Published: 19 OCT 2023
Invest - News - Medtech - Diana Siew

The medical technology industry is growing rapidly in Aotearoa New Zealand. The Technology Investment Network (TIN) reported in 2022 that 17 medtech companies were amongst the country’s top 200 technology firms. Te Tītoki Mataora the Medtech Research Translator held its annual forum as part of New Zealand HealthTech Week 2023. Dr Diana Siew, Strategic Partnerships Lead at Auckland Bioengineering Institute (ABI), is co-lead of Te Tītoki Mataora. We spoke to her about Tāmaki Makaurau Auckland’s medtech ecosystem, emerging trends, and the evolving clinical and commercial pathways for development.


First, some definitions. How do you define medtech, and what is a ‘research translator’ such as Te Tītoki Mataora?

Medtech covers medical devices and digital health. It very specifically does not include pharmaceuticals in this case. Te Tītoki Mataora is co-led by University of Auckland (UoA), Auckland University of Technology (AUT) and University of Canterbury (UoC) on behalf of the Consortium for Medical Device Technologies (CMDT), which includes the universities of Auckland, Canterbury and Otago, Victoria University of Wellington, AUT and Callaghan Innovation. Its purpose is to develop new technologies that could transform healthcare. The programme aims to get medical technology research out of universities and into business and clinical use. If you don’t do your research translation right, everything just sits on the shelf and our taxpayer funding is wasted.


What are the issues medtech startups are addressing right now?

Some of the biggest issues are around staffing shortages and rising costs in the healthcare system so we are looking at ways technology can support efficiency. That’s a global issue. Simply put, we need technology, clinicians, and the healthcare consumer to be able to communicate more efficiently. For example, seamless integration of medical devices and wearables into electronic health records so that a care team, GP, or hospital can become more efficient and more flexible in supporting the client.

Artificial intelligence (AI) and machine learning are used to automate patient data, analysis and triage, and support administration management processes. Diagnostics would be one use. An example is Toku, which uses retinal images to evaluate a patient’s cardiovascular risk, providing a real-time alternative to the often time-consuming methods currently in use.

The global staffing shortage comes at a time when governments all over the world are strongly pushing to transition healthcare into communities. We need to empower the community with technologies patients can use for self-care and self-diagnosis. This allows individuals to take control of their health and overcome financial, social, and cultural barriers. But we must be careful it helps address some of the inequities in the system and not add to it.


How can medtech improve equity?

A study of the use of wearables or other technologies to support health and wellbeing in the community has just been completed by Whānau Tahi. The heart failure mortality rate among Māori is far higher than that of non-Māori and the disparity is glaring. Whānau Tahi is the arm of Te Whānau Ora o Waipareira Trust supporting Whānau Ora delivery and building the trust’s experience in this area. It has a purpose-built software platform that centres on principles of whānau-based care and a drive for self-sufficiency. Whānau Tahi partnered with Auckland medtech company to provide a range of wearable ECG devices to a group of young people at school to take home to care for their families and use as if they were a doctor. The devices were educational and by using the wearable ECG system, the programme discovered 14 undiagnosed cases of heart disease, which would not have been picked up otherwise.


How is the industry changing?

What is exciting is that New Zealand now has a great portfolio of high-growth companies in its medtech pipeline. These are ‘deep tech’ medical devices and digital health companies founded on science and clinical expertise and solving challenging problems. Most of them have come out of New Zealand universities. They have a niche that is big enough, and their technologies are not easily copied. That is what is changing the landscape of the medtech sector in New Zealand, and especially in Auckland. Twelve years ago, there were about 50 to 60 medtech companies across the nation. Fast-forward to 2022 and we have more than 200. We’ve created critical mass, and it is so much more vibrant than what we had back then. What we need to do now as a nation is to help scale and accelerate this sector.


What does the ecosystem look like?

Our anchor medical device companies in the digital health space are Fisher & Paykel Healthcare and Orion Health. Then there are 15 others that are between $5 million to $100 million in revenue based on the TIN 2022 list, and of these, Aroa Biosurgical, Molemap, Medtech Global, Intrahealth Systems, Sysmex, Whanau Tahi and Atlantis call Auckland home.

Within Auckland as well, there is a cohort of around 10 spin-outs from AUT and UoA coming through which are growing rapidly and adding excitement to the scene such as Alimetry, The Insides® Company, Formus Labs, JUNOFEM, RosterLab, Kitea Health and RespirAq. Together, these companies have raised around $78 million, created 140 jobs, and introduced seven new medtech products into the market, here in New Zealand and globally.

Our innovation ecosystem goes all the way from publicly funded research to exports. New Zealand is quite special, because you can join up all the organisations and their activities in terms of the support around funding and programmes. If you are trying to develop new technologies out of research, you can shepherd it from one stepping-stone to the next. But critical to success is the collaboration between clinicians, researchers, and people with lived experience to co-design solutions that work and are actually wanted. Australia’s innovation ecosystem is possibly not as well joined up: it might have more money in some places, but we are probably more efficient.

In New Zealand, the government has provided funding for early-stage research and for research translation. Centres of research excellence were established from 2016 to 2021. We had the MedTech Centre of Research Excellence, which really helped our researchers and clinicians learn how to take their science into the commercial and the clinical arenas. Now, Te Tītoki Mataora continues the job of building capability in research translation as well as the pipeline: new opportunities that can turn into companies and provide social, economic and health impacts.

The CMDT is a national industry research network with a community of world-leading researchers, clinicians, industry partners, investors, and other collaborators. Over the last 12 years, we have created a virtual medtech innovation ecosystem for New Zealand, and we are now anchoring this to MedtechIQ Aotearoa, a national precinct comprising four interlinked physical hubs initially centred around Tāmaki Makaurau Auckland, Pōneke Wellington, Ōtautahi Christchurch and Ōtepoti Dunedin. (NZ Health Ecosystem Map)


Who are the funders?

When researchers and clinicians have a concept to develop, they can approach Te Tītoki Mataora for very-early-stage funding. The progression from there is to KiwiNet and Return on Science for pre-seed accelerator funding. Private companies are looked after by Callaghan Innovation’s eHealth Tech Activator. As companies mature, they start working with New Zealand Trade and Enterprise to export. As well as government funding, there are private angel investors well known to KiwiNet and Return on Science who would be referred and who even act as mentors. In the private space, Icehouse and Outset Ventures don’t just incubate, they’re very active angels and venture capitalists.


And tell us about some founders.

Dr Greg O’Grady is both a clinician and a bioengineer. He is CEO of Alimetry, which recently gained US Food and Drug Administration approval for its flagship product, Gastric Alimetry, a high-resolution, non-invasive device that can diagnose disorders of the gut. He is a director of The Insides Company, which is also focused on gut health. He co-founded both these biotech firms.

Dr Jenny Kruger (midwife) and Dr David Budgett (bioengineer) formed JUNOFEM to address urinary incontinence by developing a stronger pelvic floor. Urinary incontinence affects 200 million people worldwide, with women being twice as likely to develop symptoms. The JUNOFEM technology, femfit®, is based on more than 10 years of research. It is a training system that helps people gain better control of their pelvic floor and abdominal muscles by visualising how they work in real time. The device also enables clinicians to assess the muscle bed function and through a clinical portal, track their patients’ progress.


What does the future hold for medtech?

The global trend towards personalising healthcare has been a Holy Grail for some time – but with technology now catching up, it's becoming reality, although we have a fair way to go. Today’s wearables are just the first step. The future of healthcare is the creation of digital twins for every individual to support well-being and diagnose and manage disease. That work is being undertaken by the University of Auckland’s Auckland Bioengineering Institute (ABI), which is a world leader in the development of computational physiology. Led by Professor Peter Hunter, our director, the researchers at ABI have modelled all our physiological systems, from molecular level to tissue level, to whole organ function. Now with the 12 Labours Project, which is receiving $15 million funding over five years from the Ministry of Business, Innovation and Employment, it is linking up all the individual physiological systems into one. This is a world first.

AUT is strong in rehabilitation technologies, an area led by Professor Denise Taylor. More people are surviving previously fatal health conditions and trauma, but often with significant disability. This makes an urgent case for developing ‘smart’ solutions that allow people to self-manage long-term health conditions.

There’s a desire to monitor movement and physiology in real time and build physiology-based computational models to interpret patient-specific data. New Zealand research is primarily focused on stroke and traumatic brain injury, addressing the need to provide rehabilitation strategies for each patient and improve their quality of life. Research into assistive technology is intimately linked to expertise in sensing and remote monitoring, design and manufacturing technology, and software and modelling.