27/03/2013 Future strategy & opportunities Nottingham MindTech Healthcare Technology Co-operative Professor Chris Hollis

NIHR Healthcare Technology Co-operatives (HTCs) Nottingham: Mental Health Sheffield: Devices for Dignity Cambridge: Brain Injury Barts: Gastrointestinal Disease Guys: Cardiovascular Disease Leeds: Colorectal Therapies Bradford: Wound Prevention & Treatment Birmingham: Trauma Management

NIHR Healthcare Technology Co-operatives (HTCs) Aims of the NIHR Healthcare Technology Co-operatives are to: act as a catalyst for NHS “pull” for the development of new medical devices, healthcare technologies and technology- dependent interventions focus on clinical areas and/or themes of high morbidity which have high potential for improving quality of life of NHS patients and improving the effectiveness of healthcare services that support them work collaboratively with patients and patient groups, charities, industry and academics.

NIHR Healthcare Technology Co-operatives (HTCs) Nottingham: Mental Health Sheffield: Devices for Dignity Cambridge: Brain Injury Barts: Gastrointestinal Disease Guys: Cardiovascular Disease Leeds: Colorectal Therapies Bradford: Wound Prevention & Treatment Birmingham: Trauma Management

University of Nottingham Innovation Park MindTech NIHR HTC in Mental health & neurodevelopmental disorders 6

Why Mental Health? Mental health problems affect 1 in 4 people Huge economic cost to UK - £105bn per year Largest area of government health spending (13%) High unmet need with little technological innovation Subjective clinical assessment dominates practice Lack of engagement with SMEs

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Clinical Landscape Mood Disorders –Unipolar depression –Bipolar depression Neurodevelopmental disorder –Autism spectrum disorder (ASD) –Tourette syndrome –Attention Deficit Hyperactivity Disorder (ADHD) 9

Wittchen et al 2011 European Neuropsychopharmacology Current prevalence of mental health disorders in Europe

Why Nottingham? National Leadership - Nottinghamshire Healthcare NHS Trust - Neurodevelopmental and Mood Disorders - Computer Science & Biomedical Engineering Regional Hub - NIHR CLAHRC (NDL) -> CLAHRC East Midlands - East Midlands Academic Health Sciences Network (EMAHSN) - Medilink (East Midlands)

Research Strategy Technology Innovation Pipeline High quality collaborative projects User-led design New partnerships National resource Transformation of mental health care and services

Bringing Partners Together Academics Patients & Carers Clinicians SMEs University NHS Industry HTC IMH 1 Medilink TTO 2 ADDISS Tourettes Action Computer Science Nottinghamshire Healthcare Trust Biomedical Engineering Business School BuddyApp Qbtech Ltd Buzz3D Ltd 1: Institute of Mental Health 2: Technology Transfer Office £260k £330k £90k Red Embedded Ltd

Organisation Neurodevelopmental Disorders Mood Disorders Involvement & Implementation Technology Operational Group Steering Committee Charities EMAHSN Medilink SMEs NHS Trust Cross-cutting themes Clinical themes 3 rd Sector University Clinicians

Academics Technology Innovation Pipeline Implementation Development Identifying Need QbTest BuddyApp Patients, Clinicians, NHS Trusts SMEs Facial affect recognition Automated tic monitoring & NICE/ HTA

Research Approach 1.Identify the clinical problem/ unmet need 2.Identify and develop a technological solution 3.Evaluate clinical/cost effectiveness 4.Adopt and disseminate technology in NHS

Target disordersClinical problem/ unmet need Technology solution Depression ADHD Bipolar disorder Tourette’s ASD PTSD Subjective assessments – time consuming, low diagnostic accuracy Objective computerised assessment of attention and movement in ADHD Poor treatment adherence/ missed appointments SMS text messaging, video-telemedicine Lack of real-time objective monitoring of symptoms Personalised ambient monitoring (PAM) Objective (real-time) assessment of facial expression, voice, tics Limited efficacy of non- pharmacological interventions Serious Games: computerised cognitive and social communication training Virtual reality to treat PTSD, phobias etc.

Qb Test: Objective Assessment of ADHD Computerised assessment of attention and activity Supports clinical decision making Provides patients with objective reports on their condition 18

Text messaging app to support therapy Diary: SMS or web Analysis tool Goal reminders Appointment prompts

Automated objective assessment of mood and behaviour Valstar et al. (technology theme)

Personalised Ambient Monitoring (PAM) GPS module XYZ accelerometer Internal accelerometer GSM location User input: General health questionnaires Mood self- assessment Wearable Node Acceleration General light level Artificial light level Ambient sound properties Bluetooth Encounters* - Bluetooth- 3G / GPRS- User input-Internal

Computer vision / visual tracking for automatic tic monitoring & analysis Med-e-Tel o Face and expression recognition o Automatic eye blinks detection o Hand and detailed body tracking o Integration & tic data analysis

Games that engage For diagnosis and treatment Work with ADHD children shows they will engage with games Built games to treat but also promote interaction with therapist Playful environment to get young people to discuss emotional reaction 23

What can we offer ? Collaboration with SMEs, academics, NHS Trusts Support to AHSNs and funding agencies; e.g. SBRI, TSB –Clinical expertise –Technology Trials –Patient Public Participation (PPI) –Early stage Health Economics –Advice on NICE assessment procedures –An understanding of clinical pathways –Advice on procurement procedures –Technological expertise & regulatory advice 24

Contacts: Principal Investigator Prof Chris Hollis Technology Theme Lead: Prof John Crowe 25