Mike recently chaired an event for UK companies to explore the opportunities for health information technology companies in Canada. Sponsored by UK Trade and Investment, GLE London, and the Canadian High Commission, the event attracted a group of firms with expertise in this sector, to hear presentations from EMIS and RIM and also learn about R&D tax credits, FP7 opportunities and partnering opportunities that are often not exploited.
Opportunities abound in Canada as it seeks to enhance the uptake of information technology in healthcare. Canadian physicians have a low adoption rate of office-based clinical systems, while connectivity between hospitals and primary care is not well developed. The focus in Canada has seen public investment, mainly linked to InfoWay, being poured into hospitals systems, with very little actually where the bulk of clinical encounters occur, namely in primary care. Slow adoption of electronic prescribing systems, coupled with often weak and poorly defined provincial electronic health record implementation strategies suggest that market entry opportunities lie in bringing order out of chaos and demonstrating clear benefits for clinician adoption. The companies attending this event had that experience and could bring this level of structure to the market.
The partitioning of health markets into provincial systems means market entry strategies must pay particular attention to provincial characteristics and objectives, and incentives, such as tax credits, but also links to provincial infrastructure and innovation opportunities. There are pros and cons to each provincial system from a market entry strategy where the Alberta system has clearly centralised to Ontario with a purchaser/provider split and major reform underway in Quebec. There are also opportunities in specific market segments such as military health, prison health, workplace health and aboriginal health, which are frequently ignored as firms tend to focus on the publicly funded system as a whole and ignore these specific areas of opportunity and which offer market entry. Working with smaller Maritime provinces for instance offers scalable opportunities.
In addition, Canada’s position next to the US offers firms access through NAFTA, to take advantage of the huge stimulus in healthcare technology that is linked to health reform in the US; providers are early adopters and invest in technologies, including clinical systems so there are market-based opportunities around, for instance, clinical decision-support systems.
My own presentation focused on the opportunities working with Canadian academic health science centres [AHSC], which anchor provincial specialist service delivery, research and professional training. Since they combine research, teaching and service delivery, they offer partnering opportunities across a wide range of areas, and have sufficient commercial freedom to engage in alpha or beta partnering as well co-investment with start-ups. While many are still tied to the traditional technology transfer or licensing model, other ways of structuring deals are available. They are valuable sources of new technologies for early stage investment, and with a relatively small early stage health investment community, the AHSCs are always looking for new people to have commercial discussions with. There is considerable interest by the federal government to ensure that early stage firms do stay in Canada so jobs and opportunities stay domestic, rather than being exported mainly to the US. But risk aversion and apparent shortage of second round financing sees many firms find their future with US investors. The removal, though, of disincentives in the income tax act which made life overly complicated for investors (similar to disincentives used in Australia) by the current government may encourage investors to feel more relaxed about the income tax regime.
In June, Mike worked with colleagues in Brussels to develop a range of innovative research and commercial development programmes in the biotechnology, food and agriculture sectors through a research brokerage event hosted by ERRIN.
The KBBE programme — Knowledge-based BioEconomy — is a European Commission programme focused on the food, agriculture, fisheries, biotechnology and oceans. Partnering opportunities for SMEs lie in a number of areas, as some aspects of the call offer specific opportunities to firms in North America, or India for instance. Up to 50% of the call requires SME participation, and they are elegible for 25% of the funding in those programmes.
There were few SMEs at the event, while many universities sent representatives, rather than research principals so brokering opportunities were limited. However, SMEs in this sector should take note of this programme especially firms outside the EU as this offers one way to get into the EU market.
Commercially-minded higher education institutions in Europe are few, given the levels of assured public funding they receive, but noteworthy commercially partnering can be had with institutions from countries that have prioritised this such as the UK, Sweden, Denmark, Finland, Netherlands, Germany, Hungary and Poland for instance. Other countries offer many potentially beneficial relationships, but SMEs may find state bureaucracies difficult, ownership of relevant IP being mainly public sector with little incentive to commercialise, or universities unsophisticated in structuring commercial relationships with industry.
Recent research from Toronto-based The Impact Group has identified key determinants why early stage and start up research and development companies fail. I attended a small group briefing in London by one of the lead researchers, Dr Jeffrey Crelinsten, and which offered an opportunity to consider wider implications of their findings.
Key factors identified for failure included:
- no revenue from any customers, failure to identify or engage with customers
- misreading markets, either overly optimistic market metrics or weak/ineffective market entry strategies
- product not needed or failed to identify clear applications
- longer than expected research/development phase
- lack of skilled management team and poor company governance, and lack of business experience
- no sense of urgency, and
- greed.
Health and Art is an area of research and development that offers considerable opportunity to engage patients in new therapeutic activities. We need to learn more, though, about what does and does not work. Attending a recent presentation, I learned about genomics research focused on whether there was any genetic basis to musical talent. Research on this is underway in London.
A very successful innovation workshop was held to identify opportunities in pharmacy. Fresh thinking and a structured approach to innovation development for hospital pharmacy produced a number of strategic opportunities as well as at least one quick win (i.e. feasible in the short term).
Areas where innovation opportunities were identified included:
- reducing or eliminating duplicate ordering of medicines from the wards, which produces considerable medicines waste when patients are discharged
- improving the ability of patients to manage their own medicines regime, with support programmes, and with the end goal to reduce medicines waste from patients not completing the course of medication, one outcome of which can be recurrence or hospital readmission
- improving the market entry process for new medicines.
When will we build the last hospital? Probably around 2025! I recently co-chaired this conference, Hospital of the Future, hosted by ERRIN in Brussels. Here is the briefing paper.
Mike spoke at Advancia in Paris on 22 February on challenges facing entrepreneurs, with a particular emphasis on healthcare. Healthcare faces many challenges, but perhaps the greatest is how to deal with the future: the impact on health from climate change, demography, food production, and technology. Email Mike if you want a copy of the slide presentation.
Mike recently discussed commercialisation of agricultural innovation in Canada. There are real problems in this sector, not just how to feed the future and changing dietary patterns. Agricultural innovation tends to focus on new seed varieties as these can be commercialised, but we also need to look at a whole range of other issues, but research funding for soil science for instance, is small compared to other areas.
Mike was recently interviewed on his views on e-health by Euractiv in Brussels: read the interview here
Dr Tremblay supported the development of E-Health for Democratic Participation and Social Inclusion in the Regions, Congress of Local and Regional Authorities of the Council of Europe, Receommendation (2007)212, adopted 27 September 2007.