Several years ago, Andrew Murphy, a former chemical engineer, visited St James’s Hospital in Dublin as part of an MBA he was completing and stumbled onto a problem.
Used to solving manufacturing issues, he was asked his opinion on the paper trail hospitals had to deal with when it came to processing medical-insurance claims. Murphy then sketched out a map for medical staff.
Today, his company Sláinte Healthcare processes €1bn a year worth of claims across 40 healthcare sites in Ireland. The company’s latest technology called Vitro is helping doctors and nurses replace paper forms with smartphones and tablet computers.
Murphy is one of a growing number of Irish technology entrepreneurs whose software, hardware and therapeutic solutions are transforming how hospitals deliver treatment and how patients receive treatment.
Driven largely by multinationals yet bolstered by a growing community of start-ups, Ireland’s medical-devices industry exports €6bn worth of goods annually and is carving a niche out of a global industry worth US$280bn.
The country has arguably the largest concentration of med-tech companies outside of the US state of Minnesota, the world’s Silicon Valley for medical technology.
There are plenty of Irish companies that have achieved global success and developed useful technologies.
Examples of innovation developed locally include a tumour-zapping device by Cork firm MitaMed, technologies for diagnosing conditions on the spot by Dublin-based Biosensia, technologies for caring for older people by Dublin firm Sensormind, and technology for diagnosing cancer at an early stage by Dublin-based Cervassist.
Examples of Irish med-tech companies that have achieved global success include Lincor Systems, which just received €7.3m in investment from Edison Ventures for its bedside ICT systems for doctors and patients, Oneview Healthcare, which is deploying patient care systems at three hospitals in San Francisco, California, and wearable tech player Shimmer, which has won a €10m contract with US company Emerge Diagnostics to provide technology to improve the management of occupational injury claims.
Recently, Ireland’s reputation as a hub for medical-device technology came under the spotlight. Shimmer, Syncrophi, Nurse Buddy, Sláinte Healthcare, Kinesis Healthcare, Full Health Medical, and Ranesys Patient Handover presented their innovations for reforming healthcare through technology at this year’s National Healthcare Conference in Dublin.
Paul Doherty, vice-president of sales at Shimmer, said the company has developed wearable wireless sensors to harvest a range of movement and biophysical data about the wearer, thus providing patient information for a GP.
"Our expectation is that in the future GPs will be prescribing these devices to their patients to gather the right information on their lifestyle and ultimately better their lives," Doherty added.
Shimmer emerged in 2008, when it spun out of research that Ben Kuris, now Shimmer’s CTO, had been developing at Intel.
“We’ve grown organically since then and we’ve experienced great success in the enterprise space, as well as in colleges and universities. The deal with Emerge Diagnostics is our first big contract and we’re on the cusp of achieving rapid scalability," Doherty said.
Shimmer employs 15 people at its Dublin office, as well as three people at its R&D operation in Boston, Massachusetts.
The company is now working on a rehabilitation system for patients through Telefónica in Copenhagen.
“The idea is that patients who need physiotherapy, for example, don’t need to be travelling across cities to see their doctors. The doctors can remotely monitor their progress and prescribe new exercises, for example."
Wearable tech for healthcare
Also focusing on opportunities in wearable tech for the medical market is Galway-based Syncrophi. The company has developed devices similar in weight to an iPhone that can be placed on patients in A&E, enabling nurses and doctors to monitor a patient’s vital signs more remotely.
“The unit knows your location and if your blood pressure plummets the nurse will be able to find you," said David Toohey, CEO of Syncrophi.
Toohey said Syncrophi’s technology provides extra eyes and ears for very busy frontline carers. Ireland has 5,000 fewer nurses since 2009, he added.
“There has been a 15pc cut in staff numbers at a time when admissions have never been higher. Plus there is the growing absence of community nursing and often GPs have no option but to send patients home," said Toohey.
Toohey, who previously ran Boston Scientific’s 2,500-strong Galway operation, said the medical devices complement the country’s national early warning score system, which is mostly paper-based and in need of digitisation.
“Our software renders this paperless and reduces errors by 82pc," Toohey said.
Syncrophi’s units are being trialled in hospitals in Galway, Portlaoise and Northern Ireland.
Shift in attitude
Toohey said the issue until now in terms of indigenous companies helping to solve the health system’s problems has been that the HSE and Department of Health haven’t been buying innovation from indigenous med-tech companies, yet that attitude is changing.
“There is so much pressure on now to do something and there is appetite for change. Frontline scoring has emphasised this. The tie is right."
For Murphy, every health system in the world is under pressure. Sláinte’s new electronic communications system for X-rays and other previously paper-based systems is being used by hospitals in Brazil, Australia, the Middle East and more than 120 hospitals in the US.
“In Ireland, the typical challenge is patient charts and hospitals need a smooth-running patient administration system that tracks patients between beds and allows medical workers to track this information on computers, tablets or smartphones," Murphy said.
The technology has all the flexibility healthcare workers associate with paper, but a lot of fields can be pre-completed with data from elsewhere, he added.
“Ask any doctor or nurse in Ireland today and they’ll tell you they are spending a lot of time trying to manage information, which is mostly on paper."
Sláinte’s Vitro technology is being trialled by the cystic fibrosis department at Cork University Hospital. Murphy said accountability is built into the system in terms of electronic signatures that meet EU directives.
To achieve his vision, Murphy remortgaged his house and the risk paid off – the company now employs 100 people and will be hiring a further 60 people in Ireland in the coming year.
Funding for med-tech companies
One main challenge facing local med-tech players has been the availability of a local venture-capital scene that understands the challenges these companies face.
Unlike most technology start-ups, these companies have to endure a battery of regulatory approvals before they can be deployed or tested in the market, a surefire way to soak up dwindling funds.
“What we desperately need is a functioning venture-capital sector that has healthcare expertise and understands the risks and challenges," said Toohey. "If we were doing this all over again, we would have begun our funding journey in London."
Help may be at hand. In the coming week, more than 30 venture-capital firms with more than €6bn in funds under management will meet in Dublin as part of the IN3 Medical Devices 360° conference to explore opportunities to invest in the Irish med-tech sector.
Peter Sandys is managing partner of Seroba Kernel, the Dublin-based venture-capital firm with €95m in funds under management. He said regulatory uncertainty and unforeseen consequences of Obamacare are driving US innovation overseas, to the benefit of Ireland.
“We focus mainly on medical-device technology and drugs rather than digital health, but certainly one of the challenges is that it is a very highly regulated industry," Sandys said.
There are massive opportunities for Ireland, he added. In the US, the FDA (Food and Drug Administration) has been less predictable in awarding approval for products.
In Europe, there is a focus on making sure the device is safe and getting clinicians to say whether they want to use it or not. So the barriers are lower in Europe. In the US it’s all about comparable effectiveness to what’s on the market, Sandys said.
“In Europe, you can run trials with key industry leaders and if they adopt it, it takes off," Sandys added. "It’s a different model but it allows companies to get to market more cheaply and more predictably."
Innovation, as a result, is flooding out of the US and into Europe, and now Europe tends to be the first port of call for innovative US med-tech companies and investors.
“It generally makes sense to have European operations and Ireland is a great place (for) that," said Sandys.
For early stage companies locating in Ireland or already here, the country’s legacy of manufacturing and the wealth of experience of people in the medical-technology industry offers a chance of early success, he added.
“If one of these companies could be successful with its products, you’re talking 700 new jobs at a minimum," Sandys said.
A version of this article appeared in The Sunday Times on 6 April