Proceedings of the Standing Senate Committee on
Social Affairs, Science and Technology
Issue No. 23 - Evidence - May 10, 2017
OTTAWA, Wednesday, May 10, 2017
The Standing Senate Committee on Social Affairs, Science and Technology met this day, at 4:15 p.m., to continue its study on the role of robotics, 3-D printing and artificial intelligence in the health care system.
Senator Kelvin Kenneth Ogilvie (Chair) in the chair.
[Translation]
The Chair: Welcome to the Standing Senate Committee on Social Affairs, Science and Technology.
[English]
I'm Kelvin Ogilvie from Nova Scotia, chair of the committee. I'm going to start by asking my colleagues to introduce themselves, starting on my left.
Senator Eggleton: Art Eggleton, senator from Toronto and deputy chair of the committee.
Senator Dean: Tony Dean from Ontario.
Senator Hartling: Nancy Hartling from New Brunswick.
[Translation]
Senator Petitclerc: Chantal Petitclerc from Quebec.
[English]
Senator McIntyre: Paul McIntyre, New Brunswick.
Senator Stewart Olsen: Carolyn Stewart Olsen, New Brunswick.
Senator Seidman: Judith Seidman, Montreal.
The Chair: We are here to continue our study of robotics, 3-D printing and artificial intelligence in the health care system. I need to inform you that while there will be some use of the instrument that appears at the other end of the room during the presentation, we will have an opportunity at the end to get up close and personal with this demonstration. I'm proposing that I adjourn the meeting 15 minutes before its normal end so we can do that and not have to deal with all the other encumbrances of the normal process of the meeting; is that agreed?
Hon. Senators: Agreed.
The Chair: Thank you very much.
Today we have two witnesses. I'm going to identify them as I call them to speak. I'm going to invite Mike Monteith first, who is Representative, Co-Founder and CEO, Thoughtwire, Council of Canadian Innovators. Mr. Monteith, would you present, please?
Mike Monteith, Representative, Co-Founder and CEO, Thoughtwire, Council of Canadian Innovators: Thank you, Senator Ogilvie and thank you to the other members of the committee. I'm here to present evidence today with two hats on: one as the CEO of Thoughtwire, an Ontario-based company that is scaling up applying artificial intelligence in the health sector; as well as on behalf of the Canadian Council of Innovation.
I haven't always been a CEO. For more than half of my career, I had the privilege of being a civil servant working in Ontario, where I helped craft many of the strategies being executed on. Through the course of my career, I have been inspired by our front-line health care workers and I created a company that is using artificial intelligence as well as deep Internet of things connectivity to bring our hospitals to life using the array of sensors that pervade our environments and applying artificial intelligence to be able, in real time, to create a digital twin of these facilities emerging from the signals and to deploy algorithms to make life for health care workers better, to give them more time to be patient-facing and to solve very hard problems.
An example of which is an award-winning project which we did with Hamilton Health Sciences which virtually eliminated code blues, which is unrecognized patient deterioration leading to cardiac arrest, by being able to monitor for the small signals and changes in health status of individuals, to engage care teams earlier, to save our citizens' lives and to send them home healthy and safe.
In addition, my work with the Council of Canadian Innovators, led by Jim Balsillie, is a collection of over 70 high- growth, high-potential firms who are scaling up internationally. Our technology companies focused on AI and health technology in Canada, many of which are in Ontario, have done ground-breaking work leveraging made-in-Toronto expertise related to deep learning as well as symbolic reasoning, to bring the promise of AI to bear, again to the benefit of our health system.
I'm here today to talk to you about two things that I think are important for the panel to consider. One is that there is a lot of fear growing in the community related to artificial intelligence and the impact that may have on employment within communities. In health care, I believe that we have a unique situation with an aging workforce, critical shortages of key resources, where the aim of artificial intelligence, whether that's to improve work flows and efficiency or to improve diagnosis — faster, speedier more accurate diagnosis — in fact slaves machines to make people better so that our workforce is more capable, so that our citizens and their families benefit from better care, more timely care, and to take much of what has been intrinsic knowledge in our health system and to formalize it in a way that future health care workers can benefit from the combined knowledge of our existing health care worker space.
With that I'll turn it over to my friend. Thank you.
The Chair: I will invite Mr. Charles Deguire, Co-Founder and President, Kinova Robotics. Please proceed.
Charles Deguire, Co-Founder and President, Kinova Robotics: Thank you, Mr. Chair, ladies and gentlemen. Good afternoon. I'm Co-Founder and President of Kinova Robotics. It's a Canadian company that operate worldwide. I'm very proud to be here to discuss the role of automation in the health care system, particularly robotics in direct and indirect care to patient and home care. At Kinova, our mission is to empower humanity through robotics. We believe that people with disabilities should focus on their education, work opportunities and personal development, instead of worrying about finding someone to open a door, or drinking a glass of water. We also strongly believe that health care professionals should focus on human interaction and developing new interventions instead of managing logistic issues, reporting and performing repetitive tasks which all have limited added value.
Therefore, 11 years ago, we developed Jaco, a simple, safe and intuitive robotic assistive device. This robot is meant to be integrated on a wheelchair. Of the severely disabled users, it uses existing wheelchair controls, so we adapt to the wheelchair controls that are already in place. It might be a mini joystick, a chin control, a head control, a sip and puff, eyes control, and newly brain computer interface. Whatever means the user has to control the wheelchair, we can take that knowledge and apply it to the robotic arm.
A typical task for our users and for any human being is taking a glass of water. If you have muscular dystrophy, cerebral palsy, this is something you haven't been able to do for a while, if ever. With Jaco on your wheelchair, you will be able to do that again. It's pretty simple to learn. We even have Prime Minister Trudeau who was able to learn and try the arm lately. He challenged us and was successful to perform the task.
Everyday activities such as scratching yourself, picking up an object on the floor or having a meal by yourself were impossible for people with upper body limitations. Now, with our robotic arm, they become less dependent on caregivers and enjoy an improved quality of life.
The Kinova team has always maintained and had multiple examples that persons with reduced mobility want to regain their autonomy — not only for their own well-being but also to contribute even more to their communities.
To accelerate the development and integration of robotics in health care, we successfully reached, over the past year, hundreds of researchers and developers in more than 35 countries. They contribute their knowledge to elevate the application of robotic technologies. Through these collaborations, we have secured strategic partnerships to produce new solutions in the array of medical robotics. At this time, Kinova is actively working with surgeons and health care professionals to develop better tools for them and their patients to ultimately increase the standard of health care. The scalpel and hand used by a surgeon have not changed a lot in the past 100 years. It's time for medical tools to evolve and robotics is there to help that.
Kinova would like to see all levels of government become more involved, leading the evolution of medicine to deliver better patient outcomes. Using robotics to shift focus from low-value task to value-added activity will empower the health care system.
Creating the tool is imminent, but making them accessible will require a conscious, societal change. Thank you.
The Chair: Thank you both very much. I expect we will have an interesting discussion today.
Senator Eggleton: I have a question for each of you. I'll start with Mr. Monteith. You said one of the fears that people have is about employment; that is, about losing their jobs to a robot, to artificial intelligence systems in general. How do you convince people that there are jobs that can be created? Are there educational programs where you suggest people become involved? Not everybody will become a high-tech kind of person. There are jobs that pay little and are threatened as well. How would you see people of different income levels being able to overcome that fear that a lot of jobs will be lost?
Mr. Monteith: That's a really important question and one that I think we are still debating as a country. I believe that the new economy and the shift in this fourth industrial revolution can be inclusive. I think that as people are progressing through their career, we need to very actively engage all levels of academia, community colleges and universities, to find high-value work for people to participate in an age where we're displacing manual work. Much like happened when we shifted from agriculture to manufacturing — and now from manufacturing to a new information age powered by machines — I think there is an extraordinary opportunity for generational change, for people to find opportunities.
I think that as we shift our focus in the knowledge economy, and as we compete, frankly, as Canadians on a global stage, there are many opportunities, both in primary and applied research as well as becoming practitioners, leveraging the new skill sets that create value for us to become significant exporters of those capabilities. That is, the tool sets that we're building together, as well as the skilled jobs required to install, implement and coach other economies through this extraordinary transition.
To go back to the point that I made, I really believe that using artificial intelligence, robotics and even robotic process automation, which lives in between, represents a sea change opportunity for us to address the needs of our citizens from a health care delivery perspective by applying these technologies from a quality perspective, as well as to reposition some of our key resources to higher value work. Instead of having personal support workers fetching water for individuals, for example, to retrain those people to man exactly those teams I spoke about, in terms of preventing code blues. More people participating in preventing bad outcomes means job growth.
I believe that, as Canadians, with expertise in robotics and artificial intelligence, once again, we could lead the world stage in this area.
Senator Eggleton: Mr. Deguire, I don't know how much this machine costs, but you say it attaches to a wheelchair. Is it affordable and for whom?
Mr. Deguire: That's a very good question. At the moment, the price in Canada will range between $30,000 to $45,000 which can seem quite expensive at first. However, when you compare the cost that it is saving, this is what the Netherlands did. They fully covered the reimbursement in the coverage of an robotic arm. If you save an hour and a half a day of a caregiver, at the hourly rate of a caregiver, in the Netherlands you have a return on investment under two years.
This is exclusively on the return on investment from the caregiver cost. You see users in the Netherlands and Germany, and in Germany now it's covered by insurance, where you have more and more cases of young students going back to school, and people going back to work. So the potential for the users, and the new opportunity to create value and to create added value work, is going way up.
As I say, making it accessible is a team sport. We will have to work with the communities, health care insurance, and the company supplying the technology together. This product was developed for the reality in Europe, and we have been in Canada for over 10 years. But today, 98 per cent of our revenue comes from outside Canada.
Senator Eggleton: How would a low-income senior, somebody on a pension, get one of these? How is that possible? They are not going to be able to afford $30,000.
Mr. Deguire: The same way people won't buy a wheelchair today. They don't buy a power wheelchair; it is covered by insurance. If you don't pay for a wheelchair, you have to pay somebody to move them around. If you cannot have a meal by yourself, somebody has to feed you. Somebody has to give you this glass of water. So you're already paying for that.
The challenge in Canada is converting service, paying people on an hourly rate, to a capital purchase of equipment. There is no streamline process to do that.
Senator Eggleton: Are these covered by insurance now?
Mr. Deguire: So the caregivers are covered by insurance now. They pay the hourly rates every week, every month, to attend to people in need. What we are proposing is converting a part of those expenses into a capital expense. This is not a direct thing. This process needs to be improved in order to accelerate the integration of innovation. Today, nobody is telling us, if the arm was half the price, we could cover it. They don't even know how much it would need to be so that they could cover it.
Senator Eggleton: Is this covered by any insurance schemes in Canada?
Mr. Deguire: No.
Senator Eggleton: So that's one of the issues that needs to be resolved.
Mr. Deguire: Yes.
Senator Stewart Olsen: I have a question for each one of you. Mr. Deguire, this question has two parts. The arm would have a shelf life of how long? The capital expenditure is $30,000, then maintenance, et cetera. You mentioned something I found intriguing, which was societal change. We would need to move. Can you elaborate a bit on that?
Mr. Deguire: To the first part, our first users in the Netherlands have been using the first generation of arm for seven years, and they're still working fine. Minimum service in the first year. After that, once they understand how to work with it, it goes well. It was engineered for eight years and over. You have to understand that we are using technology that is used in industrial processes for a million and plus cycles, applying it to home care. You don't do a million cycles in home care. So we have a very long-lasting technology, which corresponds to the price. So that is for the first part of it. Can you repeat the second part?
Senator Stewart Olsen: The societal change you mentioned.
Mr. Deguire: If we want to integrate more innovation, there needs to be a clear path to integrate innovation. We're talking about a knowledge-based society. But the biggest consumer in Canada is the government. If there is no clear path to integrate new knowledge, new innovation, into the government purchase system, how could we in Canada accelerate the development of those innovations?
Senator Stewart Olsen: Mr. Monteith, can you perhaps help me? I'm wanting our educational systems to move forward into the new technologies. So if you were looking to hire someone to work in your business, what would their resume state?
Mr. Monteith: It's very interesting question. My company is made up of people with very diverse backgrounds. There are people with nursing backgrounds, who became masters of health informatics, looking at ways of applying best practices. We have engineers who have moved into software. I even have somebody who did a masters degree — something about iridium lasers and quantum mechanics — who had to teach themselves how to code in order to prove their thesis and then graduated into the realm we play in.
Being pioneers in the area of symbolic reasoning, as opposed to what you have heard about the deep learning camp, we had to actually manufacture talent ourselves. We hire really smart, curious people, and apply our own techniques to bring them up to speed very quickly. I believe that we need our community colleges to be more engaged in the area of creating programs to support applied innovation. We have a great academic system, which is generating masters and PhD students, and with the investment the Government of Canada is making in Vector Institute and others, we will have even more. I think that the real opportunity for companies that are scaling these innovations out nationally and internationally is really about bringing more people into the workforce in an applied way.
It is through collaboration of public sector entities, governments at all levels and private sector entities who are scaling to work to create programs that are aligned with the very hard problems we want to solve in health care together, as well as in the areas of applied innovation, and even primary research.
At the council, we have had numerous discussions recently about how, by bringing together health sector entities who want to scale out innovations that have been created, and working with companies that have proven themselves within the Canadian marketplace or internationally, we can create very large data sets and knowledge, and a bank of ideas and problems that we also believe will attract more students into stem, as well as into health economics and health research, by giving them something to actually focus their attention on.
So by combining the idea of driving innovation at scale, creating ideas and new hard problems to solve, plus working with community colleges to develop those skills, we think we can change the game for Canadians.
Mr. Deguire: Yes, to give the example at Kinova, the one thing we love the most is passion. We are at war. It's a challenge. We need speed on our side. So the people who learn the fastest are the people who are the most passionate. We have technicians, we have PhDs all working together. It doesn't really matter what diploma they have. One of our best software engineers, in fact, is not an engineer; he is a technician. But he is our technical leader coaching other engineers. While people were doing their bachelor degrees, he was coding. He became very good at it because he was passionate about it.
So when we talk to young people that are studying, and they want to do robotics, we say be passionate enough to learn every day on it. Anything you are going to learn at school in technology, when you're getting out, it's going to be too late. So the one thing you need to learn is how to learn. That's the only thing that matters in our business — the speed at which you can integrate new knowledge and make those connections with your teammates.
Senator Stewart Olsen: That's the societal change too, I think. Thank you very much.
Senator Seidman: Thank you both very much. I'm not sure if I really heard everything you said or perhaps I'm missing something. I would like to pursue the question that Senator Stewart Olsen just asked about the whole approach to re-educating current workers, or encouraging young people to go into programs that might lead them into this field.
My sense is that if you look at the average elementary and high school curriculum, they are still pretty standard. If you talk to young people, they may be holding digital devices all the time, and are very integrated, but when you ask them where they see their careers going, it's not often that you hear someone say, "I want to do AI or robotics.''
First of all, do you find it easy to recruit people? Are you having trouble finding Canadians, generally speaking, to recruit to work for you? And if you do have trouble, where do you go to look? Do you have to go outside the country? What recommendations would you have to help the educational system revamp some of their programming so that we can lead young people into this field?
Mr. Deguire: First of all, we are 150 people, 75 engineers, with all levels of degrees. We're not having a hard time recruiting engineers. They're coming from all over the world if we need them.
We had trouble recruiting people with technical skills and technical backgrounds, including technicians and assembly people on the production line. We had a harder time recruiting those guys than recruiting the engineers at the moment. We are a manufacturer, so it's a big part of our workforce. That was first.
Second, I think youth and students need to touch enough different fields so they can learn which one they're passionate about. After that, it's a mechanism on how to work. Often we need to teach them why, what and how: Why are you doing that task? What is your strategy to do it? How are you going to apply your knowledge to perform it? It's very basic, but whatever type of work you're doing, it's always the same process: structure it, work in a team and use the knowledge from others. You can specialize or be general, but I think this type of exercise of solving a complex problem can help them more. I think we need to challenge our youth and our students much more.
When we recruit, especially engineers, we interview all of those who did competitions as an engineer outside of the classical pathway. They need to go this extra mile of putting themselves in things they don't know well and competing on a worldwide level. This is what we're looking for and I think we should not wait until university or college to have competitions for the young.
Mr. Monteith: I would agree. We're based in Toronto and we find it incredibly difficult to compete with the banks who are re-imagining themselves as software companies, with large multinationals filling up the downtown corridor and driving up core salaries and wages. On a day-to-day basis, I think my company and many of our counterparts through CCI have all experienced the same thing. Access to talent is a real challenge.
Congratulations to the government for looking at accelerating access for foreign workers to come to Canada. I think that's an extraordinary measure, and I think it could be the way that we get over that.
Addressing the other part of your question, to get youth engaged in science and technology, they need exposure to just how cool it is. We participate in programs like teaching kids to code and encouraging women to get into coding and technology. As a society, we need to make it cool. What differentiates countries like Iran, Russia and many others is, from a societal perspective, whether it's males or females, they're encouraged to excel, and it's okay to get into science and technology.
There's still very much a stigma associated with that in the North American context, and together we can work with media and all kinds of outlets and visit schools and just make it cool and a fun thing to be part of.
Senator Petitclerc: Thank you for your presentations. It's fascinating. In fact, myself being in a wheelchair and knowing many people with disabilities, I do know someone, I think, in Montreal who owns something similar. I can confirm that it did change his life, literally.
I'm interested to know and to understand from both of you — maybe Mr. Monteith could begin — how the process of coming up with those innovations works. Is it science-driven, technology-driven, novelty-driven, or is it driven by the needs of whom you are trying to help? Is it a mix of both? How does that dynamic work? Do you go to figure out what an individual, hospital or nurses need, and then build something, or does it go the other direction?
Mr. Monteith: I think it all starts with a spark and a desire. I can speak for myself and my co-founders. When we started our company, we were re-imagining the world of how people would interact with the digital things in their life to make their life better and easier. So much technology had been applied previously that turned people into slaves of technology. We wanted to flip that over. That was our motivation.
Having perfected our craft, we decided that health care was the most worthwhile place to apply our skills and experience, and we sought out like-minded people who had very hard problems that we could help to solve. Then we just expanded that innovation from the point of view of their stories and the outcomes that can drive.
I think the journey is very different. Some of the great innovations that have been created have come out of universities, but it all starts from the same place, which is passionate entrepreneurs who want to change the world, and then finding and clawing your way to create traction and build a scalable business. I think that's the heart of it. It is encouraging and continuing to encourage entrepreneurship and, again, making it cool. We have amazing talent in this country. It's a very far-ranging set of circumstances.
Mr. Deguire: For me, it comes from my family. I grew up with three uncles who have muscular dystrophy. I was witness to their everyday life but I was a witness to their rage to fight and to gain more independence every year. I would see them every summer and they would lose capacity. Muscular dystrophy is degenerative. Still, every year they were able to do more because they adapted their wheelchair and some tools around them.
As a young Canadian, I saw that innovation potential and it struck me. When I became an engineer, I specialized in robotics and realized the potential of robotics and the knowledge I had gained from my uncles, and it was easy for me to put the two together and say we're going to do something better about it.
When we developed the first generation of Jaco — just the name Jaco is in honour of my Uncle Jacques; we all call him Jaco — I had this reality in mind. This is why we've developed all the features. It's safe, kids can play around it, because there are kids around people. This is life. You can be hard with it. It's intuitive. You don't need a PhD in robotics to drive Jaco.
When we come to all the features, this is also what drove the cost. We say we don't want to fit in a low cost because it's going to be easier to go on the market. We want to have the right solution. If that's the price, but this is what is going to change a life, this is what we want. It changed a lot of things. We were coached by business people, saying, "You should go in that direction,'' or "You should sell to other markets.'' But we had a clear path in mind. If my uncle was to use a Jaco, it had better do the job. This is what we had in mind.
[Translation]
Senator Mégie: I think Mr. Deguire will be able to answer my health-care-related question. I found your presentations fascinating, much like this topic. I have seen how resourceful people with muscular dystrophy are. Even without robotics, I saw how they handled situations by using mechanical devices to move their wheelchair with their chin, for instance.
In terms of health care delivery, you gave the example of a nurse or support worker having to fetch their patient a glass of water. If that could be done robotically, instead, that nurse could work on something else. On a practical level, can you tell me who programs the robot so that it can assist the patient? Is it done in advance to save the nurse time? How does that work?
Mr. Deguire: The limits or boundaries of robotic process automation are becoming increasingly flexible.
At Kinova, we specialize in empowering the person at the heart of the activity. In our platform, a human is always in control, whether it be the nurse, the surgeon or a person with a disability. If the person wants to control the task of fetching a glass of water, they can control every step of the process. If the person decides to just hold the glass, they can do that as well. If the nurse or surgeon wants to access a certain part of the human anatomy, they can go right to the point where they want the automation to occur.
More and more, technology will give the user that choice. That way, the user can focus on certain tasks, as in the case of the nurse. Fully automated solutions for logistical tasks are available. If, then, the nurse knows which drugs she may need, rather than fetching them, she could have the robot deliver them. She initiates the activities and receives the result.
Reporting is another task that can be partly performed by artificial intelligence. The time and energy saved could be spent on added value activities. Because these choices are available to health care professionals, it fosters the ability to progress to the next level in order to help the health care providers, because they are the ones who retain the control. Some activities will have more value for certain patients; the same activities will not necessarily be useful for other patients. The key, then, to encourage integration and create added value is through robotics or automated processes that are human-controlled.
[English]
Senator McIntyre: Thank you, gentlemen, for your presentations. In the last few months, this committee has heard from a range of stakeholders on the new technologies. That said, it's interesting to hear from you, in light of the fact that you produce and market technologies.
Some people may consider these new technologies as being perhaps disruptive to the health care sector, so I'd like to have your comments on that. On top of that, is the health care sector ready for these new technologies? If they're not ready for these new technologies, how do they prepare for them?
Mr. Deguire: Are they ready? At the moment, with the system, I don't think so. Do the population and Canadian citizens need it? Yes, I think so. This is where we will have to work together to make it happen. As I say, there's no clear path to integrate innovation within our health care system, so how could they be ready to integrate?
The thing we hear the most is, "I'd like to help you, but this is not my job; this is not my responsibility.'' So whose responsibility is it to integrate innovation within the health care system?
The system should challenge the private businesses. We've been dealing with many other health care systems worldwide. We are in 35 countries. We would love to work with our Canadian health care system. Just challenge us. If the way we are doing business with you doesn't suit your needs, tell us what would suit your needs. For that, you need to know your metrics, your data and make it available. We are in robotics. We are used to working with data.
We're talking about the economics. If we can have clear numbers — how much does it cost you to take care of somebody who has muscular dystrophy in that region and we could make you an offer where you would save money and we could integrate a solution, this would be a win-win situation. But when we get into the case where this information is not available or doesn't exist, how can we make things move forward?
A lot of things need to change. Being aware of the economic advantages for innovation is nonsense for me. How could an accountant work without a spreadsheet or computer today? For us, it's as simple as "how could a surgeon operate without a robot within the next 10 years?'' It will be the same thing.
If we keep the system the way it is today, we will be late. We cannot afford to be late. We're talking about health care. It's quality of life, and it's the life of the people. I urge everybody here to make it mandatory for health care systems to be proactive toward innovation. Let's not wait for them to see innovation and think it's a good idea. Let's make it mandatory to go for innovation. You cannot afford to wait.
Mr. Monteith: I'd like to reflect on the health system. We use that term very broadly, but what we have is a system of hundreds of thousands of individual workers who work at 1,200-plus hospitals across our country in various health care settings.
If we look at our track record for innovation, we are a nation of pilots. There are pockets of innovation across the country. Where we fall down is in scaling that innovation. I don't think it's really a health system readiness. Like every market, there are early adopters, then the early majority and then everyone. If we look across our great country, we'll see people at different levels of readiness to participate in scaling different kinds of innovation, depending on the particular needs of their organizations, geographies and the constituents that they seek to serve.
We need to look at the opportunity of creating a model in which organizations can find like-minded organizations that have proven technology and its ROI, and allow them to form groups to scale that innovation and to teach others in the system that we can get a triple bottom-line outcome from this kind of innovation at scale, one that benefits our citizens and their families, one that actually defrays some of the operating costs of running our great system —$228 billion this year — and one that actually generates revenue for our companies that are scaling up.
Quite frankly, we look at traditional approaches. A dollar of revenue going to a company scaling up can be worth as much as $6 to $8 of valuation as wealth creation for Canadians. A dollar of corporate welfare in the form of grants is worth nothing but augmented cash flows. If we think about how innovation at scale will actually benefit great companies and our health sector simultaneously, there's an opportunity.
By bringing academia to bear — once again, back to one of my core thoughts, as an innovator in our community — I believe we can put academia to work on really hard problems and study the outcomes and benefits of innovating at scale, which become marketing and sales tools for globalization.
Establish the 2 or 4 per cent increase in the bottom line for our country from a revenue perspective by betting on the companies. There are probably 20 to 30 companies in Canada right now that could become billion-dollar companies with the support of government.
The Chair: Mr. Monteith, you hit on a comment that has permeated many of our studies, beginning with our study of the health accord, and that is we do not have a health system in Canada; we have a collection, as you said, of what we saw, which are silos. We use the term "silos.''
More importantly, in response to Senator McIntyre's question, you mentioned the idea of pilot projects. We are a country of pilot projects, and what we have identified in most of our studies is that there's no way to disseminate the advantage from one locale to another, even within a province, let alone across provinces. You've hit on a major theme — or you've repeated a major competitive disadvantage that we have in Canada, particularly where knowledge is the basis of the future.
[Translation]
Senator Cormier: Thank you for your presentation, and congratulations, sir, on winning the Governor General's Innovation Award in 2016. It's a testament to your leadership in this field. Clearly, you are quite passionate when you talk about your innovations. You are also very convincing. Our job is to identify what the federal government can do to encourage this transition, which involves many factors, including access, cost — which we discussed earlier — and training. If you had to pinpoint three priorities that the federal government should work on in order to facilitate the transition for both individuals and the hospital sector, what would they be?
Mr. Deguire: The first would be to challenge companies; the results would change the future of every health care system in the country. Earlier, we were discussing education. We also talked about the companies we compete with internationally; we do a lot of work around challenges.
[English]
The one risk that is hard for us to live with is the market development risk. If you can remove that by saying the government is willing to pay this amount if you can solve this issue, then I guarantee you, young and businesses will come together to face the challenge. We are a generation that likes to be challenged. If the government can list a challenge in healthcare that can touch all provinces and territories, and that is meaningful for all of them, and we can find solutions for those, we have more than enough academia, research centres and developers and passionate people to tackle any of those inventions or new technology problems.
The one we can not tackle is the worth of tackling this issue. This information is owned by the people who are paying it today, and those are the separate healthcare systems, the silos. If one project could touch all the silos at once, this would help.
You have to put yourself in my position. I'm a CEO of a company. It's going to take us the same energy to develop the healthcare system in Quebec as it would to do in California. If you compare the size, Quebec loses every time. This is why we have 98 per cent of exportation today. Each dollar we invest into market development is important. We need to have the best return on investment. Simplify it in Canada and people will come.
A challenge that would cross all provinces and territories would be a first aspect. It would allow different provinces to work together, and the challenge aspect for the school and for the young is the way to go. I will encourage you.
Mr. Monteith: Reflecting on this through the years, as a former civil servant I spent some time thinking about these issues as well. As a country, in order to align our fragmented health system towards some goals so information sharing starts to flow, quality of information goes up and the desire to innovate increases. We need to pick a few important themes that will have a direct impact on healthcare delivery, the investments that we make with our precious healthcare dollars. There is nothing like a call to action, going to war on something that resonates with everyone from citizens and their families to our front-line healthcare workers and their leaders to get behind a cause.
We look at the statistics. CIHI just published data that validates data that came from Johns Hopkins. Hospital injury is the third leading cause of death in North America. The ECRI, a group in the U.S. that studies implications of these things, is now calling this a public health crisis. If we think about reducing harm as a call to action, improving accessibility and quality of life or improving the timeliness and accuracy of diagnosis to drive our system to get aligned behind some important themes where we have companies that have solved these problems domestically is the way to get started, and to create an ecosystem that functions not on a 2- or 5-year scale but as a 20-year scale and an operating model that supports discovery, Mr. Chair.
The reason why we're a nation of pilots is our health system is so busy being overwhelmed by the demand they cannot actually service that it leaves no time for discovery. We teach each other through PowerPoints at conferences that many don't attend. There is no forum for discovery. There is no forum for participation by Canadians, by citizens to understand the domestic innovations that have occurred, to actually speak to you with one voice and say this is important.
The way we overcome this challenge is by calling people to action on a few important themes based on the capabilities we have in-country.
Mr. Deguire: You asked three we can change. I think a third one would be an incentive to use innovation. Today, if one silo, one healthcare system, wishes to go forward and use innovation, they don't have a real incentive to do it internally, so they assume the risk on their own. I would exchange any dollar of grants for an order anytime. Perhaps there could be a transition from giving development grants to instead having a small portion to support the healthcare system, to do a pilot project of their own and then have an incentive for doing it, so lowering the risk for them.
On the other side is the consequence if you don't use innovation. This is our quality of life. I said it earlier: We cannot afford not to invest in innovation. A ministry or government or healthcare system that would choose not to use innovation, it's not a choice for them to make.
[Translation]
Senator Cormier: As someone who comes from the creative sector, with a background in arts and culture, I am curious as to whether you gave any thought to the aesthetics of the device? Some people might be afraid of it. How young people adopt or integrate the device into their lives will be different from how older people do.
[English]
Mr. Deguire: The goal of the arm was to be integrated into the life of our users and to be accessible to young and older generations. For that, it needed to be attractive. A good example of that is our young users, as young as five years old but let's say eight years old. When Oliver in Montreal goes around with his arm, he is holding the hand of Jaco and presenting Jaco to his friend. It's an extension of himself. It's a friend. You need technology to reach a position where they are not scared. They want this part in their life.
It's a positive attraction, especially with people in wheelchairs. Often people that don't have a disability don't know how to approach them. When you put something that looks good — it's a robot; it's cool — you have a positive impact on their image and around them. So yes, it was very important for us. It looked good and was low noise so it doesn't interfere with their reputation or their image.
Senator Hartling: Thank you very much. It's so interesting and exciting to hear what you're doing. I got on this committee and started learning about robotics and then just happened to meet a student from Moncton who was very interested in robotics. I keep in touch with him, and he has gone to a robotics competition in Halifax where he met the Prime Minister, and he is planning to study robotics. There is a movement I wouldn't have thought of or wouldn't have known of if I had not been here and met him.
Just to piggyback on what Senator Cormier is saying, are there other hurdles or things in your business, red tape, things that you're finding difficult? You're very pumped about what you're doing, but are there some other things that are really difficult or you want to tell us about that would make it easier to go forward with your innovations?
Mr. Monteith: We have been working closely with Health Canada on this. In the realm of artificial intelligence and software in general, the rate of change is very high. My company has been encouraged, polled by our customers to get even closer to patients. As an example, for a patient who does go into cardiac arrest, to lower a bed into CPR position and stop the infusion pump if it has narcotics because they have already died, we need to give them half a chance. That would make us a Class II medical device. Health Canada as a regulator understands the gap. We don't know how to address this issue. The FDA in the U.S. is certainly considering it. It is creating a very specialized digital health group to focus on different kinds of engineering talent and processes. I would encourage that locally.
Certainly getting medical device establishment licenses and going through certification, but then being limited by that same certification in terms of the rate of change and continued invention is a major barrier for many health technology companies in Canada.
The Chair: Mr. Monteith, who in Health Canada, or which division are you interacting with?
Mr. Monteith: We have met with Mr. Kennedy, the deputy, as well as his team, Marion Law. They are a fantastic team of people, very engaged in the subject and working hard to get their heads around this changing world. Even the devices themselves are software-driven today. So whether it's domestic companies trying to scale up, or multinationals, we all suffer from the same issue.
Many years ago, Health Canada decided it would encourage the registration and certification of software across the country. There was a major amount of pushback from everybody from hospitals and others, who built their own software in some cases, to large multinationals because there isn't enough capacity in the country to go through these exercises. Yet not achieving those goals means that penetrating our own marketplace, when people ask, "Well, are you Class II medical device certified,'' becomes a barrier to sale.
Mr. Deguire: The biggest roadblock for us, and the thing that would accelerate the growth of our business, would be early access to the Canadian market. In our cycle, our first customer ever at Kinova was in the Netherlands. We had to do our clinical trials in the Netherlands. It's a lot of investment and time to go there. If we could do that in Canada, again, I say challenge us. If Canada provided us early access to the market, and in exchange we give them better pricing for a lifetime, it's a win-win situation. We are open to that. Please, have people from health care come and talk to us about that.
The Chair: We're trying to get them to come talk to us.
Senator Unger: Thank you very much for your presentation. Is there anything you can do for a non-working voice? Mr. Monteith, you have already answered one question I had, which is about the fragmentation of your industry. So not only is the health care system itself fragmented, you are in the early stages of what I think will be a booming industry, but still fragmented, so I wondered how that would all come together.
I'm also wondering, Mr. Deguire, about competition. I envisioned something like that looking like a bionic arm, the skin covering over top. I think some people might be afraid of it, but if you need the help it can give you, then it's your best friend. With competition, I'm also wondering about Canada's telecommunications infrastructure. Is it sufficiently robust for these kinds of innovations?
Mr. Monteith: I'll begin with a question of fragmentation in the industry. There are many important things happening today as the Government of Canada brought forward a strong innovation-focused budget to encourage the creation of super clusters. I think that natural clusters have been functioning, at least at a rudimentary level. There is the corridor between Waterloo and Toronto, certainly as it relates to digital technology development, pockets of excellence in artificial intelligence in Montreal, and in Toronto, et cetera.
I believe that we have an opportunity to come together as a nation, to embrace the inventors and the companies scaling up and the early stage companies, to compete with places like Silicon Valley in a different way.
If you look at the creation of the Council of Canadian Innovators through the leadership of Jim Balsillie, and John Ruffolo, rewind to the 1980s. They created Communitech as five emerging technology companies who agreed to share the cost to find a way to speak to governments and the banking sector and finance with one voice. At CCI, we brought together 70 very high potential, promising, scaling-up companies as a group of volunteers to speak with organizations like yourselves about this.
Government can show continued leadership in this space, to create a higher functioning ecosystem by encouraging the creation of forums, and emphasis across the spectrum of companies and their various development stages. We believe that there has been too much emphasis put on pure academia and incubators, and creating more start-ups. We believe in balance. New policy needs to come forward that focuses on companies that are scaling up as well. We believe by doing these two things that we will, in fact, encourage more collaboration as we look to the world as our marketplace as opposed to domestic sales as being the things that fuel the creation of — let's be frank — lifestyle businesses as opposed to strong Canadian companies becoming multinationals.
Mr. Deguire: On the competition topic, there is competition in robotics but the industry is wide enough that we can each have our place. There are still not enough players in robotics. I hope there will be more robotic players attacking the health care issue. We welcome competition, and at the moment, most competition we either surpass or we change them to an ally. The first distributors in Netherlands, they were a competitor, but they became our largest distributors in Europe. We all have the same goal in mind. We want to help the people. We had a better technology than what they had. Competition is there. We want more competition. We expect more competition.
This is why our war, our race, is on the speed of innovation. What this product can do is far outreaching the first generation of our robot. And our next generation of robots, already in development for a few years, will outpace whatever the generation did before. Our target is always the efficiency of the users. So today, with Jaco, you can have a full meal in 35 minutes. With the newest development you can do it in 20 minutes, which is much closer to what an able-bodied person can do. So competition for us is the status quo; it's the limitation of the human person. In that goal, we have more allies than we have competition.
On the telecom infrastructure, some of our new technology and next generation relies on learning robots. Robots can learn the way you act and use them, and understand and better support you in your decision and in your control. For that, we need a strong telecom infrastructure. This is for sure. We already have enough, but at the speed that we are developing, we might outpace the existing infrastructure. If we want to continue to develop in Canada, the quality of our infrastructure is very strategic.
Mr. Monteith: I would like to talk about intellectual property policy as well as global standards as tools to improve Canada's standing from a global, competitive point of view.
Companies face many challenges as they are scaling up. For those companies that start to get enough traction, where they become a bother for large, foreign companies, or have shown high potential for growth, we see spurious lawsuits being brought, related to intellectual property infringement. An intellectual property strategy that focuses on supporting companies as they scale up, creating almost a NATO of Canadian corporations and the pooled intellectual property, and pooled resources to defend our companies from these kinds of spurious lawsuits, which can be life- ending, is a very important part. The other side of that is as we're protecting our intellectual property, as many of you know, it can take as much as seven years to prosecute a patent to release. During that time, I believe that it's in collaboration with groups like the Standards Council of Canada to find the niche places like my esteemed colleague occupy, or many of the companies in Canada who are thought leaders, to chair the international standards committees that drive Canadian intellectual property to become the international standard.
As you know, we don't have great collaboration with some countries related to respecting intellectual property, but they are adopters of international standards. Where we can define the standards, we can become the global standard which drives commercialization success abroad. It's an arms race. We are in an arms race globally, competing with countries like — I won't actually mention them on camera, but you all know them.
If you look at patent filings and you look at the rate of development and the amount of capital that has been put into play to drive that, that's where a lot of competition comes from. We lead here, and then we get overcome because we're not the standard or because we can't survive those sorts of challenges.
The Chair: Before I go to Senator Eggleton and Senator McIntyre, I want to bring up some issues.
First of all, I was really delighted with both of you when you talked about what you're looking for in people. It's typical of competitive innovative operations, where you actually look at the individual more than the number of degrees or programs after their names.
In reality, in the 1970s, that's the way the world was, in general. Companies hired bright people. Sure, they wanted them to be able to read and write, so a university degree was a start, but it wasn't so much exactly what they knew coming in. It was what they were going to be capable of doing and what they were motivated to do within the companies.
Then we saw the companies get bigger, and they wanted products coming out of the university, so we started turning out widget graduate degrees that were hired as particular units. That's still true in large organizations with a repetitive function. But not in those that are innovative. It's coming back to exactly where you are.
But, of course, you are at the front lines of innovation and you're able to make those decisions yourselves, whereas the big corporation trying to figure out who is the bright person, they hire people to try to figure out who they want. You know who you want. You have a real advantage in identifying really bright, eager and dedicated young people who want to make a difference. I've been following this for a while and some of the examples of young people who have come into the worlds you are in, and the IT world, which has been going on for a while, is really remarkable in that regard. It's very exciting, so your adding that dimension to this discussion is really important.
Mr. Monteith, I wanted to come back to your earlier example, where you described in a hospital setting the ability of technology to alert in advance, in a case of a cardiac situation. Let's take the situation that I think you were describing. You were talking about a patient in hospital and being able to follow them quickly and being alert to a developing event.
We had another witness, and this individual was talking about the cardiac patient who has come through the therapy, and they are back out in the real world. But as we know, there is the possibility of recurrence. It's a wide range of people. The description was that there will be technology, and he was implying that it's already virtually there, that you can perhaps wear and will alert you to an event in the type of person I'm talking about — somebody who survived a cardiac event, and is rehabilitated. Now they are out in the real world. It could alert them that in two or three days, they may have a problem, and suggest getting to a support system very quickly.
You are in this and you're looking at it here in Canada. Can you give us a little bit of a sense of how the use of this technology is going to move forward in being able to alert individuals in their homes, or wherever, to a potential event and that they should seek support before the crisis actually occurs?
Mr. Monteith: I think there is just an absolute explosion of invention and innovation in the area of wearables, sensory input and algorithms driving individual awareness of everything from a level of activity, for those of you who have a Fitbit when it pokes you and says get up and walk around, all the way to really life-critical events.
Let's say that person had a cardiac arrest, went through cardiac surgery and they have been discharged home. Now imagine even beyond the wearable, a smart scale and all of the other devices that could be deployed very cost effectively today working under the umbrella of AI in real time, to actually say, "You're at risk of being readmitted and you should phone your general practitioner.'' Or go beyond just the individual to engaging the family and the care team to improve the outcome.
I believe that that's happening today. We're actually involved in a study with McMaster University which is looking at the post-surgical discharge problem to prevent readmissions and improve outcomes. I think that consumer technologies are going to converge with the hospital's imperative to do more with less and provide more services in home in a way that is going to fundamentally change where care gets delivered, focusing more on early intervention and prevention of recurrence, as opposed to picking up the pieces when everything has gone wrong.
The Chair: Mr. Deguire, early on you were talking about your arm. You made the comment a couple of times about having one that's been operating in the Netherlands for seven years. Yet, you can't get them introduced into Canada in an organized way. That's an enormous competitive disadvantage. Our citizens have a tremendous disadvantage in terms of their opportunities, as well, as a result of this.
So, tell us a bit more about what the Netherlands did, more than seven years ago, so as to be able to adopt that technology within a system and a scheme for dealing with it being paid through insurance?
Mr. Deguire: First of all in the Netherlands, the health care system is a bit different from here.
The Chair: Every place is different than here.
Mr. Deguire: I'll just state a few examples. Everybody needs to have health care insurance, but the major health care insurance companies are private and they can compete. So there is no monopoly, like there is in Quebec, where there is only one player. So if they don't move, there are no consequences of not moving, so this competition creates a need for innovation.
Second, what they did was the research. They asked, "Can robots reduce costs?'' It's a fair question that everybody should ask. So they did the study with the businesses and it was a competitor of ours that was there before us. They did the study with users who had a robot arm on their wheelchair to find out how much they could reduce caregiver time per week? They got the numbers, and the number that they got after their study was two hours per day. They multiplied that by the hourly rate of a caregiver and they say, "You know what? This is what we're willing to cover. If you can do better than that, good for you.''
So they set up a challenge, and they said, "If you can fit in that price range, it is worthwhile for us to pay for that.'' So they gave the information to the industry and the industry answered, so they had a product that fit in their range.
When we went to the Netherlands, we knew the price we had to fit in. It was clear from the start. You need to fit in that price to be covered and we did. You know, that price is 28,000 euros. This is where we went. It was very simple. It simplified the risk for the businesses and the developers to have market access.
They give you the answer, and you have to fit in that price. So if we could have that here, in Canada, again, challenge us and we will be there. If it's not the price for a capital purchase, if it's a price per day, we can innovate not only on technology. We can innovate on the business model. You want us to provide a solution so that people can have a meal by themselves for $15 per day, and we will answer the challenge. We will find solutions for that.
The Chair: Well, this is extremely important for this committee to hear, as we're trying to look at the implications of these technologies to the health care system. We are already seven years behind with regard to key issues.
By the way, on the example you gave, now the U.S. health insurers are doing exactly that. They are searching the health care system for examples of where this can be done, and paying for business creation to deliver the solution.
Mr. Deguire, I want to follow up on the question that Senator Mégie asked you. Her question started off with regard to programming and so on, but it really comes back to the operation of the arm itself.
You gave a quick overview in your initial remarks. I think it would be good for the committee to hear more about how, today, we can take a quadriplegic, connect electrodes and have the signals actually move technology around them. In the last two or three months alone, the developments that I've seen occurring are absolutely remarkable.
Could you take what you did but elaborate a bit more and give a few examples of the different kinds of individual and how they interact directly with your arm?
Mr. Deguire: First of all, the robotic part is completely agnostic of the control part. Whatever type of control you can have, you can still have the same feature and function. A good example of that is our five-year-old using the joystick. We can have a mini joystick or we can have a similar piece of technology but more precise for surgeons who use an Xbox controller. Those are the available means of control.
We've built a structure to prepare for the next generation. We were talking about brain-computer interface. Today, we don't develop a Kinova brain-computer interface, but there are more than four projects worldwide using Jaco technology and controlling the Jaco through brain-computer interface. Some have chips implanted in your brain; some are external to your brain. The pace at which those technologies have developed in the last few years — even in the last few months — I'm in technology, and I'm surprised every day. It's going fast and faster. We're getting ready for that.
The pitch and the value propositions stay the same. As long as you can have a means of control — so if it's with your eyes, your brain or your residual muscle signal, we will use that and move the hardware with it. This opportunity means for someone with a degenerative disease, if at first you have muscular dystrophy, you can pick up your glass but you can't open the door; the reach is too far. The robot will help you bridge that and bring a pencil so you can write. If you lose mobility and can only move one finger, you can still have your meal and open that door. The day you lose full function of your hand and you need to control the wheelchair with your chin, you can keep the ability to have your meal by yourself and open that door.
Stability of capabilities through robotics is a value proposition. You can look at the direct value but also look at the psychological effect that this brings. We have a population that is used to losing capacity and now you can offer them a stable capacity, whatever stage they will be in their disease. This has a huge impact. Then you can envision going back to school to get a job because you know you will be able to open that door and get that paper, and not rely on your co- worker every day, even if you have a bad day, if you lose energy on that day or if your pathology is more aggressive than expected.
It gives hope for a more stable future.
The Chair: I'm going to push you a little more, because it doesn't matter that I know some of this; we have to have it on the record to be able to use it in a report. I'm going to push you further so you tell us about the ability of sensors today to pick up signals — any signal from the brain down through various systems. You can tap in at almost any point, and as long as you can get that signal, you can have it directed to control the arm; is that correct?
Mr. Deguire: It's exactly correct. Today, the bottleneck to control the robot is the amount of information you can send to the robot. The reason why we're using artificial intelligence is to use less information from the human to do more with the robot.
On the other side of the scale, we're pursuing and making alliances and partnerships with any development team that is pursuing a way to get more information out of the human. This means tapping on the nervous system, tapping directly on the brain, so getting those signals where they're generated. Sometimes, if you cannot move your muscle doesn't mean the signal is not going to your muscle. If you can connect directly to that, you have more information, less filter and a more direct approach to it.
We're developing hardware and control interfaces, and we're getting ready, because this technology is coming.
The Chair: Absolutely excellent. That's what I wanted on the record. Thank you very much.
Senator Eggleton: Let me come back to you, Mr. Deguire. You indicated that there's no insurance plan in this country — none of the provincial plans, none of the private plans — that covers this. Are you able to still sell these in Canada?
Mr. Deguire: I will make a correction to that: Some premium insurance will cover it. With the Canadian Armed Forces, we did add a few coverage. Also, in Quebec, some specific insurance and some private insurance were able to, but we do not have major health care system insurance.
It has started, and those discussions have also started. For the moment, most of the sales in Canada would be through a charity — so a foundation — or private pay directly.
Senator Eggleton: Or hospitals maybe?
Mr. Deguire: Not hospitals but research groups that are affiliated with hospitals.
In Canada, we sell more robots for research than for assistive devices. They're doing research in many types of applications, such as agriculture, the food industry, bomb technicians and power technicians wanting to use our robots. Assistive device use, such as for people in wheelchairs, is still limited.
We have progress. In seven years, it's not like we haven't been doing anything. We've been working and answering the questions, the need and going step by step. It just needs to be faster than that.
Senator Eggleton: You have devices other than this one — other than Jaco?
Mr. Deguire: Yes. In Canada, we can supply assistive devices that have a range from arm support, which is a simplified exoskeleton. You still have the ability to pick up something. You don't have the ability to raise your arm, we have arm support. We have passive arm support and active ones that are motorized. We have a smaller robot called Mico and we have Jaco.
As long as you're in a powered wheelchair and you have a limitation to upper body, we have a wide range of solutions that will go from $7,000 to $45,000 that can support you to have a meal, more independence and compensate for your upper body mobility.
Senator Eggleton: Are these approved by Health Canada as a medical device?
Mr. Deguire: Yes, those are medical devices, same as a wheelchair.
Senator Eggleton: So they all have that approval.
Mr. Deguire: Yes.
Senator Eggleton: Mr. Monteith, I take it you don't have the same problem with insurance. You're selling to hospitals, and it's not necessarily just robotics but software and artificial intelligence.
Mr. Monteith: It doesn't make the sale any easier or shorter, for sure. We look to the motivation to make investments, whether it's private insurers or our health system direct dollars being spent. The problem is the same largely.
The challenge, post-commercialization, that all companies in Canada face is really what we call more access to customers. It's the discovery. How do you get attention? How do you live in Ontario within a framework of HBAM, which makes organizations project their operating costs for three years? How do you plan for innovation?
A number of the challenges that exist today — I think it's access to capital for these organizations to be able to participate in a non-punitive way. We punish early adopters today by going over budget if it's operating or capital dollars. It doesn't really matter if it's private sector entities or public sector entities that are funding health care. They're not planning for these kinds of disruptive capabilities coming to market, and we need to find new business models that make that okay. We live in a world where the cost of capital is near zero, and there's plenty of it in the sidelines, even in Canada. How do we bring together all of these forces and actually enable guys like him to sell this amazing technology into our hospital system, which would be fundamentally changed?
[Translation]
Senator McIntyre: Mr. Deguire, your company manufactures robotics platforms and components for assistive and service robots, so could you kindly explain the difference between an assistive robot and a service robot?
Mr. Deguire: We developed the Jaco robot using a modular structure. Originally, it was to keep the service simple, cut costs and allow the technology to evolve. The modular actuator technology can be sold for use in other types of applications. It is often possible to have the exact same configuration or some variant thereof. Given that the device can have six degrees of freedom, or motion, versions with four, five or seven degrees of freedom are also possible. Rather than having a hand designed to grasp everyday items, it is possible to have a more rigid hand, designed for use in an industrial or agri-food setting. The components can be configured that way.
The size and model will always be the same for rehabilitation purposes. For a service robot, the components are broken up and specifically used for each application. Instead of starting from scratch, we start from modules to arrive at a tool much more quickly. The actuator technology is modular and scalable, so both smaller and larger actuators are possible.
In medicine, our surgical applications have actuators that are 10 times more precise; they include redundancy and are designed for specific applications. They also come with a different price tag.
We have specialists in robotics development. The expertise is in following a set of specifications for a very specific application. The specifications are tied to the price. If the customer — the health care system, in this case — has the data and knows the cost associated with a given problem, we can develop a product specifically tailored to that price and application. We are able to do that.
Service robot technology is booming, and the medical industry is the biggest market. Agriculture and logistics are two industries where the use of service robot technology is also growing fast. No world leader in the field has yet emerged, so that title could go to Canada. With the minds and knowledge we have here, in Canada, we could play a leading role in the service robot sector. It's an opportunity we mustn't miss.
[English]
The Chair: This has been fascinating. We're looking forward to getting up close and personal with your arm there. You've covered a wide range of issues that we are facing in Canada to maintain our quality of life overall because we have to have innovative companies that will help us move into the world of tomorrow by developing the products and opportunities for people to work in those companies to be able to be part of this modern world.
You've given us a wide range of issues. The issue of Mr. Monteith with regard to the patent issue is not a new issue, and even for the old industries, the viciousness, it's part of the competitive cycle. If you have enough money, you can drive another company out of business just by keeping them in court over their intellectual property. But the part that I liked about your comment was the idea of trying to think of some new cooperative, a new way within a country to allow the evolving companies to compete in that kind of circumstance. We've had comments from you ranging from things of that nature all the way through to where this is likely to go.
Unfortunately, Mr. Monteith in particular, you've reinforced what we have known for some years in this committee, the challenge we have of dealing with what most people call a health care system and isn't. It's not a system is what I mean. The simple example, which I use quite often because it's easily understood by our audience, is the electronic health record. It's been nearly a decade now at least, maybe slightly longer, in which federal governments have poured billions of dollars into the idea of developing an electronic health record, and we still don't have one. The major part of that, as near as I can tell, is the RFPs are such that the primary requirement is on protection of data, and there will never be a system that is totally 100 per cent safe in that regard.
On the other hand, as we've said a number of times in this committee, Canadians love to submit their income tax electronically, and it's far more sensitive in terms of information than most health information that would be out there. Until we can get an electronic health record, you're not going to have access to the information you need even within our narrow system. The one-payer system doesn't allow for the adaptation and collection of information the way all 35 other industrialized nations have.
So you've brought a wide range of issues to us, in addition to the actual examples of how these technologies are benefiting people around the world today and where it's likely to go.
On that note, I will adjourn the meeting, but I remind my colleagues that they are invited to stay behind and get hugged by Jaco down there, who is very friendly, I understand, very sociable. I declare the meeting adjourned.
(The committee adjourned.)