Tyree IHealthE has an audacious vision to improve patient care and deliver cost-effective solutions to 21st century health issues. It’s a goal that aligns with the history of the Sir William Tyree Foundation and its long commitment to health innovation and education.
Longer waiting times in both emergency departments and on public hospital elective surgery lists are evidence that the Australian health system is struggling to keep up with demand. According to the Australian Institute of Health and Welfare (AIHW), much of that demand is generated by what amounts to an epidemic in chronic disease. Around half of all Australians currently live with a chronic condition such as asthma, type 2 diabetes or cardiovascular disease. Among the over 65s, the figure increases to 80 per cent. And in 2017-18, chronic disease was the cause of more than one in two hospital admissions.
As the Australian population ages, the need to overhaul the current model of healthcare becomes ever more critical. This is the sobering context for a far-sighted and impactful vision, and the landmark philanthropic gift that will support it.
In December 2020, the Sir William Tyree Foundation announced that it would commit $10 million over 10 years to establish the Sir William Tyree Foundation Institute of Health Engineering at UNSW Sydney, an interdisciplinary hub of healthcare transformation that would be known by the name Tyree IHealthE.
“As longstanding supporters of UNSW, we are thrilled to support the establishment of Tyree IHealthE and join the global effort to generate sustainable and accessible solutions to burgeoning healthcare challenges,” says Robbie Fennell, Sir William Tyree’s daughter and chair of the Sir William Tyree Foundation.
“With our ageing population, we are really looking at some challenging statistics, and some serious health problems that need to be solved. It makes sense for us to help fulfil that need. And it's something that will benefit Australians for generations to come."
The framework and methodology of the hub is ground- breaking, but the mission is uncompromisingly practical: to improve patient outcomes and to deliver cost-effective solutions to the issues of 21st century health.
“It’s the start of an exciting adventure for prevention and treatment, reaching out to communities across Australia,” says Emeritus Professor Ian Webster AO, a long-time friend of foundation founder Sir William Tyree, a former UNSW Professor of Community Medicine & Public Health, and current chair of the Tyree IHealthE steering committee.
“The institute will connect the work of hospitals through to care in the community. And it will be a conduit for practical innovation in disease prevention and management and healthcare delivery.
“These were the hopes of Sir William Tyree, our benefactor, 50 years ago. He would be proud of this initiative and the calibre of the projects involved.”
Find, fund, facilitate
To achieve its goals, Tyree IHealthE will use as its framework a model for collaboration first established in Boston in 1998. Called the Consortia for Improving Medicine through Innovation and Technology (CIMIT), it is a network of institutions that fosters early-stage collaboration among clinicians, technologists and industry groups.
The founders of CIMIT recognised that to ensure the implementation of their research, they had to treat the process of innovation as a discipline in itself. Accordingly, they developed various processes, referred to as ‘the CIMIT model’, to find, fund and facilitate collaborations.
“One of the things we’re really excited about is applying a process to map out the pathway of innovation, from identifying the unmet need right through to delivery into the healthcare system,” explains Professor Laura Poole-Warren AM, Tyree IHealthE’s deputy director.
“[The CIMIT approach] is a great tool so that you actually know the barriers that are going to come up at different stages, and you’ve planned for those.
“It does make the whole innovation process a lot smoother. It makes sure that you’re asking the right questions at the right time, so that whatever you’re developing is actually going to be much more fit for purpose in the health system.”
Image: UNSW President & Vice-Chancellor Professor Ian Jacobs and Scientia Professor Vlado Perkovic welcome The Honorable Brad Hazzard, Minister for Health and Research, to the launch of Tyree IHealthE, December 2020
Breaking down the silos
The Sydney CIMIT (SCIMIT) is a collaboration between UNSW and its partners in The Sydney Partnership for Health, Education, Research and Enterprise (SPHERE). It will bring together clinicians, technologists, entrepreneurs and industry to ensure that all projects have clinical and commercial relevance, accelerating their translation into cost- effective, everyday practice.
“We plan to leverage UNSW’s partnerships with a number of local healthcare providers and industry collaborators to ensure Tyree IHealthE’s innovations are adopted into mainstream healthcare practice,” says Scientia Professor Nigel Lovell, Head of the UNSW Graduate School of Biomedical Engineering and inaugural director of Tyree IHealthE.
The Institute will be located inside the Prince of Wales Hospital Integrated Acute Services Building, part of the Randwick Health & Innovation Precinct that’s currently under construction. The co-location of all the experts involved will maximise opportunities for collaboration. For example, researchers in bionics and biorobotics will have their offices on the surgical floor, so they can rapidly prototype and test new robots to assist in surgery. Team members charged with predictive analytics and app development will be situated near the hospital’s Medical Assessment Unit and the Virtual Care Centre.
“Sitting on our own and developing technologies as a graduate school, and then looking out to see if anyone can use the technologies, is not the right approach. It's not the way to co-design a solution,” says Nigel.
“If we're sitting there with the clinicians, it does make a difference in the design phase. It really is critical to have everyone in the room, including the patients, when you’re creating health solutions.”
Although Tyree IHealthE is a collaboration between the Faculties of Engineering and Medicine & Health, it will also involve experts from across UNSW Faculties including Arts, Design & Architecture, Business, and Science.
“It's taking us out of our own little isolated area. We're getting input from specialists in various disciplines to come up with a much more holistic view of the whole translation ecosystem,” says Nigel.
But there is another silo that can be harder to bridge: the one between funding bodies. Nigel explains that biomedical engineering projects can fall in the gaps between the Australian Research Council (ARC), which does not typically address medical research and clinical trials, and the National Health and Medical Research Council (NHMRC), which maintains a tight focus on clinical work.
“The beauty of the Tyrees’ philanthropic gift is that it's funding that gap,” he explains. “It's funding the joining of the two disciplines.”
An engineer with a passion for health
Using engineering to improve health outcomes is something the late Sir William Tyree applauded.
When the visionary engineer sold his Tyree Holdings electrical transformer business to Westinghouse in 1969, he invested $1 million from that sale into a foundation that would grow into a philanthropic powerhouse. Throughout his life, he donated millions to UNSW and other institutions with a focus on education, research and improving educational facilities in the field of engineering.
In 1971, the A.W. Tyree Foundation, as it was known then, funded Medicheck, a revolutionary health screening referral centre in Sydney. The centre was the first multiphasic health screening centre in Australia and an early example of the sort of preventative healthcare that will be a focus for Tyree IHealthE.
In two hours, referred patients took an automated questionnaire and then went through Medicheck’s various testing stations, including blood, vision and hearing tests, mammograms and X-rays. This allowed a comprehensive examination of a patient with a poorly defined illness in minimal time, and picked up previously unknown abnormalities in patients who were showing no obvious symptoms. The centre also pioneered a computer record and retrieval system.
“If he wasn’t an engineer, I think he would have become a doctor and studied medicine. He always had a passion and an interest in medicine,” says Robbie of her father. “He was passionate about making the world where he lived a better place. He was full of energy. Very hard-working, practical and determined. He wouldn’t let anything beat him.”
Looking to the future
The COVID-19 lockdowns saw a sudden uptake in remote monitoring and telehealth, prompting Tyree IHealthE to select Connected Health as its inaugural area of focus. Connected Health is a conceptual model for health management in which devices and services are designed around the patient’s needs, and health-related data are shared, so that care is delivered proactively and efficiently.
“Everyone is starting to understand Connected Health, including telehealth, and realising that you can move data around instead of patients,” says Nigel.
In a Connected Health model of care, people who present at the emergency department will go through the Medical Assessment Unit to quickly assess whether they should be admitted, or if their needs would be better met by telehealth or other resources, such as a case worker.
When discharged, a patient who has had an acute episode requiring treatment in a hospital will be equipped with wearable monitoring technology and a connected smartphone app when they go home. A remote monitoring team will then be able to look at the data, assess the patient’s needs, and prioritise any home visits accordingly.
“COVID-19 opened this door of understanding that remote monitoring is absolutely critical moving ahead,” says Nigel.
“We have these technologies that can reduce hospital readmissions by 50 per cent. Similarly, they reduce the number of deaths because we can continuously monitor the patient. At the same time, it's scalable and saves money.”
Across the Connected Health program, Tyree IHealthE has trials running to monitor patients with heart failure or at risk of stroke, and to help people with chronic diseases better manage multiple medications.
Bionics and biorobotics are slated as the focus for the 2021-22 financial year, then medical imaging analytics, bioengineered materials and technologies, and biomolecular innovations in the years ahead.
It all adds up to a game-changing agenda for the future of health care. The dynamic example of Sir William Tyree lives on.
The Boards of the Sir William Tyree Foundation and the Tyree Group at the launch of Tyree IHeathE, December 2020
Images: Richard Freeman
Words: Jo McKinnon