Integrated Action ARIDHIA Aridhia Leads the Way in the Development of Systems to Manage Chronic Disease

Integrated action ARIDHIA Aridhia leads the way in the development of systems to manage chronic disease. Here, company members introduce their innovative work

Healthcare is undergoing a dramatic evolution and, if we’re going to get things right, close multidisciplinary collaboration L-R: the most effective treatment regimes. Its across sectors is essential to ensure Dr Rachel Knight (Chief Medical Specialist) aim is always to support improved treatment decisions through a better understanding that IT, genomics, public health and Dr Catherine Kelly (Medical Director) of what has happened to similar patients in Rodrigo Barnes (Chief Technology Officer) the past. As a methodology, it could help data science are all utilised us move from a reactive to a proactive care Dr Andy Judson (Director of Data Science) delivery model.

Could you outline the concept of integrated multidisciplinary collaboration across sectors Could you outline the background to and care and how it relates to Aridhia’s vision? is essential to ensure that IT, genomics, public vision behind Aridhia? health and data science are all utilised. RK: Integrated care is the facilitation CK: Aridhia is a young biomedical informatics of appropriate, timely and accurate We partnered with Pivotal, as their Pivotal One company founded by David Sibbald, a successful communication and coordination between platform promises a faster, more productive business entrepreneur, and Professor Andrew a number of varied care providers. This is way to develop applications with big data. We’re Morris, Consultant Diabetologist and Head of particularly pertinent for patients suffering now working closely with Life Technologies to the Biomedical Research Centre in Dundee, UK. with one or more chronic diseases. By provide the biomedical informatics platform They aimed to bring together their collective integrating clinical data from a variety of and DNA sequencing technology that drive experience in medical informatics, high- pertinent clinical systems that hold data on discovery and genetic analysis. performance computing and analytics for the these patients, an holistic overview of the benefit of healthcare. patient’s care pathway can be shared across What are Aridhia’s plans for the future? organisational boundaries. Aridhia’s main focus is to support the RB: Our experience to date suggests that there management of chronic disease through the AJ: Although there are an increasing number are a range of similar issues at play in any given use of informatics. These chronic diseases of IT systems and technologies that capture or environment. There is also a willingness to include diabetes, cancer, and respiratory and store healthcare data, this information often pool the experience of healthcare operations cardiovascular disease, all of which have an remains in silos and is not linked, curated or and academic research to find more effective increasing global prevalence. analysed. Our services are designed to help treatments and pathways of care. We hope to squeeze the most value out of this data. This contribute to an expanding body of knowledge RK: We are also trying to create a gives clinicians the data they need at the that incorporates datasets and analytic multidisciplinary team which includes partners point of care, but also enables health system methods to help tackle the problems of from clinical, technological and research regulators, providers and policy makers to chronic disease management. backgrounds. Aridhia is working to resolve make informed healthcare decisions. That’s the gap between healthcare data collection/ truly integrated care. AJ: Working at Aridhia you sometimes feel collation and the application of focused ahead of the curve, relative to what national analysis. This will inform clinical practice, Has a collaborative approach proved health services are asking for right now. service design and linkage to research. important to the success of Aridhia? Aridhia’s focus for the coming years is to build a portfolio of analytics and informatics products What is understood by the term CK: Every project we undertake is a and services. These range from disease- ‘stratified medicine’? collaborative process. Each individual, specific patient profiles and population-based institution or company can learn from others, quality performance indicators, to survival AJ: Stratified medicine constitutes and that’s why we work the way we do. modelling and risk stratification with a library observational, clinical and genomic data for a Healthcare is undergoing a dramatic evolution of predictive models and statistics research large group of patients and is used to predict and, if we’re going to get things right, close conducted in a safe and secure environment.

54 INTERNATIONAL INNOVATION ARIDHIA Healthy partnerships International Innovation looks at four Aridhia collaborations and the impact they are having on the ground

KUWAIT HEALTH NETWORK DECIPHER HEALTH

Providing healthcare professionals with the information they Delivering a scalable informatics platform that will support need to demonstrate the quality of care they are delivering to linked phenotype-genotype datasets from consented patient patients with diabetes and its complications, and to identify cohorts from Lothian and Tayside across a range of cancer types areas where care could be optimised The system will include: The system includes: • A set of Clinical Analytical Services, which enables healthcare • A diabetes disease registry which enables healthcare professionals professionals to gain a cancer-focused view of clinical patient to track and monitor their own patient population. This provides information at different stages of the cancer pathway; obtain accurate and up-to-date information about the true prevalence insights into local clinical outcomes; and demonstrate achievement of diabetes across specific regions and country-wide of national cancer quality performance indicators

• Patient profiles, where key information required for clinical • A Research Analytics system, which will deliver a platform where outcomes can be entered and viewed on the system. The owners of clinical and genomic datasets and researchers can patient profile includes the subset of laboratory results which collaborate in a sustainable, secure environment which meets the are commonly used to monitor diabetic control and risk of elastic computing, analytical and statistical requirements to deal future complications with big data

• Analytical services, which allow healthcare professionals • Bi-directional flows of data between the clinical and to view their organisation’s achievement of recommended research environments Ministry of Health standards of care through a range of charts, reports and infographics Every year, about 30,000 people in Scotland are told they have cancer, and trends predict that the number is likely to rise to almost The system has been developed collaboratively with colleagues 35,000 between 2016-20. The Scottish Government has given from Dasman Diabetes Institute and the heads of four Primary DECIPHER Health its full backing, highlighting it as a major milestone Health Centres within the capital region – Abdulla Al Salem, Al in the advance of personalised medicine, and an accolade for Sager, Nuzha and Shuwaikh – as well as with support and input Scotland’s life sciences sector. from laboratory clinicians working at Amiri Hospital, Al Sager and Dasman Diabetes Institute.

The full system went live in the four Primary Health Centres in NHS SCOTLAND early 2013, bringing the benefits of an integrated care record to the capital region’s diabetic patients. Delivering a range of analytical services focusing on quality improvement, patient care and information governance

Working with a range of senior academic and clinical experts from across a range of specialities, the project has developed a range of KUWAIT SCOTLAND EHEALTH INNOVATION NETWORK analytical services including:

Nominated as ‘International Collaboration of the Year’ in the • A patient and cancer tracking solution at NHS Tayside and NHS Times Higher Education Awards 2012 Fife which integrates a variety of data sources for use by administrative staff Aims: Coverage: This solution tracks all patients referred or admitted to • Effective and safe treatment of patients through real-time secondary care facilities, from within a population of 800,000 patients integration of clinical and administrative services for disease across the two NHS boards. Cancer Tracking alone currently monitors management, audit and governance 17,000 patients.

• Capacity-building through training and development of staff • A Risk Stratification application currently in use in general practice in NHS Tayside and NHS Grampian which provides a portfolio of risk • Scientific advancement through engagement with international scores for chronic disease in the over 40’s research community Coverage: Currently live in 30 GP practices across the two NHS In addition to the delivery of the Kuwait Health Network system, boards, covering over 100,000 patients. there are now also over 100 Master’s students on the University of Dundee-accredited degree programmes working in healthcare in • The Data Driven Quality in Prescribing project is a clinical trial in Kuwait, mainly in primary care, where they are applying this learning NHS Tayside and NHS Fife featuring real-time data integration and directly in clinical practice. analysis to improve safety and quality of medicine prescribing in primary care. Partners: Ministry of Health of the State of Kuwait, Dasman Diabetes Institute, the University of Dundee, NHS Tayside Coverage: Live in 39 GP practices across the two NHS boards, covering almost 240,000 patients.

WWW.RESEARCHMEDIA.EU 55 ARIDHIA

Clinically led, technology driven

With chronic diseases a growing concern among the medical industry, health and biomedical informatics company Aridhia is spearheading the development of novel analytics through a truly collaborative approach

CHRONIC DISEASES ARE the world-leading Despite these warnings, patients with chronic working environment of Aridhia is dynamic, cause of mortality and morbidity, claiming diseases often fail to receive the long-term, and encourages the whole team to innovate. 36 million lives each year. A UN summit coordinated clinical care they require. The Whether these insights are into the needs of in 2011 acknowledged that dealing with provision of healthcare services for these patients, healthcare organisations, researchers chronic diseases is a global priority, while the patients is often fragmented, with silos of or policy makers, they can all help to improve World Health Organization has stated that clinical information held by different care care for those with chronic diseases. there is a pressing need for comprehensive, providers. This fragmentation can make it integrated action to reduce the burden difficult to share information effectively, and COLLABORATION of noncommunicable diseases. The World to assess clinical outcomes across the entire Economic Forum has estimated the financial pathway of care. Collaboration is also central to Aridhia’s burden of these diseases to be at $47 trillion approach. Working closely with other over the next 20 years, placing a huge financial organisations has proved crucial to ARIDHIA strain on healthcare systems. identifying how best to address the chronic A shared ethos of using informatics to enable disease challenge. Rodrigo Barnes, Chief a more integrated approach to healthcare Technology Officer, notes: “Collaboration delivery led Dr David Sibbald and Professor is a complex undertaking but can be very Andrew Morris to form Aridhia in 2008. They rewarding. There is a strong trend to open believed that, if the treatment of patients with innovation that reflects the underlying chronic diseases was to improve despite the diversity of organisations needed to find new need to deliver more care with less budget, solutions. We know our industrial approach then healthcare systems needed to be more can enhance existing academic/health coordinated, with data analysis used to support science partnerships”. decision making and evaluation of outcomes. Today, Aridhia provides this integrated The relationship the team fosters with its approach via a groundbreaking use of clients is also particularly collaborative. Each biomedical informatics and analytics. Through client that approaches Aridhia has their own a series of collaborative projects, the team set of needs and aims. Rather than proposing leads the way in improving the management ‘out-of-the-box’ solutions, each programme and understanding of chronic conditions. is tailored to meet the exacting requirements. As such, the team works closely with clients to Describing themselves as ‘clinically led, ensure that analytical services are configured technology driven’, their work focuses on to their requirements. linking pre-existing data from information silos to support clinical care, quality improvement SUPPORTED BY ANALYTICS and translational research, and to provide an accurate, complete understanding of chronic Aridhia maximises the utility of data available illnesses and the impact of treatment on from existing sources within a healthcare clinical outcomes. system to develop a set of linked, validated events for individual patients which follows them across organisational and institutional A MULTIDISCIPLINARY TEAM boundaries to provide a patient-centred view What makes Aridhia particularly unique is of clinical information and support integrated their in-house expertise from a range of care delivery across health economies. These diverse fields. Medical Director, Dr Catherine analytical services offer different ways of Kelly elaborates: “Success requires a visualising data, including pathway analysis multidisciplinary approach and our people and clinical outcome metrics, providing are our most important asset”. The team population- and patient-level insights to care comprises experts from clinical, academic, providers, patients and policy makers. data science, computer science, health policy and information governance domains. This Further secure export of these de-identified collaborative approach enables the group data to Aridhia’s research service facilitates to identify innovative technology solutions linkage with other clinical, genomic or that meet the requirements identified by image datasets. It also provides a suite of the clinical and research communities, analytical tools for researchers to investigate while understanding the specific challenges new models for predicting risks of disease, of these environments. Furthermore, the complications or response to treatment,

56 INTERNATIONAL INNOVATION INTELLIGENCE PROJECT ARIDHIA OBJECTIVES Defining roles • To help healthcare providers deliver safe, efficient, effective, equitable, timely and Aridhia’s professional scope facilitates excellence in many areas patient-centred care at the lowest cost with the best clinical outcomes • To provide a world class sustainable, secure, collaborative environment where researchers can analyse multiple complex datasets to gain insights into disease trends KEY COLLABORATORS Pivotal Life Technologies EMC Dasman Diabetes Institute Kuwait Ministry of Health NHS Scotland Health Science Scotland University of Dundee The data science team University of Glasgow brings together data from University of Edinburgh multiple sources, gathers University of Aberdeen Software engineers, insight and understanding, NHS Tayside developers and develops predictive NHS Lothian infrastructure services healthcare models, tests Dundee Cancer Centre Clinical and life science experts manage the hypotheses, helps develop Edinburgh Cancer Research UK Centre professionals outline the development, testing, ETL logic and provides Peter MacCallum Cancer Centre product strategy for the deployment and hosting anonymised research Glencoe Software business of client solutions extracts FUNDING Aridhia was established as a collaboration among the founders, Dr David Sibbald, Professor Andrew Morris, Sumerian Europe Limited, NHS Tayside, and the University of Dundee. This brought together the commercial while ensuring compliance with privacy and in Kuwait, and has designed and implemented acumen of David and Sumerian with the confidentiality requirements at all times. a clinical analytics service, which is currently academic abilities of the University and Critical insights gained from analysis in this operational within Kuwait City and scheduled to Andrew, and the health service facilities of NHS research environment can be packaged up be rolled out across the country in 2014. Projects Tayside. This partnership has been fundamental and deployed back in through the clinical closer to the company’s UK base have included a to Aridhia’s development, and established analytics service, further enhancing the risk stratification service alongside the National collaborative working as the Aridhia model functionality available to clinical users. Health Service (NHS) Scotland (which predicts from the outset. Aridhia is privately funded and the risk of admission to secondary care within the current shareholders include NHS Scotland, 12 months), and the biomedical informatics A PLATFORM TO SUCCESS University of Dundee, Dasman Diabetes platform underpinning the Stratified Medicine Institute, and Scottish Equity Partners. The Aridhia Platform is unique in bridging Scotland Innovation Centre. the gap between healthcare and research CONTACT analytics through the use of big data analysis. FUTURE PLANS Pamela Brankin Built using EMC and Pivotal technologies, the Aridhia has very ambitious plans. It aims to Aridhia Aridhia Platform provides scalability in terms of continue collaborating with world-leading Hobart House user numbers, data storage and computational organisations in order to develop and roll 80 Hanover Street requirements. It integrates patient and clinical out new clinical and research services. Edinburgh, EH2 1EL data from existing sources, and then processes The company also hopes to exploit recent UK and models this data before delivering it to end advances in next generation sequencing, users via a range of analytical focused services. and develop an advanced image analytics T +44 131 560 1470 The Platform includes Clinical Analytics and platform applying state-of-art technology E [email protected] Research Analytics services, which ensure that innovation from big data, while also aligning www.aridhia.com the data provide utility for both clinical and current analytics with the new cancer research professionals. outcomes and services dataset (COSD) and National Institute for Health and Care Aridhia is already using the Platform and Excellence (NICE) guidelines in England. services to improve the treatment of chronic Alongside this, the team will continue to build disease around the world. As part of the Kuwait the capacity, analytical and technical skills to Scotland eHealth Innovation Network, the become a global market leader in biomedical team has been working to support integrated informatics, and address the global issue of clinical care, audit and governance of diabetes chronic disease management.