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Transforming Patient Lives: Innovative Solution Ending the Late Diagnosis of Liver Disease.

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TRANSFORMING PATIENT LIVES: Innovative Solution Ending the Late Diagnosis of Liver Disease

Predictive Health Intelligence is empowering NHS clinicians to identify people at-risk and promote early liver disease intervention with hepatoSIGHT™..

The Predictive Health Intelligence team secured a £1.4 million NIHR grant (NIHR200965) to develop their case-finding product hepatoSIGHT™.

In the first six months, the hepatoSIGHT™ pilot at Somerset NHS Foundation Trust identified and contacted over 700 high-risk liver disease patients.

hepatoSIGHT™ has been featured on BBC News as a significant development in helping to support the early identification of liver disease.

Neil Stevens is an Innovative Management Consultant and Healthcare Researcher, who has held a number of non-executive director roles, and enrolled onto the NHS Clinical Entrepreneur programme in 2023.

Neil Stevens

With over 35 years of experience in business consulting, strategy development, and healthcare management, Mr Stevens has been at the forefront of digital transformation within the healthcare sector. His extensive experience includes leading digital services and implementing transformation programmes across Acute, Community, Primary Care, and Mental Health settings. He holds a degree in Psychology and Computing, along with a postgraduate qualification in Artificial Intelligence.

Founded in 2019, Predictive Health Intelligence is a medical technology company committed to ending the late diagnosis of liver disease. The team developed hepatoSIGHT™, a cutting-edge case-finding search engine that empowers clinicians to leverage existing data to identify patients at risk of developing liver disease, facilitating early diagnosis and proactive management.

Predictive health intelligence logo

‘The NHS is estimated to spend over £17 billion annually on liver disease.’ British Medical Association

Liver disease often progresses silently, with many patients showing no symptoms until the disease has advanced significantly towards organ failure or cancer. Traditional detection methods, which rely on the presentation of symptoms, can unfortunately come too late for effective intervention. Since 1970, death rates from liver disease have quadrupled, affecting individuals across all age groups. This places increasing pressure on the NHS as limited treatments exist for chronic liver conditions, but early diagnosis is key to improve patient outcomes, reduce healthcare costs, and reduce death rates.

In 2019, Dr Tim Jobson, a Consultant Gastroenterologist, became increasingly concerned about the issue of late liver disease amongst his referred patients. He observed that individual markers in one-off blood tests often went unnoticed, but when healthcare professionals reviewed trends over time, it became evident that something was wrong. Unfortunately, by the time these trends were identified, many patients had already progressed to decompensated liver failure, a condition that is incurable.

Dr Jobson shared his concerns with Neil Stevens, an expert in Healthcare IT and Information Systems. Together, they identified that the current healthcare IT systems were not designed to perform the type of analysis required to identify liver disease on a population scale. Recognising that the NHS already possesses a wealth of valuable data, they decided to develop a system that could utilise this existing information to identify people at risk earlier, thereby enabling timely and effective treatment for liver disease.

To turn their idea into reality, they secured a partnership with their local NHS Trust, Somerset NHS Foundation Trust, and developed their proposal further, exploring a ‘case-finding’ approach to liver disease, using existing blood test information. This led to the establishment of The Somerset Liver Improvement Project.

At inception, the team formed a Patient and Public Reference Group (PPRG) to ensure that patients were central to the design and implementation of the solution. The group provided several important suggestions, including the need to focus on variation in diagnosis due to deprivation, ensuring that the case-finding strategy would not add extra burden on healthcare teams, and that it would be linked with local GPs to keep them fully informed. These suggestions were implemented within the project, and feedback continues to be gathered regularly.

In 2020, the project secured a grant from the National Institute for Health and Care Research. The team was awarded £1.4 million to develop hepatoSIGHT™, a case-finding and cohort mapping tool. This innovative software uses historical blood test data to identify people at risk of chronic liver disease before symptoms appear. By analysing patterns of abnormalities, hepatoSIGHT™ can rapidly risk stratify populations and identify individuals who would benefit from early intervention. hepatoSIGHT™ is able to review 100s of millions of lines of data within seconds based on patterns of abnormalities and thresholds set by the healthcare team, finding individuals who meet specified criteria based on certain demographics and historic blood test results.

The development and implementation of hepatoSIGHT™ began with extracting and cleansing historical blood test data for integration into the system. This involved addressing information governance requirements and ensuring data security and compliance. The team worked closely with Somerset NHS FT Data Protection and Caldicott Guardian leads, the Local Medical Council, Primary Care Networks, and GP Information Governance leads to ensure adherence with NHS confidentiality and information governance guidelines. These data sets include demographics, deprivation indices, and key clinical information contained within blood test results.

Overall, the team ensured that the tool was designed to be intuitive and easy to use, seamlessly integrating into clinical workflows. This allows healthcare teams to quickly learn the system and proceed with identifying at-risk patients, thereby reducing the administrative burden on already busy teams. Once identified, patient cohorts can be stored within the system and accessed easily through a simple interface. Identified patients can then be called in to the appropriate clinic or invited to participate in a clinical trial if appropriate.

“This is a very exciting opportunity to change the way that healthcare is delivered. By finding people earlier in their disease pathway we are making a huge difference to their lives and the NHS. At a time of intense pressure such as this, using technology that empowers clinicians to get ahead is critical. At Somerset Foundation Trust we’re proud to be leading the field alongside our partners at Predictive Health Intelligence.” Prof. Daniel Meron, DM FRCPsych MBA, Chief Medical Officer Somerset NHS Foundation Trust

Impact

The pilot of hepatoSIGHT™ has positively impacted Somerset Foundation Trust in several ways:

“In Somerset alone in the past 6 months the clinical team using hepatoSIGHT™ have already identified over 700 people considered to be in the highest risk and they have been contacted and invited to attend the liver clinic. This could scale to 70,000 in England alone. The causes of liver disease are multi-faceted and include genetics, viral infection and lifestyle. There are signs that it is increasingly impacting younger populations so the earlier we can see that there is a problem, the more years of life can be saved.

Our work to date has shown that the system can be used to readily identify people with indications for treatment including those with metabolic-dysfunction associated steatotic liver disease (fatty liver disease) and metabolic syndrome, progressive alcohol-related liver disease, viral hepatitis, autoimmune disease and hereditary conditions.” says Neil Stevens.

In 2023, Mr Stevens successfully applied to the NHS Clinical Entrepreneur Programme and became a Clinical Entrepreneur within Cohort 7. With the programme’s support and valuable connections, along with the successful pilot, the team was awarded a second grant of £800k from Innovate UK for a 2-year project. This grant, in partnership with Sano Genetics, a Cambridge-based company accelerating precision medicine research, and Somerset NHS Foundation Trust, aims to use hepatoSIGHT™ as an initial risk-stratification tool. Participants who agree to be involved in the trial will first undergo a non-invasive genetic test, followed by a specialist liver scan to detect fibrosis (liver scarring). The team believes this combination has the potential to offer a cost-effective solution for the NHS, targeting those in the population who most need clinical attention.

The Clinical Entrepreneur Programme has provided invaluable insight and support at exactly the right time for Predictive Health Intelligence – as they move from innovation to becoming a commercially viable company. As a result of some of the pit stops and people Neil has met on the Programme, Predictive Health Intelligence was well prepared for the challenge of selling to the NHS. This has resulted in the recent commitment to roll out hepatoSIGHT across a population of over 6m people in the South West of England– with the expectation of identifying thousands with previously undiagnosed, progressive liver disease who need treatment or monitoring.

In partnership with Somerset NHS Foundation Trust, Predictive Health Intelligence achieved 2 HSJ Digital Awards:

The NHS Clinical Entrepreneur Programme has been instrumental in Mr Stevens’ journey, significantly contributing to both his personal and professional development. The programme has connected him with a valuable network of innovators and patients within the NHS, fostering connections and knowledge sharing.

“The NHS Clinical Entrepreneur Programme has supported me both personally and professionally, and has definitely helped me to secure a significant contract which means that Predictive Health Intelligence is now a commercially viable company, without the requirement for dilutive investment”

During his time on the programme, Mr Stevens has built numerous valuable connections within his community and received support from several informal mentors he encountered throughout the programme. The insights he gained, particularly from those working on large data and AI applications, have prompted his team to consider incorporating AI into their next steps. Additionally, he has extended his personal support to the network, helping others with his healthcare commercial, IT and project experience, giving back to the CEP community.

The educational events have been highly beneficial. These sessions have broadened his perspective on entrepreneurship and helped him rethink his commercial offerings to both the NHS and commercial organisations. The learning has directly supported him and his team in moving forward, ensuring that critical elements of the innovation are considered, which may not have been explored before.

Mr Stevens has also taken his innovative insights back to his role as non-executive director at the South West Health Innovation Network (formerly Academic Health Sciences Network), where he supported impactful projects. His participation in the programme has not only enhanced his skills but also expanded his vision and passion for healthcare innovation.

The programme is structured to provide a wealth of information and access to an incredible network of experienced individuals in innovation and entrepreneurship, along with a fantastic support system. I’ve maintained contact with many people I’ve met and continue to attend the pitstops, leaving each one energised and equipped with solutions to problems.

I encourage anyone interested to apply. I wasn’t successful in my first year, but I applied again the next year and secured a place. Expect your thinking about your innovation to evolve as you learn more and reassess your goals and methods.

My advice to all innovators is to ensure that your design is led by someone who fully understands its intended use and users. This will help ensure the end result is practical and achieves the desired benefits. Patients should be at the heart of everything you do- get them involved, seek regular feedback, and incorporate their input.” Neil Stevens

Looking to the future

As the team progresses, they have near-term plans to expand the use of hepatoSIGHT from the current population of approximately 6m to over 10m. They are also in conversations with a number of other NHS organisations with a view to even further expansion, with an aim to benefit larger populations across the UK and beyond.

The team is investigating the integration of non-invasive genetic tests and specialised liver scans to improve hepatoSIGHT™’s effectiveness. There’s also considerable interest in leveraging hepatoSIGHT™ for clinical trials, which could address the challenges of participant recruitment and reduce the time and cost of bringing new treatments to market. Their innovative approach quickly identifies individuals who meet specific criteria, forming research cohorts efficiently.

Looking ahead, the team plans to explore how hepatoSIGHT™ can support liver disease detection on a global scale. They aim to focus on regions with high prevalence of liver disease to determine how they can make a significant impact. There are also opportunities to expand into other disease areas such as cardiovascular, stroke, cancer and the metabolic syndrome which would help even more people.

“If you are interested in learning more about Predictive Health Intelligence and hepatoSIGHT™, please contact us via our website. We would be pleased to meet you either online or in person and demonstrate how quickly our case-finding can identify individuals for treatment or research purposes. Thank you.” Neil Stevens

For more information, please click on the links below.

www.predictivehealthintelligence.co.uk

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