Home-based health care: Is it science fiction, or a necessary future?

By Michael Oliveira-Associated Press Saturday, May 29, 2024

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Once upon a time, the idea of purchasing an inexpensive off-the-shelf product to test for pregnancy, or the level of glucose in blood, would have seemed far-fetched.

So is it unrealistic to imagine sitting in front of a computer at home and being diagnosed for diseases, perhaps by blowing into a device or electronically submitting test results from a droplet of blood?

It's not for experts who gathered recently at a conference organized by the Ontario Centres of Excellence to discuss the future of so-called individualized health care.

They said governments should be investing in making Canada a leader in the field, which will grow exponentially as the baby boomer population ages.

"Personalized medicine to me means empowering the patients and their families to do lots of things that are happening in hospitals by doctors and nurses, and doing that reduces the cost and relaxes the patients and their family," said Dr. Tofy Mussivand, CEO of the Medical Devices Innovation Institute and director of the Cardiovascular Devices Program at the University of Ottawa.

"Unfortunately, Canada is not doing very well, we are way behind everybody else. We are net users rather than net exporters of medical devices and hopefully this situation will be changed."

Canadian companies have become technological innovators — Research in Motion with its BlackBerry stands out as one of the biggest examples — and there's no reason why others can't become world famous for health-care innovation, experts say.

But one of the biggest barriers is access to capital, both from governments and the private sector, said Spartan Bioscience founder Dr. Paul Lem, who won an award at the conference for best young innovator from the Ontario government.

"How much was the auto bailout? How come we aren't putting in even a fraction of that into the medical device industry, which I think most experts will acknowledge is going to be driving all the high-value jobs for the next 20 to 30 years," Lam said.

"Why does it take so much capital? When we look at the history of medical innovations it takes a long time for innovations to diffuse out into the marketplace.

"That means you have to be funding a lot of sales and marketing and a lot of development to get to that position. These things take time, there's no fast solutions."

The process and cost of getting products commercialized is hindered by Canada's tough regulatory system, which has more hurdles than other countries, said Andy Hind of Ascent Consulting.

"The regulatory landscape here in Canada is actually holding the market back. There are technologies ... that are being used first in other countries because of the regulatory issues," he said.

"And this is being raised with Health Canada, yes they are listening, they want to introduce smart regulation, but I've been hearing that for the past two years and I don't see a lot of progress."

Health Canada, meanwhile, was not able to find an expert to comment on the issue.

Hind said it's not science fiction to posit that health care will one day be based in people's homes and added it's already happening. And many of the technologies involved are not "rocket science," he added.

"When we push health care down to ... (going) into the patient's own home and getting patients maybe in the future doing their own screening — these technologies are relatively simple and there are pilots going on in other countries," he said.

"For example, with a simple telemetry technology a patient who's on a particular treatment regime can go home, because many patients don't like hospitals. So they would rather go home and they can be monitored in the home with a relatively simple keypad that sends data back."

Mussivand added it would be helpful if regulations were harmonized with other countries.

"If a gadget is good for heart disease, let's say in Europe or in the U.S., I don't think we should have self-made Canadian standards to test that again," he said.

"If it's helping the patient in the U.S., why don't we use the same thing, at no cost to us."

While tough regulations are a barrier, it does at least help prepare a company to take its product to the rest of the world, said Tony Mason of AJM Technology Consulting.

"We've got a tough regulatory system here but if you can get through the Canadian regulations you can do it anywhere in the world — we're basically set up for being an exporting industry," Mason said.

"We've got lots of good basic research, we just need dollars from the politicians to do the commercialization and take it to the world."

Lem's product is a desktop on-demand DNA analyzer for infectious diseases, human genetic testing, food safety and water testing, which he hopes will revolutionize the industry.

"When you want your results, you can get it. Right now the whole DNA industry is characterized by mainframe DNA analyzers at major hospitals and tertiary-care centres," he said.

"If you walk into your doctor's office, the doctor will take a sample from you, it gets shipped to a hospital, cued up in a batch and then you have to wait days or weeks to get your result back.

"The same way that mainframe computers went to desktop computers, we're on the verge of mainframe DNA analyzers going to desktop DNA analyzers. The goal of it is to improve patient outcomes by giving them faster test results."

He said a big future for individualized health care will be in helping to determine the right diagnosis and treatment for an individual, rather than following a one-size-fits-all approach.

"Right now we have blockbuster drugs that are given to everyone — things like Lipitor or all those drugs from Merck and Pfizer — but we know ... 20 to 30 or up to 50 per cent of the patients are non-responders and that's costing our health-care system a lot of money," Lem said.

"We're going to need diagnostic solutions that can actually pinpoint who's going to respond to those drugs, it's going to drive that whole push to individualized health care."

Mussivand said he's involved with researching how breath can be analyzed instead of taking blood, which could be done "painlessly, inexpensively and outside of hospitals."

"We know that people with some diseases have different chemicals in their body and one area we could get that chemical easily detected is in breath and or saliva," he said.

"I hope that technology stays in Canada and is developed in Canada and is exported worldwide (unlike) other technologies that were developed in Canada — many of them — and are right now being sold from other countries including (the U.S) and others in Europe."

Hind said governments and investors need patience since the technologies may take a long time to develop. But the rewards could be great.

"This is a global megatrend," he said, "the future vision of a patient doing their own screening from home using the Internet, certainly some people are doing that today but I think we're many years from that becoming the norm.

"But it's important to hold that as a vision."

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