There’s a growing trend across medtech to reduce hospital visits for patients by empowering them to manage more of their own care.
Medtech companies based in Ireland are at the forefront of this movement which covers the full gamut of care.
Few exemplify this approach more than SymPhysis Medical. The Galway-based company, which has raised €9.2 million in funding to date, is focused on end-of-life care for terminally ill cancer patients.
The business, cofounded by Michelle Tierney and Tim Jones in 2018, is enabling cancer patients to spend more of their final months away from hospitals.
RM Block
“We treat fluid in the chest that occurs in late-stage cancers,” says Tierney. “The amount of fluid gets knocked out of whack. Healthy people have a few teaspoons of liquid in their chest cavity. With lung cancer and breast cancer, litres and litres build up,”
“That puts a lot of pressure on the diaphragm and the lungs, giving patients severe breathlessness and pain. We’ve developed a digital drainage device that gets placed in the hospital and the patient goes home with a discrete port that they can use.”
The device enables the patient to manage fluid drainage at home with a monitor informing them of when they need to act. This device doesn’t just reduce the amount of time spent in hospitals, it’s also helping gather more data for doctors.
“The movement from the hospital to the home has been a challenge that a lot of people have been focused on for a long time. A lot of medtech companies have it as their mission to give the patient the option to stay at home more,” says Jones.
“We’ve seen more technologies developed over the last few years that have enabled that more. Whether that’s a device on the body, a monitoring app or some form of communication, the focus is on meeting the patient’s needs.”
Fire1 is taking a similar approach towards treatment of heart failure. The Dublin-based business has raised $213 million (€181 million) to date for its treatment, which is designed to make life management easier for patients.
“We’re focused on heart failure. It’s the biggest cause of hospitalisation in Europe and the US. One in five of us will get it and, in the US, $70 billion is spent on it with most of that on hospitalisation,” says Conor Hanley, chief executive of Fire1.
There are many therapies, including a diuretic which requires appropriate management. The key challenge is managing blood volume. Too much or too little can lead to hospitalisation so knowing how often to take treatments can be tricky.
This leads to more need to be assessed directly by clinicians. The device developed by Fire1 aims to make it easier for the patient to monitor their blood volume, and with it their medication dosage.
“Most of your blood is stored in your veins. Our monitor can measure your individual status to know how close you are to a hospitalisation,” says Hanley.
“It’s physician-directed self-management to allow the patient to adjust their medication under the guidance of the clinical centre.”
Even treatments heavily associated in the public psyche with in-hospital visits are moving more towards home-care. Vantive, which employs 1,500 people in Ireland, is focused on enabling more home-based dialysis.
“Our goal is to help patients live longer, fuller lives, and we believe empowerment and flexibility throughout therapy is key to achieving this while making care more sustainable for patients. This is particularly relevant for dialysis care,” says James Morrison, vice-president of integrated supply chain at Vantive.
“Today, access to dialysis varies across regions, and patients on dialysis often face physical and emotional burdens throughout the therapy process. That’s why we’re working to expand access to therapy options that allow people to receive the dialysis care they need where they need it, including at home. Importantly, independence does not mean patients are in it alone.”
The push towards home care covers all stakeholders in the healthcare system, most notably the patients.
“The main benefit is quality of life. With palliative care, it’s one of the most important things. Even anyone with a chronic condition, however, benefits from being able to manage their care on their own schedule,” says Tierney.
“There’s nothing more frustrating than waiting for something to be done when you can do it yourself. The other benefit of remote monitoring is that more data is being collected, so the patient has more control of their own care with that information readily available to them.”
Hanley says this approach also makes the patient feel like they are being put first rather than having to wait for treatment.
“The current healthcare sector is reactive. The trend is to make it more proactive to support the patients,” he says.
The prevalence of wearable devices for day-to-day fitness has helped make patients more aware of how access to data can give them with healthcare, according to Hanley.
“Outcomes can be better. Patients tend to be in the dark as to what their status is. Wearable devices like Fitbits have shown people want to know how to live better. This is taking it to the next level, helping people who are sick avoid hospitalisation,” he says.
“That whole trend of people being familiar with data and using it to change their lifestyles has improved buy-in from both the healthcare systems and the patients.”
Morrison expects the results to be enormous for patients, with time spent in hospital reducing substantially. That, naturally, will also free up resources for health service providers.
“Home dialysis can save patients approximately 624 hours a year at renal centres, and studies show 29 per cent of patients can return to work or education,” he says.
“By supporting patients with home care, we can help reduce the need for hospital beds; providing high-quality care at home helps avoid 45,000 hospital visits a year.”
Therein lies the reason as to why providers and the governments that fund them are prone to supporting more home-based healthcare.
“With healthcare costs soaring in Ireland and systems and healthcare workers stretched thin, we need to provide solutions for patients to better manage their care,” says Morrison.
“Ireland is making progressive moves for patients. The government’s starting to see how home care can save millions while giving patients more say in their treatment, cutting down on costly hospital trips.”
Tierney’s co-founder of SymPhysis, Tim Jones, concurs and says the time saved can lead to better prioritisation within the health service. That, he says, is driving more support for companies developing these types of technologies.
“It helps preserve resources. The time saved means a clinical team can get the information it needs easier while the number of people that need to come in drops. That reduces costs as well as the burden on the staff while also providing better data for the clinicians,” says Jones.
“There’s a lot of support for companies in this space. Enterprise Ireland provides a lot of help for developing patient-centric design and the medtech ecosystem enables that development to be fuelled.”
Hanley expects an increase in the number of medtech companies in Ireland focusing more on solutions designed to reduce time spent in hospitals.
“We’re going to see more of this. There’s a lot of patients living longer with different types of conditions. For that not to overload the current healthcare system, there needs to be a look at how data and empowerment are used to address that,” he says.
“People want empowerment. The triumvirate of healthcare is lower cost, higher quality and better access. I think moving as much care as possible to that lower cost should meet all those needs.”
