Innovation in elderly care: progress so far
Promising results for the ELANA® heart bypass system in initial study on patients with coronary artery disease
Vilans, a leading knowledge institute for care and support, systematically tracks innovations in elderly care. Recently they published an overview highlighting various innovations that have been piloted or implemented through long-term contracts in recent years.
Our commitment to elderly care innovation
In 2013, Nextgen Ventures began investing with the expectation that elderly care—including nursing, assisted living, and home care, collectively representing an annual spend of around €20 billion—would see a high demand for innovation. With a rapidly aging population, fewer workers are available to support an increasing number of elderly clients, creating an urgent need for technological solutions.
A decade of good intentions and promising technologies
Over the past decade, there has been no shortage of investment in promising technologies. Care robots like Roos and Lea, lifestyle monitoring systems, fall protection solutions, and a wide range of digital applications—including voice-activated assistants—have all been explored. These efforts are documented in the report “Time-Saving Technologies in Elderly Care.”
A major breakthrough still awaits
Despite these efforts, our cautious conclusion is that the major technological breakthrough in elderly care has yet to materialize. One of the more widespread implementations in the study, lifestyle monitoring, reached just 1,000 systems—representing less than 1% of the market. There is still a vast opportunity for innovation and growth in this sector.
Promising results for the ELANA® heart bypass system in initial study on patients with coronary artery disease
Promising results for the ELANA® heart bypass system in initial study on patients with coronary artery disease
AMT Medical has developed an innovative and unique system that connects blood vessels without the need for sutures. The technology is designed for use in both open-heart surgery and fully endoscopic procedures, offering significant benefits for patients. This technique has now been successfully tested on the first 10 heart patients.
Major milestone towards European approval
The success of these initial procedures marks a major milestone for the clinical company for medical devices. First, it demonstrates the team’s ability to reach this critical point. Second, it opens the path towards securing European regulatory approval for commercial use.
A versatile technology with broad applications
The ELANA technique was developed to connect blood vessels (vascular anastomoses). What makes the ELANA method unique is its versatility and potential applications. The technique is already certified for use in brain surgery, where it has saved approximately 500 lives by creating a bypass without interrupting blood flow. This significantly reduces the risk of stroke during the procedure.
The ELANA heart bypass solution uses a clip to connect the donor vessel beyond the blockage, which is then opened to allow blood to flow through the newly created path. This clip offers a significant advantage over manual suturing, as it is reproducible and requires less time and skill from the surgeon.
The ELANA technique also utilizes an excimer laser. The laser and clip allow the surgeon to connect the blood vessels after securing the graft, ensuring a precise and controlled connection.
This technology has the potential for even broader applications in the future. It could be used in procedures such as organ transplants, including kidney transplants, and has already been tested in preclinical studies by AMT Medical. The technique may also be applicable for creating dialysis shunts.
Promising results from first-in-human study
The first-in-human (FIH) study of the ELANA® heart bypass solution has been completed. For safety reasons, the FIH study involved open surgery.
Dr. Patrick Klein, cardiothoracic surgeon at St. Antonius Hospital in Nieuwegein, and Dr. Bart van Putte, principal investigator, announced that the initial procedures did not result in any major complications (major adverse cardiovascular events, MACE). In all 10 cases, there were no instances of heart-related mortality or heart attacks, and no repeat surgeries were required.
This paves the way for further research. The study will be expanded to include an additional 65 patients in 2023. The results will be used to pursue European approval for commercial use of this solution.
Narrowing and hardening of the arteries
Coronary artery disease (CAD) is the leading cause of death worldwide, responsible for 7 million deaths annually. In the Netherlands alone, more than 750,000 people suffer from CAD, leading to over 57,000 hospital admissions in 2020. In 2019, the estimated healthcare costs for coronary artery disease in the Netherlands exceeded €1.4 billion.
CAD occurs when the arteries around the heart become narrowed and hardened due to the buildup of plaque (fats, cholesterol, and other substances). This restricts the heart’s supply of oxygen-rich blood, leading to symptoms like chest pain and shortness of breath.
As plaque buildup worsens, it can fully block the artery, resulting in a heart attack. In early stages, CAD may be treated with blood thinners, but more advanced cases often require a stent to be placed in the artery.
CABG procedure: coronary artery bypass grafting
In severe cases of arterial plaque buildup, a bypass is necessary. A bypass reroutes the blood around the blocked artery using a healthy blood vessel from the patient’s own body. This allows the heart to receive adequate blood flow again. The procedure is called coronary artery bypass grafting (CABG) and is the current standard of care.
CABG is an open-heart surgery that involves significant risks: the chest is opened, the heart is stopped, and the patient is connected to a heart-lung machine to maintain blood flow.
Risks and disadvantages of CABG for patients include:
● Risk of heart attack, internal bleeding, and infections
● Long recovery time
● Painful chest post-surgery
While CABG can save lives, it requires patients to undergo an extended recovery period after the procedure.
AMT Medical’s safer, more patient-friendly and cost-effective technique
AMT Medical’s minimally invasive technique offers the possibility of performing a bypass without the significant disadvantages of CABG. Instead of opening the chest, only three small incisions are made around the heart. There’s no need for a heart-lung machine, the chest remains intact, and there are no sutures required for closing the incisions.
As a result, patients face significantly less risk during the procedure and recover much faster. They can return home in just a few days, pain-free, and resume their lives much sooner.
Moreover, the technique is significantly more cost-effective than CABG, leading to savings in both direct and indirect costs.
Direct cost savings:
● Shorter operation time
● Fewer postoperative complications
● Reduced hospital stay
● Faster patient recovery
Indirect cost savings:
● Lower mortality and morbidity rates
● Patients can return to work within 1–2 weeks
● Surgeons can master the technique faster than CABG
The total cost per patient for AMT Medical’s minimally invasive procedure is reduced by more than half, from over €70,000 to around €30,000.
Nextgen Ventures’ 2017 investment in AMT Medical
Nextgen Ventures made its first seed investment in AMT Medical in 2017. We help startups grow quickly with expertise, network and financial support.
How a venture fund can contribute to responsible AI in healthcare
How a venture fund can contribute to responsible AI in healthcare
How can we responsibly apply artificial intelligence (AI) to improve our health? And how can an investment fund contribute to this? Read Peter Haasjes’ vision this topic in this article. As an investor, he’s focused not only on the technology itself but also on its practical applications. It’s crucial that innovation solves a real problem.
Considerations from an investor
We are a venture fund focused on investing in companies developing technology that can make healthcare more affordable and accessible. Increasingly, AI forms the foundation of this technology. We seek dual returns from our investments: both societal and financial. If customers and societal stakeholders, such as patients and insurers, don’t see value in the technology, it becomes difficult for the company to achieve profitability.
One of our partners, Noaber, invested in a company that uses patient data from hospital information systems (HIS) to estimate the risk of sepsis in patients. Studies show that around 6% of ICU patients experience sepsis, with mortality rates ranging from 28% to 55%. Early detection of sepsis allows for timely antibiotic treatment, significantly reducing mortality.
We have also invested in a company developing software that will improve the ability to predict whether immunotherapy will be effective for cancer patients. Immunotherapy can have serious side effects, and many immunotherapies benefit only a small subset of patients. This AI application, through techniques like massively parallel sequencing and subsequent data interpretation, can analyze whether a patient will respond to immunotherapy. If not, the treatment—and its side effects—can be stopped early. This more personalized approach to administering expensive medications can also help control healthcare costs.
Evaluating practical implications
When selecting companies to invest in, we look for solutions that meet practical needs. A company must be viable, meaning there must be a market for its technological solution. The technology must also contribute positively to healthcare, ideally at the same or reduced cost. However, we can’t always prevent a technological solution from increasing costs. We don’t control how customers use the technology we’ve invested in. If they treat the solution as an add-on rather than a core tool, there’s little we can do to change that.
We see many AI innovations designed to diagnose diseases or conditions. These are interesting for research purposes, but their practical implications aren’t always significant. For instance, a technology that detects early-stage dementia might be scientifically impressive, but with limited treatments for dementia, early detection has limited practical value. Additionally, few people visit their doctors suspecting early dementia, so the AI system lacks the necessary data to be truly effective.
There are many developments in AI, but often they are relevant to only a small group, limiting their broader impact. Scaling an innovative product is challenging and expensive. Scientific validation is required, and the entrepreneur must meet various standards to bring the product to market. From the outset, an entrepreneur must ask: What problem are we solving, and how large is this problem?
No AI revolution in healthcare yet
AI is particularly useful when analyzing large amounts of relatively homogeneous data, such as patient records for a specific condition. An algorithm can analyze thousands of patients based on a select number of characteristics—such as gender or inclusion criteria for a study—far better than a human can.
However, when it comes to diagnosing a single patient, such as one with a skin condition, AI can’t yet analyze every possible diagnosis and definitively conclude whether the patient has basal cell carcinoma, melanoma or another condition. AI might suggest the patient has melanoma, but that might not be the patient’s primary concern. The patient wants to know what’s wrong with their skin and what treatment options exist. When it comes to answering those specific questions, humans are still better than AI.
Challenges in changing healthcare processes
As investors, our team has learned that changing healthcare processes is difficult. This makes the acceptance of innovation a challenge. For instance, it was harder than expected to get mental healthcare professionals to adopt online modules, where parts of an intervention could be delivered through online course material. Despite technological possibilities, healthcare providers still prefer face-to-face conversations with their patients or clients.
AI applications automate small parts of healthcare processes. Step by step, they can improve healthcare by providing greater safety or saving time. A doctor will always remain responsible for the system’s output. They need to be able to trace how the system reached its conclusion. In five years, I believe radiologists will feel like they’re doing the same work as today. The technology will quietly be integrated into their workflows by the industry, but it won’t revolutionize their jobs.
This is an adjusted version of an article that first appeared in a blog series by the Rathenau Institute.