Active and Healthy Ageing: challenges and opportunities
Ilias Iakovidis, PhD
DG CONNECT European Commission
CESAER 8 October 2015, Leuven
Horizon 2020
•Excellent science
•Industrial leadership
•Societal challenges
H2020 – Excellence • European Research Council
• Future and Emerging Technologies
• Marie Skłodowska-Curie actions
• European Research Infrastructures,
including e-Infrastructures
H2020 – Industrial Leadership •A new generation of
components and systems
•Advanced Computing
•Future Internet
•Content technologies and information management
•Robotics
•Micro- and nano-electronic technologies, Photonics
•Nanotechnologies •Advanced materials •Advanced manufacturing and processing •Biotechnology
+ •Access to risk finance • Innovation in SMEs
•ICT
Components and Systems - Where, and When ? -
Open - 4-April-2016
ICT-03
Smart System Integration ICT-01
Smart Cyber Physical Systems
ICT-04
Smart Anything Everywhere
ICT-31
Micro- and nanoelectronics technologies
ICT-02
Thin, Organic and Large Area Electronics
ICT-29 + ICT-30
Photonics KET
IoT-01 + IoT-02
IoT Large Scale Pilots - eg, Autonomous vehicles, Wearable…
Hardware intensive
Software intensive
Communication intensive
Not yet open - 2017 ICT-03 - NCP event – 7-Oct-2015 - HR
NMBP-13
Cross-cutting KETs for diagnostics @ point-of-care
Area 1 : CPS and embedded systems Area 2 : Customised /low energy computing for CPS and IoT Area 3 : Advanced micro electronics components Smart System Integration Area 4 : OLAE
Access to design, manufacturing, prototypes
…some technological breakthroughs, and industrial successes
NEUROPROBES
PASTA
Technology Application ICT project
Smart Probes
Packaging of Electronic threats
Spin-off: ATLAS Neuroengineering: www.atlasneuro.com/
In Vitro diagnostics portable solutions
Molecular Biology on Chip/foil
In Vivo extra-cellular
neurons recording
Incubator: Primo1D: www.grain-incubation.com/projets/primo-1d/
Smart Textile with integrated
sensors, LED and RFID
LabonFoil
Spin-off: POC Microsolutions, www.pocmicrosolutions.com
Proposed funding (million EUR, 2014-2020)
SC1: Health, demographic change and wellbeing 7 472
SC2: Food security, sustainable agriculture and forestry, marine and maritime and inland water research and the Bioeconomy
3 851
SC3: Secure, clean and efficient energy * 5 931
SC4: Smart, green and integrated transport 6 339
SC5: Climate action, environment, resource efficiency and raw materials
3 081
SC6: Inclusive, innovative and reflective societies 1 310
SC7: Secure societies 1 695
Science with and for society 462
Spreading excellence and widening participation 816
Coming soon… Innovative Medicines Initiative 2
www.imi.europa.eu
European & Developing Countries Clinical Trials Partnership
(EDCTP2) www.edctp.org
Active and Assisted Living 2 www.aal-europe.eu
European Innovation Partnership on Active and Healthy Ageing
https://webgate.ec.europa.eu/eipaha
Strategic Initiatives of SC1
The International Initiative for Traumatic Brain Injury Research
(InTBIR) http://intbir.nih.gov/
International rare diseases
research consortium (IRDiRC)
www.irdirc.org
AAL2*: 2014 - 2022
• AAL: €600 million from 22 EU countries + EU funding €150 million
• Scope AAL 2: Market-oriented ICT research in assisted living technologies & services
• New instruments: e.g. prizes or innovation grants
• More EU co-funding: Participating countries pay €225 million (indicative), EU pays up to €175 million (indicative, ~40% of total public funding)
*Ambient assisted living Joint Programme, Art 185, P2P
Further information
• H2020: http://ec.europa.eu/research/participants/portal/desktop/en
• Calls 2016-2017: http://ec.europa.eu/research/participants/portal/desktop/en
• IMI: http://www.imi.europa.eu/
• AAL: http://www.aal-europe.eu/
• EDCTP: http://www.edctp.org/
• EIT KIC on Healthy living and Active Ageing
• http://eit.europa.eu/eit-community/eit-health
• Joint Programming Initiatives: http://www.neurodegenerationresearch.eu/
https://www.healthydietforhealthylife.eu/
http://www.jp-demographic.eu/
http://www.jpiamr.eu/
• Conclusion #1: Find out how to participate in the calls
Medical and Health Sciences Expenditure
A pathway to sustained innovation and stronger economies, Janssen, 2015 http://www.janssen-emea.com/hpc/reports/European-Health-RnD-2015Update
Global trends in health-related R&D expenditure, New England Journal of Medicine, 2014: http://www.nejm.org/doi/pdf/10.1056/NEJMp1311068
A Stronger Biomedical Research for a Better European Future - Funding for biomedical research in Europe and globally, European Medical Research Councils (EMRC) White Paper II, 2011 http://www.esf.org/fileadmin/Public_documents/Publications/emrc_wpII.pdf
Joint Programming Initiative Data Project http://www.jpi-dataproject.eu
Check you national policy & budget in different scientific fields
OECD: Expenditure on R&D by sector of performance and field of science http://stats.oecd.org/Index.aspx?DataSetCode=GERD_SCIENCE
Conclusion #2:
Influence national and EU policy setting priorities and budgets
11
DEMOGRAPHIC CHANGE
• In the last 20 years, people all over the world have, on average, gained 6 years of life expectancy.
• Europe - one of fastest ageing continents.
Societal Challenge
Major Opportunity
••• 13
Dependency Ratio
•From 1:4 to 1:2
•80+ doubles by 2025
Cost of Care
•Up by 4-8 % of GDP by 2025
Human Resources
•Shrinking work force •Lacking 20 million carers by 2020
Empowerment
•Active Ageing
New Care Models
•Home based
•Integrated care
•Large Efficiency gains
Growth and Markets
•3000 B€ wealth
•85 Million Consumers - and growing
13
Demographic Shift
• Economic opportunities in the public and consumer markets • Global Silver Economy valued at $7 trilion per year, to reach $15
trillion by 2020 • Considered the 3rd largest economy in the world
2. THE SILVER ECONOMY
• 3000 B€ Wealth by people over 65
• 85 Million Consumers over 65 and growing
• <15% ICT use
The Consumer Market
• Care costs ~1000 B€ /year in Europe (8 % GDP)
• 10% for innovation ~100 B€ /year
The Public Market
2. THE SILVER ECONOMY
A SCALABLE MARKET
The ‘silver’ economy: A growth opportunity for Governments
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GDP, current trajectory, constant 2010 prices (left scale)
Employment, alternative trajectory (right scale)
Employment, current trajectory (right scale)
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GDP, increment in alternative trajectory, constant 2010 prices (left scale)
GDP, current trajectory, constant 2010 prices (left scale)
Employment, alternative trajectory (right scale)
Employment, current trajectory (right scale)
For Germany, the silver economy holds the
potential to
• Boost GDP by €61 billion, an increase of 2.1
percent above the current trajectory.
• Lift employment levels by 1.5 million by
2020.
For the UK, the silver economy holds the
potential to
• Boost GDP by £46 billion, an increase of 2.5
percent above the current trajectory.
• Lift employment levels by 1.3 million by
2020.
Source Accenture Study 2012 16
Some possible lead markets
• Scaling up innovative health and care services for active and healthy ageing
• Connected and Age friendly renewal of housing
• Age friendly tourism
• Age friendly smart cities
• Age friendly workplaces
• National/regional initiatives (FR, DE, UK, PL,)
Conclusion #3: Send us info on relevant developments in your area.
17
http://ec.europa.eu/research/innovation-union/pdf/active-healthy-ageing/silvereco.pdf#view=fit&pagemode=none
Connected and Age Friendly Housing
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safety & security
Health/care monitoring
Prevention Wellbeing
Social Inclusion
Daily living
safety & security
Example: Smart Homes for Ageing Well
Palumbo, F.; Ullberg, J.; Štimec, A.; Furfari, F.; Karlsson, L.; Coradeschi, S. Sensor Network Infrastructure for a Home Care Monitoring System. Sensors 2014, 14, 3833-3860.
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Example: Smart Homes for Ageing Well
Nonna Lea and Mr Robin https://www.youtube.com/watch?v=9pTPrA9nH6E
Helping older persons stay safely and independently in their own home
20
Conclusion #4: Check out call for proposls for large scael pilot for age friendly Smart home pilot (20M€), in the Internet fo Things Focus area – deadline April 2016 Joined pilot of Societal Challenge 1 and LEIT see Participants portal: http://ec.europa.eu/research/participants/portal/desktop/en
CESAER 8 October 2015, Leuven
Integrated care What this means for patients
Hospital
Home Care
Primary Care Practitioners
Allied Health Professionals
Specialists
Long-Term Care Homes
22 22
Community and Social Services
Common principles
for coordinated care
plans so all complex
patients will have the
same experience
Help for patients and
families to navigate
the health system
Listening to and
involving the patients,
families and
caregivers in all stages
of the care design
process
'Integrated Medicines Management 150,000 people currently receive the service with over 97,500 being 65 or over
• Reduced length of stay (2 days - 20% decrease)
• Return on Investment £5 for every £1 invested
• Pharmaceutical Clinical Investing Programme Savings £140
million (25% of prescribing Budget)
• Improved medicines appropriateness index(17.48 to 5.69)
• Reduced medication errors at admission (4.2)
• Reduced errors at discharge (20%-<1%)
Northern Ireland
OSASUN SAILA DEPARTAMENTO DE SALUD
BASQUE REGION
Decreased AP pharmacy and induced spending Decreased derivations between from PL on a 3.37% average (medical and surgical)
• Reduction in admission : 26,8% • Reduction of emergencies : 33,2% • Reduction in admission: 20%
From the professional view: • Assistance to patients after the integration
process: 74.3% of professionals believe that has improved
Continuous of care unit (UCA) - OSI BIDASOA
Conclusion #5: Encourage your local health and care providers to participate in the call for proposals for Procurement of Public Innovation ( see Annex)
CESAER 8 October 2015, Leuven
Horizon 2020 - societal challenge 1
26
Overview
Ground- breaking R&D
in Personalised Coaching (2017)
EU – Japan Cooperation
(2016)
PPI for deployment
and scaling up (2016)
CSAs Standards & Silver Economy
take-up 2016 Stimulate
research and growth in SMEs (2016-17)
Smart Living Environments Large-scale
pilot (2016)
• Exploring new
opportunities
• Catalyse Silver Economy
• IoT for Smart Living Environments (with ICT-LEIT)
• Scale up Innovative Care Services
• Complementing previous calls
Draft – Pending Committee Opinion and Commission Decision
ICT solutions for Active and Healthy Ageing
Workforce evolution
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JOB opportunities in US
• http://www.technologyreview.com/news/541551/where-the-tech-jobs-are/
Conclusion #6: Find attractive areas with good employment opportunities to attract good students. STEM and engineering in particular wil be in demand in the future digital economy & society Silver economy and health & well-being sectors provide good opportunities for science, jobs and growth
CESAER 8 October 2015, Leuven
ANNEX
CESAER 8 October 2015, Leuven
What is the Silver economy?
• Money spent by consumers, companies, and governments on products, services and activities as people age
• Employment, personal income, corporate revenue and profit, personal and corporate paid taxes, and other macroeconomic multiplier benefits
• Productivity increases from changes that integrate the physical capabilities and behaviours of workers aged 50+
• Value creation by new 50+ entrepreneurs
• Tangible and intangible benefits of retaining older skilled workers
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••• 32
What is Integrated care
• Integrated Care: is a coherent set of methods and models on the funding, administrative, organisational, service delivery and clinical levels designed to create connectivity, alignment and collaboration within and between the cure and care sectors.
• Kodner & Spreeuwenberg (2002)
• The management and delivery of health and care services so that citizens receive a continuum of preventive and curative services, according to their needs over time and across different levels of the health and care system.
Future Healthcare R&D Expenditure
Investing in European health R&D A pathway to sustained innovation and stronger economies, Janssen, 2015 http://www.janssen-emea.com/hpc/reports/European-Health-RnD-2015Update
33
Number of chronic disorders by age group
Source: Barnett et al. 2012. Lancet 370: 37-43.
For Savings, Go Where the Money Is
Distribution of health expenditures for
the U.S. population, by magnitude of
expenditure, 2009
1% 5%
10%
45%
65%
22%
50%
97%
$90,061
$40,682
$26,767
$7,978
Annual Mean
Expenditure
• 10% of patients account for 65%
of costs
• Focus efforts on patients with
highest costs
• Three part strategy:
– Primary care/delivery system
reform
– Payment reform
– Health information technology
https://agenda.weforum.org/2015/10/what-are-the-economic-implications-of-ageing-populations/
Representative (public) spending and tax profiles by age
From curing diseases to improved functioning
37
European Innovation Partnership on Active & Healthy Ageing
health & quality of life of European
citizens
growth & expansion
of EU industry
sustainable& efficient
care systems
+2 HLY by 2020 Triple win for Europe
Improving prescriptions and
adherence to treatment
Better management of health:
preventing falls
Preventing functional decline &
frailty
Integrated care for chronic
conditions
ICT solutions for independent
living & active ageing
Age-friendly cities and environments
specific actions
crosscutting, connecting & engaging stakeholders across sectors, from private & public sector
Pillar I
Prevention
screening early
diagnosis
Pillar II
Care & cure
Pillar III
Independent living &
active ageing
• https://webgate.ec.europa.eu/eipaha/
1,000 regions & municipalities
1 billion euro mobilised
30 mio citizens, >2 mio patients
> 500 commitments
3,000 partners & 300 leading organisations
Marketplace >72,500 visits >1,240
registered users
Reaching scale
EIP on Active & Healthy Ageing
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Region Skane
University Hospital Olomouc
City of Oulu
Coimbra
Southern Denmark
Collage (3)
Saxony
Ile-de-France Pays de la Loire
Lower-Rhine Council Languedoc-Roussillon
Liguria Campania
Friuli Venezia Giulia Emilia-Romagna
Piemonte
Northern Netherlands Twente
Province of Gelderland and Overjssel
South Holland Province Noord-Brabant:
Slimmer Leven
Galicia Basque Country
Madrid Catalonia Valencia
Andalusia
Liverpool Scotland
Northern Ireland Wales
Yorkshire
Reference Sites - coverage
EIP on Active & Healthy Ageing
40
VPH research initiative
European Framework Programmes
• 51 VPH projects funded under FP7 (2007-2013)
• Overview
• - Bioinformatics projects from FP6 pioneering VPH
• - "VPH projects" from FP7
• 250 Meuro
• IPs, STREPS, CSAs, NoE
28 completed projects
Clinical validation, workflows and business models!
41
Modelling diseases. In silico simulations
Virtual Physiological Human: EC Initiative (2007-2013)
Computer modelling of structures and processes
Personalisation of the model
Computer simulations of drugs and interventions
Range: Knowledge discovery; personalisation; simulation; integration
Applications: Early diagnosis, Treatment outcome, Surgery planning
Sim-e-Child:
• a platform for large scale simulations in paediatric cardiology (CoA)
• a digital database
• a cloud linking hospitals in Europe and the United State
• https://www.youtube.com/watch?feature=player_embedded&v=9b5vSEdDMt0
• http://youtu.be/dj7BkKsEW9Q
42
MD-PAEDIGREE, March 2013-March 2017
Ospedale pediatrico Bambino Gesu (Rome)
Re-uses the models developed in Sim-e-Child, paediatric cardiomyopathy
Why?
• Management:small patient numbers, limited outcome data, limited prognostic indicators: systolic function, age
How?
• - cloud based repository (Europe, US, 7 centers): that allows similarity research. « Patients like mine »
• - design and development patient-specific computer re-usable models
• - provide modeling and simulation
• - develop workflows including the models
• http://www.md-paedigree.eu/
• Best Exhibit Award at ICT2013
43
MD-Paedigree 1. Cardimyopathie
• Computational models
• Predict disease progression
• Dilated cardiomyopathy
• Modeling:
• - anatomical model of the heart (MRI, echo)
• - muscular fiber directions
• - electrophysiologic and biomechanical model
• - haemodynamical model
• Predict the impact of therapy in reducing mitral regurgitation.
• Clinical study: 180 patients, 16 months
44
MD-PAEDIGREE 2. Childhood and adolescent obesity
• Model integrates the known biomarkers for CVD risk assessment into one common framework, including MRI fat assesment
• Data mining and understanding the mechanism of CVD development
•
• Analyses of historical cases in the digital repository
• Estimation of cardiovascular personalised risk and predict the success of the therapy
45
Smart Homes
46
The number of European households that have adopted smart home systems is forecasted to grow at a compound annual growth rate (CAGR) of 61 percent during the next five years, resulting in 29.7 million smart homes by 2019. Market revenues grew by 60 percent to € 0.77 billion (US$ 1.0 billion) in 2014. The market is forecasted to grow at a CAGR of 58 percent between 2014 and 2019 to reach € 7.6 billion (US$ 10.2 billion) at the end of the forecast period.
http://www.berginsight.com/ReportPDF/Summary/bi-sh3-sum.pdf
Personal Health System and Patient Guidance Services supported by ICT
- R&I initiatives
• - 90+ PHS, PGS projects funded under FP7 (2007-2013)
• Overview
• - Personal Health Systems
• - Patient Guidance Services
• assist in the provision of continuous, quality controlled personalised health services to empowered individuals regardless of location.
• EC contribution 348 Meuro (FP7)
• IPs, STREPS, CSAs, PCP
47
A Modular Smart System for Infants’ Rehabilitation At Home
based on Mechatronic Toys
- Stroke and other neurological conditions affect the population of infants,
- The aim of this project is to promote early intervention in the first
year of life and to reinforce therapy by “CareToy”: a telemonitored portable low cost smart system, designed to augment the clinical effectiveness of the therapy while reducing cost.
48
mHealth and Pre-Commercial Procurement
49
Tele-detection and tele-care of high-risk intensive care unit patients THALEA enables Intensive
Care Units (ICU) to improve the care for acutely live-threatened patients by telemedicine and telemonitoring. Hospitals from Germany, Netherlands, Spain, Belgium and Finland initiate the joint PCP to get a highly interoperable telemedicine-platform developed for detection of ICU-patients at increased risk.
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Horizon 2020 - societal challenge 1
SC1-PM-13–2016 PPI for deployment and scaling up of ICT solutions for active and healthy ageing Specific Challenge
• Scale up innovative solutions, which have been tested and have demonstrated success in smaller scale setting
• Solutions not yet deployed on a large scale
• Contribute to collaborative efforts in public purchasing of innovative ICT-based solutions for active and healthy ageing.
Call - Personalised Medicine 1.4 Active ageing and self-management of health
Research & Innovation
Horizon 2020 - societal challenge 1
About Public Procurement of Innovation (PPI)
The PPI instrument can stimulate innovation by bringing innovative commercial end-
solutions earlier to the market.
Public Procurement of Innovative solutions (PPI) is used when challenges can be
addressed by innovative solutions that are nearly on the market (or already in small
quantity in the market) and don't need new Research & Development (R&D). PPI acts as
launching customer / early adopter / first buyer of innovative commercial end-solutions
newly arriving on the market
Call - Personalised Medicine 1.4 Active ageing and self-management of health
Horizon 2020 - societal challenge 1
Scope
• Target deployment of active and healthy ageing solutions at large scale across different regions in Europe
• Specify, purchase and deploy ICT based solutions for active and healthy ageing
• Must contribute to:
• Scaling Up Strategy of the European Innovation Partnership on Active and Healthy Ageing
• Boosting the Silver Economy and Digital Single Market in Europe
• Proposals requesting a contribution from the EU of between EUR 2 and 5 million would allow this specific challenge to be addressed appropriately through PPI
Call - Personalised Medicine 1.4 Active ageing and self-management of health
Horizon 2020 - societal challenge 1
Expected Impact
• Growing awareness and successful use of public procurement to boost ICT innovation applied to active and healthy ageing,
• Contribution with data and experiences to regulatory and legislative process development
• Contribution of open and comprehensive socio-economic evidence base for ICT investments in the field that can support the development of sustainable business models
• Support initiatives on interoperability and standardisation that can contribute to defragmentation of the market
• Creation of economic boundary conditions that can support long-term sustainability of health and care systems and emergence of new business models
• Support forward looking, concerted public-sector investment strategies that benefit from joint approaches across different regions;
Call - Personalised Medicine 1.4 Active ageing and self-management of health
Horizon 2020 - societal challenge 1 SC1-PM-14-2016: EU-Japan Cooperation on novel ICT robotics based solutions for active and healthy ageing at home or in care facilities
Scope
• Advanced ICT robotics based solutions as basis for services demonstrating extended active and healthy ageing in daily living, driven by user needs
• Involving multi-disciplinary research combining health, social, technology, behavioural disciplines
• Building on advances in open service platforms, IoT, intelligent living environments, personalised and self-adaptable interaction
• Novel service models for extended independent living, prevention, efficient care provision, improvements in social situation, keeping active
• Realistic test environments in EU and Japan with sufficient users involved to validate the expected impact including ethical and safety aspects
Call - Personalised Medicine 1.4 Active ageing and self-management of health
Horizon 2020 - societal challenge 1
Expected Impact
• Extended independence and autonomy of older adults in need of care
• Improved quality of life of older adults and their carers
• Improved efficiency in care provision
• Reduced burden on caregivers
• Global leadership in advanced solutions supporting active and healthy ageing
Call - Personalised Medicine 1.4 Active ageing and self-management of health