one of the leading
and thus reasonably accessible; community care is extremely inefficient in this manner as one
Accountable Care Organizations in the U.S. HOM, through eShift, is actively pursuing adult patients
professional is generally responsible for the home visit. This inefficiency, coupled with an increasing
with complex care needs, such as Type II diabetes, congestive heart failure or chronic obstructive
shortage of nurses for home care complicates the capacity to deliver home care at lower costs.
pulmonary disease (COPD). Again, the new hybrid home-care team enabled by eShift can manage
those patients better, reducing the risk of hospitalization where the really expensive care kicks in.
Sensory Technologies has worked with the Community Care Access Centre (CCAC) in Southwestern
Case
Physicians Manager
Physicians
Case
Manager
Delegating
Delegating
Nurse
Nurse
Nurse
Aide
Clinical Family
Analytics Portal
Clinical
Analytics
Family
Portal
Visiting
Visiting
Nurse
Nurse
Nurse
Aide
Ontario to look closely at home care in that region. The CCAC, which is responsible for orchestrating
The eShift home care model and software is an ideal fit for groups like HOM and other ACOs, and
home care service providers for the region, was struggling with the problem of insufficient nurses to
Sensory Technologies has used financing from HTX to localize the software for the U.S. and
deliver care, and wanted to figure out how to expand the reach of the nurses it does have within the
international markets. This includes modifications allowing for regional requirements for privacy and security of patient data collected at home,
region. Based on this work, Sensory Technologies created a new clinical service model called eShift
and added functionality to make the eShift application and the mobile client used by the PSWs on their iPhones suitable for use with adult
for treating and managing end-of-life patients at home that optimizes nurse utilization, lowers costs,
complex-care patients.
a company that was primarily focused on developing software to a company that is delivering healthcare technology and services, it will be
(DRN) that directly supervises four personal support workers (PSWs). The DRN manages, mentors and
expanding its current staff of 18 to include technical sales & support, training and quality assurance professionals.
monitors the PSWs during home care visits, in-home patient data-collection and medical tasks. eShift
allows the DRN to work at home or a telemedicine centre with a laptop, and connect to the PSWs via
smartphones and provide constant communication and care while the PSWs visit patients homes.
The service model enabled by eShift better leverages available nurse resources by expanding each
nurses reach by managing multiple PSWs at one time. PSWs are delivering near-nursing level care
under guidance of that specialized and experienced DRN. By using the DRNs skills to remotely guide
any additional interventions required, the capacity to adjust the level of care needed at the bedside
is greatly expanded. This approach allows both DRNs with eShift and visiting nurses to cover many
more patients than compared to existing service models.
This new hybrid home-care team, enabled by eShift, delivers a higher level of complex care
management to considerably more patients. eShift enables higher-acuity patients that could
30
HTX financing has been critical in leveraging the investment of local Angel investors and founders. As Sensory Technologies transitions from
In addition to the HTX financing, Sensory currently has one local angel investor and will be raising more capital with Series A funding, likely
late-2014 or early 2015. This will allow the company to increase internal development, deliver more services within Canada and expand its
reach internationally. This will include securing HIPPA certification in the U.S. by mid-2014, and delivering eShift pilots in the U.K. and France
with leading healthcare organizations from each country.
The eShift software is a fully hosted, Web-based application based on the Software-as-a-Service (SaaS) delivery model in which customers pay a
monthly subscription fee to access the application via the Internet, using any standard Web browser. For Canadian customers, the application is
hosted at a third-party datacentre site in Ontario to ensure patient data remains within Canada; similarly for HOM, eShift is hosted at a secure
datacentre in Detroit to ensure clinical data generated or accessed within the U.S. stays within the borders.
Overall, Sensory Technologies, through the development of eShift, is a good example of the application of technology and service innovation
to transform care and deliver better service at lower cost.
I N V E N T | I N N O VA T E | I N V O I C E
31
demonstrate value for money and comparative effectiveness is increasing evidentiary requirements on manufacturers, as more and more
In 2012, purchases of medical technology by Canadian healthcare providers were ~$7B, of which ~$5B was imported and only ~$2B
approach to consolidate regulatory, reimbursement and HTA requirements into a single integrated pre-market process for Ontario. What is
was met by Canadian suppliers. In addition, Canadian companies exported ~$2.3B, mostly to the slow-growing US market. Canada
needed is an integrated, strategic approach to evidence development across multiple foreign markets.
represents only about 2% of the global medtech market, but we perform on the order of 3-7% of global medtech clinical trials, and
are the 3-5th ranked globally in medical research productivity. Canada has about the same domestic medtech revenue per capita as
France and the UK, about 20% less than Italy, but only 1/3rd as productive as Germany and the US, with Switzerland a startling 11 times
The Harmony Project, led by HTX in collaboration with MaRS EXCITE, is the first step in developing a process and related content to assist
more productive! A large factor in this is that the Ontario health care system, like those of other Canadian provinces, is not a leading
medtech companies in anticipating and simultaneously addressing regulatory, reimbursement and HTA evidentiary requirements for
adopter of innovation. The implications of this are critical to Canadian medtech success:
multiple jurisdictions and payers. Harmonys strategic approach is intended to reduce medtech product time-to-market, reduce investor
risk, eliminate redundant evidence generation and speed product adoption. Although isolated components of this concept have been
We are investing in medical research, but not realizing the benefits from that research
in terms of Canadian company domestic sales, job growth and exports.
Our domestic market must become more strategic for Canadian medtech companies,
providing benefits to Canadian patients and early revenue to companies.
Canadian medtech companies MUST aim to increase their focus into global markets,
especially to high-growth markets such as Korea, China, India and Brazil.
HTXs tag-line is Invent, Innovate, Invoice. HTXs early evolution focused on Invention and Innovation; Now, increasingly HTX is building
capacity for companies to pursue International Invoices. Here are several initiatives that HTX has either led or actively participated in
over the past year, that will help Ontario companies reduce the risk, cost and time to access both domestic and foreign markets.
developed in select medtech and biopharma eco-systems, to our knowledge, there are no companies currently offering the integrated
scope and value proposition of the proposed Harmony Methodology. Harmony will be a worlds first, and has received extremely positive
reception from the medtech industry to-date.
The Project
Through a Request for Qualifications (RFQ) and Request for Proposals (RFP) process, several highly qualified global market access
specialists were identified for the purposes of Harmony. A combination of an internal due diligence process with support from an
international Advisory Board, led to the retention of Hull Associates a global medtech consultancy, as a key partner for HTX in the
development of the Harmony Methodology.
Harmony will focus on key markets of interest to the medtech community Canada, US, UK, France, Germany and Australia. Using
a combined pathway and case-study based approach, Harmony is identifying regulatory, reimbursement and HTA requirements for
a cross-section of medical devices, and optimal evidentiary coverage across multiple target markets.
Harmonys goal is to identify areas of similarities and differences in the commercialization pathway of medical devices across the target
markets, providing end-users with a practical and heuristic based approach in developing and planning their market access strategy.
Additionally, through collaboration and partnerships, Harmony will provide insight, education, and connectivity for medical device
innovators and enable expedited access to key international resources and individuals versed in market access. HTX anticipates
launching a web-accessible Harmony collaboration service in late 2014.
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33
A critical milestone for medtech companies that are seeking to expand into international
markets, is establishing sound relationships with key individuals within local settings.
Through the Soft Landing Program, HTX offers an international registry of partners in
specific geographic areas that can deliver the services required to reduce the time, cost and
risk of market entry and/or provide collaboration opportunities for Ontario-based companies.
Canada, and Ontario are rightfully proud of their world-class levels of medical
research funding a fundamental input to global medical technology innovation.
Canada represents only 1.5-4% of the global market for various medical
As a component of Harmony, the HTX led Soft Landing Program is designed for small and medium enterprises (SMEs) seeking assistance with
technology sectors, yet we perform a strong 3-7% of global clinical trials in those
all, or a subset of regulatory, reimbursement and HTA compliance, corporate representation, manufacturing and clinical research, sales and post
sectors. Canada is one of the world leaders in medical research, and Ontario
market support, within their priority foreign markets. The program is aimed at decreasing the cost and risk associated with premature pursuit
of foreign markets, as well as minimize the burden and challenge of identifying the optimal commercialization pathway in unfamiliar regions.
HTX envisions that the Soft Landing Program will also provide reciprocal resources and bilateral introductions to the Canadian market for
HTX is very pleased to have played a key role in several initiatives, which will
fundamentally change the dialogue between the health system, research, industry,
was the first initiative arising several years ago from the Open-For-Business
process between the Ontario Government and the Medtech industry. The second
Access to accurate data on the number and type of medtech companies and entities in Canada, along with other industry statistics, is critical for
aligning innovation and import/export opportunities with companies that can use them. In addition, a strong need exists to increase connectivity
between researchers, customers, collaborators, suppliers and talent at a global scale. Over 20 medtech databases have been created in Canada
within the last decade to address subsets of this overall challenge however, all suffer from single-organization mandates, limited data sets, and
Services and Ontario Buys, seeking to reform the procurement process for
This year, HTX in conjunction with key Canadian medtech ecosystem partners, led the
development and establishment of a national, shared, online registry containing all identified
players within Canadas medtech ecosystem. Medtech RISE Registry of Innovators, Suppliers
and Exporters, is accessible online and provides the most up-to-date portrayal of Canadas
medtech ecosystem. Medtech RISE is maintained on a cloud-based platform provided by
Biotechgate of Switzerland, a company operating similar databases for BIOTECanada, Life
Sciences Ontario, and many of the worlds leading medical technology clusters. To support
the growth of our medical and assistive technology industry, Medtech RISE provides a
platform to monitor the growth, trends, and needs of a constantly changing medtech
market, and exposes Canadian medtech companies to the rest of the world.
dialogue on priorities and technical feasibility occurs early and often in the
evolution of medical technologies.
Most recently, the Ontario Government has created the Ontario Health Innovation
Council (OHIC), representing Government, the health system, and industry, with a
goal of transforming Ontario into one of the leading adopters of beneficial health
technology. Virtually all of HTXs past and planned programs align with OHICs
There are currently over 2500 entities that have been identified through this collaborative endeavour, ranging from medtech manufacturers
and distributors to research and government organizations, investors and service providers. Over the next twelve months, combined efforts of
HTX and its partners will foster continued expansion of this iterative database, making it a robust and comprehensive tool of high value to the
local, national and international medtech community. Medtech RISE is accessible through the HTX website as well as through partner websites.
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35
MaRS
Mount Sinai Hospital
Ontario Legislature
The Hospital for Sick Children
Toronto General Hospital
Womens College Hospital
University of Toronto
2013
Auditors responsibility
Our responsibility is to express an opinion on the summary financial statements based on our procedures, which were
conducted in accordance with Canadian Auditing Standard 810, Engagements to Report on Summary Financial Statements.
Revenue
2013
2012
$ 4,844,906
4,000
42
$ 3,462,171
10,000
9
4,848,948
3,472,180
3,643,516
490,423
339,485
332,807
40,512
2,192,854
463,076
437,690
313,851
69,071
4,846,743
3,476,542
2,205
$ (4,362)
Opinion
In our opinion, the summary financial statements derived from the audited financial statements of htx.ca The Health
Technology Exchange as at March 31, 2013, March 31, 2012 and April 1, 2011 are a fair summary of those financial
statements, in accordance with Canadian accounting standards for not-for-profit organizations.
Chartered Accountants, Licensed Public Accountants | Toronto, Canada | August 30, 2013
Grant Thornton LLP | Suite 200 | 15 Allstate Parkway | Markham | ON | L3R 5B4 | T +1 416 366 0100 | F +1 905 475 8906 | www.GrantThornton.ca
2
I N V E N T | I N N O VA T E | I N V O I C E
2013
Invested in property
Total
and equipment Unrestricted
Balance, beginning of year
$ 183,098
$ 94,628
$ 88,470
2,205
(40,512)
42,717
1,405
(1,405)
$ 185,303
$ 55,521
$ 129,782
2012
Invested in
Total
equipment Unrestricted
Current
Cash
Accounts receivable
Prepaids
Contributions receivable
$ 184,337
32,191
5,792
717,489
543,161
1,687,611
939,809
55,521
94,628
108,895
$ 598,682
$ 1,782,239
$ 1,048,704
$ 106,089
307,290
$ 95,932
302,065
1,201,144
$ 79,028
302,065
480,151
413,379
1,599,141
861,244
55,521
129,782
94,628
88,470
98,986
88,474
185,303
183,098
187,460
$ 598,682
$ 1,782,239
$ 1,048,704
$ 460,363
69,350
13,448
$ 1,649,121
29,214
9,276
LIABILITIES
Current
$ 187,460
$ 98,986
$ 88,474
(4,362)
(59,162)
54,800
54,804
(54,804)
$ 183,098
$ 94,628
$ 88,470
Net assets
ASSETS
(Note 2)
Invested in equipment
Unrestricted
See accompanying notes to the financial statements.
I N V E N T | I N N O VA T E | I N V O I C E
2013
Increase (decrease) in cash
2012
Operating
Excess (deficiency) of revenue over expenses
Items not affecting cash
Change in non-cash working capital items
$ 2,205
40,512
(1,230,070)
$ (4,362)
59,162
1,464,788
(1,187,353)
1,519,588
Investing
Purchase of property and equipment
(1,405)
(54,804)
(1,188,758)
1,464,784
Cash
Beginning of years
End of years
1,649,121
184,337
$ 460,363
$ 1,649,121
The information selected by management for presentation in the summary financial statements has been identified as being the
most pertinent and useful financial data for inclusion in the htx.ca The Health Technology Exchange annual report.
Audited financial statements are available upon request from management of htx.ca The Health Technology Exchange.
I N V E N T | I N N O VA T E | I N V O I C E