2013 HTX Annual Report

HTX ANNUAL REPORT | 2012 2013
Financing innovative medtech companies

from development to international sales
www.htx.ca
INSIDE
Vision & Mission
HTX: Team, Board of Directors, Observers,
Business Advisory Committee 04-05
From the Editors
Messages
This report reflects work completed or in progress between April 2012 and early 2014.
From the President & CEO 06

From the Chair 09
Materials in this report may be reproduced with the written consent of htx.ca The Health Technology Exchange.
This is to ensure an awareness of the manner in which these materials may be used for other purposes.
Financing & activities
Editor: Rob Hall
Health Technology
Commercialization Program 10
Assistant Editor: Cheryl Verscheure
201213 HTx Financial

Statements CENTRE PULLOUT
Design, Layout & Print: Slant Creative Group

Photos: provided courtesy of project partners and affiliate organizations.
The report in its entirety can be downloaded by visiting www.htx.ca.
Setting the Stage for

Global Competitiveness 32
HTX is an independent, not-for-profit corporation funded by the Government
Soft Landing Program 34
of Ontario through the Ministry of Research and Innovation.
Medtech RISE 34
Copyright 2014
Highlights
Additional copies of this report in book form are available upon request.
The Harmony Project 33
22
HInext
24
Profound Medical Inc.
26
Therapeutic Monitoring Systems
28
Octane Biotech Inc.
30
Sensory Technologies
Health Technology Exchange (HTX)

522 University Avenue, Suite 1201
Toronto, ON M5G 1W7
General Enquiry: admin@htx.ca
Tel: 647-258-0381
Fax: 647-258-0390
www.htx.ca
HTX is an independent, not-for-profit corporation funded by the

Government of Ontario through the Ministry of Research and Innovation.
I N V E N T | I N N O VA T E | I N V O I C E
HTX TEAM
JOHN SOLONINKA
President & CEO
From Invention through Innovation
Rob Hall
Vice President,
Finance
NORMAN PYO
Senior Director,
Business Development
CHERYL VERSCHEURE
Executive Assistant/
Office Coordinator
Shahira Bhimani
Manager, Strategic
Initiatives
Damian Lamb
Co-Founder & Managing
Director, Genesys Capital
MORRIS (MICKEY) MILNER

Former CEO HTX, Former
CEO Ontario Rehab
Technology Consortum
DAVID SHINDLER
Former CEO of
BioDicovery Toronto
HTX BOARD OF DIRECTORS

DAVID AMES
Retired, Ex-Director of
Emerging Technologies
and Health Economics,
Johnson & Johnson
Medical Products
Peter Goodhand
Board Chairman,
Executive Director (Acting),
The Global Alliance for
Genomics and Health
Gary Hodgins
President, Pharmax Ltd.
Ken Lawless
President, Epitope
Capital Corp.
Michael Sefton
University Professor, Institute
of Biomaterials & Biomedical
Engineering, University of
Toronto
PHIL SPENCER
Life Sciences Counsel
HTX OBSERVERS*
BILL MANTEL
Assistant Deputy Minister,
Research, Commercialization
& Entrepreneurship Division
ALLEN PAUL
Life Science Programs
Mark Roseman
Manager, Innovation
Strategy and Programs
Dimitri prokopiev
Senior Policy Advisor
Frank Baylis
President, Baylis
Medical Canada
Jeremy Bridge Cook
Senior Vice President,
Assay Group, Luminex
Molecular Diagnostics, Inc.
John Buckingham
Founder & Partner,
Buckingham
Alliance Partners
Ted Hewitt
Former Vice President,
Research & International
Relations, The University
of Western Ontario
Frederic Lachmann
CTO, Medipattern
Damian Lamb
Co-founder & Managing
Director, Genesys Capital
Genevieve Lavertu
Director, Legal Affairs,
Business Development
& Clinical Research,
Medtronic of Canada
John MacRitchie
Regional Director, Central
Region, Ontario Centres
of Excellence
to International Invoice,
HTX continues to be the leading resource

and catalyst for accelerating the growth
of Ontarios medical technology industry
cluster, and enhancing Canadas position
as a global leader in commercializing
innovative technologies.
HTX provides non-dilutive

project financing to emerging
and established Ontario-based
companies to develop, produce
and commercialize innovative
market-leading advanced
health technologies.
mission
HTX supports the growth of a dynamic,
prosperous Ontario medtech sector
that aligns with and advances world
class healthcare, enabling enhanced
healthy living for its citizens.
HTX aims to generate the
following results for Ontario:
Through the Health Technology Commercialization
An enhanced Small and Medium Sized
activities, HTX is the leading resource and catalyst for
Enterprise (SME) base, creating export

ready products and companies and
HTX BUSINESS ADVISORY COMMITTEE

David Ames
Retired, Ex-Director of
Emerging Technologies
and Health Economics,
Johnson & Johnson
Medical Products
Vision
Kieran Murphy
Vice Chair & Chief
of Medical Imaging,
University of Toronto
Kris Shah
Vice President, Technical
Division Manager, Baylis
Medical Canada
Thomas Reeves
President & CEO,
Interface Biologics, Inc.
Bill McClean
Former GM, IBM Canada
Cheryl Reicin
Partner, Torys LLP
LifeScience M&A
Practice Lead
Doug Tessier
Former Acting Senior
Vice President of Development
& Implementation, eHealth
Ontario
Program (HTCP) and HTXs MedTech ecosystem support

accelerating the growth of Ontarios MedTech industry,
ultimately more high growth international
and enhancing Canadas position as a global leader
marketing companies;
in commercializing innovative medical technologies.
More well founded and financed start-up
With 33 recipient companies in its financing portfolio
companies with the capability of negotiating
conducting 38 projects supporting commercialization
global marketing partnerships and attracting

inward investment and research collaborations;
Greater capitalization of publicly funded
and exports, HTX strives to promote connectivity,

efficiency and impact across all healthcare system
research, creating more market focused
silos. HTX manages a $21.4M fund on behalf of the
innovative medical and assistive technology
Ontario Ministry of Research and Innovation and is a
products validated by effective utilization
member of the Canadian Venture Capital Association.
of technology evaluation, appraisal

and assessment.
The HTCP program has levered more than $65M in

spending from industry and strategic partners, for
total program funding exceeding $86M.
*Ministry of Research and Innovation
Message from the
PRESIDENT & CEO

As I write, it is February 2014, 3.5 years into my mandate as President and CEO of HTX. With virtually
all of our current round of investment funds committed, we can now forecast more accurately the
impact of the Health Technology Commercialization Program (HTCP) on Ontario medtechand it is
considerable! We are also deep into our planning for whats next for HTX as our investment phase
of HTCP draws to a close in December 2014, and we embark on exciting new initiatives.
Follow-on financings:
Infonaut Expanding the footprint of this Hospital Acquired Infection monitoring
technology into US markets customers.
Profound Medical Pursuing the next phase of clinical trials in Ontario, the US and Germany
of a novel technology for prostate cancer the entire prostate gland can be ablated from inside
the urethra, in one treatment session, destroying cancer while sparing surrounding tissue.
SensoryTech Implementing their mobile care management platform into US Hospice and
palliative homecare provider customers.
We continue to be impressed by the disruptive potential of these world-class medical technologies
38 Medtech Financings
$86M in Total Project Value 4x Leverage
Over this last year we reviewed 36 applications and selected another 11 projects to finance,
John soloninka, PEng, MBA

President and CEO, The Health
Technology Exchange
Growing the Medtech Ecosystem
bringing our total to 38 funded projects for the last 4 years. We have committed approximately
In addition to our financing, HTX is very pleased to support and drive creation of medtech
$21.4M into strategic medtech commercialization and ecosystem projects, which was matched
commercialization capacity in Ontario. We collaborate with a large number of public and private
by $65M from private sector companies, their investors and strategic public and private-sector
entities enhancing the sector, including:
partners. The companies have been aggressively hiring and advancing their products to market.
MaRS EXCITE As a founding member of EXCITEs Management Board, HTX is very pleased to
HTXs project-based funding is designed to help companies de-risk both their business models
see EXCITEs portfolio grow to 15 companies undertaking field evaluations and health technology
and technologies for follow-on investment.
assessments in the pre-market space. HTX is also working in collaboration with EXCITE in providing
funding support to two EXCITE projects; the first one being with Rna Diagnostics in supporting field
New Financing Approvals:

ApneaDx An inexpensive sleep apnea detector designed to be easily used by patients at home
that can greatly increase access to care for sleep apnea sufferers, and reduce the proportion of
patients requiring expensive polysomnography (sleep clinics).
Intellijoint Medical Inc. (formerly Avenir Medical Inc.) Intra-operative hip-to-femur positioning
technology to improve outcomes and reduce revision rates for hip replacement surgery.
Imagistx Ultra-high frequency ultrasound imaging for prostate cancer.
Harmonic Medical The next generation of high focused ultrasound technology being
pioneered by one of the worlds leading inventors in this space, Dr. Kylervo Hynynen.
Myndtec First-in-class electrical neuromodulation therapy that promotes the restoration of
voluntary movement in patients paralyzed by stroke, spinal cord injury (SCI) or traumatic brain injury.
Perimeter Medical A spin-off of Tornado Medical, this technology provides intra-operative
assessment of surgical margins during breast cancer surgery.
Synaptive Intra-operative visualization, simulation and brain access for neurosurgery.
Vascularix A safe technology using CO2 gas to perform cardiac stress testing. Vascularixs
emerging from Ontario: as sophisticated and competitive as any internationally.
studies and clinical trials with leading cancer centers in Ontario and Quebec, and the second with
ApneaDx, described above.
Harmony A collaboration with Hull and Associates and an international advisory board,
Harmony will enable medtech companies to select attractive export markets for their technologies
Over this last year

we reviewed 36
applications and
selected another 11
projects to finance,
bringing our total to
38 funded projects
for the last 4 years.
and to reduce the cost, time and risk of evidence development supporting global market access.
Our related Soft-landing initiative has identified a roster of highly qualified regulatory and
reimbursement consultants internationally to assist companies achieving global market access.
CORTECHs HTX led the creation of a 40-organization neuro-imaging, simulation, navigation,
surgery and assessment consortium, capitalizing Canadas strong global positioning in
neuroscience research. HTX and the Ontario Brain Institute are now exploring further funding
potential for the CORTECHs initiative.
Medtech RISE A coalition of 12 organizations across the country coming together to create
a single, comprehensive registry of over 3000 medtech innovators, suppliers and exporters.
Medtech Working Group and Innovation Procurement Initiatives public-private
collaborations aimed at improving Ontarios ability to speed adoption of beneficial technologies.
New Horizons for Medtech - Last year we reported creating a collaboration between HTX,
MEDEC and FEDDEV to provide $1M to support Ontario companies pursuing global markets.
technology has the promise to dramatically reduce side effects of current drugs, reduce cost
We are very pleased to report that 29 companies were awarded funding for global market
and increase access to this increasingly important diagnostic procedure.
development initiatives that will increase export sales for Ontarios medtech companies.
HTX has developed deep experience in medtech company creation, financing, evidence
Message from the CHAIR
generation, market access and adoption issues facing medtech companies. Our tag line
As the Chair of the Board, it is hard not to sound repetitive: we have completed yet another
is from Invention through Innovation to International Invoice: our early years incented
outstanding year, driving towards the completion of the HTCP mandate. As we approach this
academic/industry collaborations; our middle phase focused on innovation investments
final year of the current HTCP funding program, its helpful to take stock on just how far the
through the HTCP program; and now we have entered our phase focused on adoption,
Ontario Medtech Ecosystem has progressed since 2002, and the impact HTX has had.
Whats Next?
foreign market access and export revenue growth.

In that year, as the president of MEDEC, I helped to lead the creation of the multi-stakeholder
HTX has developed

deep experience in
medtech company
creation, financing,
evidence generation,
market access and
adoption issues facing
medtech companies.
HTX is well positioned to pursue several areas of additional core and

program funding, including:
Redistribution of repayments from our $14.2M loan portfolio;
Funding programs for innovation procurement, incubator and virtual company infrastructure;
Completion of Harmony and delivery of local and foreign market access services;
Continued collaboration with OCE, MaRS Innovations, FEDDEV, OBI, CIIRDF, ISTP Canada and
Medical and Assistive Technologies Consortium (MATC). Its goal: to understand why we were so
good at medical research, and yet so poor at commercialization, adoption and export of medical
technologies compared with other industrial clusters around the world. An industry cluster analysis
was conducted and recommendations made which included the creation of an entity like HTX, and
a focus on breaking down the silos dividing providers, innovators, financiers, regulators, and payers.
My enthusiasm for the creation of HTX was so strong that I became the founding Managing
Director and have stayed fully engaged for more than a decade as the Chair of the Board.
International innovation and funding partners.

In recognition of this next phase of HTXs trajectory, we are pleased to unveil our new logo
and branding, dropping the imagery of a limited focus on Canada, and presenting international
symbolism combining medical technology, rapid growth, and our continued focus on the need
to invent, innovate, and most importantly, invoice!
Again, this outstanding year would not have been possible without
the contributions of many:
Our extremely capable and experienced colleagues and staff at HTX;
Our Board and Business Advisory Committee;
Look at the Ontario medtech ecosystem now: the commercialization awareness, processes,
supports and funding we now have in place would have seemed unimaginable in the medtech
climate of 2002. And with the creation of the Ontario Health Innovation Council, a government/
health system/industry collaboration with a specific mandate to accelerate evidence-based
adoption of beneficial technologies, we have all of the necessary players and infrastructure
engaged. But there is still work to do. We have built the infrastructure, but now we need to use
it to ramp up private sector investment levels, commercialization and adoption rates of Ontario
medical technology, increasing exports and reducing our trade deficit. When we move the
needle on those, we have accomplished our goals from 2002.
Our President and CEO, and his team have again performed extremely well, and made the Boards
Our partners at the Ministry of Research and Innovation, the Ontario Brain Institute, MaRS
job very easy. It is indeed a pleasure to see the level of commitment, engagement, collaboration
EXCITE and CIMTEC; my colleagues on various national and provincial medtech working
and accomplishment, all within a lean, professionally managed team. But I must equally say that
groups, the Canada Israel Industrial R&D Foundation (CIIRDF); and most importantly
the unstinting commitment and creative vision of Bill Mantel and the team within the Ministry of
Our investee and collaborator companies.
PETER GOODHAND, Chairman of the

Board, The Health Technology Exchange,
Executive Director (acting), The Global
Alliance for Genomics and Health
Research and Innovation, supported so strongly by Minister Moridi and Deputy Minister Tilford,
has been critical to HTXs success.
Thank you all.

Again, the HTX Board saw a steady stream of high quality technologies brought forward by the HTX
John soloninka, PEng, MBA
President and CEO, The Health Technology Exchange
team, its external reviewers and the Business Advisory Committee. The continued discipline and
rigour of the due diligence and investment management gave the Board great confidence in the
process. The Board appreciates and thanks all involved for their efforts.
On behalf of the HTX Board I am pleased to be supporting HTXs CEO, the team and the Ontario
Medtech ecosystem in their continued success with a model that has demonstrated its value.
Financing & Activities
Cumulative Spending, HTCP Projects

90,000,000
Health Technology
Commercialization Program
Launched in the spring of 2010, the Health Technology Commercialization Program (HTCP)
80,000,000
70,000,000
Total Project Value

60,000,000
completed its fourth year of operation in December 2013. HTCP runs for a total of five
years to December 2014.
50,000,000
As of early 2014, HTCP has committed all of its funding for disbursements to companies
40,000,000
Companies and Partners
HTX Disbursements,
Operations and
Ecosystem Support
($14.25M). There are a total of 37 projects with small/medium-sized Ontario companies and
1 project with a multinational company. 23 projects have been successfully completed to date.
30,000,000
Over the five-year life of HTCP, HTX is on-track to disburse $14.25M to its recipient companies
20,000,000
and to spend $7.15M on operations and ecosystem support. Recipient companies and their
partner organizations will spend more than $65M (in addition to HTX funding) on the 38 projects.
Overall, the total value of HTCP, including all recipient and partner spending, will exceed $86M.
10,000,000
0
FY 2011
10
FY 2012
FY 2013
FY 2014
FY 2015
11
HTX Financing Portfolio: as of early 2014
Baylis Medical
Colibri Technologies
Interface Biologics
Medworxx
A developer, manufacturer and distributor of high-technology

medical devices for minimally invasive orthopedic,
cardiology, and radiology applications.
By creating versatile, disposable and inexpensive catheters

that use proprietary technology to create 3D images inside
the body, Colibri will enable a range of cardiovascular
procedures with improved safety and cost.
Commercial stage, privately held, venture-backed company

that develops biomedical polymer technologies to improve
the safety and effectiveness of medical devices.
Provides an integrated suite of software solutions for

patient flow, compliance and education. Combining
software with clinical consulting and best practices to
serve the hospital marketplace, the integrated product
suite allows hospitals to increase competency, improve
quality, reduce costs and simplify distribution of
information to staff.
In partnership with Sunnybrook Health Sciences

Centre and the University of Waterloo
In partnership with Sunnybrook Research Institute
PROJECT: Endovascular Stent Graft Materials with

Improved Blood Compatibility
PROJECT: Intervertebral Disc Augmentation and Repair
PROJECT: 3D Probe-Based Imaging
Total Project Value: $136,836
Total Project Value: $1,403,854
HTX VALUE: $ 68,283
HTX VALUE: $248,750
HTX VALUE: $250,000
PROJECT: Marketing in the UK and Europe

HTX VALUE: $50,000
Calavera Surgical Design
Infonaut Inc.
LifeLike BioTissue
OtoSim Inc
Delivers customized maxillofacial implants that utilize

different imaging modalities and materials to generate
custom surgical implant solutions following cancer
excision, trauma or plastic surgery.
The company has developed a proprietary platform that

utilizes Hospital Information Systems, RFID tagging of
hospitals assets, people and epidemiological analytic
software called Hospital Watch Live to address and
reduce infectious outbreaks within hospitals.
Uses proprietary technology to manufacture artificial soft

tissues such as skin, veins, and aortas that have the same
feel, texture and mechanical properties as real tissue.
Lifelike provides medical trainees with realistic products to
enhance skills training at a price not previously available.
OtoSimTM produces and sells an otoscopy training and

simulation system using a clinical image database that
has been shown to improve the accuracy of diagnosing
ear pathologies by 44%.
In partnership with University Health Network
PROJECT: Focus Marketing & Sales effort on the
In partnership with Stryker Canada Inc. & Sunnybrook

Health Sciences Centre
PROJECT: Surgical Forming Tool
HTX VALUE: $117,500
In partnership with The Hospital for Sick Children
US Training Hospital and Medical Device Market
PROJECT: Initial Sales Program
Implementation & Assessment
HTX VALUE: $50,000
HTX VALUE: $50,000
PROJECT: Hospital Watch Live
HTX VALUE: $749,750
12
13
PatientOrderSets.com Ltd.
Qvella
RoweBots
Segasist
Canadas only provider of a comprehensive evidence-based

orderset solution to hospitals and other health care
institutions. PatientOrderSets.com offers a web-based
collaborative model for its clients, that improves patient
safety and healthcare delivery while reducing costs.
A privately-held, medical device company developing an

automated laboratory system for the rapid identification
of bacterial species. The Qvella bacteria identification
platform is aimed to provide a more accurate and faster
bacterial identification while improving workflow and
reducing costs for the microbiology lab.
The production of embedded software that runs on small

field programmable gate array (FPGA) based processors
or microcontrollers for medical devices.
A software company developing contouring productivity

tools for medical imaging analysis offering clinicians
significant time savings and greater accuracy for diagnosis,
monitoring and treatment of prostate cancer.
In partnership with the Trillium Health Centre and

the Ontario Hospital Association
In partnership with University of California, Los Angeles
PROJECT: Development of FPGA based OS
for Medical Devices

HTX VALUE: $25,000
In partnership with Lawson Health Research Institute,

London Health Sciences Centre, and Sunnybrook
Health Sciences Centre
PROJECT: Commercializing the worlds only
PROJECT: Rapid Species Identification of Bacteria
web-collaborative patient order set technology

built in Ontario for export markets
HTX VALUE: $726,708
HTX VALUE: $38,000
PROJECT: Clinical Validation for Segasist PMR Software
HTX VALUE: $750,000
Rna Diagnostics
Scisense
Profound is developing a minimally-invasive treatment

for prostate cancer based on MRI-guided high frequency
ultrasound therapy that is designed to reduce the
collateral damage and side effects associated with
current treatments.
A molecular diagnostics company that is developing the

RNA Disruption Assay (RDA), a diagnostic test to determine
whether or not chemotherapy is effective early in the
treatment of breast cancer so that non-responders can be
spared the toxic side effects of ineffective chemotherapy,
and the opportunity to switch to more appropriate therapy.
Develops miniaturized sensing technology for measuring

cardiac function in animal models. The patented Scisense
ADVantageTM system features consistent and accurate
results, real time data analysis, reduced research time
and high fidelity pressure sensing.
Develops and implements mobile smartphone-based

enterprise systems for the home health care market. The
company offers a mobile remote clinician management
system that allows for increased capacity, a reduction in
treatment costs and reduced hospital readmissions.
PROJECT: Sales Team Expansion
In partnership with the SWCCAC
PROJECT: eShift Community Care Commercialization
HTX VALUE: $50,000
In partnership with Western University,

Siemens AG and York University
PROJECT: Manufacturing and testing of prostate
14
In partnership with Sudbury Regional Hospital and

the University of Waterloo
cancer treatment devices for clinical testing
PROJECT: Optimize RNA Disruption Assay
HTX VALUE: $750,000
HTX VALUE: $100,000
HTX VALUE: $750,000
15
Spartan
Xagenic
Profound Medical Inc. (2nd Project)
Perimeter Medical Imaging
A privately held molecular diagnostics company that

develops, manufactures, and markets DNA testing systems
for on-demand applications. The company is focusing on
point-of-care applications where rapid and convenient DNA
testing is particularly important, such as pharmacogenetics,
infectious diseases, and food and water safety testing.
Xagenic has developed a revolutionary direct detection

platform for molecular analysis enabling rapid, on-demand
diagnostic testing.
Profound Medical Inc. is developing a minimally-invasive

treatment for prostate cancer based on MRI-guided high
frequency ultrasound therapy that is designed to reduce
the collateral damage and side effects associated with
current treatments.
Perimeter Medical Imaging is a spin-out of Tornado Medical

Systems and will be continuing Tornados earlier work in
developing a novel imaging device for intra-operative
assessment of surgical margins in breast cancer surgery.
In partnership with Ottawa Heart Institute
Point-of-Care Diagnostic Platform
PROJECT: Point-of-care DNA testing for Plavix
In partnership with the University Health Network

PROJECT: Development of Probe Set for
HTX VALUE: $299,985
In partnership with Western University,

Siemens AG and York University
PROJECT: Commercialization Phase and Launch
of Prostate Ablation System

HTX VALUE: $58,032
In partnership with University Health Network

PROJECT: Margin Assessment Machine: Reducing
Re-Excision Rates for Breast Conservation Surgery

HTX VALUE: $300,000
HTX VALUE: $750,000
Tornado Medical Systems
XLR Imaging
ApneaDX
Harmonic Medical
A medical imaging and spectroscopy company with

operations in Toronto. The Company develops and
markets high-performance devices and technologies for
medical imaging applications with a focus on improving
key systems performance in areas where limited
performance is a barrier to clinical utility.
A London, Ontario-based company developing a

complete paediatric-optimized MRI workflow solution
to directly address the unique challenges in paediatric
imaging. The product will provide high resolution
images with reduced scan times, improving the safety
and efficiency of the imaging procedure.
ApneaDX is conducting an EXCITE-led clinical trial of an

inexpensive sleep apnea detector designed to be easily
used by patients at home that can greatly increase
access to care for sleep apnea sufferers, and reduce
the proportion of patients requiring expensive
polysomnography (sleep clinics).
In partnership with Thunder Bay Regional Research
In partnership with Kangaroo Design and Innovation
In partnership with EXCITE, THETA
Developing a focused ultrasound therapy system for

non-invasive surgery with treatment of uterine fibroids
and palliation of bone metastases as the lead indications.
Harmonics technology is designed to offer the precision
and ablation monitoring capabilities of MRI-guided
focused ultrasound but in a portable, easy to use, lower
cost system originated from Dr. Kullervo Hynyen, a
recognized leader in focused ultrasound.
PROJECT: Paediatric MRI System

PROJECT: Home Sleep Study with ApneaDxTM

for the Diagnosis of Obstructive Sleep Apnea:
A Pragmatic Randomized Controlled Trial
HTX VALUE: $103,472
Institute and the University Health Network

PROJECT: Tumour Margin Assessment Machine
HTX VALUE: $319,432
HTX VALUE: $165,000
In partnership with Sunnybrook Research Institute

PROJECT: Harmonic Ultrasound Guided Focused
Ultrasound Therapy
HTX VALUE: $489,270
16
17
Vascularix
HInext
Therapeutic Monitoring Systems
Imagistx
Developing the RespirAct system, which controls gas

concentrations in the lungs and blood, to use as a
non-invasive, drug-free, stress agent for use in cardiac
stress testing. Current cardiac stress agents, including
the market leading Lexiscan, a $700M drug, are associated
with a high incidence of side effects, some of which are
considered life threatening.
A Toronto-based software company focused in the

area of clinical management of mental health. The
flagship product TREAT is a mental-health specific
electronic health record that optimizes the delivery of
care by reducing the time and effort to document clinical
outcomes, standardizing assessments and creating and
tracking multi-disciplinary care plans.
TMS develops clinical decision support (CDS) software for

critical care staff in the hospital intensive care unit (ICU)
to make better clinical decisions resulting in saving lives
and money. Their proprietary CIMVA software transforms
patient vital sign monitoring from its current reactive
status quo into a predictive tool, thereby offering deeper
insights into the changing health status of patients.
Imagistx delivers unique high resolution imaging for the

screening, biopsy and potential treatment of cancer. The
companys first product, Imagistx Prostate, is currently
in clinical studies. Study results to date have been
overwhelmingly positive, demonstrating Imagistxs
superior ability to potentially identify prostate cancer
versus current low resolution ultrasound methods.
In partnership with the Cedars-Sinai Medical Center,

the University Health Network, and the Ottawa
Heart Research Institute
In partnership with Rouge Valley Health System,

Maimonides Medical Centre (Brooklyn NY) and
North Bay Regional Health Centre
In partnership with Phillips Healthcare, Ottawa

Hospital Research Institute, and Cooper University
Hospital (New Jersey)
In partnership with the Brady Urology Institute, Johns

Hopkins Medical Institutions; and the Southern Alberta
Institute of Urology
PROJECT: Commercialization of a novel,
PROJECT: TREAT Expansion in Canada and the US
PROJECT: Novel Application of Anticipatory
PROJECT: Imagistx Prostate Commercialization Project
non-invasive cardiac stress test system


HTX VALUE: $387,000
HTX VALUE: $390,511
Monitoring to the Hospital ICU & ER

HTX VALUE: $750,000
HTX VALUE: $496,912
Huron Technologies
Octane Biotech Inc.
GE Healthcare
Rna Diagnostics EXCITE (2nd Project)
A Waterloo-based global leader in imaging solutions for

digital pathology, Huron Technologies Inc. is developing
a clinical pathology scanner with unprecedented scanning
speed and image quality. Digital pathology is a high-growth
field that will provide significant improvements for patient
care, healthcare costs, and pathology resource constraints.
Octane Biotech, based in Kingston, ON, is developing

and commercializing ACTES, an automated tissue
culture system designed to standardize protocols in
cellular therapy development and stem cell manipulation
in regenerative medicine and tissue culture.
Provides transformational medical technologies and

services that are shaping a new age of patient care.
Their broad expertise in medical imaging and information
technologies, medical diagnostics, patient monitoring
systems, drug discovery, biopharmaceutical manufacturing
technologies, performance improvement and performance
solutions services help customers to deliver better care to
more people around the world at a lower cost. In addition,
they partner with healthcare leaders, striving to leverage
the global policy change necessary to implement a
successful shift to sustainable healthcare systems.
A molecular diagnostics company that is developing the

RNA Disruption Assay (RDA), a diagnostic test aimed to
determine whether or not chemotherapy is effective early
in the treatment of breast cancer. The RDA test is aimed to
identify non-responders early in treatment so that they can
be spared the toxic side effects of continued dosing with
ineffective chemotherapy.
Southlake Regional Health Centre, and CIMTEC
In partnership with Aesculap (B. Braun), Queens

University, University Hospital Basel (Switzerland),
Hospital Maisonneuve, and the University of Toronto
PROJECT: Digital Pathology Solution
PROJECT: Advancing the development of
In partnership with Sunnybrook Health Sciences Centre,

HTX VALUE: $585,000
ACTES towards commercialization

HTX VALUE: $452,050
In partnership with the University Health Network

PROJECT: Pathology Innovation Centre of Excellence (PICOE)
HTX VALUE: $514,279
18
In partnership with EXCITE, THETA

PROJECT: Study of RNA Disruption Assay as a Predictive
tool for Response to Neoadjuvant Chemotherapy in Breast

Cancer A Prospective Mixed Methods Study to be carried
out under the MaRS EXCITE program
HTX VALUE: $300,000
19
Interface Biologics (2nd Project)
Intellijoint Surgical Inc.
The major objective of Interface Biologics Inc. II is to

evaluate the compatibility and anti-thrombotic potential
of Endexo technology in several antimicrobial polymers
developed by BASF.
Intellijoint Surgical Inc. (formerly Avenir Medical) is developing

PelvAssist, a low cost and easy to use surgical navigation
tool that allows surgeons to properly align the artificial
implant in hip replacement surgery without disruption to
surgical workflow. PelvAssist improves clinical outcomes
in hip replacement surgery, reduces surgical revision rates,
and reduces healthcare costs while improving patient care.
In partnership with BASF Future Business GmbH

PROJECT: Central Venous Catheters with Combination
Antimicrobial and Anti-thrombogenic Properties

HTX VALUE: $61,700
In partnership with Mount Sinai Hospital, Oakville

Trafalgar Memorial Hospital, Grand River Hospital,
Rush Presbyterian Hospital, Thomas Jefferson
University Hospital, Massena Memorial Hospital
PROJECT: Post Limited Market Release Development
and Commercialization of PelvAssistTM (Gen II)
Synaptive Medical Inc.
MyndTec Inc.
Synaptive Medical is developing advanced visualization

software and imaging equipment for surgical navigation
and intervention in neurosurgery.
Myndtec is commercializing MyndMoveTM, a first-in-class

electrical neuromodulation therapy that promotes the
restoration of voluntary movement in the upper extremities
of patients severely paralyzed by stroke, spinal cord injury
(SCI) or traumatic brain injury.
In partnership with Colibri Technologies Inc.,

Clear Canvas Inc., and P&P Optica Inc.
PROJECT: In-vivo multimodality imaging system
HTX VALUE: $741,800
In partnership with Toronto Rehabilitation Institute, the

Heart and Stroke Foundation, and ICC HealthNet Inc.
PROJECT: MyndMoveTM Implementation, Integration,
Adoption, and Reimbursement

HTX VALUE: $749,600

HTX VALUE: $ 750,000
Infonaut Inc. (2nd Project)

Infonauts flagship product, Hospital Watch Live (HWL),
combines business intelligence software with RFID (radio
frequency identification) tagging of personnel and equipment
to identify, measure, monitor and predict the spread of
infections in hospitals. This allows for real-time disease
mapping in hospitals to better manage outbreaks and reduce
rates of hospital acquired infections. The project focuses on
the implementation and evaluation of HWL in the neuro ICU of
the Gates Vascular Institute which is a member site of Kaleida
Health, the largest healthcare provider in Western New York.
In partnership with Kaleida Health and Dapasoft
PROJECT: Kaleida Health Hospital Watch Live
Sensory Technologies (2nd Project)

Develops and implements mobile smartphone-based
enterprise systems for the community and home health
care market. The company offers a mobile remote
clinician management system that allows for increased
capacity in the overall healthcare system, a reduction
in treatment costs, reduced hospital readmissions,
resulting in improved care.
In partnership with the Hospice of Michigan and SWCCAC
PROJECT: US Pilot and Privacy Certification
for Market Expansion
Morris (Mickey) Milner Award Winner

Dr. Milos Popovic, PhD, PEng, Toronto Rehabilitation Institute (TRI)
At our 2013 Annual Open House, we announced the second award winner, Dr. Milos Popovic of Toronto Rehabilitation Institute
for his outstanding achievements in the development of assistive technologies, and devising the functional electrical stimulation
(FES) in the treatment of cervical spinal nerve injuries. Dr. Popovic is the Toronto Rehab Chair in Spinal Cord Injury Research.
Mickey Milner Award Presentation

HTX Open House | From left to right:
Dr. Milos Popovic, Toronto Rehab Chair, Spinal
Cord Injury Research, Morris (Mickey) Milner,
Infonaut US Market Entry
Former President and CEO, HTX, John Soloninka,
HTX VALUE: $ 200,000
President and CEO, HTX
HTX VALUE: $125,083
20
21
HTCP Project Highlights
HInext Inc.
HInext Inc.
Providing a high quality of care
for our clients whose array of
needs is complex has been made
Helping the mental health & addictions

community take care-delivery to the next level
In both Canada and the U.S., the market for Electronic Health Records (EHRs) and health information
exchange in the community mental health and addictions sector (known in the U.S. as behavioral
quite easy with TREAT.
health) is greatly underserved. As a result, provider organizations operate many processes
Ricardo Santiago,
Chief Information Officer,
Village Care of New York
manually, and diagnosis and treatment are based largely on subjective personal analysis rather
Partners from the mental health community play a key role in contributing to TREATs continued enhancement. A prototype for the typical standalone,
community-based mental health organization, for example, is Manhattans Village Care, with 30 psychologists and psychiatrists treating outpatients.
The mental health department of New Yorks Maimonides Medical Center (MMC), a large acute-care hospital, is a prototype for the use of TREAT
in a typical Accountable Care Organization. MMC is part of a cooperative organization of 50 healthcare providers comprising a network called the
Brooklyn Health Home. This network is responsible for the care and management of about 25,000 people with Bipolar Disease and Schizophrenia.
MMC is particularly excited about TREATs Metabolic Monitor, a sophisticated software algorithm that uses data from standard medical monitors and
measuring devices to calculate a patients risk of developing one of the metabolic disorders that often arise as a side effect of their medications.
than objective assessment.

However, ObamaCare and initiatives such as the Affordable Care Act and Meaningful Use Certification
are prompting the mental health community to find ways to provide additional higher-quality care
at a lower cost. As a result, this community is increasing automation, including implementation
of EHRs and improvement in the quality of electronic clinical documentation and the ability to
exchange it amongst providers.
To capture this market opportunity, HInext is proceeding quickly with significant enhancements
to its flagship product TREAT.
Specifically designed for mental healthcare providers, TREAT provides integrated healthcare clinical
documentation (e.g. EHRs), including: powerful clinical assessments; screening and management tools;
comprehensive care planning and clinical documentation; simplified data collection and submission;
and detailed reporting and graphing. The product, which has already been successfully implemented in
HInexts strategy is to offer TREAT as a fully hosted, Web-based application based on the Software-as-a-Service (SaaS) delivery model in
more than 30 provider organizations, achieved Meaningful Use Certification in the U.S. in August, 2013.
which customers pay a monthly subscription fee to access the application via the Internet, using any standard Web browser. The SaaS value
The enhancement project, expected to be completed by the end of Q1, 2014, includes patient and
resource scheduling, and patient billing. As a result, TREAT will be a fully integrated, market-ready
solution that meets U.S. regulatory requirements. Equally important, it will meet the needs of
fast start-up and little or no upfront costs; and regular, predictable subscription fees. This deployment model will facilitate greater adoption
of TREAT across a broader geographic area.
standalone mental health organizations and large community organizations, such as those
As part of the healthcare ecosystem, HInexts goal is to help mental health patients get their disorders addressed and move them out of
participating in emerging multi-provider Accountable Care Organizations.
high-cost, acute-care into community- or home-based care, where they can live and function like other members of society. As a business,
TREATs unique value proposition is based on key differentiators, such as scientifically designed,
best-practice diagnosis and screening assessment tools. TREATs screening assessment tools take
the determination of a patients mental condition from being a subjective, personal analysis to
one that is based on objective measures. HInext has spent years researching and refining these
tools with the help of medical experts. Another differentiator of TREAT is its focus on the Recovery
Model the idea that, through a multi-disciplinary treatment plan, a person with behavioral
health issues can achieve a level of recovery that is coordinated, managed and measured.
22
proposition is widely accepted and field-proven anywhere, anytime user access; no IT infrastructure for customers to buy and maintain;
HInexts goal is to grow the company as an Ontario-based entity, adding new jobs and new investment in Ontario. At this point, just prior to
full commercialization of TREAT, HInext has 22 staff, with a target of 30. Executive management is grateful for the HTX funding assistance,
particularly because it is difficult to raise money in a secondary, stigmatized, underserved and under-funded niche market such as mental health.
And with TREAT live in numerous provider facilities in the U.S., including a large, nationwide insurance company, HInext has a viable foothold
and has begun to establish credibility in the U.S. market. Completion of the enhancement project will yield a product that is positioned strongly
against any competition and uniquely meets the needs of U.S. mental healthcare providers.
23

Profound
Medical Inc.
This minimally invasive procedure
has been very well tolerated by
the patients so far. I think it will
be a valuable tool within the
repertoire for the treatment
of this disease.
Dr. Sascha Pahernik,
University Hospital Heidelberg,
Department of Urology,
Heidelberg, Germany
Innovative MRI-guided ultrasound ablation

technology sets new standard of care for the
treatment of prostate cancer
Prostate cancer is the most common form of cancer in men. One man in every six in North America
Everything has returned to normal and in some

cases is better than what it has been for five years.
Brian Denter, TULSA patient
dr. joseph chin, Chief of Surgical Oncology at London Health Science Centre,
removed cancer from Brian Denters prostate using a world first procedure.
Derek Ruttan, The London Free Press/QMI Agency
develops prostate cancer, and one in every 28 dies from the disease. Although advances in early
detection and treatment have dramatically improved survival rates (99%) for those diagnosed with
this disease, the side-effects commonly associated with current treatments can severely undermine
quality of life for survivors. Loss of healthy bladder, bowel and erectile function are often part of the
treatment outcome, along with fear of recurrence and long recovery periods.
Profound Medical has developed a safe, accurate, minimally-invasive and non-surgical treatment
for localized prostate cancer that potentially eliminates complications and long-lasting side-effects.
The treatment uses an innovative Ultrasound Applicator (UA) to ablate an entire prostate gland
from inside the urethra, in just one treatment session. This novel technology, combined with
state-of-the-art MRI image guidance, delivers highly accurate and precise treatment, destroying
cancer while sparing surrounding tissue.
The procedure takes place with the patient inside an MRI scanner, which provides image-guidance
for the UA positioning, treatment planning and live monitoring of the prostate being ablated.
During treatment, the UA is inserted into the prostate and rotated 360 degrees, emitting
ultrasound energy toward the prostate boundary, heating and killing the prostate tissue. Real-time
temperature images from the MRI are used to automatically adjust the energy intensity and rate
of rotation of the UA, resulting in precise conformal targeting of the prostate tissue, while sparing
surrounding structures. The actual ablation takes only about 30 minutes, and early trials show
that subjects are regaining urinary function very quickly.
Following successful completion of a pre-clinical canine study conducted at the University of
Western Ontario, a Phase 1 trial was approved for Canada, U.S. and Germany. The trial is being
conducted at London Health Sciences Centre in Canada and William Beaumont Hospital in the U.S.,
as well as at Heidelberg University Hospital in Germany to facilitate subsequent commercialization.
Partnerships continue to be a key success factor in the development of Profounds technology, which grew out of early work by two scientists
at Sunnybrook Research Institute in Toronto. Of particular note is Torontos York University, which has been very accommodating and flexible
in making its research MRI scanner available at a very reasonable cost for initial concept validation and testing. Siemens Medical has also been
very helpful, providing technical support and facilitating introductions to the German hospitals where trials are taking place. The project is also
benefiting from the ongoing advice and guidance of leading experts in urology and radiology at such prestigious institutions as the Cleveland
Clinic, Vienna University Medical School, Harvard Medical School and Sunnybrook Health Sciences Centre.
In addition to Genesys Capital, the Business Development Bank of Canada and the MaRS Investment Accelerator Fund, HTX has provided
substantial early funding and support for Profound Medical, and management at Profound has been taking full advantage of HTX partnerships
and resources. The firm hopes to provide a return through job creation, the potential for local manufacturing and by helping other emerging
firms learn about clinical trial design, sourcing of complex manufacturing and navigating the FDAs Class 3 approval process. Perhaps most
Following successful completion of the Phase 1 trials in early 2014, a Phase 2 trial of the efficacy of
important of all, Profound is poised to make a ground-breaking contribution to a new standard of care for men with prostate cancer and to
the Trans-Urethral Ultrasound Ablation (TULSA) procedure in treating cancer is expected to begin.
cost-reduction in the Canadian healthcare system.
The 30 patients from the Phase 1 study will be enrolled in the Phase 2 trial and monitored for up to
five years to ensure they remain cancer-free.
24
25
Therapeutic
Monitoring Systems
Therapeutic
Monitoring
Systems
CIMVA technology offers a novel
approach to help me take care
of our institutions critically ill
patients, and I look forward to
its further development and
eventual commercialization.
Dr. Frank Jacono,
Assistant Professor of Medicine,
Division of Pulmonary, Critical
Care & Sleep Medicine, Case
Western Reserve University
School of Medicine, Cleveland
Clinical Decision Support software helps

critical-care clinicians predict outcomes
for complex procedures in the ICU
CIMVA consists of two components: 1) the CIMVA Universal software platform, which is the
Currently, critical-care vital signs monitors in hospital intensive care units (ICUs) only have cursory
The first clinical application CIMVA Extubation Advisor helps the care team better determine
analytical capability, and as a result offer little, if any, point-of-care clinical decision support for
when to take patients off mechanical ventilation (by removing their breathing tube) prior to their
physicians and nurses facing difficult decisions. Despite round-the-clock vital signs monitoring for
release from the ICU. In the U.S. alone, 1.4 million ICU patients annually are on ventilation and
the critically ill patient, hospitals commonly resort to a wait and see approach to assess how a
about 15% of these patients fail the extubation procedure, resulting in increased risk of death and
patient will respond (improve/deteriorate) to therapeutic treatment. This clinical uncertainty
almost $7 billion of avoidable cost. Other CIMVA applications in the development pipeline include
leads to thousands of unnecessary deaths annually, longer hospital stays and billions of dollars
one for assessing the risk a patients will deteriorate rapidly from infection (sepsis), and another
of avoidable cost to the health system.
for determining when to decrease the level of sedation in critically ill patients.
Therapeutic Monitoring Systems (TMS) is addressing this critical problem with CIMVA clinical
A key partner for TMS has been the Ottawa Hospital Research Institute, which has been very
decision support (CDS) software that incorporates novel predictive analytics that can determine
supportive and its three associated hospitals have been CIMVA software study sites. Other
a patients health status in advance of current, standard-of-care clinical indicators.
noteworthy Canadian and U.S. teaching hospital sites supporting CIMVA testing to date include:
engine for the complex mathematics and predictive analytics; and 2) individual CIMVA clinical
applications running on top of the platform that address specific clinical interventions and
procedures. The CIMVA Universal platform received U.S. FDA clearance in 2013.
St. Michaels Hospital (Toronto), Mount Sinai Hospital (Toronto), London Health Sciences Centre,
CIMVA technology was conceived by TMS founder Dr. Andrew Seeley, a practicing ICU clinician
University of Michigan Hospital, Columbia University in New York City, the Billings Clinic in
and thoracic surgeon at The Ottawa Hospital. Development has been funded by angel and venture
Montana and the University Hospital of Case Western Reserve University in Cleveland.
investors and timely strategic funding from agencies such as the Health Technology Exchange and
the Federal Economic Development Agency. The strategic funding has enabled TMS to leverage
CIMVA Extubation Advisor recently completed a 12-hospital U.S./Canada clinical study involving
investor money in an effective manner.
700 patients. Comparison of predicted outcomes with the subsequent real-life outcomes showed
that using CIMVA may lead to a 75% reduction in extubation failures. A second study is in the
Using data collected from patient monitors, CIMVA employs complex mathematics to illuminate
planning stages to confirm the results seen in the initial study, and once the results data is
hidden information in patient vital signs and predict the outcome of a patient undertaking a risky
complete, an application will be filed with the FDA for clearance to market CIMVA Extubation
procedure that may result in increased harm and a costly increased length of hospital stay. Presented
Advisor, which is anticipated for 2016.
to a doctor using a tablet at the patient bedside, CIMVA calculates a risk score that, when used in
combination with other clinical metrics and the care teams judgement and experience, enables
CIMVA will be initially deployed on an OEM basis, as software embedded within monitors, ventilators
better treatment decisions that can improve patient care and cut hospital costs. TMS envisions
and electronic medical records (EMR) systems from leading healthcare product vendors. This will
physicians invoking CIMVA episodic CDS applications similar to the way physicians currently order
give TMS a strong, well-established and far-reaching channel into the marketplace, which, in the
patient lab tests. CIMVA transforms patient data into actionable information for use by doctors
U.S. alone, includes more than 3,500 acute-care hospitals and almost 70,000 ICU beds. In mid-2013,
and nurses at the point-of-care to improve decision-making and the delivery of patient care.
TMS signed a device integration partnership agreement with Cerner Corporation, a leading vendor
of EMR systems to acute-care hospitals.
26
27
Octane Biotech Inc.

Octane
Biotech Inc.
Octane possesses the technology,
multidisciplinary expertise and
stem cell experience we require
to scale-up the production of
our NurOwn stem cell therapy
candidate. Cocoon technology
could significantly accelerate
the commercialization of this
promising therapy.
Dr. Adrian Harel,
Director of Research,
BrainStorm Cell Therapeutics
Cocoon
Automated
bioreactor systems overcome
living implant production barriers and accelerate
adoption of regenerative medicine
Regenerative medicine the use of cell therapy and tissue engineering to treat trauma and to stop,
and even reverse, the progression of disease is not new, and is becoming increasingly successful
in neurology, cardiology, orthopaedics and numerous other areas.
In orthopaedics, for example, where hip and knee cartilage degeneration leading to joint replacement
has become common, regenerative medicine can be especially effective on two fronts. The
introduction of new cells can stop degeneration by repairing cartilage lesions early, following
detection, thereby delaying or even eliminating the need for full-joint replacement using implants.
Even severe cartilage disease affecting the underlying bone can be successfully treated using
advanced living implant technology incorporating cells and scaffolds to form repair tissue that
The patients entire cell production process, including all inputs (donor cells, reagents, stimulatory
chemicals) and outputs (waste products, resulting new cell population), is managed via the patients
single-use cassette, in which the patients cells are nurtured, grown and directed in terms of their
biological function.
The use of automation and bioreactors not only provides greater control over production, thus
enabling greater cell performance, but also reduces production cost significantly by eliminating
a lot of the manual labour previously required for the production of cells and tissue. Use of small,
portable and relatively inexpensive Cocoon bioreactors also allows cell production to be dispersed
geographically. As a result, the manufacture of living implants can take place closer to the point
of care, thus eliminating transportation problems and related costs associated with a centralized
manufacturing model.
large, multinational regenerative medicine companies that have cell therapy and living implant
products on the market or in development but are struggling with manufacturing scalability.
The Cocoon technology and cell production process is incorporated by those companies into
their manufacturing process.
For example, the Israeli company BrainStorm Cell Therapeutics is using the Cocoon platform to
unlike conventional metal or polymer hip and knee implants that have a limited lifetime.
grow, and enhance the performance of, an expanded population of stem cells that can be used
therapy and living implants, manufacturing is a major barrier to widespread clinical and commercial
adoption. Cell production, which traditionally takes place in a specialized clean-room environment,
is very complicated and expensive. It also requires an extremely capital-intensive infrastructure to
to stop further neurologic degradation for those suffering from ALS (a.k.a. Lou Gehrigs Disease)
clinical areas being addressed by Octane partners include diabetes, blood-related diseases such
as leukemia, and a host of orthopaedic applications.
While all the product development activity on the Cocoon platform is undertaken in-house,
In addition, todays centralized approach to manufacturing cells and implants creates considerable
Octane fosters close collaborations with numerous academic partners, including the Centre for
transportation complexities and cost associated with delivering living implants to the point of care
Commercialization of Regenerative Medicine based at the University of Toronto, the Centre of
in a timely fashion.
Excellence for Cell Therapy based at Hpital Maisonneuve-Rosemont in Montreal, the University
manufacturing barriers to the adoption for cell/tissue therapy and living implants.
Cocoon Instrument
of Basel in Switzerland, KU Leuven University in Belgium, the University of Zagreb, the University
of Bristol, and the University of Genoa and the Rizzoli Institute in Italy.
Apart from the obvious clinical benefit of Cocoon technology for patients across Canada and
28
Sterile Cassette
by repairing and re-establishing key neurological processes interrupted by the disease. Other
efficiently make cells in sufficient number typically hundreds of millions to be clinically effective.
With funding assistance from HTX, Kingston, Ontario-based Octane Biotech has overcome these
OCTANE
Bioreactor
Technology
Octanes primary channel to market for the Cocoon platform is through partnerships with
integrates with the surrounding cartilage. These biological solutions avoid further medical intervention,
Although clinical trials throughout the world continue to demonstrate the medical efficacy of cell
Cell Source
Octanes innovative Cocoon bioreactors allow the automated production of large populations of
throughout the world, Octane is also bringing value to Ontario and the local economy in the form
cells and tissue outside of a traditional clean-room facility. The patented Cocoon technology provides
of job creation (the company has grown from eight to 24 employees) and local manufacturing
a complete environment for cell and tissue growth, while protecting the cells from any external
(the firm has recently expanded its production footprint from 17,000 square feet to 50,000).
hazards that may be present due to the bioreactor location. Provision of support resources required
Octane also provides a significant amount of training for summer/co-op students and is involved
to maintain a living environment inside the container is fully automated and software controlled.
in multiple collaborations through Centres of Excellence across Canada.
Part of the innovation is in the use of bioreactors within a disposable cassette for processing the
Octane has taken Cocoon from functional prototype to a pilot production run of roughly 20
cells and allowing the entry/exit of support resources. The cassette, which sits inside the Cocoon
complete systems that have been successfully tested internationally. The company is currently
instrument, consists of snap-together modules customized to each clinical application.
preparing its marketing launch package, and plans full commercialization by mid-2014.
Automated Production
of Allograft and
Autograft Implants
Versatile
Automated
Economical
Standardized
29
Transitioning to eShift
Transitioning to eShift
1 Nurse
1 Nurse
New model for home care delivery leverages

limited nurse resources and cuts health system
costs by reducing hospitalizations
otherwise be in an institution to be cared for at home and reduces hospital re-admissions. In
Clinical Data Collection
Southwestern Ontario, for example, hospitalizations for palliative care patients were reduced
from 50% to 2%, which is a significant impact on health system cost as well as patient satisfaction.
In the US, eShift can deliver even greater value, given the higher cost of healthcare. This is especially
true under the recently enacted Accountable Care Act, whereby Accountable Care Organizations
(ACOs) that create efficiency and process improvements that save money for the health system
receive significant incentive bonuses, which is a significant driver of innovation adoption. Using
1 Patient
1 Patient
eShift to reduce expensive hospital stays through better home care allows ACOs and their partners
desire to manage more patients at home and prevent admissions (& re-admissions) is a growing
to deliver these cost-savings.
and necessary trend for health systems. However, home care delivery today follows an extremely
Delegating
Nurse
Delegating
Delegating
Nurse
Nurse
Nurse
Aide
Nurse
Aide
With the continually increasing costs of healthcare, whether from economics or demographics, the
Nurse
Aide
inefficient human resource model. While a hospital may be expensive, it is relatively resource
With this strategy in mind, Sensory Technologies has entered the U.S. through its relationship
efficient because varying levels of medical skill (specialist, GP, nurse, allied health) are available
with Hospice of Michigan (HOM) headquartered in Detroit. HOM is a member of one of the leading
and thus reasonably accessible; community care is extremely inefficient in this manner as one
Accountable Care Organizations in the U.S. HOM, through eShift, is actively pursuing adult patients
professional is generally responsible for the home visit. This inefficiency, coupled with an increasing
with complex care needs, such as Type II diabetes, congestive heart failure or chronic obstructive
shortage of nurses for home care complicates the capacity to deliver home care at lower costs.
pulmonary disease (COPD). Again, the new hybrid home-care team enabled by eShift can manage
those patients better, reducing the risk of hospitalization where the really expensive care kicks in.
Sensory Technologies has worked with the Community Care Access Centre (CCAC) in Southwestern
Case
Physicians Manager
Physicians
Case
Manager
Delegating
Delegating
Nurse
Nurse
Nurse
Aide
Clinical Family
Analytics Portal
Clinical
Analytics
Family
Portal
Visiting
Visiting
Nurse
Nurse
Nurse
Aide
Ontario to look closely at home care in that region. The CCAC, which is responsible for orchestrating
The eShift home care model and software is an ideal fit for groups like HOM and other ACOs, and
home care service providers for the region, was struggling with the problem of insufficient nurses to
Sensory Technologies has used financing from HTX to localize the software for the U.S. and
deliver care, and wanted to figure out how to expand the reach of the nurses it does have within the
international markets. This includes modifications allowing for regional requirements for privacy and security of patient data collected at home,
region. Based on this work, Sensory Technologies created a new clinical service model called eShift
and added functionality to make the eShift application and the mobile client used by the PSWs on their iPhones suitable for use with adult
for treating and managing end-of-life patients at home that optimizes nurse utilization, lowers costs,
complex-care patients.
increases capacity and improves patient care.

The new service model is based on hybrid virtual home care teams, which are led by a delegating nurse
a company that was primarily focused on developing software to a company that is delivering healthcare technology and services, it will be
(DRN) that directly supervises four personal support workers (PSWs). The DRN manages, mentors and
expanding its current staff of 18 to include technical sales & support, training and quality assurance professionals.
monitors the PSWs during home care visits, in-home patient data-collection and medical tasks. eShift
allows the DRN to work at home or a telemedicine centre with a laptop, and connect to the PSWs via
smartphones and provide constant communication and care while the PSWs visit patients homes.
The service model enabled by eShift better leverages available nurse resources by expanding each
nurses reach by managing multiple PSWs at one time. PSWs are delivering near-nursing level care
under guidance of that specialized and experienced DRN. By using the DRNs skills to remotely guide
any additional interventions required, the capacity to adjust the level of care needed at the bedside
is greatly expanded. This approach allows both DRNs with eShift and visiting nurses to cover many
more patients than compared to existing service models.
This new hybrid home-care team, enabled by eShift, delivers a higher level of complex care
management to considerably more patients. eShift enables higher-acuity patients that could
30
HTX financing has been critical in leveraging the investment of local Angel investors and founders. As Sensory Technologies transitions from
In addition to the HTX financing, Sensory currently has one local angel investor and will be raising more capital with Series A funding, likely
late-2014 or early 2015. This will allow the company to increase internal development, deliver more services within Canada and expand its
reach internationally. This will include securing HIPPA certification in the U.S. by mid-2014, and delivering eShift pilots in the U.K. and France
with leading healthcare organizations from each country.
The eShift software is a fully hosted, Web-based application based on the Software-as-a-Service (SaaS) delivery model in which customers pay a
monthly subscription fee to access the application via the Internet, using any standard Web browser. For Canadian customers, the application is
hosted at a third-party datacentre site in Ontario to ensure patient data remains within Canada; similarly for HOM, eShift is hosted at a secure
datacentre in Detroit to ensure clinical data generated or accessed within the U.S. stays within the borders.
Overall, Sensory Technologies, through the development of eShift, is a good example of the application of technology and service innovation
to transform care and deliver better service at lower cost.
31
Setting the Stage for

Global Competitiveness
The Harmony Project
HTX expands its services to promote international

sales of Ontario medical technologies
demonstrate value for money and comparative effectiveness is increasing evidentiary requirements on manufacturers, as more and more
Navigating the complex world of foreign market regulatory, reimbursement

and health technology assessment requirements.
Regulatory and reimbursement environments globally are becoming increasingly stringent and complex to navigate for medical technology
companies. Overcoming the hurdle of safety and efficacy alone is no longer sufficient to ensure access to foreign markets. The demand to
jurisdictions are relying on Health Technology Assessment (HTA) as a gateway to market access. In the past, companies with limited knowledge
and experience might generate sufficient data for their first market, only to find out that data proves insufficient for subsequent markets,
necessitating additional trials, delays and expense. MaRS EXCITE, of which HTX was a founding collaborator, uses a highly innovative and efficient
In 2012, purchases of medical technology by Canadian healthcare providers were ~$7B, of which ~$5B was imported and only ~$2B
approach to consolidate regulatory, reimbursement and HTA requirements into a single integrated pre-market process for Ontario. What is
was met by Canadian suppliers. In addition, Canadian companies exported ~$2.3B, mostly to the slow-growing US market. Canada
needed is an integrated, strategic approach to evidence development across multiple foreign markets.
represents only about 2% of the global medtech market, but we perform on the order of 3-7% of global medtech clinical trials, and
are the 3-5th ranked globally in medical research productivity. Canada has about the same domestic medtech revenue per capita as
The Proposed Solution
France and the UK, about 20% less than Italy, but only 1/3rd as productive as Germany and the US, with Switzerland a startling 11 times
The Harmony Project, led by HTX in collaboration with MaRS EXCITE, is the first step in developing a process and related content to assist
more productive! A large factor in this is that the Ontario health care system, like those of other Canadian provinces, is not a leading
medtech companies in anticipating and simultaneously addressing regulatory, reimbursement and HTA evidentiary requirements for
adopter of innovation. The implications of this are critical to Canadian medtech success:
multiple jurisdictions and payers. Harmonys strategic approach is intended to reduce medtech product time-to-market, reduce investor
risk, eliminate redundant evidence generation and speed product adoption. Although isolated components of this concept have been
We are investing in medical research, but not realizing the benefits from that research
in terms of Canadian company domestic sales, job growth and exports.
Our domestic market must become more strategic for Canadian medtech companies,
providing benefits to Canadian patients and early revenue to companies.
Canadian medtech companies MUST aim to increase their focus into global markets,
especially to high-growth markets such as Korea, China, India and Brazil.
HTXs tag-line is Invent, Innovate, Invoice. HTXs early evolution focused on Invention and Innovation; Now, increasingly HTX is building
capacity for companies to pursue International Invoices. Here are several initiatives that HTX has either led or actively participated in
over the past year, that will help Ontario companies reduce the risk, cost and time to access both domestic and foreign markets.
developed in select medtech and biopharma eco-systems, to our knowledge, there are no companies currently offering the integrated
scope and value proposition of the proposed Harmony Methodology. Harmony will be a worlds first, and has received extremely positive
reception from the medtech industry to-date.
The Project
Through a Request for Qualifications (RFQ) and Request for Proposals (RFP) process, several highly qualified global market access
specialists were identified for the purposes of Harmony. A combination of an internal due diligence process with support from an
international Advisory Board, led to the retention of Hull Associates a global medtech consultancy, as a key partner for HTX in the
development of the Harmony Methodology.
Harmony will focus on key markets of interest to the medtech community Canada, US, UK, France, Germany and Australia. Using
a combined pathway and case-study based approach, Harmony is identifying regulatory, reimbursement and HTA requirements for
a cross-section of medical devices, and optimal evidentiary coverage across multiple target markets.
Harmonys goal is to identify areas of similarities and differences in the commercialization pathway of medical devices across the target
markets, providing end-users with a practical and heuristic based approach in developing and planning their market access strategy.
Additionally, through collaboration and partnerships, Harmony will provide insight, education, and connectivity for medical device
innovators and enable expedited access to key international resources and individuals versed in market access. HTX anticipates
launching a web-accessible Harmony collaboration service in late 2014.
32
33
Soft Landing Program
Medtech Working Group,
A critical milestone for medtech companies that are seeking to expand into international
The Ontario Health Innovation Council

and Innovation Procurement
markets, is establishing sound relationships with key individuals within local settings.
Through the Soft Landing Program, HTX offers an international registry of partners in
specific geographic areas that can deliver the services required to reduce the time, cost and
risk of market entry and/or provide collaboration opportunities for Ontario-based companies.
Canada, and Ontario are rightfully proud of their world-class levels of medical
research funding a fundamental input to global medical technology innovation.
Canada represents only 1.5-4% of the global market for various medical
HTX co-authors the

Canadian medtech
market access
pathway for ISPOR
As a component of Harmony, the HTX led Soft Landing Program is designed for small and medium enterprises (SMEs) seeking assistance with
technology sectors, yet we perform a strong 3-7% of global clinical trials in those
all, or a subset of regulatory, reimbursement and HTA compliance, corporate representation, manufacturing and clinical research, sales and post
sectors. Canada is one of the world leaders in medical research, and Ontario
market support, within their priority foreign markets. The program is aimed at decreasing the cost and risk associated with premature pursuit
represents about 60% of Canadas medical technology ecosystem. However, we
of foreign markets, as well as minimize the burden and challenge of identifying the optimal commercialization pathway in unfamiliar regions.
need to become as effective in medtech commercialization as we are in research.
HTX envisions that the Soft Landing Program will also provide reciprocal resources and bilateral introductions to the Canadian market for
HTX is very pleased to have played a key role in several initiatives, which will
group of Canadian academics and market
innovative international companies seeking to gain market access into Canada.
fundamentally change the dialogue between the health system, research, industry,
access experts, jointly contributed to the
and Ontarios effectiveness as a medtech commercialization cluster. MaRS EXCITE
Global Health Care Systems Road Map,
was the first initiative arising several years ago from the Open-For-Business
published online by ISPOR (International
process between the Ontario Government and the Medtech industry. The second
Society for Pharmacoeconomic Outcomes
is the Medtech Working Group-a multi-stakeholder public/private forum that
and Research). As a first step in under-
Medtech RISE (Registry of Innovators, Suppliers and Exporters)

A comprehensive pan-Canadian medtech ecosystem database
This year, HTX in conjunction with a select
identifies priorities and recommends changes to facilitate a more rapid adoption
Access to accurate data on the number and type of medtech companies and entities in Canada, along with other industry statistics, is critical for
of medical technologies benefitting patients, reducing costs to the health system
aligning innovation and import/export opportunities with companies that can use them. In addition, a strong need exists to increase connectivity
and increasing economic growth in the province. The third is an Innovation
between researchers, customers, collaborators, suppliers and talent at a global scale. Over 20 medtech databases have been created in Canada
Procurement and Adoption working group initiated by the Ministry of Government
within the last decade to address subsets of this overall challenge however, all suffer from single-organization mandates, limited data sets, and
Services and Ontario Buys, seeking to reform the procurement process for
atrophy over time due to a lack of regular maintenance and updates.
medical technology, transforming it into a highly collaborative process, where
This year, HTX in conjunction with key Canadian medtech ecosystem partners, led the
development and establishment of a national, shared, online registry containing all identified
players within Canadas medtech ecosystem. Medtech RISE Registry of Innovators, Suppliers
and Exporters, is accessible online and provides the most up-to-date portrayal of Canadas
medtech ecosystem. Medtech RISE is maintained on a cloud-based platform provided by
Biotechgate of Switzerland, a company operating similar databases for BIOTECanada, Life
Sciences Ontario, and many of the worlds leading medical technology clusters. To support
the growth of our medical and assistive technology industry, Medtech RISE provides a
platform to monitor the growth, trends, and needs of a constantly changing medtech
market, and exposes Canadian medtech companies to the rest of the world.
dialogue on priorities and technical feasibility occurs early and often in the
evolution of medical technologies.
Most recently, the Ontario Government has created the Ontario Health Innovation
Council (OHIC), representing Government, the health system, and industry, with a
goal of transforming Ontario into one of the leading adopters of beneficial health
technology. Virtually all of HTXs past and planned programs align with OHICs
standing the Canadian Health Care system

as it relates to commercialization of
medical devices, this tool provides an
overview of the Canadian regulatory,
reimbursement and health technology
assessment pathways and acts as a
valuable preliminary resource for medtech
companies. This publication marks the
first of several publications that have
been planned for this coming year. Access
to the Canadian Health Care System Road
Map for medical devices can be found at
www.ispor.org.
mandate. Collectively, these initiatives represent an inflection point for Ontario,

positioning it to become as strong in commercialization as it is in research, and
one of the leading medtech clusters globally.
There are currently over 2500 entities that have been identified through this collaborative endeavour, ranging from medtech manufacturers
and distributors to research and government organizations, investors and service providers. Over the next twelve months, combined efforts of
HTX and its partners will foster continued expansion of this iterative database, making it a robust and comprehensive tool of high value to the
local, national and international medtech community. Medtech RISE is accessible through the HTX website as well as through partner websites.
34
35

Toronto, ON M5G 1W7
Tel: 647-258-0381
Fax: 647-258-0390
www.htx.ca

Centre for Addiction & Mental Health
MaRS
Mount Sinai Hospital
Princess Margaret Hospital
Ontario Legislature
The Hospital for Sick Children
Toronto General Hospital
Womens College Hospital
University of Toronto
Summarized Financial Statements 2013
2013
HTX.CA | THE HEALTH TECHNOLOGY EXCHANGE
Report of the Independent Auditor

on the Summary Financial Statement
Summary Statements of Operations

Years ended March 31
To the Board of Directors of htx.ca The Health Technology Exchange

The accompanying summarized financial statements, which comprise the summary statements of financial position as at March 31,
2013, March 31, 2012 and April 1, 2011 and the summary statements of operations and changes in net assets and cash flows for
the years then ended are derived from the audited financial statements of htx.ca The Health Technology Exchange for the years
ended March 31, 2013 and March 31, 2012. We expressed an unmodified audit opinion on those financial statements in our report
dated July 17, 2013. Those financial statements, and the summarized financial statements, do not reflect the effects of events that
occurred subsequent to the date of our report on those financial statements.
The summary financial statements do not contain all the disclosures required by Canadian accounting standards for not-for-profit
organizations. Reading the summary financial statements, therefore, is not a substitute for reading the audited financial statements
of htx.ca The Health Technology Exchange.
Managements responsibility for the financial statements

Management is responsible for the preparation of a summary of the audited financial statements in accordance with
Canadian accounting standards for not-for-profit organizations.
Auditors responsibility
Our responsibility is to express an opinion on the summary financial statements based on our procedures, which were
conducted in accordance with Canadian Auditing Standard 810, Engagements to Report on Summary Financial Statements.

Revenue
2013
2012
$ 4,844,906
4,000
42
$ 3,462,171
10,000
9
4,848,948
3,472,180
Health technology commercialization program

Commercial market development program
Research and development program
General and administrative expenses
Amortization
3,643,516
490,423
339,485
332,807
40,512
2,192,854
463,076
437,690
313,851
69,071
4,846,743
3,476,542
2,205
$ (4,362)
Ontario Ministry of Research and Innovation grant

Educational seminar grant
Interest

Expenses
Excess (deficiency) of revenue over expenses

See accompanying notes to the financial statements.
Opinion
In our opinion, the summary financial statements derived from the audited financial statements of htx.ca The Health
Technology Exchange as at March 31, 2013, March 31, 2012 and April 1, 2011 are a fair summary of those financial
statements, in accordance with Canadian accounting standards for not-for-profit organizations.
Chartered Accountants, Licensed Public Accountants | Toronto, Canada | August 30, 2013
Grant Thornton LLP | Suite 200 | 15 Allstate Parkway | Markham | ON | L3R 5B4 | T +1 416 366 0100 | F +1 905 475 8906 | www.GrantThornton.ca
2
Summary Statements of Changes in Net Assets

Summary Statements of Financial Position

2013

Invested in property

Total
and equipment Unrestricted
Balance, beginning of year
$ 183,098
$ 94,628
$ 88,470
2,205
(40,512)
42,717
Purchase of capital assets
1,405
(1,405)
Balance, end of year
$ 185,303
$ 55,521
$ 129,782
2012

Invested in

Total
equipment Unrestricted
March 31, 2012 April 1, 2011
Current
Cash
Accounts receivable
Prepaids
Contributions receivable
$ 184,337
32,191
5,792
717,489
543,161
1,687,611
939,809
Property and equipment
55,521
94,628
108,895
$ 598,682
$ 1,782,239
$ 1,048,704
$ 106,089
307,290

$ 95,932
302,065
1,201,144
$ 79,028
302,065
480,151
413,379
1,599,141
861,244
55,521
129,782
94,628
88,470
98,986
88,474
185,303
183,098
187,460
$ 598,682
$ 1,782,239
$ 1,048,704
$ 460,363
69,350
13,448

$ 1,649,121
29,214
9,276
LIABILITIES
Current
Balance, beginning of year
$ 187,460
$ 98,986
$ 88,474
Deficiency of revenue over expenses
(4,362)
(59,162)
54,800
Purchase of capital assets
54,804
(54,804)
Accounts payable and accrued liabilities

Payable to Ontario Ministry of Research and Innovation
Deferred contributions

Balance, end of year
$ 183,098
$ 94,628
$ 88,470
Net assets
March 31, 2013
ASSETS
(Note 2)
Invested in equipment
Unrestricted

Summary Statements of Cash Flows

Notes to Financial Statements

March 31, 2013

2013
Increase (decrease) in cash
2012
1. Criteria for presentation of summary financial statements
Operating
Items not affecting cash
Change in non-cash working capital items
$ 2,205
40,512
(1,230,070)
$ (4,362)
59,162
1,464,788
(1,187,353)
1,519,588
Investing
Purchase of property and equipment
(1,405)
(54,804)
(Decrease) increase in cash
(1,188,758)
1,464,784
Cash
Beginning of years
End of years
1,649,121
184,337
$ 460,363
$ 1,649,121
The information selected by management for presentation in the summary financial statements has been identified as being the
most pertinent and useful financial data for inclusion in the htx.ca The Health Technology Exchange annual report.
Audited financial statements are available upon request from management of htx.ca The Health Technology Exchange.
2. Impact of the change in the basis of accounting

These summary financial statements are HTXs first summary financial statements prepared in accordance with Canadian accounting
standards for not-for-profit organizations (ASNPO). The date of transition to ASNPO is April 1, 2011. These accounting standards
were used to prepare the summary financial statements for the year ended March 31, 2013, the comparative information and the
opening statement of financial position as at the date of transition.
The adoption of ASNPO did not result in adjustments to the previously reported assets, liabilities, fund balances and excess of
revenue over expenses of HTX. Accordingly, the reconciliations and disclosures required by Section 1501, First-time adoption for
not-for-profit organizations, for the net assets at the transition date, and the comparative period statements of operations and
cash flows are not necessary and have not been presented in these summary financial statement notes.


Toronto, ON M5G 1W7
Tel: 647-258-0381
Fax: 647-258-0390
www.htx.ca
HTX is an independent, not-for-profit corporation funded by the

Government of Ontario through the Ministry of Research and Innovation.

2013 HTX Annual Report

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HTX ANNUAL REPORT | 2012 2013

Financing innovative medtech companies

HTX ANNUAL REPORT | 2012 2013

From the Editors

From the President & CEO 06

Financing & activities

Editor: Rob Hall

Assistant Editor: Cheryl Verscheure

201213 HTx Financial

Design, Layout & Print: Slant Creative Group

The report in its entirety can be downloaded by visiting www.htx.ca.

Setting the Stage for

HTX is an independent, not-for-profit corporation funded by the Government

Soft Landing Program 34

of Ontario through the Ministry of Research and Innovation.

The Harmony Project 33

Profound Medical Inc.

Therapeutic Monitoring Systems

Octane Biotech Inc.

Health Technology Exchange (HTX)

HTX is an independent, not-for-profit corporation funded by the

HTX ANNUAL REPORT | 2012 2013

HTX ANNUAL REPORT | 2012 2013

From Invention through Innovation

MORRIS (MICKEY) MILNER

HTX BOARD OF DIRECTORS

HTX continues to be the leading resource

HTX provides non-dilutive

Through the Health Technology Commercialization

An enhanced Small and Medium Sized

activities, HTX is the leading resource and catalyst for

Enterprise (SME) base, creating export

HTX BUSINESS ADVISORY COMMITTEE

Program (HTCP) and HTXs MedTech ecosystem support

ultimately more high growth international

and enhancing Canadas position as a global leader

in commercializing innovative medical technologies.

More well founded and financed start-up

With 33 recipient companies in its financing portfolio

companies with the capability of negotiating

conducting 38 projects supporting commercialization

global marketing partnerships and attracting

and exports, HTX strives to promote connectivity,

research, creating more market focused

silos. HTX manages a $21.4M fund on behalf of the

innovative medical and assistive technology

Ontario Ministry of Research and Innovation and is a

products validated by effective utilization

member of the Canadian Venture Capital Association.

of technology evaluation, appraisal

The HTCP program has levered more than $65M in

*Ministry of Research and Innovation

HTX ANNUAL REPORT | 2012 2013

HTX ANNUAL REPORT | 2012 2013

Message from the

PRESIDENT & CEO

John soloninka, PEng, MBA

Growing the Medtech Ecosystem

entities enhancing the sector, including:

and technologies for follow-on investment.

New Financing Approvals:

emerging from Ontario: as sophisticated and competitive as any internationally.

Over this last year