Healthcare and Wellness : Innovation + Job News

Last week, Ontario took a step towards digital health with the launch of Akira.

Akira is a mobile app for iOS and Android that was developed by Dustin Walper after his own brush with thyroid cancer left him frustrated and annoyed with the Canadian healthcare system.

After founding and building his previous startup MyPlanet for five years, he felt that this was something he had to do.

“As someone who was busy trying to build a business, anytime you have any kind of medical issue you just want to get it over with,” a task which Walper recalls wasn’t easy to do.

“That was the core frustration that I felt with the health care system.”

Akira costs $9.99 per month and launched officially on Wed., May 18. Walper’s goal with this service was to put a doctor in the pocket of every Canadian.

Several physicians have already signed up to take part in Akira’s mission, enabling them to digitally interact with patients who’ve downloaded the app whenever the patient requires.

While Akira has the potential to lessen the burden on the healthcare system by redirecting non-critical inquiries to a digital service, Walper stresses that in order for Akira to serve its purpose, it shouldn’t be used for medical issues that require a physical examination.

“There are some things that just weren’t appropriate for this kind of service,” he says.

He anticipates however, that this is what Canadian patients need – a fast, reliable way to have their immediate healthcare needs met.

In order to do that, Akira has partnered with another popular Canadian health startup, PopRX. Unlike Akira, PopRX specializes in digitizing the pharmaceutical industry by offering prescription delivery, renewal and inquiries all though an app.

“What’s really important for our type of model is that we want to make healthcare accessible and convenient to everyone,” said Walper. “A big part of that is prescriptions.

PopRx fonuder Dr. Ali Esmail stated that as soon as the platform began allowing for specialists (Akira only supports general practitioners at the moment and Esmail is an ear, nose and throat specialist), he would gladly consider joining the platform.

Esmail goes on to agree with Walper in saying that redirecting non-critical medical issues can potentially reduce the strain on Canada’s medical system.

A lot of those people show up in emergency rooms or wait for hours in walk-in clinics,” said Esmail.

Overall however, he believes that Akira and PopRx share one mission: to bring the benefits of telemedicine to Canadians.

“What PopRx and what Akira are trying to do is provide a much more convenient service.”  

Currently, Akira is not covered under OHIP, though several tech companies have begun offering Akira as part of their employee benefits packages.

While undergoing research on an anticancer drug targeting colorectal cancer cells, researchers at the Princess Margaret Cancer Centre found something surprising. The researchers discovered that the drug can actually trick the cancer stem cells into responding as if they had been infected with a virus, which in turn, limit the cancer cells' ability to multiply.

The findings were published academic journal Cell, and for Dr. Daniel De Carvalho, lead researcher on the project since its start in 2012, the finding is significant as colorectal cancer recurs in 50 percent of patients and is among the top three leading causes of cancer-related deaths. “We work with DNA methylation inhibitors, such as azacitidine and decitabine, both of which affect DNA methylation have already been approved by the FDA for use in myelodysplastic syndrome, a form of blood cancer,” Dr. De Carvalho said. “We are very interested in the ability of epigenetic agents to identify markers that are found mainly on cancer cells. Epigenetic drugs track down cells that have a lot of epigenetic markers, which are more likely to be cancer cells, whereas chemotherapy kills proliferating cells first, regardless of their epigenetic markers and regardless whether they are tumor or normal cells.”

The team found that these DNA methylation inhibitors make cancer cells more likely to attract immune cells, and in a phenomenon he calls ‘viral mimicry’, the drugs then trick the cancer cell to look like a cancer infected cell. “Combining epigenetic therapy with immunotherapy, where the brakes of the immune system are released, will probably improve patient response. We are currently starting trials to test this hypothesis.”

“By targeting colorectal cancer stem cells with a new anticancer agent, Dr. De Carvalho has succeeded in limiting the ability of these cells to grow and maintain tumors,” said Dr. Katie Wright, senior manager of Research Communications at the Canadian Cancer Society, Ontario Division. “This novel approach could potentially complement therapies for more effective treatment of other cancers.”

For 2016, Dr. De Carvalho is excited to continue research and hopes that this basic discovery will eventually improve patient care. “We are continuing this work in multiple fronts. First, by doing clinical trials to evaluate the synergistic effect of epigenetic inhibitors with immunotherapies,” he said. “We are also evaluating the effect of epigenetic therapy on the T cells. T cells are the ‘soldiers’ of the immune system. We want to know whether we can make these soldiers stronger by using epigenetic therapy.”

One of the biggest keys to preventing or treating cancer effectively is rapid detection and diagnosis; for the two of four Canadians that will have cancer in their lifetime, detecting it early can mean the difference between life and death.

Dr. Shana Kelley, a professor from the University of Toronto’s faculty of pharmacy, has discovered a tool to make diagnosis easier. Currently, doctors employ surgical procedures to extract samples from tumors that are then tested to determine the type of cancer a patient has, a process process that is both invasive and time consuming.

In contrast, Kelley has developed an extremely sensitive blood test that uses sensors on a chip to detect cancer mutations. “Dr. Kelley’s new blood test using microchips to detect cancer mutations has the potential to transform cancer screening. Finding cancer before symptoms are noticed greatly increases the chances of successful treatment.” said Dr. Katie Wright, Senior Manager of Research Communications, Canadian Cancer Society, Ontario Division.

The development is based on recent research that show that significant levels of cell-free nucleic acids (cfNAs) are present in the blood of cancer patients, and contain the potential to reveal the mutational spectrum of a tumor without the need for an invasive sampling of the tumor. Currently, conventional means of using these samples requires differentiation between the nucleic acids that originate from healthy cells and the mutated sequences shed by tumor cells, which can take time and is often complicated by excessive handling.

With Kelley’s chip-based technology, the test would not require sample purification, and would be capable of detecting the presence of mutations within 15 minutes. The same day that she published her findings in Nature Chemistry, Xagenic Inc., a molecular diagnostics company developing the lab-free Xagenic X1 platform, announced the exclusive acquisition of this technology.
 

In a collaboration between Toronto-area hospitals, health care professionals and the University of Toronto, students are encouraged to submit ideas for the HealthEDGE initiative, a year-long health care hackathon aimed at improving healthcare delivery. 

“We are all touched by the health system from birth.  And at times we have all experienced moments where we have witnessed snags, frustrations, delays, fundamentally illogical processes or practices, and outdated devices or approaches.” said Joseph Ferenbok, a University of Toronto professor and co-director of the Faculty of Medicine’s Health Innovation HUB (H2i). “But though we may have had these experiences, we are not all in a position to do something about these frustrations.” 

The current call for proposals is the first round of the initiative. A panel of industry experts will curate the submissions and channel them to teams of students with expertise in a variety of disciplines, and the groups that present the most interesting ideas will get at least $10,000 in funding. “The advantage of the HealthEDGE initiative is that it is an on-the-ground attempt to reach out to a variety of people, curate and categorize their experiences into practical challenges that are put in front of creative entrepreneurial minds to generate, develop, test and evaluate potential innovations,” said Ferenbok. “In doing so, we empower people in communities that may not be able to address the issues they identify.”

While the health care system in Canada is notorious for being slow to adopt innovative solutions, Ferenbok said that the fact they are working with hospitals as partners is an advantage. “Not only will some of the challenges come from within the hospital communities, mentorship and development will also be done in coordination with the hospitals, said Ferenbok. “We hope that this type of buy-in will create local champions who are aware of the innovation and act as internal advocates to help improve the chances of adaptation.”

As the boomer population reaches retirement age, the strain on the Canadian healthcare system that will inevitably happen is a much-discussed topic in politics. But the The Champlain Community Care Access Centre,  one of the largest health service providers in eastern Ontario, is tackling the issue head-on. 

The CCAC is launching an innovation centre that it says will help people stay at home longer, better support caregivers, and improve access to home health-care technologies. “Demand for home and community care is growing dramatically -- and the patients we are supporting are sicker than ever before,” said Marc Souganivski, the Champlain CCAC CEO. “The combined growth in patient volumes and rising acuity is an important lever for modernizing the home and community care sector.”

The Centre will work by allowing health care technology developers and vendors to test, evaluate and recommend new technologies with patients and caregivers in real-life situations through its new Impact Centre. Some opportunities that the Centre will pursue include Better monitoring of patients’ ongoing conditions, better tracking of home care services being provided as planned and better access to home care supports and resources. 

“The Champlain CCAC innovation initiative is focused on e-Consumer health solutions that are industry-funded, focus on consumers (patients/caregivers) and include a supportive/social element,” said Souganivski. “There is growing recognition at all levels that technological innovations can help more people stay at home longer, better support caregivers, and improve outcomes.”

As breastfeeding becomes a more popular method for mothers to feed their infants, not much is known about whether or not a breastfeeding mother’s prescription medications adversely affect the child.

Right now, University of Toronto researchers are trying to change that. David Colantio, a professor in the Faculty of Medicine’s Department of Laboratory Medicine and Pathobiology and clinical biochemist at SickKids, and Shinya Ito, from U of T’s Faculty of Pharmacology and Toxicology, and the head of Clinical Pharmacology and Toxicology at SickKids, are working on guidelines to help guide new mothers through the process.

As 60 to 70 per cent of breastfeeding women use some form of medication, Colantio and Ito’s research is looking at over-the-counter drugs, like sleep medication and antihistamines, and prescription for Crohn’s, colitis, arthritis and depression, to see if it can have any effects on children.

Using specialized technology including high pressure liquid chromatography and mass spectrometry, the researchers can accurately measure any drug at very low levels. In a way, this helps the researchers study the effects of certain drugs on nursing mothers, as pharmaceutical companies are not allowed to conduct research on this group.
 
“The reason is one of ethics and likely legal risk. It would be unethical to give nursing mothers a medication/drug that they may not need, exposing both the mother and the infant to both known and unknown side effects,” said Colantio. “The advantage of our research is that we are not prescribing any medications, the participating moms have been prescribed medication by their primary care provider and are concerned about how this may affect their nursing infant.”
 
Once they gather enough data, they plan to develop guidelines within the next two years. In the meantime, they’re providing individual guidance to women who have questions about breastfeeding while taking medication.
 
“We have published a case study demonstrating that a certain medication the mother was prescribed did result in seizures in her nursing infant. We have also presented preliminary data at scientific conferences, which has helped to generate interest in our research,” said Colantio. “Our long-term goal is to publish our results in peer reviewed scientific journals, continue to present our data at scientific conferences and to help draft and publish guidelines to help provide guidance to both physicians and nursing mothers. “
 

In Canada and the United States, 15 million women rely on oral contraceptives to prevent pregnancy — yet one in 10 of these women will become pregnant during their first year on the Pill, mostly because they take it irregularly or forget to take it completely. These statistics demonstrated a need for University of Toronto MASc students Eric Ma and Tony Zhang, and PhD candidate Valentin Peretroukhin, to come up with the idea for Pillsy, a smart pouch to help women consistently take their birth control pills.

The pouch, which is outfitted with sensors, stores the pills and detects if the user has actually taken the pill. The pouch then communicates this to the user’s smartphone via BA luetooth, and doesn’t require any manual input.

Currently, the project is undergoing beta testing, while the student group behind the project will move on to a Kickstarter campaign in 2016.

“We chose Kickstarter as it will provide further market validation as well as increased funding,” says Courtney Smith, a student working on the Pillsy project and an MPH candidate at the Dalla Lana School of Public Health. “Kickstarter is known to be popular among our target demographic of young women and their partners, so this will serve as a cost-effective mechanism for organic advertising.”

While the pouch is being marketed to women who use birth control, eventually the group will expand to other pill markets. “It is definitely our plan to expand to other time-sensitive medications in the future like heart disease medications, especially as new generations of older adults become more and more tech savvy,” says Smith.

 

One of the largest pharmaceutical companies in the world decided to mark World Cancer Day, February 4, with a significant monetary contribution towards finding new ways to combat the deadly disease.

On Wednesday, Merck Canada announced that is donating $7.5-million to the Structural Genomics Consortium (SGC).

The SGC, which is based in the MaRS Discovery District, is a not-for-profit public-private partnership led by the University of Toronto and Oxford University. Its main goal is to promote medical breakthroughs by creating a database of open sourced research that can be accessed by almost any organization or company.

Not to be outdone, the Government of Ontario also announced a significant investment on the same day. The provincial government said it will give the Ontario Institute for Cancer Research (OICR) a four-year, $6.4-million grant to research new ways in which to increase screening rates for colon cancer and to decrease the harm chemotherapy inflicts upon patients, among other things.

To date the provincial government has invested $756.9-million toward cancer research.

“Ontario is proud to support the Ontario Institute for Cancer Research, which is working with key partners on ground-breaking research that is leading to very real benefits for Ontarians fighting cancer,” said Reza Moridi, Ontario's minister of research and innovation, in the press release that followed the announcement. “This investment will help the OICR get their discoveries out of the lab faster, improving both prevention and treatment and making a difference in people’s lives.”

Not a bad day in the fight against cancer.

Source: MaRS and University of Toronto. 
Photo: Courtesy of CNW Group/Merck

Released shortly before the holiday shuffle—and subsequently missed by most people—the Ontario Health Innovation Council (OHIC) Catalyst report lays out six recommendations the province should follow to become a innovative healthcare entity.

The goal of the report's authors was to find ways to improve the quality, speed and delivery of Ontario's healthcare services while also finding ways to transform the province into a bastion of medical innovation.

The most interesting recommendation is the third one, which suggests that the province create a fund for made-in-Ontario technologies. The proposed four year, $20-million fund should be used to help speed the adoption of technologies that are developed within Ontario's borders, says the report's authors.

Another of their recommendations calls for the province to create an office for the “Chief Health Innovation Strategist,” who, if the government goes through with the appointment, will be responsible for identifying the province's most pressing medical needs and aligning the medtech sector's efforts to develop solutions for those needs.

Following the release of the report, MaRS published a statement endorsing the report's recommendations. “We believe that implementing these recommendations will position Ontario as a global health innovation powerhouse, while improving citizen health, and growing Canada’s new health economy,” said Dr. Ilse Treurnicht in the organization's press release.

The full report can be read here.

Source: Ontario Health Innovation Council. 

In the 1960s, a pair of researchers from the University of Toronto discovered the existence of stem cells.

In a way, Ontario has been a hotbed for this type of research since then; various provincial governments have invested more than $150-million towards helping unlock the powerful medicinal qualities of stem cells. Diabetes, Parkinson's, Alzheimer's, Crohn's and cancer are just some of the diseases where regenerative cell therapy may present treatments that are far more effective than what we have access to today.

Last week, the provincial government announced that it was reaffirming its commitment to stem cell research by investing $3-million in the creation of the so-called Ontario Institute for Regenerative Medicine, a joint partnership between the Ontario Stem Cell Initiative (OSCI) and the Centre for Commercialization of Regenerative Medicine (CCRM). The two organizations will towards developing new treatments and finding ways to monetize the treatments they create.

According to the province, the commercialization of regenerative medicine represents a major potential source of revenue for Ontario. In 2011, the global market for regenerative tissue therapy reached $10-billion. By the end of 2015, that figure is expected to reach $19.4-billion.

In a press release that accompanied the announcement, Reza Moridi, Ontario's then-minister of research and innovation, said, “Ontario is thrilled to support this collaborative initiative, which holds the promise to help treat, manage and cure some of the world's most devastating diseases while offering significant economic benefits.”




 

Since its resurgence at the end of last year, ebola has claimed the lives of nearly 5,000 people in West Africa. Its return has sparked panic throughout the world and left researchers and officials scrambling to find a cure. 

Enter a Toronto-based startup called Chematria. The company may hold the key to stopping the disease before it spreads any further. 

Chematria has developed software that allows a supercomputer to analyze how thousands of different drugs might affect a disease like ebola. What’s game changing about the software is that allows researchers to skip the time consuming step of physically synthesizing and testing drugs. 

“We are going to explore the possible effectiveness of millions of drugs, something that used to take decades of physical research and tens of millions of dollars, in mere days with our technology,” says Dr Abraham Heifets, one of Chematria’s co-founders and its CEO. 

The company’s research is possible because it has access to IBM’s Blue Gene/Q, one of the world’s most powerful supercomputers. Chematria, which is based at the University of Toronto’s Impact Centre, has access to the supercomputer through the Ontario Smart Computing Innovation Partnership (SOSCIP), an agreement that grants 11 Ontario universities and their host of researchers access to IBM’s suite of supercomputers.

Although clinical trials will likely remain an important part of drug testing, Chematria’s research has the ability to dramatically reduce the time it takes to hone in on the drugs that have the best chance at treating a disease or illness. If the company is successful, the face of medicine could be changed forever. 

Source: Chematria

Let's say you've just arrived in Toronto, moved here from abroad. You'll immediately be faced with a host of challenges—everything from navigating the city's streets to finding an apartment and a job.

Among those challenges: managing your health in an entirely new environment. This includes everything from learning how the health care system works to understanding how to cook nutritious food when you can't necessarily find some of the ingredients that you're used to, or see different fruits and vegetables at the market than the ones you are familiar with.

Enter Self Care Catalysts, a health care company, and local charity Community Matters. They have teamed up to launch a new project in St. James Town, a Toronto neighbourhood with one of the highest concentration of newcomers in Canada. The project, called "Healthy Living in St. James Town" will enable residents to participate in their own health care management by allowing them to create customized platforms that can tackle anything from diabetes monitoring to dietary goals. Users will be able to access their personalized platforms either via mobile devices, or through desktop computers at Community Matters.

Because the majority of the population at St. James Town are newcomers, says Grace Soyao, CEO of Self Care Catalysts,  “many of them do not have an understanding of the health care system in Toronto."

What local community workers realized is that these residents "needed a tool to help educate them about things like differences in the types of food you can buy and consume here versus their home countries. Many residents also have different beliefs about health and how to manage their health—culture essentially defines the way that they manage their health," and our health care system works differently than what residents may have been used to in their countries of origin.

Right now the service is provided in English, but given that many newcomers are also new to English, the goal is to add in other languages over time.

As for Self Care Catalyst, their business model doesn't rely on user fees: the service is free for all residents. What they do is gather information from their user base, stripping out all identifiable information about individuals, and create data sets that they can then sell to governments or health care companies, to help them improve health services based on the real behaviours of specific populations.

"We collect [various] kinds of data and correlate it with patient groups and profiles so that way we are almost collecting voices by patients…that can be used to develop better health care solutions," explains Soyao. So, for instance, with enough information about dietary habits, a data set could be used to generate a more culturally diverse food guide (or to create a series of culturally specific food guides, based on the kinds of ingredients different cultures tend to rely on).

It's a way of allowing patients to participate in their own care, the new partners hope, and also a way of allowing health care providers to learn from those very patients about how to serve them better.

Writer: Hamutal Dotan
Source: Grace Soyao, CEO, Self Care Catalysts

Xagenic (pronounced ex-a-GEN-ic) is a medical startup dedicated to making diagnoses faster and easier for both patients and clinicians. Founded by Shana Kelley, a University of Toronto biochemistry professor, the premise is simple: allow medical professionals to diagnose of a range of illnesses on-site, wherever patients are, without needing to wait for a lab to process test results.

The product Xagenic currently has under development—described as a “molecular diagnostic platform”—can provide test results in 20 minutes.

It is promising enough that Xagenic recently announced a second closing of its Series B financing: $25.5 million, to be precise.

Among Xagenic’s investors are the Ontario Emerging Technologies Fund and BDC Capital, a subsidiary of the Business Development Bank of Canada. Clinical and analytic studies of the new platform are planned to start later this year, and the company aims to launch its product in 2015 or 2016.

Consulting firm Frost & Sullivan awarded Xagenic its 2014 award for New Product Innovation Leadership. In its announcement of the award, Forst & Sullivan said that "it is unique as a low-cost, simple, rapid sample-to-answer desktop instrument, requiring no manual sample processing or cold storage… For its portfolio of cartridge-based tests, Xagenic focuses on infectious diseases (HSV 1+2, Flu A+B, CT/NG, strep A, group B strep, trichomoniasis, HCV and upper respiratory infections) that will benefit the most from rapid on-site testing. The company also intends to apply the platform to counter a critical public health threat—antimicrobial resistance.”

In short: it’s the medical equivalent of cutting out the middleman, allowing clinicians to know right away if a patient has a certain illness and begin treatment right away. If the product’s development continues successfully, it has the potentially to significantly streamline the diagnostic process, reducing health care costs, saving clinicians time, and minimizing stress for patients waiting to hear about their test results.

Writer: Hamutal Dotan
Source: Xagenic

The University of Toronto and the University Health Network have announced that they are launching a new institute dedicated to one of the most fraught areas of medicine: how we handle death and dying.

The Global Institute for Psychosocial, Palliative and End-of-Life Care (GIPPEC) will focus on interdisciplinary research, bringing together medical experts along with academics in subjects ranging from religion to law, to work collaboratively on what is not just a medical issue, but a growing subject of public interest and policy.

"What happened in the history of medicine is that as medicine became more specialized and technical, many of the aspects that had to do with control of physical symptoms, psychological symptoms, end of life care, fell off the radar," explains Dr. Gary Rodin, who will serve as the new institute's director. At one point those matters, he says, "would have been part of expertise of generalists, but as doctors became more focused on organ systems and diseases…palliative care emerged to fill that void."

That growing field isn't sufficient, however, to tackle the numerous and complex questions faced by those grappling with end-of-life issues.

"Many of the questions are broader questions than can be answered by medicine alone," Rodin continues, "including withdrawal of care, assisted suicide, and resource distribution—not just medical issues. A whole variety of disciplines…are needed to address these issues."

There are investigators in a variety of disciplines working on various aspects of these questions, and one of the institute's main goals is to bring them together so they can share their insights and work collaboratively.

Given than many of the laws, regulations, and procedures which shape end-of-life decisions are made by politicians and courts, rather than decided by physicians, another of the institute's major goals will be to "provide at least scholarly opinion to inform the public debate we think that's been lacking. There's a lot of emotion around [these issues] but not a lot of research."

This is also why Rodin is planning a significant programming element: there will be a series of talks, as well as a large annual conference that includes both professional and public components.

The institute will have its formal inauguration in October, and will be up and running within the next year. It will include a core staff of about half a dozen, and will have numerous Canadian and international researchers contributing part-time.

Writer: Hamutal Dotan
Source: Dr. Gary Rodin, Director, Global Institute for Psychosocial, Palliative and End-of-Life Care
Photo: The Princess Margaret Cancer Centre and the University Health Network

Explaining breakthroughs in medical technology can be difficult. The tools are precise and specialized, and the difference new innovations can make can be hard to grasp.

But here's one that's relatively easy to wrap your head around: researchers at Ryerson University and Sunnybrook Health Sciences Centre are piloting a new imaging technology for use during surgery.

The goal is simple: give surgeons a clear and near-instant ability to see exactly what they are doing and where they are going within a person's body during the course of an operation.

"Everyone knows how to use a GPS when they're driving," says Victor Yang, the researcher leading the project.  "This is a GPS for surgeons."

The system, 7D Surgical Navigation, is now a spin-off company, and has started pilot testing in a number of patients.

Essentially the problem until now is that surgeons have had to choose, Yang explains, between operating largely blind, learning about a patient's precise anatomical condition as they go, or ordering images such as x-rays, but having to wait up to 30 minutes during surgery for those images to be developed.

Practice tends to vary from doctor to doctor, with some preferring to wait for x-rays while patient is on the table, and others working much more quickly, but free hand, and thus with less accuracy. 7D allows surgeons to benefit from the accuracy imaging provides, without sacrificing time with patients open on the table—both a cost savings in terms of reducing operating times, and a health benefit since it's generally preferable to keep surgical times to a minimum.

The trials of the new device began in March. So far, 13 patients have been enrolled, with a variety of medical problems: some have tumours in the middle of their brains, some were in car accidents and had broken their spines. The ultimate goal is to have 60 participants in this pilot phase.

"The technology is broadly applicable," Yang says, "but the engineering team that I have is very focused on spine and brain surgeries [at the moment]—these are the surgeries that require highest precision. Afterwords we will go on to ear nose and throat, and then orthopaedic surgeries."

As with all new medical devices 7D will need to clear several regulatory hurdles, including  licensing from Health Canada and the FDA. Yang says his team is aiming to hit those targets within 12-18 months.

Writer: Hamutal Dotan
Source: Victor Yang, lead researcher, 7D Surgical