About Reach


What is REACH?
HTX REACH Procurement

REACH” (Resources for Evaluating, Adopting and Capitalizing on Innovative Healthcare Technology) is a new matching grant funding program managed by HTX – the Health Technology Exchange, with support from the Government of Ontario. REACH is a 3.5-year program targeting late pre-market, early post-market, pre-diffusion technologies where procurement and local evidence are challenges. REACH will provide 50% matching grant funds to competitively-selected projects. Projects must be led by public healthcare delivery organizations (the “Lead Applicants”).

The goal of REACH is to help Ontario public healthcare delivery organizations use new ways to evaluate, procure and more rapidly adopt beneficial medical technologies addressing high-priority health system problems.

As shown pictorially, traditional innovation support in the form of funding, mentoring and product development support is heavily geared towards early stage technology development and early evidence generation. But crossing the infamous “1st valley of death” does not always equate to a successful trajectory to commercialization, adoption and ultimate diffusion. REACH funding will uniquely target later stage technologies that have either received or are at the cusp of receiving regulatory licensing or registration in Canada. REACH funding will facilitate innovative local and/or foreign medtech companies to enter Ontario healthcare settings, generate the right type of evidence that supports reimbursement activities and ultimately lead to local procurement.


The REACH Value Proposition

Designing technologies/services that align with healthcare system priorities maximizes likelihood of adoption. By working directly with public healthcare delivery organizations and identifying the gaps and current needs of the system, REACH will foster a “pull” model of technology development through innovation procurement; promoting a more seamless approach to the development and ultimate adoption of innovative medtech technologies and services geared at addressing current health system challenges.

Why should Public Healthcare Delivery Organizations and Medtech Innovators apply to REACH?

REACH Value Proposition for Public Healthcare Delivery Organizations
  • Be seen as an innovation leader in the Province and globally.
  • Faster access to innovative technologies focused on solving your priority needs.
  • Implementation of an alternative, more flexible path to routine procurement.
  • Receive up to 50% matching grant funding to build capacity for innovation procurement.
  • Public healthcare delivery organizations with in-house incubator hubs can leverage REACH funds to expedite transition of innovation from bench to bedside.
REACH Value Proposition for Medical Technology Innovators
  • Begin dialogue with customers earlier and align products to the customers’ needs and prerequisites for procurement and adoption, including potential to learn foreign market requirements beyond Ontario.
  • Potential recognition of greater value in the technology/service offering, rather than simply lowest cost.
  • Receive up to 50% matching grant funding on evaluation studies targeted at attaining endpoints relevant for local and scaled procurement.
  • Potential for direct procurement of innovations successfully meeting pre-defined criteria for adoption.
  • Potential links to foreign market stakeholders following successful evaluation.

How Funding Works
  • REACH will provide 50% matching grant funds, ranging from $300,000 to $600,000 with some exceptions of up to $1,000,000 to 10-12 competitively-selected projects.
  • Projects must be led by publicly funded healthcare delivery organizations (“Providers”, the “Lead Applicant”)
  • 1:1 matching will be required on eligible direct project costs (using a combination of in-kind and cash matching, with a minimum of 25% of the match in cash from all parties involved).
  • Funds will support eligible project costs of both the public healthcare delivery organization and the technology company based on a reimbursement model. Broader Public Sector (BPS) organizations must follow BPS Expense and Procurement Directives as applicable for the project.
  • Funding for REACH projects will be released to the public healthcare delivery organization (Lead Applicant) which in turn will be responsible for reimbursing their project participant(s) (including the technology company) as applicable.
Eligible and Ineligible Expenditures Guidelines

General Principles and Guidelines

  1. “HDO” means a publicly-funded healthcare delivery organization located in Ontario.
  2. “Medical Technology Participants” are those private companies that have entered into an agreement with one or more of the HDOs leading a Pre-Procurement Pilot Project and will be net contributors to the Pre-Procurement Pilot Project, although, with the pre-approval of HTX, they can be compensated by an HDO for supplies, equipment or services provided to the Pre-Procurement Pilot Project.
  3. “Project” shall be the specific project described in the funding agreement between HTX and the HDO(s) conducting the project, and shall include a detailed project plan, milestones and budget.
  4. “Eligible Expenditures” can be either eligible cash contributions or eligible in-kind contributions. Eligible cash contributions are payments made by HDOs for expenses for the direct costs of the project that are directly related to achieving the objectives or milestones for which REACH funding was awarded. Eligible in-kind contributions are the fair value of non-monetary resources that HDOs and Medical Technology Participants provide to support the Project.
  5. “Total Project Value” is the total amount of Eligible Expenditures spent by HDOs on the Project, plus any Eligible Expenditures provided by Medical Technology Participants as in-kind contributions only. It should be noted that Total Project Value will be equal to the sum of the net contributions from the various funders of the Project.
  6. To count as Eligible Expenditures, all expenses must comply with both:
  7. - the HDO's internal purchasing guidelines and policies; and the Broader Public Service (BPS) Procurement Directive

  8. Eligible cash contributions include expenses for the direct costs of the Project that are directly related to achieving the objectives for which REACH funding was awarded.
  9. Eligible in-kind contributions include eligible non-monetary resources provided to support the Project. In-kind contributions can include personnel time, services, supplies, expenses, and capital equipment (or the use thereof for specified periods), to execute the Project.
  10. All Project participants shall be required to submit back up documentation for all Eligible Expenditures (support for payroll, invoices or equivalent receipts for services, purchases, etc.).
Compensation of Personnel
Eligible Expenditures Ineligible Expenditures
  • Salaries, statutory employer assessments (EI, CPP, EHT) and benefits of staff for time spent working directly on the Project.
    • HDOs and Medical Technology participants will be required to maintain timesheets or equivalent records for all employees working directly on a Project.
  • Consulting or professional fees as pre-approved by HTX; maximum per-diem rate is $800. Consulting services must be competitively procured.
  • Administrative overhead.
  • Additional fees for practicing clinicians or other staff who already receive remuneration for the time allocated to work on the Project.
  • Costs related to REACH proposal development (i.e. application preparation costs prior to the start date of the Project). Costs related to RFIS development within an Innovation Procurement ARE eligible.
  • Staff awards and recognition.
  • Discretionary severance and separation packages.
  • Passport and immigration expenses.
  • Professional membership fees.
  • Recruitment expenses.
  • REACH is not an academic or student-supporting program and thus all of the following expenses are ineligible:
    • Compensation for faculty/teaching staff.
    • Student living expenses.
    • Costs associated with thesis examination/defence.
Travel and Living Expenses
Eligible Expenditures Ineligible Expenditures
  • Travel costs incurred by project participants to execute project activities (economy airfare, mileage at $0.40/km, parking fees at the lowest reasonable cost).
  • Complete documentation (receipts, boarding passes, expense reports indicating approval and by whom) will be required.
  • Expense claims must be compliant with all of:
    • the supporting HDO's policies with regards to travel and living expenses;
    • the BPS Procurement Directive
    • the Travel, Meal and Hospitality Expenses Directive
  • Costs of alcoholic beverages.
  • Costs of entertainment, hospitality and gifts; reasonable food and venue costs for specified (and budgeted) project management meetings or similar project-oriented meetings can be eligible with the pre-approval of HTX.
  • Commuting costs.
  • Reimbursement of airfare purchased with personal frequent flyer points programs.
  • Gifts, stipends or expenses provided for staying with friends or family while travelling for Project purposes.
  • In general, attendance at conferences, scientific meeting etc. will not be eligible under REACH.
  • Costs associated with activities or operations performed outside of Ontario, unless the Applicant obtains the prior approval of HTX in writing for any proposed out-of-province travel or expenditures.
Operating Expenses
Eligible Expenditures Ineligible Expenditures
  • Laboratory materials and consumables.
  • In-kind contributions of HDO resources used for the Project, at the standard billing rate charged by the HDO (examples include use of MRI or CT scanners or specialized lab facilities already installed at the HDO.
  • Services purchased from third-party providers for direct project expenses that comply with the HDO's internal guidelines (examples include lab tests done by a third party; statistical analyses performed by a methodology centre; installation of equipment done by the HDO's approved trade contractors).
  • Purchases by an HDO of supplies, equipment or services from Medical Technology Participants that (1) comply with the HDO's internal purchasing guidelines, and (2) are pre-approved by HTX (typically in the Project budget) Any such purchase cannot be considered to be an in-kind contribution by the Medical Technology Participant.
  • Purchases of supplies, equipment or services from private companies that have responded to requests for innovation services, or comparable RFPs, under an Innovation Procurement Project, that comply with the HDO’s internal purchasing guidelines, that is within the budget pre-approved by HTX. Any such expenditure cannot be considered to be an in-kind contribution by the respondent.
  • Office supplies and services.
  • Personnel training costs when specifically required for the Project, with pre-approval by HTX.
  • Equipment purchase or leasing, installation, usage charges and maintenance, with value pro-rated to the Project, as pre-approved by HTX (typically in the budget). Installation may include product-specific facility modifications (new power outlets, shielding, modifications to operating rooms, etc.), but this must be less than 10% of total cost allocated to equipment and installation.
  • Transportation costs, including brokerage and customs charges for acquisition of equipment and supplies.
  • Disposal costs for wastes.
  • Insurance costs for trials involving human subjects as pre-approved by HTX (typically in the budget).
  • Project-specific software licensing, purchase or leasing, installation, usage charges and maintenance, with value pro-rated to the Project, as pre-approved by HTX (typically in the budget).
  • Computer equipment can be eligible but must be specifically required for the Project and be pre-approved by HTX. If such equipment will continue to be used after the conclusion of the Project, the value and charges allocated to the Project will be pro-rated.
  • Overhead.
  • Tangible capital costs (land, buildings, vehicles, capital equipment)
  • Insurance costs other than specifically approved by HTX.
  • Construction, renovation or rental of laboratories or supporting facilities; site remediation.
  • Equipment warranty or maintenance plan expenses beyond the duration of the Project (such fees may be pro-rated for the duration of the Project).
  • Infrastructure costs not directly associated with the Project.
  • Lobbying or government relations activities.
  • Costs related to REACH proposal development (i.e. application preparation costs prior to the start date of a Project). Costs related to RFIS development within an Innovation Procurement Project ARE eligible.
  • Costs associated with activities or operations performed outside of Ontario.
  • Interest or financing charges.
  • Depreciation / amortization of assets.
  • Losses on investments, contracts or projects, including the Project.
  • Donations or sponsorships of any sort.
  • Any costs for which a rebate, credit or refund is received (including but not limited to HST).
  • Federal and provincial income taxes, surtaxes, or any costs incurred in relation to taxes.
  • Fines and penalties.
  • Opportunity costs.
  • Standard telephone access, computer hardware and software (including mobile handsets), including connection costs, normally provided to employees or other project personnel by the institution or employer that is not specific to the Project.
  • Any costs not directly associated with meeting the deliverables and milestones as specified in the funding agreement with HTX.

REACH Eligibility Criteria

Our overarching theme for the first Call for Innovation is “Contracting for Outcomes: Using innovation procurement and outcome-based specifications to drive direct clinical and economic outcomes”.

At a minimum, each eligible project must be aligned with the identified theme to participate in the REACH program's first Call for Innovation.

Eligible REACH projects must also meet the following criteria:

    ▸ Lead applicant must be a publicly funded Ontario healthcare delivery organization.
    ▸ Proposed project must be completed in less than 2 years.
    ▸ Lead applicant must identify 2 or more additional peer healthcare delivery organizations that could be involved in this project.
    ▸ Proposed technology must have Health Canada Investigational Testing Authorization (ITA) or license approval/registration (as required), prior to the initiation of a proposed field evaluation.
    ▸ If proposed technology/service is currently on the market somewhere in the world, recorded sales for the trailing year must be <$5,000,000 globally.
    ▸ Project partners (healthcare delivery organization + technology provider) must be able to cover at least 50% of costs of project (with minimum of 25% of value in cash).
    ▸ An Outcome Based Specification (OBS) must be submitted for qualification of REACH funding. Refer to details on OBS below.
    ▸ Multi-site field evaluations must comply with the Clinical Trials Ontario (CTO) Streamlined Research Ethics Board (REB) system, if applicable. Refer to details on the CTO Streamline REB system below.
    ▸ Funded projects may be subjects of case studies completed by a third-party reviewer as determined by HTX Refer to details on the REACH Project Case Studies below.


REACH Components

Outcome Based Specifications (OBS)

The identification and procurement of innovative products (equipment, goods, or services) improves the quality of patient care, and achieves better long-term value for money (VFM). It also stimulates innovation within the economy by enabling the market to respond to current and future public service needs. When Purchasing Organizations or Purchasers are procuring products, it has been common practice to use public tenders based on detailed product specifications. However, overly-detailed specifications often restrict what vendors propose, and which vendors qualify, and result in only incremental improvements rather than step-change innovations.

OBS are written in performance terms which describe the functions or performance that a solution (equipment, goods and/or services) must achieve for the end-user. It allows for flexibility in determining how a specific need can be met, without restricting the solution to a specific type of product or service. An outcome-based approach to specifications can give new life to existing products in the market, better align what vendors create with what customers need, creatively share risk, and go a step further in improving the quality of care provided to patients.

Healthcare Supply Chain Network (HSCN) has developed an Outcome Based Specifications guide to assist healthcare organizations with this important aspect of innovation procurement.
Click here for the HSCN OBS Guide for more information.

The Clinical Trials Ontario Streamlined Research Ethics Board (REB) Review Process

REACH is encouraging multi-site product evaluations in order to accelerate adoption and scaling of beneficial technology solutions. To make the multi-site trial process most efficient, REACH is collaborating with Clinical Trials Ontario (CTO) to streamline the Research Ethics Board approval for multi-site trials. CTO’s Streamlined Research Ethics Review System allows any single ‘CTO Qualified’ Research Ethics Board (REB) to review and provide Ontario-wide ethics approval and oversight for multiple research sites involved in the same clinical trial.

The CTO Streamlined System is supported by CTO Stream, a web-based portal that manages the research ethics review process and communication across multiple research sites. CTO Stream provides transparent, timely and reliable information regarding the ethics review status of an application.
Learn more about the CTO Streamlined System here.

Project Case Studies

REACH funded projects may be part of a portfolio of case studies to be developed by a third party reviewer as determined by HTX to:

  • Identify key lessons learned; identify opportunities for supporting policy development to drive and support momentum in health system innovation (e.g. procurement models); identify barriers, key success factors (e.g. policy, tools, consumer engagement, provider engagement and leadership) to accelerate the adoption of innovative products and services in the public healthcare sector.
  • Disseminate lessons learned, project outcomes and impact across key health system stakeholders groups to build capacity in Ontario for health system innovation and scalability.
  • Develop performance measures and metrics for demonstration projects.

Which REACH Stream is Right for You?

We anticipate funding two types of public healthcare delivery organizations-led projects through REACH: Pre-Procurement Pilot Projects and Innovation Procurement Projects. Each stream will require the following:

  1. Generation of an OBS that outlines the relevant outcomes that would ultimately need to be achieved to support procurement activities at the Lead Applicant’s institution.
  2. Sharing of OBS with peer organizations in order to incorporate any additional data points into their evaluation protocol that would support multi-site procurement activities down the line. A sample listing of Ontario based organizations grouped by peers can be found here: http://www.health.gov.on.ca/en/common/system/services/hosp/locations.aspx

Project applications that comply with both these criteria will have a greater opportunity to secure REACH funding.

Pre-Procurement Pilot Projects

GOAL: To demonstrate the value proposition, create client testimonials and create the foundation for future procurement and broader adoption.

Pre-Procurement Pilot Projects are demonstration projects that allow identified technologies and/or services to be tested within a publicly funded Ontario healthcare delivery organization in the form of a field evaluation. Lead applicants will pre-determine study outcomes that will be relevant to future procurement activities, and will use this as a capacity building exercise with regard to Outcome Based Specifications. Although no procurement can occur as a result of this type of project, Pre-Procurement Pilot Projects are intended to be conducted with the “rigor” of procurement assessment, and if justified by the evidence, lead to a future open procurement process using an Outcome Based Specification.

Breakdown of anticipated activities in the Pre-Procurement Pilot Project stream:

  1. Public healthcare delivery organization identifies a need (aligned with a REACH-identified health system priority) and defines the outcome they expect from an innovative solution.
  2. Public healthcare delivery organization finds an appropriate technology partner willing to share risk on the pilot.
  3. Public healthcare delivery organization submits an Expression of Interest (EOI) Application to HTX.
  4. Upon HTX review, eligible projects will be invited to submit a full application.
  5. Public healthcare delivery organization creates an Outcome Based Specification (OBS) internally or through external support.
  6. The resulting OBS is shared for comment with 1-3 peer organizations to ensure broad applicability of the results. Optionally, this OBS can be assessed by one or more foreign organizations facilitated by HTX to increase the attractiveness for industry to participate in the pilot.
  7. Project team (Healthcare delivery organization + Technology Company) develops an Evaluation Protocol (internally or through external support) that outlines relevant endpoints and conditions necessary for local procurement. HTX can facilitate contact with external organizations versed in creating evaluation protocols.
  8. Project team creates an overall budget including their 50% share of the eligible project expenses (with at least 25% in cash contributions) to conduct a pre-procurement pilot.
  9. Public healthcare delivery organization submits a full application for review by HTX.
  10. HTX will evaluate all full applications.
  11. HTX will advise successful applicants and contracts will be executed. Only successful applicants will receive funding.
  12. Project starts.

HTX REACH innovator engagement

Innovation Procurement Projects

GOAL: To support the public healthcare delivery organization in planning and executing an identified innovation procurement methodology, and building capacity for alternate innovation procurement pathways in Ontario.

Innovation Procurement Projects are intended to:
a) build capacity within public healthcare delivery organizations and medtech innovators to use Outcome Based Specifications, and
b) when evidence justifies, lead directly to procurement of innovation.

REACH funding will support the entire process of innovation procurement including any field evaluation studies required to test the identified technology and/or service within an Ontario public healthcare delivery organization. Successful completion of an evaluation program in one or more sites, and meeting of specified outcomes would enable procurement by one or more organizations.

Innovation Procurement Models

The following procurement models that have been listed for consideration are based on experts and practices from non-Canadian jurisdictions. The choice of procurement model should be based on product maturity stage and complexity of requirements, and subject to legal advice on the process and the implications on the contractual obligations. The models outlined below pertain to solutions that have been identified for testing through REACH.

    1. Design Contest: the process of entering into a contract with the design contest winner for further exploration and prototyping of the winning design(s) and/or solution(s). As a procurement strategy, the public organization must state upfront its intention of entering into a contract in the invitation for design contest.
    2. Competitive Dialogue: a process that allows the public organization to thoroughly discuss each aspect of the procurement with supplier(s) prior to specifying the requirements and prior to an invitation to submit their full and final proposals to meet the complex needs of the public organization. It is often used for large or complex projects when technical specifications cannot be defined with sufficient precision.
    3. Competitive Tender with Negotiation: a competitive procurement process which includes an element of adaptation, design, or innovation, among other features. The public organization must specify the solution requirements before the beginning of the competitive process.
    4. Alternative Proposals: allows suppliers to offer alternative solutions to an identified need of the public organization. The solution requirements are defined at the beginning of the open competitive procurement process, but some flexibility is allowed in terms of accepting different solutions to address a specific need. One set of evaluation criteria must be applied across the board.

    Breakdown of anticipated activities in the Innovation Procurement Project stream:

    1. Healthcare delivery organization identifies a need (aligned with a REACH-identified health system priority) and defines the outcome desired from an innovative solution.
    2. Healthcare delivery organization submits an EOI Application to HTX. Upon HTX review, eligible projects will be invited to submit a full application.
    3. Healthcare delivery organization creates a draft Outcome Based Specification (OBS). The resulting OBS is shared for comment with 1-3 peer organizations to ensure broad applicability of the results. Optionally, this OBS can be assessed by one or more foreign organizations facilitated by HTX to increase the attractiveness for industry to participate in the procurement.
    4. Lead Applicant has/or obtains a budget for procurement. Priority will be given to those lead applicants that can demonstrate funding capacity towards procurement upon completion of REACH project.
    5. Lead Applicant submits a full application for review by HTX.
    6. HTX will evaluate all full applications.
    7. HTX will advise successful applicants and contracts will be executed. Only successful applicants will receive funding.
    8. Project starts.

    REACH Processes
    REACH Application and Decision Making Process

    REACH is a competitive program with limited funding. All eligible projects will be assessed on their merit and will undergo a structured review process. Applications will be assessed against pre-determined eligibility criteria. The REACH Advisory Committee (RAC), subject matter experts and the HTX Board of Directors will assess the overall quality of applications and make decisions on funding.

    REACH Timelines


    REACH Registries

    Health System Priorities Map

    One of the goals of the REACH program is to help expose the unmet needs and priorities of the health system to the medtech innovation community. Procurement practices and limited access to expert resources have made it difficult for small and large medtech companies to engage in early dialogue as to what customers truly need early in the technology development cycle.

    To ensure REACH projects are focused on high-priority problems of the health system, HTX has developed an initial Health System Priorities Map. The map shows a collection of health system indicators that are relevant to each of the health sectors of hospitals, primary care, home care and long term care. Many of these indicators align with those in the Health Quality Ontario Quality Indicator Program, while others were derived from interviews with healthcare delivery organizations and other sector experts.

    REACH Applicants are asked to select one or more indicators that are important to their institution, that can be used as the focus of their REACH project. If applicants would like to use a priority area that is NOT on the REACH Health System Priority Map, please provide a justification as to how this area of interest is relevant to a broad range of Ontario healthcare delivery organizations.

    Over time, this map will be expanded and validated to ensure it accurately represents where the health system wants to encourage innovation and that this information is helpful to the innovation community.

    Example Transformations, Outcomes and Enablers

    In addition to the Health System Priority Map, REACH is providing several examples of different types of health system transformations that are currently the focus of many innovation initiatives internationally. For each of those transformations, REACH has provided a list of example outcomes and examples of enabling technologies. Applicants are NOT required to use any of these examples. Rather, the examples are given to help guide applicants towards the concepts of outcome-based specifications, and the scope of innovative technologies in the market.

    Innovative Technology Registry

    When considering procurement of innovation, designated Ontario publicly funded healthcare delivery organizations must fully comply with the Broader Public Sector Procurement Directive set out by the Government of Ontario, to demonstrate openness, fairness, transparency, value for money and accountability1. To ensure fairness to all vendors, health delivery organizations typically engage with vendors only during a procurement event, after a Request For Proposals (RFP) is issued. Furthermore, limited resources at healthcare delivery organizations typically mean limited bandwidth to keep abreast of the latest medtech innovations that directly impact patient care.

    For medtech innovators, it is difficult to showcase their innovations to healthcare delivery organizations without formally responding to a procurement call. In addition, there is not a scalable process for innovators to showcase their technologies/products to all Ontario healthcare delivery organizations without having to approach each of them individually.

    The Innovative Technology Registry is designed to address such challenges. The Innovative Technology Registry aims to capture and collate the details of innovative medtech solutions and companies. The registry in turn will be made available to healthcare delivery organizations in Ontario to showcase innovative solutions available in the Canadian market, empowering healthcare delivery organizations to recognize the latest medtech innovations available for procurement.

    Medtech innovators interested in being included in the Innovative Technology Registry are invited to complete the form below.
    Innovative Technology Registry Form

    Submissions are reviewed periodically and innovative products are added to the registry as appropriate.

    Click here for the latest version of the HTX Innovative Technology Registry .

    1 BPS Accountability Act 2010. http://www.ontario.ca/laws/statute/10b25


    FAQs

    Content for FAQs to be provided shortly.


    Contact Us

    For general inquiries about the HTX REACH program, contact us by email at REACH@htx.ca