Better outcomes for all…
Core business: Health informatics
Date incorporated: 2007
Annual revenues: About £3 million
Number of employees: 60
Major customers: UK, Kuwait, Australasia
Better outcomes for all
In health care, better outcomes are the target that everyone aims for. And Aridhia not only promises better outcomes for patients and healthcare providers, but also for its own stakeholders and the economy...
In 2007, David Sibbald was sitting in his Edinburgh office, analysing vast amounts of data, trying to puzzle out better solutions for his clients. How can we improve the telecoms network? How can we deliver better results for the bank?
Meanwhile, in Dundee, Professor Andrew Morris was trying to understand why diabetes was spreading so quickly in Scotland and how to improve patient care, analysing vast amounts of data sometimes going back to the early 1950s.
Then the two men had dinner (Sibbald claims he paid the bill) and founded one of Scotland's most successful biomedical companies, specialising in health informatics.
Today, Aridhia employs 60 people, including software developers, life scientists and clinicians, and has revenues of £3 million a year. Its client base is also growing fast around the world, including major contracts in the Middle East and beyond.
In 2007, Morris already had extensive experience in diabetes, using data to develop solutions for patients and healthcare providers, and realised the obvious next step was to apply this highly specialised knowledge to other common chronic diseases, and ultimately also in other countries. Sibbald was used to looking at data “whizzing around the infrastructure,” and saw a lot of parallels between commercial clients and the medical sphere – everyone wants high-performance solutions, integration, analysis, scalability, robustness, reliability and good presentation of data. Everyone wants to ask “what-if” questions. In medicine, there are lots of “domain-specific” data (including thousands of parameters for diabetes, covering everything from lifestyle to genetics) but also lots of general data, too. In fact, the worlds of informatics and medical research are not as different as they may first appear. Customer service and patient care are also very similar, and lower costs are always near the top of the wish list in any enterprise – including a
In healthcare, some diseases are more common – and more costly – than others. Common chronic diseases such as cancer, diabetes and respiratory and cardiovascular problems are a huge and growing problem all around the world. They are not just the leading causes of mortality, but are also forecast to double in prevalence by 2030. In a global “market” where the healthcare bill is expected to rise to $30 trillion by the year 2030, the business potential is also enormous – because of the growing demand for more cost-effective approaches. “And when you apply informatics to medical problems,” says Morris, “better can also be cheaper.”
Rising to the challenge
Aridhia's solutions are designed to address three main aspects of health care: patient outcomes, costs and individual engagement. And the company’s mission is simple: To support the management of chronic diseases through the use of health informatics.
Health informatics is the integration of computer and medical science to analyse data – including observational and genetic data – so that healthcare providers can improve their understanding of trends in the wider population, as well as provide better, more personalised care for individual patients by studying risk factors and the impact of treatment and public health programmes. Morris says it’s also important to “stratify risk” – grouping patients according to their individual
Aridhia also stresses the need to use health informatics to engage individuals in their own care – for example, self-monitoring. “There is an enormous asymmetry,” Sibbald explains, “between the data held by the healthcare provider and the information available to individuals. Most industries use informatics to transfer responsibility back to individuals, so why should healthcare not do the same?”
Morris also talks about the “journey of care,” pointing out that patients with common chronic diseases tend to see multiple professionals (podiatrists, cardiologists and dieticians, etc.). “We are not good at joining up the different parts of the story,” he says. “Health informatics is a very simple idea, but it makes a big difference. We also want it to encourage more self-care – pushing information to the patient. The focus is always on the patient.”
The company journey
When Aridhia was formed, what Sibbald brought to the table was his knowledge of commercialisation and productisation, as well as industrial-strength informatics. He was able to combine this with Morris’s medical expertise and knowledge of informatics, gained in his own research projects over the years.
For example, in 1996, Morris and his team in Dundee received £100,000 from the Chief Scientist Office at the Scottish Government Health Department to build a multi-disciplinary team to analyse data to improve patient care for diabetes, focusing on the area around Dundee. In those days, there were about 7,500 people with diabetes in Tayside. Today, says Morris, there are 21,000, and it is estimated that people with diabetes are responsible for more than 10% of healthcare expenditure, or approximately £1.5 billion in Scotland alone. The total number of people with diabetes in Scotland is currently running at just over 250,000.) “The technology has evolved a lot over the years,” Morris says, “and the scale of the problem has also increased.”
Morris, who was recently appointed Chief Scientist at the Scottish Government Health Department, is a Director of Aridhia. He is also Governor of the Health Foundation, and Convenor of Health Science Scotland, but despite all this he still sees patients every week, to keep in touch with healthcare in the real world.
The company also draws great strength from its other major shareholders, NHS Tayside and the University of Dundee, who provide raw data and expertise, and play a major role in the “collaborative partnership” between the different organisations.
Sibbald’s company, Sumerian, and Scottish Equity Partners are the largest private investors.
Before Aridhia was formed, Sibbald ran a company specialising in high-performance computing, and as soon as he and Morris started working together, he saw the “huge opportunity to bring diverse domains together.”
The “good chemistry” between the two founders has been the driving force behind the company’s growth. “The key to health informatics is cross-domain skills,” Sibbald explains. “People tend to stick with their communities, but we wanted to bring them together.”
The logical next step for Aridhia’s technology is the extension to genomic and genetic data. There are multiple parameters in every disease – e.g. cancer is not one disease, but a combination of factors and pre-existing conditions – and the application of genomics will provide more precise diagnosis and treatment of individual conditions.
The ultimate goal of Aridhia and every healthcare provider is better patient care and lower costs. But the “journey” is only beginning. “Many healthcare systems don't capture data in real time,” says Morris, “partly because there are so many factors involved. There is a disconnect between activities and costs.”
Morris is also concerned about a waste of resources, duplication and harm: “Knowledge through data is key,” he adds. “We have to drive knowledge to the front line, in real time, to personalise patient care.”
Health informatics, in its current form, is a relatively new approach to health care. It is hard to measure the benefits of any advance, including health informatics, because healthcare is an ever-changing, ongoing process and the populations and the individuals change over time. But there is little doubt that health informatics will soon become a cornerstone of healthcare, because the pressures on the system are so great and the benefits of more intelligent data analysis promise to relieve at least some of the pressure.
“Current models of healthcare provision are not sustainable,” Morris concludes. “If the bill for healthcare starts to increasingly erode GDP, as current projections suggest, then we’re in trouble – not just in terms of health but also the economy.”
Computers vs Cancer
One of the most challenging projects undertaken by the Aridhia team is a study of the seven main types of cancer, developing new software to improve our understanding of the disease and how to deliver better patient care. There are 15,000 new cases of cancer in Scotland per year, and by combining different methods, including analysis of observational data as well as biopsies, a clearer picture should emerge not only of the general trends but also of highly individual factors. Like many other common chronic diseases, cancer is a “cocktail” of problems and pre-existing conditions, and the optimum treatment is usually different for different patients.
The project, which involves NHS Lothian, NHS Tayside and cancer centres in the Universities of Edinburgh and Dundee and is funded to the tune of £1 million by the Technology Strategy Board (a sum matched by Aridhia), is scheduled for completion by the end of 2013. “It is the first and most significant study of its type in the world,” says David Sibbald, “and the results could dramatically change our approach to the treatment of cancer.” Sibbald also believes that it will not just provide a solution for Scotland, but also have an international impact.
This international outlook is what drives the two founders on. “We want to grow a successful company in Scotland that exports solutions, bringing benefits back to Scotland”, says Morris. “And for that we need to align our clinical research and knowhow with informatics and the knowledge of how to commercialise what we are doing.”
Case study: Kuwait
One of Aridhia's most notable projects to date is the Kuwait Scotland eHealth Innovation Network (KSeHIN), a collaboration between Kuwait’s Ministry of Health (MOH), the Dasman Diabetes Institute in Kuwait and a Scottish consortium consisting of the University of Dundee, NHS Tayside and Aridhia.
The collaboration with Kuwait (population 3.1million) involves using a package of solutions to do in-depth research into diabetes, including a”smart learning environment” for 105 MSc students, plus clinical network development, exported by the NHS research interactions and informatics platforms developed by Aridhia for data analysis.