Future strategy & opportunities
Nottingham MindTech
Healthcare Technology Co-operative
Professor Chris Hollis
27/03/2013
NIHR Healthcare Technology Co-operatives
(HTCs)
Bradford: Wound Prevention
& Treatment
Leeds: Colorectal Therapies
Sheffield: Devices for Dignity
Nottingham: Mental Health
Cambridge: Brain Injury
Birmingham: Trauma Management
Barts: Gastrointestinal Disease
Guys: Cardiovascular Disease
NIHR Healthcare Technology Co-operatives
(HTCs)
Aims of the NIHR Healthcare Technology Co-operatives are to:
• act as a catalyst for NHS “pull” for the development of new
medical devices, healthcare technologies and technologydependent interventions
• focus on clinical areas and/or themes of high morbidity which
have high potential for improving quality of life of NHS
patients and improving the effectiveness of healthcare
services that support them
• work collaboratively with patients and patient groups,
charities, industry and academics.
NIHR Healthcare Technology Co-operatives
(HTCs)
Bradford: Wound Prevention
& Treatment
Leeds: Colorectal Therapies
Sheffield: Devices for Dignity
Nottingham: Mental Health
Cambridge: Brain Injury
Birmingham: Trauma Management
Barts: Gastrointestinal Disease
Guys: Cardiovascular Disease
MindTech
NIHR HTC in Mental health & neurodevelopmental disorders
University of Nottingham Innovation Park
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Why Mental Health?
• Mental health problems affect 1 in 4 people
• Huge economic cost to UK - £105bn per year
• Largest area of government health spending (13%)
• High unmet need with little technological innovation
• Subjective clinical assessment dominates practice
• Lack of engagement with SMEs
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Clinical Landscape
• Mood Disorders
– Unipolar depression
– Bipolar depression
• Neurodevelopmental disorder
– Autism spectrum disorder (ASD)
– Tourette syndrome
– Attention Deficit Hyperactivity Disorder (ADHD)
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Current prevalence of mental health disorders in Europe
Mental retardation
1.0
opiate dependence
0.4
OCD
GAD
0.7
Eating disorder
0.9
Cannabis dependence
1.0
Specific
phobia
Psychotic disorder
1.2
Personality dis.
1.3
PTSD
1.7
6.4
Social
phobia
2.3
2.0
Conduct disorder
Agoraphobia
3.0
Alcohol dependence
2.0
3.4
Somatoform disorders
4.9
ADHD
5.0
Dementia
Panic
disorder
0
5.4
Unipolar depression
6.9
Insomnia
7.0
Anxiety disorders
14.0
0
2
4
1.8
6
8
10
12
14
Wittchen et al 2011 European Neuropsychopharmacology
4
8
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Why Nottingham?
 National Leadership
- Nottinghamshire Healthcare NHS Trust
- Neurodevelopmental and Mood Disorders
- Computer Science & Biomedical Engineering
 Regional Hub
- NIHR CLAHRC (NDL) -> CLAHRC East Midlands
- East Midlands Academic Health Sciences Network (EMAHSN)
- Medilink (East Midlands)
Research Strategy
• Technology Innovation Pipeline
• High quality collaborative projects
• User-led design
• New partnerships
• National resource
• Transformation of mental health care and services
Bringing Partners Together
Nottinghamshire Healthcare Trust
NHS
ADDISS
Biomedical
Engineering
£330k
1: Institute of Mental Health
2: Technology Transfer Office
Medilink
HTC
University
Academics
Business
School
Tourettes
Action
Patients & Carers
Clinicians
IMH1
Computer
Science
£260k
£90k
Qbtech Ltd
Industry
TTO2
BuddyApp
SMEs
Buzz3D Ltd
Red Embedded
Ltd
Organisation
NHS Trust
Medilink
SMEs
EMAHSN
Steering Committee
3rd Sector
Charities
Clinicians
University
Operational Group
Neurodevelopmental
Disorders
Mood
Disorders
Involvement & Implementation
Cross-cutting
themes
Technology
Clinical themes
Technology Innovation Pipeline
Patients, Clinicians, NHS Trusts
Identifying Need
Implementation
Development
NICE/ HTA
NICE/ HTA
Academics & SMEs
Facial affect recognition
Automated tic monitoring
QbTest
BuddyApp
Research Approach
1. Identify the clinical problem/ unmet need
2. Identify and develop a technological solution
3. Evaluate clinical/cost effectiveness
4. Adopt and disseminate technology in NHS
Target disorders
Clinical problem/ unmet
need
Technology solution
Depression
ADHD
Bipolar disorder
Tourette’s
ASD
PTSD
Subjective assessments –
time consuming, low
diagnostic accuracy
• Objective computerised
assessment of attention
and movement in ADHD
Poor treatment adherence/ • SMS text messaging,
missed appointments
video-telemedicine
Lack of real-time objective
monitoring of symptoms
• Personalised ambient
monitoring (PAM)
• Objective (real-time)
assessment of facial
expression, voice, tics
Limited efficacy of nonpharmacological
interventions
• Serious Games:
computerised cognitive
and social
communication training
• Virtual reality to treat
PTSD, phobias etc.
Qb Test: Objective Assessment of ADHD
• Computerised assessment
of attention and activity
• Supports clinical decision
making
• Provides patients with
objective reports on their
condition
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Text messaging app to
support therapy
Diary: SMS or
web
Analysis tool
Goal
reminders
Appointment
prompts
Automated objective assessment of mood and
behaviour
Valstar et al. (technology theme)
Personalised Ambient Monitoring (PAM)
User input:
• General health
questionnaires
• Mood selfassessment
Wearable Node
•Acceleration
•General light level
•Artificial light level
•Ambient sound
properties
GSM
location
GPS
module
XYZ
accelerometer
Internal
accelerometer
Bluetooth
Encounters*
- Bluetooth
- 3G / GPRS
- User input
-Internal
Computer vision / visual tracking for
automatic tic monitoring & analysis
o
o
o
o
Face and expression recognition
Automatic eye blinks detection
Hand and detailed body tracking
Integration & tic data analysis
Med-e-Tel 2013
22
Games that engage
• For diagnosis and treatment
• Work with ADHD children shows they will engage with games
• Built games to treat but also promote interaction with
therapist
• Playful environment to get young people to discuss emotional
reaction
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What can we offer ?
• Collaboration with SMEs, academics, NHS Trusts
• Support to AHSNs and funding agencies; e.g. SBRI, TSB
– Clinical expertise
– Technology Trials
– Patient Public Participation (PPI)
– Early stage Health Economics
– Advice on NICE assessment procedures
– An understanding of clinical pathways
– Advice on procurement procedures
– Technological expertise & regulatory advice
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Contacts:
Principal Investigator
Prof Chris Hollis
chris.hollis@nottingham.ac.uk
Technology Theme Lead:
Prof John Crowe
john.crowe@nottingham.ac.uk
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