Vision splendid

Children who have received a bionic ear and have learned to hear and speak

A life changed by Hear and Say. Photo: Supplied

Integrating bionics into humans holds out the prospect of fuller participation by people with previously untreatable conditions

I see an image of the dark eyes of a sturdy toddler gazing back at me. In a twist of fate, a recent diagnosis of Usher syndrome for this youngster, now well into manhood, has followed rapid loss of his sight and soon he will not only be profoundly deaf but possibly also legally blind.

It is bleak news indeed, and yet I am struck by a level of optimisim only made possible by the many breakthroughs in human bionics I see unfolding, breakthroughs which prompted me to found Hear and Say in Queensland.

In celebrating Hear and Say’s 25th anniversary in this past year, I’ve looked back at images and stories like this one that show the legendary achievements of so many children who have received a bionic ear and have learned to “hear and speak”.

If this young man is eligible for bionic eyes as well as his current bionic ears, is it just possible – even probable – that his treatment could be co-ordinated across two separate signal processing systems?

The convergence of humans and bionics is fast changing our vision of humankind. Now, more than ever before, we can envisage new bionic pathways back to optimal health.

Professor Graeme Clark’s multi-channel bionic ear was first implanted in a child with profound hearing loss in 1987.

It was in anticipation of the possibilities for auditory brain access which this Australian innovation could bring for children born severely or profoundly deaf that I founded Hear and Say.

Helping children and their families to access and benefit from this life-changing technology became my life’s focus.

Since then, thousands of young children have passed through our doors, learning to listen, speak and read. They have gone on to receive a typical education in the school of their parents’ choice, attend university and forge careers.

Following his very first implantation of a bionic ear, Professor Clark’s words were: “It is the first time the human brain, the human consciousness and a replaced human sense have been interfaced.”

It was also the first successful commercialisation of a neuromodulation device – a technology that acts directly upon nerves.

More recently, this interface between humans and bionic devices has expanded to cover not only the ear, but also many other areas of the body, vastly increasing the potential for bionics devices to treat previously untreatable medical conditions.

Human bionics has the potential to not only transform the lives of people with organ problems, brain disease, blindness, limb amputation, paralysis or other disorders, but also to become a high-growth, science-based industry for Australia.

This is the backdrop we must create to enable that young man with those captivating dark eyes now suffering Usher syndrome to capitalise on the visual memory he has of today’s world.

The Monash Vision Group (MVG), for instance, led by the electrical engineer Professor Arthur Lowery, has developed a wireless multi-electrode prosthesis to be implanted in the visual cortex to restore vision in blind individuals. Professor Jeffrey Rosenfeld and the MVG are planning for the first-in-human trial in 2019.

Each part of the manufacturing chain, from innovative research, supportive exponential technologies, engineering and medical skills right through to the commercialisation of medtech products slots neatly into Australia’s key assets and talents.

Delivering these outcomes will necessitate not only new hybrid professionals and new cross-compatible devices, but also regulatory changes, new production and manufacturing organisations and facilities, and commercialisation practices.

This is the backdrop we must create to enable that young man with those captivating dark eyes now suffering Usher syndrome to capitalise on the visual memory he has of today’s world.

Most importantly, he will need a program of yet-to-be-invented brain training so he can use his bionic eye to comprehend the new visual images he receives.

He’ll also need a new regulatory environment enabling bionic procedures to be performed safely and ethically. And, timely funding to enable new partnerships between science, product development and clinical practice.

The promise of the Health 5.0 revolution for digitised, personalised accessible health must be delivered for this young man soon. As his vision wanes, neuroplastic changes to this brain caused by delayed treatment could make useful visual experiences more difficult and slow for him to acquire.

A key challenge in responding to the immediate needs of this young man (and many others like him) are the silos of endeavour that exist across seemingly unrelated research groups, engineering and technology hubs that, once unified, can accelerate an array of human bionics breakthroughs.

These are just some of the reasons why I created Australia’s Human Bionics Interface (HBI) alliance in 2013.

It is vitally important for a national overarching bionics group to connect the needs of end users or patients with the clinicians, scientists, technologists, device manufacturers, start-ups, policy-makers and investors who have a mutual interest in bionics solutions.

Bringing all parties together in an expanding human bionics “living laboratory” will enable people in all corners of the globe to lead more fulfilling lives.

The HBI alliance will co-ordinate, facilitate and accelerate Australia’s role in delivering personalised human bionics solutions and customised healthcare services globally.

And our national scientific endeavours in human bionics have accelerated. In June this year, Bionics Queensland was formally incorporated.

As a not-for-profit incorporated entity with DGR status, Bionics Queensland has an ambitious long-term vision, a strong suite of partnerships and a measured and realistic strategy to deliver results.

I have an equally ambitious vision for Australia’s HBI alliance, as the founder of Bionics Queensland.

With an estimated value of $US10.53 billion in 2016, the bionics market is expected to reach $US21.37 billion by 2021 with especially high growth in the Asia Pacific.

A powerful alliance across multiple Australian states and territories has the potential to deliver a much wider suite of new and enhanced bionics solutions, advocating collectively for government and private sector funds and capitalising on our shared and distinctive scientific and commercial expertise.

The HBI alliance will strive to give health consumers early access to breakthroughs in bionic vision, hearing, the bionic heart and brain, artificial limbs and organs and medical wearables that interface with the brain. Digital and real-world collaborative platforms will connect and energise projects, resources and people across all fields of bionics to deliver ground-breaking solutions.

A new action plan for bionics industry development will underpin new and emerging medtech devices, artificial organs and limbs, medical wearables and customised healthcare services.

Exponential technologies such as machine learning, artificial and augmented reality, quantum computing and biofabrication will converge with human learning, advanced engineering, neuroscience, brain mapping and robotics to define and integrate the future of bionics healthcare.

Participants in the HBI alliance could potentially contribute to Global Health Care Equivalency (GHCE). According to molecular manufacturing specialist Frank Boehm: “Our working together might culminate in a positive critical mass on a global scale” which will finally transform lives to “support all in our natural unalienable right of optimal health for life”.

Boehm also sees the potential for women in STEMM fields like bionics to be major contributors to GHCE. The next 10 years will require all the planning and oversight that groups like the HBI alliance can offer.

By 2028, I anticipate that our concept of “human” will have been tempered by the advent of new bionics devices which could alleviate a medical issue or enhance human performance. But ethical policies will have been developed with some urgency to govern their use.

Whatever the technologies and related developments, while humans are in the driving seat, we must make certain that the future will not be all in coding but focused on human empathy.

Nowhere is the need for acceleration, collaboration and co-ordination of the bionics industry more humanised than in the words of engineer, Bionics Queensland Board member and quadruple amputee, Matthew Ames.

“Everything I do from the moment I wake up each day involves some form of device. My bionics are part of me. They need to be expertly designed, locally sourced, easy to repair and masterfully programmed to help me live life to the fullest.

“This requires great communication, expertise and collaboration between many bionics industry professionals. There are still many challenges to overcome and improved devices will transform not just my life, but the lives of many.”

Dr Dimity Dornan AO FTSE

Founder and Executive Director of Hear and Say

Dr Dornan is an entrepreneur, bionics activist, speech pathologist and researcher. In 1992 she established Hear and Say as a leading not-for-profit for deaf children learning to listen and speak, particularly with surgically implantable hearing technology. In 2013 she created an Australian national alliance, Human Bionics Interface, and also in 2016, founded Bionics Queensland, which was incorporated in 2018. Both of these groups seek to promote and accelerate the bionics industry and help bring new bionics solutions to market for the benefit of people with previously untreatable medical problems.