Proceedings of the Standing Senate Committee on
Social Affairs, Science and Technology
Issue No. 14 - Evidence - February 1, 2017
OTTAWA, Wednesday, February 1, 2017
The Standing Senate Committee on Social Affairs, Science and Technology met today at 4:15, to study and then report on the role of robotics, 3D printing and artificial intelligence in the healthcare 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, a senator from Nova Scotia and chair of the committee, and I'm going to start the meeting by asking my colleagues to introduce themselves, starting on my left.
Senator Eggleton: Art Eggleton, senator from Toronto, deputy chair of the committee.
Senator Merchant: Pana Merchant, senator from Saskatchewan.
Senator Meredith: Senator Meredith, Ontario.
Senator Neufeld: Senator Neufeld, British Columbia.
[Translation]
Senator Petitclerc: Chantal Petitclerc, senator from Quebec.
[English]
Senator Raine: Senator Nancy Greene Raine from B.C.
Senator Seidman: Judith Seidman from Montreal, Quebec.
Senator Stewart Olsen: Carolyn Stewart Olsen, New Brunswick.
Senator Beyak: Lynn Beyak, Ontario. Welcome.
The Chair: I will return to the end on my left for a moment.
Senator Dean: Tony Dean, Ontario.
The Chair: I'm welcome you all back to the start of a new season, and we are beginning, with this meeting, our study on the role of robotics, 3-D printing and artificial intelligence in the health care system.
On October 25, 2016, this committee was given the following order of reference:
That the Standing Senate Committee on Social Affairs, Science and Technology be authorized to examine and report on the role of automation in the healthcare system, with a particular focus on robotics, artificial intelligence and 3D printing, in:
Direct patient healthcare;
Indirect patient healthcare; and,
Home healthcare.
That the committee submit its final report no later than December 31, 2017, and that the committee retain all powers necessary to publicize its findings until 180 days after the tabling of the final report.
Today the committee will begin the study by hearing about some of the research being carried out in these specialty areas and the support offered by Canada's federal research agencies.
Before I identify our witnesses, if we have time at the end of this meeting I'd like us to go in camera for a few minutes, for the benefit of the new members of the committee, to go over some of our quick operating procedures. We'll hope that we do get a few minutes at the end. This meeting will end at 6:15, and, if you are in agreement, even if we go to that time, perhaps we could take three or four minutes just to go over some quick general rules.
We are very fortunate today to have some of those research enterprises and the people who can inform us with regard to our study and the involvement of our research community as represented here today. I'll take them one at a time as I ask them to present. In the first instance, I'm going to invite Dr. Jane Aubin, who is the Chief Scientific Officer and Vice President, Research, Knowledge Translation and Ethics, with the Canadian Institutes of Health Research or, as we all know it, CIHR. So Dr. Aubin, would you please present to us?
Jane E. Aubin, Chief Scientific Officer and Vice President, Research, Knowledge Translation and Ethics, Canadian Institutes of Health Research: Thank you very much, Mr. Chair and honourable senators, for the opportunity to testify before you as part of your study on automation in health care. As was said, my name is Jane Aubin, and I'm Chief Scientific Officer and VP of Research, Knowledge Translation and Ethics at CIHR. I'll use the acronym to save time.
As a federal funding agency, CIHR provides support for the full spectrum of health research, ranging from very basic biomedical studies to population and social aspects of health. Given that health research is ultimately about making us healthier, we also play an important role in moving proven health innovations into practice. It is by funding this continuum that CIHR is able to influence transformational changes in Canada's health care system.
Today I would like to provide you with a few concrete examples of CIHR-funded research projects related to automation that have the potential to transform the lives and health of Canadians.
The first examples are related to CIHR investments in robotics, which are enabling health professionals to provide patients with more precise and personalized courses of treatment. With more than $1.1 million invested from CIHR, Dr. Sean Dukelow from the University of Calgary was able to optimize cutting-edge robotic technology to deliver tailored treatments to stroke survivors. Typically, physicians must rely on their own observations to rate a patient's abilities following a stroke. Dr. Dukelow's research has shown that by using an exoskeleton called KINARM, clinicians can precisely assess stroke patients and tailor their rehabilitation to address specific deficits.
Advances in robotic surgery are also helping to improve access to care. For example, CIHR investments at the Centre for Surgical Invention and Innovation, a Centre of Excellence in Research and Commercialization, have led to the development of an image-guided automated robot, which can be operated remotely, allowing radiologists to biopsy and treat cancer patients in remote locations.
CIHR is also investing in artificial intelligence, which is producing promising results in multiple settings, including for older adults and people with disabilities. Again as an example, CIHR has invested more than $487,000 to support the work of Dr. Alex Mihailidis from the University Health Network in Toronto to develop an automated prompting system called COACH. COACH provides verbal or visual prompts to help people with moderate to severe Alzheimer's disease with basic tasks such as handwashing and has been found to work effectively in long-term care facilities. The COACH artificial intelligence system is now being adapted to help with other daily living activities and to operate in individual homes using mobile robots.
CIHR is also supporting new medical applications for 3-D printing, with recent developments focusing on the creation of accurate 3-D models for custom bones, hip joints, knee replacements and other organ tissues, to name a few. For example, CIHR invested close to $340,000 over four years to support Dr. Stephen Waldman of Ryerson University in his research on organ reconstruction and tissue engineering. With this particular investment, Dr. Waldman will be able to successfully reconstruct a functional living replica of his patients' ears using engineered human tissue and 3-D print molds, an approach that should achieve superior reconstruction with fewer surgical complications. As you can imagine, this research holds huge promise for victims of severe burns or other accidents.
In 2014, CIHR and 14 partner organizations invested more than $32 million over five years in the Canadian Consortium on Neurodegeneration in Aging, which investigates neurodegenerative diseases and their impact on cognition. An important area of focus of this research is on technological supports like artificial intelligence and robotics, which will help improve quality of life for people with neurodegenerative conditions of multiple sorts.
Through our eHealth Innovations initiative, CIHR with partners, including the National Research Council and the European Union's Active and Assisted Living Programme, is helping to develop, integrate and evaluate eHealth technologies such as health care apps that demonstrably improve the quality and cost-effectiveness of patient-oriented and population-centred care. Future directions for this initiative will focus on adapting innovative technologies for more personalized health care approaches.
Moving forward, automation is expected to continue to be an important area of investment for CIHR. As I mentioned earlier, the future of health care in Canada lies in our ability to innovate. This means that we must think differently, be bold and be prepared to engage partners not traditionally associated with the health sector.
Today, research and innovation in automation have led to sophisticated technologies that are creating greater efficiency in the health care system and improved patient experiences. CIHR has long been a supporter of cutting-edge research and will continue to invest in pioneering research projects through both its strategic or priority-driven research and its investigator-driven research programs.
We look forward to continue to work with partners to invest in automation research and other emerging areas and ensure that these innovations translate into improved health for Canadians, more effective health services and products, and a strengthened Canadian health care system.
Mr. Chair, thank you and colleagues for the opportunity to share our work with you. I would be happy to respond to questions that you may have.
The Chair: Thank you very much.
I'll next call on the Natural Sciences and Engineering Research Council of Canada, or as we are more commonly familiar with, NSERC. I'm going to identify the two representatives that we have here today with us: Dr. Bettina Hamelin, Vice President, Research Partnerships; and Pamela Moss, Director, Manufacturing, Communications and Technologies (MCT), Research Partnerships. I believe, Dr. Hamelin, you will present to us.
Bettina Hamelin, Vice President, Research Partnerships, Natural Sciences and Engineering Research Council of Canada: Thank you very much, Mr. Chair and honourable members of the committee, for the opportunity to speak before you on this fascinating subject. I will make my comments in both official languages today.
I offer my comments today from the perspective of an agency with deep connections to universities, colleges and polytechniques as well as industry partners. NSERC is the lead investor and convener of the academic community in the area of natural sciences and engineering and a major investor in and convener of academic-industry research partnerships.
[Translation]
NSERC actively supports basic discovery research in the natural sciences and engineering. It also supports innovative, discovery research partnerships that are designed to meet the needs of the private sector and of stakeholders in the innovation ecosystem.
[English]
We have seen time and time again how such innovation tends to stimulate new questions that can only be addressed by fundamental and applied research.
I also need to stress that NSERC is no stranger to health research. In the past fiscal year, we invested approximately $184 million, or 18 per cent, of NSERC's budget in biomedical research. Generally, this has consisted of discovery- oriented research into basic biological mechanisms, as well as bioengineering-oriented projects. It also includes major innovation-focused research efforts focused on bringing novel biomedical devices and IT tools to market.
Pertinent to the three areas that we will be discussing today, in 2015-16, NSERC invested $52 million into biomedical engineering and medical technologies, a 37 per cent increase from 10 years ago.
[Translation]
Industry partnerships are a strategic priority for NSERC. In 2015-16, there were 3,700 businesses that were industry partners in research projects supported by NSERC. These investments serve to develop the next generation of talent in science and engineering, which represents more than 30,000 people every year. Ten thousand of these people are involved in industry research, while the rest are involved in postsecondary research.
[English]
When we talk about technologies — such as artificial intelligence, robotics and 3-D printing — and health, there is clearly major potential for technologies to improve delivery of health care services within traditional settings.
AI is about deeper analysis and interpretation of data, allowing for the creation of better algorithms, software and systems used for such purposes as sharing patient data between health care professionals and treatment planning. Robotics plays a front-line role in areas such as surgical suites and artificial limbs. Finally, 3-D printing is beginning to allow for the rapid fabrication of essential parts and devices for clinical settings. Research supported by NSERC is pointing to a new generation of devices incorporating or even built on scaffolds of biological materials fabricated using 3-D printing technologies.
I would like to stress to the committee that, in the long term, what may prove to be the more profound area for innovation and disruption is how these new technologies will accelerate the development of new models of health care delivery. Think non-institutional, patient-centred, and indeed patient-managed systems. I believe researchers grasp this possibility. They often highlight themes such as self-management, personal independence and quality of life as goals for their work.
[Translation]
In the area of artificial intelligence, I would like to draw your attention to a do-it-yourself smart-home project. This is one of the research projects of the AGE-WELL network, supported by the Networks of Centres of Excellence Program, which is administered by the three federal granting agencies. This project is being conducted jointly with the University of Waterloo and the Université de Sherbrooke and seeks to develop a smart-home that would help older adults live comfortably and safely in an environment suited to their needs. That environment could be connected to a dynamic database containing information on the resident's specific needs and lifestyle. This home environment is supported by artificial intelligence, making it truly smart.
[English]
In the area of robotics, I would like to highlight innovative work taking place in the lab of Dr. Mike Van der Loos from the University of British Columbia. Dr. Van der Loos is merging robotics technologies with software design and electronic gaming platforms to develop innovative rehabilitation tools. He is using the gamification of therapy to make dull and tedious exercise more enjoyable. The project uses custom-designed, motion-sensing game controllers, combined with new software that requires the patient to coordinate hand movements. This will change how post-stroke hemiplegia and cerebral palsy therapy is done and would serve as a major break-through in medical rehabilitation.
The last example I will provide involves 3-D printing using so-called bio inks. NSERC has provided support to several researchers in this area, research that has included a number of partnerships with industry. Dr. Stephanie Willerth at the University of Victoria is working on tissue engineering using 3-D printing. This process uses 3-D printers and a fluid with biological components — bio inks — to create small vascular tissue that can be connected to create a vascular network.
The implications of this work are significant. It allows for complete engineering of organs, transplantation and even medical treatment testing. Leveraging 3-D printing and bio ink in health care will strengthen patient treatment and disease prevention. It is a major step toward keeping Canadians healthy longer.
[Translation]
NSERC is proud to fund all these interesting projects and is proud of its efforts to support innovation in health care.
[English]
The Chair: Thank you very much. I will turn to the National Research Council of Canada, or NRC, and we have Dr. Roman Szumski, Vice President, Life Sciences; and Robert Diraddo, Section Head Simulation & Digital Health, Medical Devices.
[Translation]
Dr. Roman Szumski, Vice-President, Life Sciences, National Research Council of Canada: Hello. My name is Roman Szumski and I am the Vice-President of Life Sciences at the National Research Council of Canada, or NRC. I am joined today by Dr. Robert DiRaddo.
First of all, I would like to thank you for this opportunity to speak to the committee about the types of work we do at NRC that enhances the health of Canadians, and in many cases, improves and saves lives.
[English]
I joined the NRC in 2005 as the Vice President of Life Sciences. I am a medical doctor and a pathologist by training and a former executive within the life sciences industry. I was attracted to this organization because of the innovative work it was doing in working with public and private sector partners to transform Canadian S&T discoveries into significant health care advances for the country.
To give you an idea of the scope and scale of the NRC, we are a national organization and have about 3,700 researchers and employees that are highly skilled and innovative, and they're located right across the country.
[Translation]
Our work covers a broad range of scientific and engineering disciplines, the outcomes of which have changed the lives of people right around the world.
[English]
In my mind, there's no better time to highlight this track record of longevity and relevance, as last year was the centennial for the NRC. From inventing the first cardiac pacemaker and electric wheelchair to more recent inventions like a vaccine to prevent meningitis in infants, the innovations have saved countless lives and have spawned new generations of solutions.
At NRC, we have always worked in a space where technology converges for multiple disciplines or communities. We rely heavily on our collaborative relationships with community partners, including companies, teaching hospitals, universities, supported by my colleagues to the left and other government departments to create the best solutions possible.
Given the area of study for the committee, I would like to take some time to discuss our experience in health care system automation and focus on some real-life examples.
Most of us here today would agree that Canada must increase the efficiency of our health care system to get better value and to serve the needs of an aging population. As such, we have made it a priority to investigate solutions that address this challenge.
Imagine if you will a virtual reality environment where our health care workers are able to practice and train on simulated patients outside of clinical settings, such as an operating room. This virtual training improves the quality of patient care and reduces risks to the patient.
Just as important as the research is ensuring that these innovations don't gather dust in the closet. Currently NRC is working with the world's largest medical simulation company, CAE Healthcare of Montreal, to commercialize and deploy NRC-developed neurosurgical simulator technology around the world. This is the same company that trains pilots on simulators. The technology, known as NeuroVr, is already installed in 20 teaching hospital sites across the Canada, the U.S., Europe and Asia.
I would like to take you to another part of the world for a moment and speak of our work with the University Health Network in Toronto and Korle Bu hospital in Ghana. Working closely with this international team, NRC has developed and delivered surgical simulators to both locations to facilitate tele-simulation training of surgeons in Ghana by surgeons in Toronto.
This training is focused on training for endoscopic third ventriculostomy surgery, the treatment of choice for hydrocephalus in infants. Affecting about 90,000 babies in that region, hydrocephalus is a condition that causes an excessive and dangerous amount of clear fluid to surround the brain and spinal cord, causing deformities and harmful pressure on the brain. Getting this treatment to sub-Saharan Africa is critical to saving and improving these lives.
We have also cultivated a strong applied data analytics capability at NRC. An excellent example of this specialized capability in action for Canada would be when we capitalized on our natural language processing technologies expertise to develop a health surveillance tool for the Public Health Agency of Canada. The tool provides health analysts with alerts and summaries of emerging health issues as they appear in media articles from around the world. By automatically categorizing and organizing documents from multiple languages, the agency can anticipate trends and threats on the global stage that would affect the health and safety of Canadians at home.
I would like to take a minute to touch on an area of the NRC that is different from the exciting research and development that we are known for, stimulating both economic and social benefits for Canada. NRC's Industrial Research Assistance Program, or IRAP, as it is often referred to, provides innovative small- and medium-sized Canadian companies with the advice and funding they need to move their health projects to commercialization.
One of my favourite examples of an IRAP-supported company that has produced an extremely innovative product is Medella Health in Ontario. Medella's revolutionary contact lens supports a preventative model of care by continuously monitoring glucose levels and transmitting the information to a mobile device so patients can manage their diet, exercise and habits. The smart contact lens works by integrating a small sensor, a chip and a micro-antenna into the structure of the contact lens.
Imagine the impact this could have for severe diabetics who are having trouble monitoring their condition. This real-time and continual monitoring improves the overall quality of life for patients and eliminates the need for continual blood access and analysis.
To close, I would like to emphasize that it's the breadth of expertise and unique scientific infrastructure and national scope, all combined, and working with collaborators that enables us to bring people together from across our innovation spectrum and abroad to work together on the most pressing challenges. It goes without saying that going forward we are equally well positioned to convene the right players to work collectively to deliver life-enhancing and life-saving interventions that make a difference across the globe today and in the decades to come.
Thank you again for your interest in NRC. My colleague and I would be pleased to answer any questions.
The Chair: Thank you all. Just before I open it up to my colleagues for questions, Dr. Hamelin, you touched briefly on one aspect that I was hoping one of you might discuss during your presentations, and that is the issue of the Networks of Centres of Excellence. Would you speak a little more about that to give the committee a feeling for where that fits in our approaches in the scientific and technological enterprise in terms of networks and so on? It doesn't matter to me which one of you responds, but I think we would like to know a bit about that right upfront in our discussions.
Ms. Hamelin: The Networks of Centres of Excellence is a key program that is administered by the three agencies: by NSERC, CIHR and SSHRC. It invests annually $110 million in projects that bring together networks of researchers and that have mandates that can reach from academic research collaborations to reaching into innovation, translating these discoveries into innovative solutions.
Health is a very important area where Networks of Centres of Excellence exist. In fact, over 50 per cent of the entire arsenal of Networks of Centres of Excellence is in the health sector. AGE-WELL, one of the networks I mentioned, is a key one that is very pertinent to the discussion today because it uses AI and lots of IT technologies to help people age gracefully. But there are a number of other networks that are funded across the country and there's really representations in each province that serve various aspects of the health care environment research to innovation.
Ms. Aubin: That was a very nice summary.
The Chair: Yes, that was a summary of the program in general. What I'd like you now to do is focus on whether there is a network or networks that deal with the topic of our study.
Ms. Aubin: AGE-WELL is clearly one. There are other NCEs and if I can call it a derivative program, the Centres of Excellence in Research and Commercialization, that are also involved in such areas, including ones that have spun out of the NCE program, for example, in regenerative medicine, where 3-D printing and approaches that will use some of the ones you have here are being implemented.
The other thing I would like to underscore about the NCE program is that they all involve partnerships. Many of them also involve patients and people who are going to use the technologies and the outcomes of the research as embedded participants, which I think is an important model for the future in the areas that we're talking about.
I think it was said well, and perhaps differently by all of us, that moving the innovations into use, which we still are learning to do as a country, learning to do well as a country. With the integration of all of the stakeholders early on as real partners in the enterprise, I think the NCEs and other networks being established through other programs are important areas.
I didn't bring a fulsome list with me today, but we can provide to the committee a list of those networks specifically that touch on the areas of interest. One of the questions that I have so that we provide the best information for you is how narrowly or broadly you would like to actually define automation in health care, because robotics and artificial intelligence are a portion of it, and we may want to have a discussion around how much of the big data analytics, which is peripheral but important to the issue, you would like us to provide information on.
I would say all of the networks in some way touch on these, but we want to focus the information that's most helpful to move your discussions forward.
Ms. Hamelin: May I add just a bit of additional information? The AGE-WELL is really the core network that is pertinent.
The Chair: Yes, we have them on our list.
Ms. Hamelin: Oh, you have them. I see.
The Chair: Thank you very much for that example. I was trying to get into the idea of your management of specific networks in this area. I think, Dr. Aubin, we would welcome your offer to identify where within existing other titled networks robotics, 3-D and artificial intelligence occurs. With regard to large data, we're not interested in that directly unless there is an issue of using it in developing an artificial intelligence application.
Senator Eggleton: Thank you very much for being here and helping to launch our study on automation for health care purposes, particularly robotics, artificial intelligence and 3-D printing. You've given us a wonderful array of research projects and innovative endeavours that are going on, products and medical procedures.
I have a two-part question. One is with respect to partnerships. Are you doing many international partnerships in coming to this? I would imagine that a lot of this research goes on in other places as well, and I hope we're not reinventing the wheel. I hope we are in fact getting an opportunity to work with people in other countries, other institutions and other universities, for example.
The second part is particularly for Dr. Aubin because she mentioned a few items that are in research. I'm wondering how they then get into further development through commercialization or being used in other medical facilities throughout the country. Dr. Szumski did mention a few cases, such as the CAE case where you're developing the commercialization of a product, but you've mentioned some things that I'd like you to tell me how you're following up or who is following up on that so that it just doesn't dead-end somewhere.
Ms. Aubin: Let me touch on the international first. I used one particular example that comes out of our e-health innovations, which is also a partnership with NRC and NRC's IRAP program. CIHR — I apologize I don't have the number at my fingertips — has multiple collaborations with the European Union, in particular, but not just restricted to the European Union. That was one of the examples I used here, but with many countries, including Japan, China, Australia, et cetera.
Obviously, health research is a global enterprise these days. As an agency, we believe very strongly that it's important that our top researchers are linked into those international efforts, not just for the reason that you commented upon — we don't want to duplicate — but because, in fact, some of our health researchers are leading particular innovations where they can bring that to the table internationally.
Just to emphasize, perhaps, the importance of the international partnerships that we have, at an upcoming meeting of our science council that will occur in about two weeks, we have invited the European Commission to come and participate for a whole afternoon with us on those areas where we have partnerships and where we may be able to build more. Obviously, I think we're all limited in multiple ways as to how many partnerships we can actually engage in internationally.
Coming back to the commercialization part, I'll ask Roman to comment a bit more about that. I want to pick up on another important aspect of the innovation pipeline that goes beyond what we've touched on with the NCE.
One of the important strategies that CIHR had has been engaged in for multiple years now is called our Strategy for Patient-Oriented Research. That's an integrated research knowledge translation collaboration with provinces and many other partners, including commercial partners, to bring all of the stakeholders that I mentioned earlier — the researchers, the policy-makers, the company representatives, clinicians, other health care providers — to the table from the beginning, as they come up with wonderful, innovative ideas, to be sure that there's a receptor at the end to help move those into practice. Beyond the NCEs as a program, there are other strategies and programs that contribute very much to this area.
Perhaps you want to comment further, Roman, on the IRAP partnership in particular that we have in the e-health innovation space, which I think is an interesting example of bringing in the commercial piece as well.
Dr. Szumski: Our organizations certainly are actively working on and exploring novel ways of working together to improve the performance of transferring technology. Jane gave the e-health example, but I would say that, in general terms, what tends to happen is that, when an innovation coming out of a teaching hospital or a university has reached the stage where it's starting to receive investor interest and have investment made — they turn into a company — those companies then become eligible for IRAP support, which can help provide them with both funding and advice in terms of how you go about growing a small company to a slightly larger company, and then, through services like the concierge service, linking those companies to other engineers and researchers within the university system or within organizations like the NRC to do the work that needs to be done to further develop.
In terms of the international linkages, in addition to what you mentioned, which is accessing expertise elsewhere and collaborating so that you don't reinvent the wheel, there's also opportunity to access components of the value chain that may not exist in your own country or opportunities to access markets. We do some active development with other countries with that in mind. Actually, in the medical device space, Taiwan is one country of interest. In the example that I gave of the Medella contact lens company, we actually went with them to Taiwan to introduce them to the contact lens manufacturers that exist there. They produce 80 per cent of the world's contact lenses. When you get a product like that, it tends to be very complex, and you need many players. You go international to make sure that you find some of the best players that you can use to help your Canadian companies.
Senator Stewart Olsen: Thanks, Senator Eggleton. That's exactly where I was going. I do want to expand a bit. Dr. Aubin, you were speaking about public-private partnerships. Because I'm really a Luddite with this whole field and just learning, when you say that, are you talking strictly research, or are you saying that a private company can come to you and say, "Can we have money to develop this?'' And they put their own money in as well? It's such an exciting field, but I can see that the Canadian government can't afford to fund the total cost.
Ms. Aubin: We have two different big program pots, if I can call it that — investigator-initiated programs and priority-driven programs. I'm making that distinction because, in investigator-initiated programs, the idea comes from the investigator, and they can come in alone or with company partners or any other kind of partner to try to get funding that way through competitive processes. That's one tranche. We would fund things within these three domains, or three topic areas, from investigator-initiated programming.
The other big envelope is our priority-driven envelope. In that envelope, a lot of the initiatives actually require partnership to be eligible for the particular program. We do it in two ways. We can design a program that actually asks an academic researcher to find their partner, a company, for example, and come in together, or we, as an agency, find potential partners through the public-private partnerships, as you mentioned, and co-develop with them a funding opportunity that researchers can then come in and apply for.
I want to make the distinction that we're not funding the company; we're funding the researchers through these kinds of partnerships. Often the money, our money, would be matched by that partner. Sometimes they will bring particular in-kind contributions to the proposal. It's a menu of ways in which we engage in that kind of public-private partnership.
Senator Stewart Olsen: As to the end product, obviously, some of the ones that you spoke of will be quite expensive but, in my finding, I would think, absolutely crucial to many provinces. Is there going to be help for the provinces to afford some of these new technologies, which would probably save a lot of money in the provinces, for instance? I'm just wondering how provinces are going to come and access these new inventions.
Ms. Aubin: I think in multiple ways. It is absolutely clear that some of what we're talking about is expensive and is going to be housed within health care settings such as hospitals and institutions. Others — and I think we all touched on examples of it — are not necessarily that expensive and are actually quite amenable to home care and patient empowerment. It's really a completely different health care model. I do think we have to keep that in mind as we talk about all of these potential new technologies.
I mentioned our strategy for patient-oriented research. I think it's an important bit of this discussion because we talk about moving these things commercially, but they have to end up in the health care system or used by people in their homes. I mention SPOR, if I can use that acronym for the patient-oriented strategy, because you're bringing all the stakeholders together from the beginning. That's a partnership with the provinces so that policy-makers, from the beginning, can begin to think about the implications and the health economics portions of some of these interventions early on. It doesn't solve the problem, but you begin the discussion very early on. In fact, many of our proposals in this area require a health economics portion to the application itself so it's up front; where is this going in terms of cost?
Senator Stewart Olsen: Thank you very much.
Ms. Aubin: It's a very important topic.
Senator Seidman: Thank you very much for your presentations.
If I might ask you all the same question, and that is basically about the way the councils function. What I would like to know, if I might, is how the councils determine their priorities for funding, and do they update those priorities? How do you determine criteria for selecting centres and networks? How do you determine apportioning of funds to particular sectors?
The Chair: I'm going to interject here. This could take an afternoon. Could you tie that down using this particular study or this particular field as an example of how it would get on your radar for funding? So use the specific example to indicate how that might get in your funding decisions.
Ms. Hamelin: Yes. In general, NSERC reviews proposals based on peer review without strategic priority areas, except for a small portfolio of programs, which is our strategic projects and strategic networks. There are target areas and they're reviewed every five years.
How would something like this come on our radar screen? A researcher applies for a discovery grant, it is peer- reviewed and it is evaluated as making the cut for funding. It is the same for the Networks of Centres of Excellence. They are peer-reviewed and then groups would come together with a proposal and bring it to us.
Ms. Aubin: We have similar mechanisms. I explained the two big pots. Increasingly we're looking for emerging trends from the investigator-initiated pot because ideas are bubbling bottom up. So that's one way where we would see areas like this coming up and then decide in a process that involves our science council whether we should give prominence to a particular area and have initiatives specifically targeted to the area.
That priority-driven envelope for CIHR, overall about 30 per cent of our annual funding, is spent in that way. We have a strategic plan in which we already had targeted areas that impinge on these three aspects as areas of priority from 2014-15 for five years, so that laid it out at a high level. But annually, there are particular initiatives from this priority-driven envelope that impinge on one or more of these areas. The eHealth Innovations is one example that we had flagged in the strategic plan for 2014-15 and are still activating initiatives that impinging on this. That's a process of prioritization at the science council for that pot of money.
Dr. Szumski: I will try to help not make it half the day.
The Chair: We're getting a focus on the issue. I've heard you people speak on this issue.
Dr. Szumski: The part of the NRC that provides funding is the one I mentioned, IRAP, which funds companies. That one is done on a case-by-case basis. It's based on on-the-ground experts. We have 270 what are called industry technology advisers located across the country and throughout the North, and they work with the companies in their community. When it looks like there is a good case for an investment in the company that would help them advance the technology, then they would do that.
The other part of the NRC, the research labs of 3,700 employees, is a doing organization, not a funding organization. In that case what we do is develop strategic plans and business plans. A good portion of what we do is industry-facing, so what we decide to focus on is partly defined by what industry is telling us they're interested in and what they need to advance their products. That's how we would prioritize.
Ms. Aubin: May I add one point? I've used the term "science council'' a couple of times. I think I should explain that it's one of our governance bodies that comprise the scientific directors of our 13 institutes, some of whom have been before your committee previously. They and the leadership of CIHR are very much tied into national and international networks of other funders, so some of these ideas come up through those channels as well. We would put that on our table, not just the bottom up but where things are going and where we should be playing.
Senator Meredith: Thank you all for your presentations this afternoon. I too am fascinated by the new technologies that have emerged. In fact, a couple of years ago I had an opportunity to tour one of the hospitals in Toronto. I was able to operate on a brain, without killing the patient, so that was quite innovative. So I am moved by this in terms of the opportunities to expand.
We had the Minister of Innovation, Science and Economic Development with us yesterday in our chamber. They always come back to the pool — and Senator Seidman has raised the question as well — with respect to funding and how that goes.
There are so many ideas and so many individuals. This is for all three of you, and I will tie back my other question to universities. We need to ensure that governments are making the necessary investments with respect to getting these cutting-edge ideas especially to market, and my colleague also raised the idea of how to capitalize and ensure these ideas are being brought forth quickly and expeditiously, especially when it comes to young scientists and those individuals who are really keen on moving 3-D technology forward.
Are you adequately funded? How does that play into how the ideas that come forward can be developed quickly? Those are my first questions, if all three of you could comment on them.
Ms. Aubin: I think you've touched on, in part, the answer to your question. There are so many good ideas. I've used the words "through competitive processes, things get funded,'' so there is obviously an enormous appetite to move all these good ideas, but there are some hoops that people need to go through to access that funding.
CIHR's per cent funding of ideas that come in is public information. Our communities use words like "overall success rates'' or how many people in the country we are funding, and I think those numbers speak to the issue that you're raising.
Dr. Szumski: As I mentioned, the NRC is a "doing'' organization, not a "funding'' organization per se on the research side. The appropriations we receive we consider appropriate, and we make sure to have a good a selection process to pick the most promising ideas that we can move forward with.
On the IRAP side, there has been a fairly healthy augmentation of its funding levels over a number of years. It's a program that is recognized to return about $11 for every one dollar it puts out to the country, and it's recognized internationally. It is actually copied around the world.
Ms. Aubin: I didn't speak to your point about early career investigators, and I should have. CIHR received in Budget 2016 $30 million additionally, which we targeted specifically to early career investigators by the definition of within five years of someone's first academic appointment.
Ms. Hamelin: I wasn't trying to avoid the question.
First of all, the budget of NSERC has not changed in the last five to ten years; it has been very stable. However, the cost of research, as you know, increases dramatically. Just to give an example, of the NSERC community of about 11,000 professors, 70 per cent of them are funded through NSERC for discovery grants. The average grant size is $35,000. Even if you only need to buy a couple of computers because IT is your field, that's not a lot because you need a server.
When we're talking about the capacity required for this research, do we fund it sufficiently? I would say no. We very much appreciated the injection of $30 million in the last fiscal year for NSERC, but you can make the calculation across the community. That's a difference of $1,000 per professor.
I will make two other points. What helps our community is that on the research partnership side, and if I talk like Jane about two buckets, the discovery side and the research partnerships, industry contributes tremendously to the research, and they contribute the funding directly into the researcher's lab.
NSERC invests $300 million a year in research partnerships, and that leverages $200 million from companies who are interested in these technologies. That money goes into the researcher's lab. So that helps, and it also provides the input from the end user, which is tremendous for the community.
I would like to mention a collaboration that NSERC has with CIHR, the Collaborative Health Research Program, where we leverage federal dollars to invest exactly at this interface of computer scientists, natural scientists and engineers and health researchers. Many of the projects we were talking about are funded through this program, and this program is about $10 million from each agency and provides grants of about $200,000 per researcher, so those are nice grants. They're larger because we're partnering, but again research is getting increasingly expensive versus the budgets we receive.
Senator Merchant: There are so many good ideas. I'm going to get parochial here. I said earlier I'm from Saskatchewan. We're bullish about the work we're doing in Saskatchewan, especially in the city of Saskatoon. First of all, we have the synchrotron in Saskatoon, and perhaps you can comment on how this tool can contribute to the things we are talking about in our study.
Second, I'm sure you're familiar with the work of Dr. Ivar Mendez in Saskatoon. Can you explain better what he has done, because he has made some very important, world-renowned discoveries dealing with surgery in the brain? Perhaps you could tell us about his work, because I'm hoping maybe we can hear from somebody from Saskatoon in our study.
The Chair: We have them on the list, but I'd like to hear it from the granting agency's point of view.
Senator Meredith: Whether we invite him or not.
The Chair: We may change our mind.
Senator Merchant: Say something nice.
Ms. Aubin: I will definitely say something nice because of all the hundreds of thousands of health researchers in the country, I don't know them all by name, but I know him by name. That says something in itself.
I'm drawing a complete blank at the moment on his work, and he wouldn't like to hear me say that because I was in a room with him three or four months ago in which we had significant discussions, but lots of other people were in that room, so I'll be pleased to follow up with him specifically on his work.
On the synchrotron, that's a partnership model funded with funds from NSERC, CIHR and others, including the CFI, Canadian Foundation for Innovation, and other provincial partners.
The use of the synchrotron for health research-related applications has been increasing, which is a good thing from our point of view because we thought it was perhaps not being as heavily used as we thought it could be for health- related applications. We asked specifically for additional promotion of the synchrotron to our communities, which we have been doing and asking the synchrotron to do, and there are fabulous examples coming out in health-related and other areas.
Senator Merchant: Can you give us examples of the things we can do through the synchrotron?
Senator Stewart Olsen: For the people watching who don't know what a synchrotron is, would you elaborate?
The Chair: Can you remind the committee and the viewing audience what it is, as a technology?
Ms. Aubin: It is high energy beams that can be used for various applications. Apologies to anyone who knows more about them than I do, but it can be used all the way from creating new molecules to be used as isotope reagents for medical applications and imaging through to the imaging itself, to whole animals, whole people or portions of your body. Those are two uses that are definitely health-related.
Ms. Hamelin: I was going to speak to the imaging capability, which is the relevant application for health. I don't have anything else to add, but we can certainly provide some of the applications.
The Chair: I think we have got it. Just for the benefit of the committee, the work plan, as we're developing it, will have whole sections on individual experts in all these areas in Canada and abroad, and today we're dealing with the funding agencies to get their broad view, so we won't dig down into the individual expertise. We will have some fairly dramatic examples before us from some of our major centres in Canada as we go through the study; so I think it will take care of the rest of your questions on that.
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Senator Petitclerc: Thank you for being here.
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My question is to take us in a different direction and hopefully not outside of your comfort zone. But because this is the beginning of the study, I'm trying to build an image of the field in general. I was curious to have your input and some examples. You've got these great ideas, innovation, and it's fascinating and amazing. I'm curious about the side effect challenges that this field represents. When we think about the social aspect, or are people losing jobs because of this? Do the health specialists need to go back to school to be able to use this? You don't need to go into specifics, but more of the social or side effect impacts of it.
Robert Diraddo, Section Head Simulation & Digital Health, Medical Devices, National Research Council Canada: I will add something about the NeuroVR. One of the driving factors on the development of the neurosurgical skill simulator was that residents were working 80-hour workweeks, and that's not sustainable. Surgical techniques and medical devices that were being developed were increasing the strain on the residents to learn extra material within a seven-year time frame.
The technology we developed is beneficial from that perspective because it allows the residents to learn outside of the OR on their own, without putting a drain on the health care system, and also contributes to reducing the load of 80 hours for the workweek. That's an example of the beneficial side of interactive simulation or automation.
Ms. Aubin: One of the other comments I would make around this is we are not usually talking about a complete loss of a job as much as doing your job differently. We talked about smartphones or robotics. We gave examples. That information is fed back to health care professionals and others who can use the information both for that particular patient or person who needs to use it, but also leads to additional innovations that need to be developed as that information comes back. So in my mind we're not so much at the point of losing jobs but changing the way we do jobs and potentially creating whole new ones to implement some of what we're talking about.
We talked about the patient empowerment piece earlier. Yes, it may very well and is already saving burdens on people having to go into particular health care settings, but it doesn't mean they can just not be monitored and followed with time. I think that's an important piece to keep as part of the discussion.
Senator Petitclerc: So you would say it's overall positive?
Ms. Hamelin: Building on changing jobs, one of our mandates at the funding agencies is to fund training, so I think all of us are funding training in this particular field. To give you an example actually that's very pertinent, Algonquin College here in Ottawa actually just opened a health and wellness senior care centre, which is basically a rebuild of an artificial intelligence home that serves for the training for the students in the health care environment, and they actually now do also training for health care professionals who are already out in the field to retrain them on some of the new technologies. And we're funding that as well.
Senator Neufeld: I've had some of the results of some of this technology used on my body and I'm happy about it. In fact, I'm very happy about it. It works well. I'm still here. But I'm not literate on this, so please understand that when I ask my question.
When I see "the COACH artificial intelligence system now being adapted to help with other daily living activities and to operate in individual homes using mobile robots,'' similar to your questions, do we see at some point in time here in care homes — because you've talked about it a bit — people actually being looked after by robots? Am I making it too simple, or is that something that actually will happen in time? I wonder about the social impact of that and, if in fact that's true, how we actually convince people of my age at that time that, look, you're a fine fellow but we're going to have a robot in there to look after you.
Ms. Aubin: I cannot predict the ultimate future around —
Senator Neufeld: Sure you can.
Ms. Aubin: Well I can, but until robots can actually fix themselves once they break down, which may indeed come, there will be the need for human intervention, but I want to flip it around also.
So far, we haven't advanced artificial intelligence in these kinds of applications to the point where there doesn't have to be human intervention, human monitoring, et cetera. In some future, could it possibly be robots solely? Personally, I doubt it, but I don't know.
Senator Neufeld: But there will be a mixture?
Ms. Aubin: In my mind it will always be a mixture, much for the reason we're talking about. Health innovation has been a continuum for centuries, and the innovations will continue. As I was referring to earlier, as we use these technologies we are learning more about health conditions and disease that can be fed back into new innovations and better ways of doing things.
I don't really see the human intervention piece ever stopping. That's my personal view. Will robots get better and better and will artificial intelligence get better and better? Yes.
The Chair: Next week we will be having experts dealing with elder care, and there may be some further examples to your very question.
Senator Dean: Thank you for the terrific presentations.
I want to return to efficiency and quality, and you touched on it. Could you dig a little bit deeper into the examples or criteria approaches in this world that offer the best opportunity to provide quality of care and at the same time stabilize — let's call it the cost curve. We could use lots of other examples. Things that would stabilize costs, if not reduce them. If that means keeping people out of hospitals, if that's the answer, that's fine.
Second and related, if we go back a generation or two in technological advancement, could you give us a sense of where we are with the digitization and sharing of patient records? Did we declare victory too early on that, to what extent are we there and if we're not when will we get there? We're talking about some neat and interesting stuff here, but I'm wondering whether we completed a project that started over a decade ago that in a basic way was about using technology to improve quality and reduce costs, if those are fair questions.
The Chair: I'm going to interject here. That last question is one of the most important things before us as a country, and we've dealt with that in this committee in great detail and written and made recommendations on it, so unless you can tie it into artificial intelligence in some way, with respect, it's a separate discussion. It's absolutely critical for the country and our reports tell us that is the case, so I'm not downplaying it at all but it is a separate, large and important critical discussion except as it relates to our use of artificial intelligence, because the information from there can inform some of that. If we can go in that direction, we'll be okay.
Senator Dean: I would be happy as a newcomer to the committee and perhaps not knowing about previous reports for you to just address the first part of the question then, and if it's relevant to get into the second, by all means do.
Ms. Aubin: I think we already have examples of changing the cost curve, decreasing it. If you can keep people out of having to go for acute care or repeated care, high system users, if you can keep them out of the system through these technologies, that's an important thing by itself.
But I want to flip it around a little bit to say there is also a quality of life issue here when you can stay at home, have your stress reduced because you know the technologies that you're using are being monitored and that in many cases may predict when you would have to go rather than just go. Those are all very important benefits, and we know that the quality of life at home is where it's better. That's hard to put a number on but we know it's there.
Senator Dean: Thank you.
Dr. Szumski: A lot of the drivers that are behind in the researchers' minds who are developing these technologies are improving quality of life. That's what they live for.
You can imagine in the example I provided of that company with the contact lenses, it's intuitive that if you're able to monitor a diabetic's condition on a continuous basis and you avoid the invasiveness of having to do pinpricks, this is all improving quality of life. That's the driver.
Where the efficiency comes in is that ultimately, with better control, it will be longer before you develop complications and you are ultimately required to go to a hospital. That's how it plays out.
Ms. Hamelin: I'll quickly add that, as a funder, we're not the content experts but we see the project. I have three examples here in front of me that are about cloud-based data monitoring of robotic patient mobile devices, which are about robotic platforms for telemedicine, actively monitoring patients at home and early mobilization of patients after stroke. Those are all interventions that keep the patient at home, not having to go to the hospital, and that saves costs. There's lots of work that is happening and that is being funded by our agencies.
SSHRC is not here today, the Social Sciences and Humanities Research Council, a funding agency, but we have collaborations with them. Those are certainly issues that occupy them as well and they're also very much involved. It might be a good idea to have them actually speak to you on some of the research they are supporting.
Senator Raine: Thank you very much. This is fascinating. This whole study will be very interesting but a big learning curve. I have one question.
A lot of the research and technology that's being developed is being done in the urban centres, and I'm just wondering if there's awareness in the funding agencies and in the universities and academic world about the need to figure out a way to deliver some of these technologies to the rural settings where they may or may not have high-speed Internet and things like that. Are you working with Canada's wonderful telecommunications companies, who are really leading-edge around the world? Are they engaged in this development as well?
Mr. Diraddo: I'd like to add something. We had mentioned in the initial discussion the project we did with the teaching hospital in Ghana with the University of Toronto. One of our motivating factors for doing that project is that we felt we could bring some of that know-how and expertise back to Canada because Canada is a sparse population country. That was one of the motivating factors for that.
A lot of the work we do is obviously dependent on the advancement of Internet-type technologies and bandwidth and so on, and there are companies like TELUS in Quebec that are seriously involved in these types of issues for the health care system.
Senator Raine: Telemedicine is actually part of the big picture. As I'm listening, I'm hearing you talk about priority areas for research funding. How do you determine these priority areas? I think it's particularly CIHR that has that pool where priority is set by CIHR. Is there any component of that that deals with the transfer of this technology to the rural areas?
Ms. Aubin: The short answer is yes. Coming back, we don't just set the priorities internally in a closed way. It comes through a variety of mechanisms that I perhaps didn't explain clearly earlier, often through discussions with partners, with other funders, with communities — I mentioned the Strategy for Patient-Oriented Research — including remote communities.
I think a very good point was made a minute ago around what we can learn from funding in global health priorities. There's a lot we can be mining to consider bringing back to Canada, and that is an area we need to pay more attention to.
In fact, it's interesting that this aspect of the Internet and working with big IT giants is being discussed here. I'm not exaggerating to say I was talking about it yesterday internally with our partnerships group about what we can be thinking about further in terms of partnerships as an agency. Already, some of those entities are collaborating with people we fund, as Bettina also mentioned. There are multiple ways of bringing that piece into the research and knowledge translation continuum.
Ms. Hamelin: If I can add a couple of things, we will provide you our list of Networks of Centres of Excellence. For example, we fund the ArcticNet. It is a northern network. A big component of it is health, and telehealth is part of that. There are certainly large-scale projects that are being funded.
There's also a Canada First Research Excellence Fund to University Laval and the Centre for the North, which also has a northern health component, so the rural areas are really top of mind to a lot of researchers. We also have a knowledge translation network program that uses different technologies and really brings them out into these kinds of communities.
Finally, I'm looking at one of our collaborative research and development programs of Dr. Mihailidis. He is in Toronto and works with a company called CrossWing, which is working on a robotic platform for telemedicine, with the goal of serving rural areas. There are a series of programs that are being supported to address those issues.
Senator Raine: What was the doctor's name?
Ms. Hamelin: Alex Mihailidis.
The Chair: Just before I turn to the second round, I'd like to focus on the granting councils as a whole and look at the five major councils in this area. We have the tri-council, of course, supplemented by CFI and NRC.
Is there an association among you where you get together and look down the road in terms of what is going to happen? We will have experts come before us and tell us that the world is going to change in ways that we can't even imagine, even though we've just been through the IT revolution. If that is already anticipated, and since knowledge is the basis of how we will ultimately deal with that and you people collectively administer the funds that catalyze that knowledge in this country, is there a brainstorming association of those five groups I've met that are looking down the road and trying to develop recommendations — in your case to governments — as to how Canada must position itself in research in the basics of these areas and ultimately the applications? A number of colleagues have asked about how to translate that into developments that will actually benefit people down the road.
I don't want a long, artificial discussion here. I just want to know: Is there such a brainstorming group among the granting councils?
Ms. Aubin: The short answer is yes. Do we do it in the most effective way to give advice as a collective? Perhaps not. We have multiple collective brainstorming and foresight visioning exercises. VPs meet. I must say we don't always meet with NRC, but the councils — CFI and Genome Canada — have those kinds of discussions often. The presidents and the VPs have them quite regularly. Some of the collaborations that we've talked about come out of those brainstorming sessions. I must say we do have those discussions with NRC, and the eHealth Innovation is again an example of that kind of collaboration. Do we collectively do it in a way beyond that? We can probably improve the way we do that.
Senator Eggleton: I want to drill down on what is an appropriate level of government investment in terms of these research programs. Dr. Szumski has said that he gets an appropriate appropriation of money, and Dr. Hamelin says not enough. Perhaps I'll start, then, with Dr. Aubin, but I'm not asking you if you want more money. I assume you would. Of course you would. But I want to get a feel for what is an appropriate level here, and maybe part of getting that feel is to know, of the applications you get, how many of them do you fund? One in five, one in twenty, or what? Of the ones you do fund, what percentage of the application do you fund? Is it a small percentage, a big percentage? You can answer it on that basis or any other basis you want to, but I'm trying to get a feel of what would be an appropriate level of government funding in this area. When I say automation, there are a lot of things that can cover, but of course we're zeroing in on the robotics, the artificial intelligence and the 3-D printing. Over to you.
Ms. Aubin: In our two big pots, investigator-initiated, bottoms up — and we're transitioning some of our program design, I should say — we are currently, in those programs of investigator-initiated, at a 13 per cent success rate. As to the predictions, as Bettina has commented, the research costs are going up, and the overall funding level has been stable. So in real-dollar value —
Senator Eggleton: Going down?
Ms. Aubin: Going down. So our prediction, in the realms we are in, is that we will have overall lower success rates.
Health research, to be internationally competitive, is expensive. That's a reflection of our success rate.
In the priority-driven envelopes, it's harder to give you a number because there are multiple initiatives, and they would have different application pressures and different success rates. I know of no example where everyone with a great idea who walks in the door can be funded, and that's a reality.
As I mentioned earlier, a lot of CIHR's money is leveraged through partnerships of various sorts, not just with other federal funders but with the provinces and with other funders, including the provincial health organizations, charities, et cetera.
Senator Eggleton: Do you help the researchers to get these additional funds?
Ms. Aubin: Yes. Well, in two ways, as I mentioned earlier. In some cases, we'll help to find the partners, and, in other cases we try to match-make by holding such activities as workshops in which we bring potential partners together with potential applicants to co-build applications. So there are multiple ways in which we try to do that.
Ms. Hamelin: It's different in the different pots of funding. NSERC has made the decision to fund 70 per cent of the clientele, and that results in the average size of $20,000, $35,000 grants, but it provides funding to 70 per cent of the community.
A big part of that reasoning is that NSERC's community includes theoretical physicists, mathematicians, disciplines that are not so close to, for example, industrial partners, so much less able to leverage that funding with other opportunities. The only funding that these folks have access to is NSERC federal funding.
If we're looking at some of the other projects, so the Strategic Networks and Strategic Projects, which are projects where there's sort of a 10-year, more disruptive research with a 10-year horizon, very competitive, the success rate is about 20 to 25 per cent. For the Networks of Centres of Excellence, the success rate is about 15 to 20 per cent. It depends on the year. It depends on the money we get that particular year. These programs are highly competitive.
Our health researchers often have opportunity but also some other groups. Engineers work very well with companies, and so they have an opportunity to leverage the federal funding to attract industry funding. We just had a very interesting discussion in that regard this afternoon. Some of the groups are more able to leverage their funding.
But I'd say that about 40 per cent of our overall budget is highly competitive, with about a 20 to 25 per cent success rate.
Dr. Szumski: I would add that getting a product through to market is a very complex and tortuous path. In addition to thinking about the amount of activity that takes place at the invention stage and the research phase, ultimately, a product has to get through with the support of programs like the regional development agencies and IRAP. They ultimately have to get out to the private sector, where you need VC money to move your company along. Even if you have a product that's successful and it has regulatory approval, you have to get on to the purchasing scheme of a hospital, or, if it's in a province, it might be a fee schedule for the physicians that will be adopting the new technology. Ultimately, it's the patient acceptance. Will they want this robot taking care of them at the end of the day? There are a lot of steps involved that need to be looked at in the whole spectrum of actually getting a product out into deployment.
Senator Seidman: I'll try to ask a question that won't take half a day to answer. I'll try to restrict it as much as I can. I would just like to ask you about something that happened in my own hometown. A couple of months ago, there was quite a momentous investment made in Montreal of $200 million to create a learning hub for artificial intelligence and big data. Now Google has recently also jumped into Montreal and says that they hope to turn the city into what they call a supercluster of artificial intelligence knowledge that will attract corporate investors, start-ups and researchers.
Having put that out there and knowing how challenging it is for these kinds of activities to stay their ground and become thoroughly competitive around the world, in other words, to give Canada a head start and become a driving force in innovation, my question is, what role do the councils play? It might be you, Dr. Szumski, who has the most to say about this. I'm not sure; I'm just hypothesizing here. What role, if any, would the councils play in helping these types of clusters to stay on the cutting edge?
Dr. Szumski: Clusters that are successful generally embrace the entire spectrum, including a very heavy engagement of the academic and university sector as a source of new ideas. They always have very strong anchor tenants, if you will, or big industry players that are part of the mix and then create all kinds of innovative mechanisms to get the small, disruptive players, which can often move faster than the larger companies, to succeed. It's a very complicated process that happened in the initial ones, like Silicon Valley, seemingly spontaneously, and now people are looking to recreate these around the world, having learned what you can from those original ones.
Does Canada have an opportunity to have a couple of superclusters? The answer is likely yes. We already have had some. Certainly, the photonic switching activities that took place in Ottawa would be a good example. There are others. I'll pass it on to my colleagues.
Ms. Aubin: I think you've said it well.
The councils can create conditions and programs that help promote what we're talking about. The kind of partnerships and partnered programs that we've already mentioned are one way of doing that. Locally or regionally, deciding that you can't do everything and choosing where your areas of focus are is contributing and helping to achieve exactly what you're saying. Not everywhere can duplicate all aspects.
I'm aware of your Montreal example. There are a few other hubs in the country where there would be the sort of focus that you're mentioning with other partners, and Google is involved in some of those.
Being sure that we can link them in a way — coming back to what we said earlier — that also drives rather than duplicates, all accelerating faster because we maintain those interactions, is an important piece as well. This is what Canada actually does well, and we're known for that — not just through the NCE programs but through other kinds of networking that we do. We're known as a country of networked researchers and collaborators. Other parts of the world do look at us and say, "Okay, how do you make that happen?'' Being sure that we're not creating barriers to having those great ideas bubble up and being able to partner where appropriate is an important part of it. I think we're achieving at least some of that.
Ms. Hamelin: I'd like to add that the world is a very competitive place. For companies like Google to come to Canada and invest and support researchers here, they will have to make a business case internally in their company about why that funding should go to Canada and not somewhere else.
We just had a conversation with Google, Qualcomm and others this afternoon. The question I asked them is how important is it for you to have Canadian government money to leverage your investment here? They said, "It's absolutely critical.'' That's how they can draw the attention, but it also shows that Canada is serious about these researchers, supports them and stands behind them. That's what companies are looking for.
The responsibility for us as councils is to set the right priorities, to invest in the best researchers, to identify those areas and to work together so that we can help convince companies to come here. That's the only way we can create and then maintain superclusters in Canada.
The Chair: Thank you. I hope we're going to hear more about the Montreal example, because the City of Montreal has made artificial intelligence a major focus for its future and has identified it. Obviously they're playing a role in this, and we hope to hear a lot about that. Your question is one of the best in the country at the moment.
Senator Meredith: Thank you again for your presentations this afternoon. This question is for you, Ms. Hamelin, with respect to the funding pool and universities. You mentioned that in your presentation with respect to the universities, and I'm keen to know about the collaboration between universities. Sometimes a researcher comes to you and says, "Here is my idea.'' My university, Ryerson, was doing a research project on a prosthetic arm using brainwaves. They've done some cutting-edge stuff there and I'm fascinated by what they've done and that collaboration. Talk to me about that. They may come to you about an idea in terms of funding. For example, UBC is developing something. How do you link those universities? It may not be part of your portfolio, but how do you ensure that knowledge isn't lost in some way? Elaborate on that, and then I have something else for you as well.
Ms. Hamelin: It depends on how that research program might come to NSERC. If this is a research university professor who applies through our Discovery Grants competition, he will apply, it will be peer-reviewed and not a lot of matchmaking is being done.
If this program comes in, for example, through our Collaborative Research and Development Grants Program, and we see that there are programs coming from us that are very similar, then we will work through our regional offices. NSERC has five regional offices across the country, and the regional offices are embedded not only in universities and colleges but also in local companies. They will help with the matchmaking. We really want to avoid duplication of the same efforts and we want to create linkages between the universities.
To come back to the Montreal situation and the AI, this is the Canada First Research Excellence Fund, which is administered by the TIPS secretariat, which is a tri-agency secretariat that we participate in. That is an interesting program because universities come with large requests for funding.
Senator Meredith: They're underfunded.
Ms. Hamelin: Yes, they're underfunded too, obviously. Actually, this year a situation arose where multiple universities, even universities in the same province, came with very similar proposals for $100 million each, and the secretariat, through a well-thought-out process on how to do that, approached the universities to say, "Look, you're working in the same area, and you haven't really talked to your neighbour. Please do so, and then we will reconsider.'' These linkages are very important for us.
Senator Meredith: Dr. Szumski, with respect to simulations, you talked about Ghana. I'm talking about it in terms of we tie this to e-health technology and so forth and how information is transmitted. What sort of other collaborations are you doing with other African countries as it pertains to testing and education? I know there's a doctor working out of Toronto working with surgeons and bringing them here for training and so forth, because again it's easier to train them here than for us to take a team there. Talk to me about how NRC will do that expansion with respect to the African continent in terms of knowledge sharing and best practices. We've all looked through development in terms of international development. How do we capture that in terms of the effectiveness of technologies that are developed here for their broader reach of the world, so to speak?
Dr. Szumski: I will refer the question to my colleague, Robert, but I want to make one general comment first. The Canadian medical system and training system is extremely highly regarded around the world. Our licensing and regulatory body for specialists, the Royal College of Physicians and Surgeons of Canada, is actively exporting to other countries their Canadian method of how you train specialists. It's something that is an area of strength for Canada. I'll let Robert speak further.
Mr. Diraddo: Thank you for the question. The project with Ghana was done I would say under the leadership of Dr. Allan Okrainec from the University Health Network. We don't pretend to be experts in training surgeons and so on. It was under his leadership. Dr. Okrainec does quite a bit of work using tele-simulation in training numerous countries in Africa. He would be the right person to look at it from a cross-continent perspective, the African continent. On a need be basis, if Dr. Okrainec feels he needs us to work with him for one of his projects, we do that willingly.
Senator Petitclerc: When we think about health and prevention and diagnosis versus curing and fixing, I'm interested in knowing, when it comes to choosing a project or investing funds, what is roughly the proportion in prevention versus medical intervention? Is it made by general priority? Is it done case by case? What does that look like?
Ms. Aubin: I'll have to get the number to provide you the exact percentage that CIHR would invest in areas of treatment/diagnosis versus prevention.
Generally I can tell you that prevention has been under-represented in what we fund through investigator-initiated or bottoms up, through that pot. Knowing that and mining that information, we made prevention research one of the priority areas within our priority or strategic pot. You will see that in our strategic plan, and so we have been doing more initiatives on the prevention side, recognizing that it cannot sustainably be all about treatment. I will have to get the number for you.
I should have mentioned something earlier. We have been talking about partnerships between the councils and with private entities. CIHR also partners with other government entities, including the Public Health Agency of Canada, where we do also try to prevent, so we have a number of programs like that that I can provide you information on.
It's an excellent question, and one that is very much on the horizon of not just CIHR as a health funder but many of our partner funders around the world.
The Chair: We're hoping that that's an issue that will come up through this study in terms of how artificial intelligence and robotics is playing a major role in detection and anticipation of disease issues. We're hoping we will draw that out from some specific areas.
I want to thank you all for being here and answering questions. We have allowed the questions to go beyond the direct artificial intelligence, robotics and 3-D because they deal with issues that will be coming up, looking at how those three can impact them.
What I would like you to do is think about the questions that have been asked to lead to strategic direction today, that is collaborations among councils looking forward or anticipation. If anything occurs to you after you leave here, we would welcome any further information you might like to provide to us through the clerk.
I want to thank my colleagues for their questions. We're getting under way with a gentle approach today, and we will start moving into some of the heavy applications funded by some of these people and their organizations.
I want to acknowledge, Roman, the role that IRAP has played over a long time in this country, and in fact, the gene machine, dear to my heart, benefited from that some 30-odd years ago.
(The committee continued in camera.)