UNIVERSITY OF ULSTER:According to those involved, the pioneering venture in connected healthcare in Northern Ireland had its origins with the 'father of emergency medicine', cardiologist Frank Pantridge, who invented the first portable defibrillator and installed it in a Belfast ambulance in 1965

PIONEERING WORK AT the University of Ulster is putting Northern Ireland at the forefront of the fast-expanding “connected health” project. Connected health uses advanced technology to provide remote delivery of healthcare, offering patients easier, more flexible ways to connect with medical staff, and new opportunities to self-manage their own care at home – rather than in a GP surgery or hospital – by using special monitors and sensors.

Prof Jim McLaughlin, director of the Nanotechnology and Integrated Bioengineering Centre (Nibec) at the university’s Jordanstown campus, says the two primary drivers behind the connected health initiative are benefits to the patient and reduced costs to the taxpayer:

“It’s about miniaturising technology, making it mobile, making it smarter – and then putting decisions into the patient’s own hands. Essentially, it’s about improving the pathway from illness to good health.”

It is not the first time Northern Ireland has been at the cutting edge of healthcare innovations. Belfast cardiologist, the late Frank Pantridge became known as the “father of emergency medicine” when he invented the portable defibrillator and installed it in one the city’s ambulances in 1965. The first defibrillator, which weighed 70kg (154lbs) and operated from car batteries, bore little resemblance to today’s smart little gadgets.

But McLaughlin says Nibec had its origins in those early breakthroughs in mobile coronary care: “It demonstrated how effective clinical practice could be achieved through the collaboration of best scientific practice into applied medicine.”

Staff at Nibec, which is one of the leading facilities of its kind in Europe, have pioneered all kinds of advances in medical sensors and instrumentation, bio-materials and diagnostic systems. McLaughlin says the multi-disciplinary nature of the project – with biologists, physicists, engineers and others all coming together to develop ideas – is the key to its success.

“The advances we have made at Nibec have already had a big impact on society through the set up of a range of spin-out companies,” he says.

“First we come up with the idea, then we develop the patents, then we take the technology to an industry or line up with a businessperson, and finally we step back and let someone else run it.”

For example in 1997, HeartSine, an award-winning company offering easy-to-use portable defibrillators was set up in collaboration with Nibec.

The centre was also instrumental in the development of Heartscape Technologies Inc, which markets a breakthrough medical device known as the Prime system, designed to allow more accurate and rapid diagnosis of heart attacks. Prime is a patented, Food and Drug Administration-approved product with an annual US market of approximately $1 billion (€700 million).

Perhaps Nibec’s best-known spin-out is Intelesens, a Belfast-based wireless health monitoring company which recently won the prestigious most promising technology award at the fourth Annual Silicon Valley Technology Leaders Awards.

Intelesens manufactures body-worn vital-sign monitoring devices, which are especially helpful for older people living at home who want to maintain their independence but also have the reassurance of medical support. The person applies patch electrodes, and then a lightweight, battery-powered device is clipped on to the patch and communicates using short range wireless to a static unit in the home such as a phone or a computer. A change in any of the monitored signs triggers the device to send a message to the person’s carer.

“The device monitors heartbeat, blood oxygen, respiratory rate, skin surface temperature and movement – all your vital signs,” says McLaughlin. “It can tell where you are if you fall or have a stroke.”

The idea is to keep the monitoring unobtrusive and low-key, integrated into the user’s personal environment – adapting the technology to the user rather than the other way around. (Simplicity is important: according to Prof Joseph Kvedar, director of the Center for Connected Health at Partners HealthCare and Harvard Medical School in Boston, “things should be iPod-simple and they’re not there yet. It’s never simple enough. We can always strive to make it easier for users.”)

But if you do have to go to hospital for treatment, McLaughlin says that “hopefully the device will also give the clinician the confidence to make the decision to get you home again as soon as possible. This saves money and the patient generally recovers more quickly at home.”

The ability to partner with internationally renowned names within the healthcare field is central to Northern Ireland’s connected health initiative. With this in mind, the European Connected Health Campus, a not-for-profit international initiative that links technology and healthcare to improve patient treatment and ease pressure on scarce resources, was set up in Belfast in 2009 by a team of independent business leaders. It organises meetings and conferences between healthcare professionals, researchers, companies, entrepreneurs, business leaders, policy makers and health ministries.

It is not only Nibec at Jordanstown that is leading the way with initiatives in connected health. The University of Ulster is also a partner in C-tric, the Clinical Translational Research and Innovation Centre, a development facility in the grounds of Altnagelvin Hospital in Derry.

Business development manager Barry Henderson says C-tric’s role is to translate ideas from the bench to the point of care, streamlining developments from the laboratory to the market place, and creating commercial opportunities to develop partnerships between academic researchers, clinical practitioners and industry. Although it only opened two years ago, the centre is thriving, and last year won the cross-Border category of the Irish Times Innovation Awards.

Set up as a joint partnership with the university, the Western Health and Social Care Trust and Derry City Council (with funding for the project provided by Ilex urban regeneration company and Invest Northern Ireland), C-tric is the only facility of its kind in Ireland or Britain. Essentially, it brings healthcare, technology and research under one roof to facilitate the development of innovative products and services.

“We’re a healthcare innovation hub. A clinician may identify an unmet need in their own area, but they may not be aware of the technological advances that may bring solutions to that problem,” says Henderson.

“Likewise, academics may know all about their own research, but they may not know where the need is. And companies need access to academics and clinicians. Because we can pull in all this expertise, we punch above our weight. And in terms of the use of public money, C-tric is a superb case study. We’re also generating intellectual capital, putting Northern Ireland on the map. Basically, we’re a local company developing solutions to global healthcare problems.”

Henderson says one of the ways C-tric sells itself is as an entry point into one of the world’s largest healthcare markets – the United Kingdom’s National Health Service.

“It’s right on our doorstep, and we can facilitate a route into that market.” The range of innovations that C-tric provides is impressive – from drug-dosage monitors to hand hygiene-monitoring systems. The centre also manages a variety of clinical studies in areas such as gestational diabetes and cardiac rehabilitation. Its recently launched “bio-entrepreneur programme” is designed to support entrepreneurs, innovators and start-ups to develop their innovations for better healthcare from prototype, research and testing to clinical validation.

With an increasingly elderly population, the benefits of connected health are more important than ever today.

“From 2000 until 2050, the world’s population, aged 60 and over, will more than triple from 600 million to two billion,” says McLaughlin.

“This demographic change has several implications for public health. Good health is essential for older people to remain independent and to play a part in family and community life.”