CAE targets medical simulation

Bertrand Marotte

On the ninth floor of the sprawling art deco main building of the Université de Montréal’s campus, flight-simulator manufacturer CAE is helping stage life-and-death crises on a weekly basis.

In a realistic operating room mock-up, a “patient” lying on the gurney can bleed up to two litres of fake blood, blood pressure falling dramatically as a result. The cyber-mannequin can go into cardiac arrest at the flick of a computer key in the control room next door, where supervisors watch through one-way glass as medical students take turns trying to cope with the emergency situations thrown at them.

The students training in different specializations – such as anesthesiology – get to learn in as close to an actual hands-on situation as you can get without actually practising on a real patient.

Mistakes – including some that could cause injury or even death – happen in this virtual environment. At a debriefing afterward, there is close study of the video and detailed computer data from the session to see what went right and what went wrong.

In another room on the floor below, students and health care professionals get intensive training on CAE’s Vimedix simulator that allows for hyper-realistic mimicking of various heart conditions. The simulator links a custom-designed mannequin to a screen showing a 3D anatomical display of an animated heart. As the trainee moves a portable ultrasound device over the mannequin’s chest, the image changes accordingly.

For Montreal-based CAE – a dominant player in the global civil and military aviation simulation and pilot training sector – this partnership with the Université de Montréal’s medical simulation centre represents the future as it seeks to diversify away from its core business into a promising new high-growth area.

“It’s been several years that we’ve been looking to diversify in different sectors,” says Marc Parent, CAE’s president and chief executive officer. “Medical is a priority for us. We view the demand as huge. We’re going into it to become a leader.”

Whether or not the expansion from simulated flight into virtual medical training will pay off is another matter. This is, after all, the second time that CAE has tried to break into medical simulation. It retreated from a previous attempt in the early 1990s. The conclusion then was that sufficient demand just wasn’t there, says Guillaume Hervé, president of CAE Healthcare, the medical simulation and training division.

“Fifteen years ago, when we were pushing this, there were 10 medical simulation centres in the world. Now there are about 1,400 and all the journals are talking about it. We decided it was time to get back in.”

Cameron Doerksen, an analyst at Versant Partners, says it’s too early to say if the venture, and other areas being explored such as mining and energy, will pay off for CAE.

“There are opportunities for CAE to leverage its technology and expertise into other areas,” he said.

“It’s not clear to the investment community what the positive impact might be from these ventures. Will they pan out?

“It might be years before there is any kind of payoff from [medical simulation].”

A key difference between the current and previous forays into medical simulation is that CAE is now more focused. In the past it tried to be in too many different sectors – including forestry – that were a distraction and didn’t really involve the transfer of its core expertise, Mr. Doerksen says.

Mr. Hervé sees CAE making a big breakthrough this time.

“There has been a growing realization over the past 10 years many of the principles of flight simulation can be applied to medical simulation,” he says. “And more and more medical and health care associations are calling for the use of simulation training starting at the undergraduate level and continuing to skills upgrading and validation for practising professionals.”

He envisages a time when doctors and other medical professionals will be required to undergo simulation training to keep up with new developments, just as jet pilots are now mandated to do.

The medical simulation and health-training services unit accounts for only a tiny portion of the company’s $1.5-billion in total annual revenue.

There have been a few modest acquisitions, as well as several partnerships, including with the Université de Montréal and one – being launched Tuesday – with the Michener Institute for Applied Health Sciences in Toronto.

“The partnerships give us a real close-up look at the real world of medical training, access to professors and people right at the heart of the crossroads of medicine and technology” Mr. Hervé says.

“The acquisitions provide us with expertise,” he adds, pointing to the recent purchase of two Montreal-based companies: ICCU Imaging – a provider of e-learning courses in critical care ultrasound – and Vimedix, maker of ultrasound simulation technology. The key players in both those companies – cardiologists Dr. Yanick Beaulieu of ICCU and Vimedix’s Dr. Robert Amyot – are now employees of CAE while continuing their practices and teaching duties.

Mr. Hervé doesn’t mince words when it comes to trumpeting the potential of medical training and simulation for CAE.

“I think it will be as big as [CAE’s main business],” he says. “It has a broader user base, different levels of disciplines and specializations within health care. It’s a bigger market per se.

“We want to be setting the gold standard in simulation-based medical training.”