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

40,0

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GDP, increment in alternative trajectory, constant 2010 prices (leftscale)

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

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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

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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

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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