Physician S.S. (Sonny) Kohli was volunteering in Haiti after the devastating earthquake there in 2010, and he was treating a woman with chest pains.
"The usual course of action would be to do an EKG [electrocardiogram] and get a picture of her heart. It's basic technology, relatively inexpensive, but not inexpensive enough for the hospital there."
That's when it dawned on him.
"The world needs inexpensive, portable medical technology that can leverage existing infrastructure, like the Internet and smartphones," says Dr. Kohli, who is an internal medicine specialist and also helps run the intensive care unit at Oakville Trafalgar Memorial Hospital in Southern Ontario.
Today, in addition to his regular medical duties, Dr. Kohli is an innovator – co-founder of a startup called Cloud DX, a spinoff of Mississauga medical tech company Biosign Technologies.
He and three colleagues have been building a device that can measure a person's blood pressure, heart rate and other vital signs and interact with computer cloud-based data to help diagnose medical conditions. The device and the software can be used to alert doctors to any problems, such as potentially life-threatening conditions during a pregnancy.
If it sounds a bit like something Bones McCoy might have used on the Starship Enterprise in the TV show Star Trek, it is no coincidence. Cloud DX was a finalist in the $10-million (U.S.) Qualcomm XPrize Foundation's Tricorder contest, named after the future-tech gadget used by the ship doctor on the show.
While the winner will be chosen from two other finalists, just to become one of the top seven has been a daunting experience for Dr. Kohli and his team. To be considered, a medical device must diagnose vital signs from a remote location with hospital-grade precision, as well as 10 core conditions ranging from anemia to pneumonia, and three more from a menu of an additional 10 more complicated conditions, such as food poisoning.
All of this data has to be recorded and available in real time, so it can be transmitted to the cloud.
The development of this kind of health technology puts Dr. Kohli and the Cloud DX team squarely in a long, proud Canadian tradition of medical innovators.
Canada's historical medical breakthroughs range from the invention of Pablum cereal at Toronto's Hospital for Sick Children to the development of insulin by doctors Frederick Banting and Charles Best, to the identification of the cystic fibrosis gene and pioneering new work in stem-cell therapy.
It's such a strong heritage that Governor-General David Johnston, with entrepreneur Tom Jenkins, has just published a new book about innovation called Ingenious: How Canadian Innovators Made the World Smarter, Smaller, Kinder, Safer, Healthier, Wealthier and Happier.
Doing all that is precisely the idea, Dr. Kohli says.
"We started building our device with the prize in mind, but then we realized that the prize is a minor part of the story. The real story is getting this device developed and clinically approved," he explains.
Cloud DX is not only part of a historical Canadian innovation tradition; it's part of a large group of innovators who are working away right now.
"We work with more than 300 startup companies, and a large percentage of them – about 50 per cent – are in digital health," says Richard Bozzato, a senior advisor for health-venture services at Toronto's MaRS Discovery District.
"The big trend is toward individuals being able to access their own health data and monitor their responses to medication and treatment. It leads to a much more educated dialogue between patients and their physicians."
One company that works with MaRS, Eve Medical, has developed self-testing kits for women to check for the HPV virus. Co-founder and chief executive officer Jessica Ching says 400 people die of cervical cancer in Canada each year, yet 30 per cent of Canadian women don't get screened; they are often intimidated and self-screening can help them overcome this barrier.
"Health care needs to move toward becoming more digital," says Raymond Shih, president and co-founder of QoC Health Inc. in Toronto. His company has designed a cloud-based platform that hospitals and clinics can use to store and transmit health data to other medical specialists and patients.
There are many good practical reasons for digitizing more health data and making it available in the cloud, such as cost savings, speedier diagnosis and treatment and reduced travel time for patients. Sometimes, though, innovation can mean simply looking at everyday products and trying to make them work better.
"Prevention is a big deal," says Geoff Fernie, director of the research institute at the Toronto Rehabilitation Institute-University Health Network.
His team has been testing nearly 100 models of every Canadian's standard equipment – winter boots – by connecting volunteers to a tethered harness and seeing how much they slip on ice. They found that 90 per cent of the boots they tested didn't meet their minimum standard for preventing a face plant – and they didn't even look at flimsy dress boots.
This testing is important for health care because, "every year, 21,000 people show up at emergency wards in Ontario after slipping on the ice, and this is not necessary," Dr. Fernie says.
The biggest challenge for innovators, in Canada and elsewhere, is not to come up with brilliant ideas to innovate in this area but to secure the funding to execute their ideas by producing prototypes and organizing clinical trials.
"The innovators are often the least equipped to do that," Mr. Shih says, and Eve Medical's Ms. Ching agrees that, "Fundraising is always a challenge."