In recent years, it has become clear that the growing availability of health data and advances in genetics and technology are starting to support a shift away from the “one-size-fits-all” model for treating a condition, as we learn more about the impact of tailored medical interventions.
Let’s take one example. An area where new approaches will increasingly enable care to be managed according to an individual’s needs is screening, Dr Charles Alessi, HIMSS chief clinical officer, recently told MobiHealthNews. In the UK, the only determinant for bowel cancer screening, for one, is age. In England, Wales and Northern Ireland, those aged 60 to 74 (in Scotland, screening starts at the age of 50) receive a home testing kit every two years. But bowel cancer can affect any age, as figures show that over 2,500 people under 50 are diagnosed with the disease in the UK every year, according to the Bowel Cancer UK charity. The modernisation of services, including based on the use of data now becoming available and new technologies, will open up an array of opportunities for prevention and care delivery.
It is expected that this transformation will span medicine and healthcare more broadly. One of the startups working to make it a reality is London-based Closed Loop Medicine (CLM), which is developing integrated care packages to deliver individualised treatment regimens. CLM’s chief executive and cofounder, Hakim Yadi, has been working for over a decade to bring innovation into the NHS in roles including founding member of the Department of International Trade Life Sciences Organisation and founding CEO of the Northern Health Science Alliance (NHSA). In 2017, he received an OBE for his contribution to healthcare technology and the economy in the UK.
This week, MobiHealthNews caught up with Yadi to find out more about CLM’s plans, the recent £2.1m raise and a new project that the startup is working on with specialists from the William Harvey Research Institute at Queen Mary University of London.
This interview has been edited for length and clarity.
MobiHealthNews: From the work that you have been involved in and led during the past decade and more, it is hard to overstate your contribution to healthcare technology in the UK. But let’s go back to the beginning. What sparked your interest in this space in the first place?
Yadi: I have always been fascinated by the life sciences sector from a very young age. I was one of these people that knew I wanted to read for a degree in biology even before I left pre-school. Then, I went on to study a PhD, and my PhD was very much focused on health, and in particular women’s health, focusing on those challenges that women face during pregnancy, such as conditions of pre-eclampsia. I realised that I was drawn more and more into how we can use technological advances, whether they be hardware, software or medicines, to improve human health rather than research. It wasn’t a very sudden thing, it happened over many years, particularly through my PhD, and then, after that, working directly with government and with health technology companies.
MobiHealthNews: That is interesting, because Closed Loop Medicine isn’t focused on women’s health at this time, is that correct to say?
Yadi: Closed Loop Medicine is a company that is developing better ways of providing precision medicine, whether that medicine be drug or non-drug (behavioural therapy), for a whole variety of indications. And when we look at the different indications that we would like to tackle, there’s mental health, there’s cardiometabolic [disease], but women’s health is also in there. We are starting with sleep and hypertension, but they are just the beginning.
MobiHealthNews: Prior to Closed Loop Medicine, however, you were leading the NHSA. What can you tell us about your work there and the partnership’s aim?
Yadi: The Northern Health Science Alliance is a fascinating organisation. There was a recognition that the north of England had a critical mass of clinical, research and teaching capability and infrastructure, but it was not acting in a way where it was being more than a sum of its part, it was very fragmented. On top of that, there is this assumption, particularly in the UK, that clinical research happens only in the golden triangle of London and Cambridge and Oxford.
The mission for the Northern Health Science Alliance was to unlock the potential, the latent potential of the clinical research infrastructure across the north of England, and show that it was recognised nationally and internationally.
But ultimately, the mission was to improve the health and wealth of the north of England. Sadly, people in the north of England have a higher chance of dying under the age of 75 than those living in the south of England, and those health geographies that can deliver greater research always seem to have better health outcomes. That’s for a whole variety of reasons, because they have access to the latest technologies, they work with the latest procedures, they recruit the best staff. And so if you can increase the amount of research being done in an area like the north, which has lower outcomes, our hypothesis was that you can improve the outcomes for the population. And so, our mission was to unite the north to make it visible, but ultimately to improve the health and wealth of the region.
MobiHealthNews: It is also well-known that innovators have struggled selling to the NHS. Can you take us through some of the challenges that you encountered in encouraging the adoption and spread of innovation for the benefit of patients through the NHSA?
Yadi: We worked as a network of hospitals and universities, always trying to leverage the best of research and best capabilities for every new innovation or piece of technology coming in. I think one of the biggest challenges was that we know the NHS is up against it in terms of delivery, in terms of just delivering the standard of care. And having the infrastructure and space to be able to think innovatively and creatively and to work with small and medium-sized enterprises and even large companies requires people to have time. What I found quite interesting is that that distribution in time was not equal, so the larger teaching hospitals, the larger clinical centres seem to have more capacity to take on innovation.
MobiHealthNews: Why is that?
Yadi: That is loosely down to people and their time. So, what our biggest challenge was often was trying to make sure that innovation was spread evenly, and that is a real challenge, and it still is a challenge, that’s why we have the Academic Health Science Networks, to increase the pace and uptake of technology across the NHS, not just in hotspots.
MobiHealthNews: But there’s more that could be done in that respect, would you agree?
Yadi: I think there’s lots more that could be done more generally about supporting health tech innovation in the NHS. I think there’s something that we were trying to pioneer is recognising the fact that you are not going to be able to suddenly increase capacity to do innovation, it’s just not something you can do overnight, and just be honest about that, it’s something that’s going to take time. But, ultimately, we should try to get to a point where there’s more creativity, more innovation across every aspect of the NHS, whether it’s primary, secondary, tertiary or social care.
What we were trying to do instead in the interim is say, well, if Manchester can evaluate something on behalf of the north, let’s make it easier for Leeds, Sheffield and Newcastle to adopt it afterwards. Or vice versa, if Newcastle does something first, if Sheffield does something first, or Lancaster does something first, and they do the evaluation, let’s involve the rest of the region, so that when it comes to the dissemination, it feels like it’s been a collaborative project from the outset.
And so there’s been buy-in to this technology or even questions or hypotheses adapted by the rest of the north to make sure that when it is evaluated, it’s evaluated in a way that everyone recognises. So it’s this idea of using centres to lead on a clinical research study and then have others effectively copy, having been involved in the whole process.
MobiHealthNews: This has been coming up a lot, different parts of the NHS working on the same thing but not talking to each other.
Yadi: Exactly. We recognise that the NHS does not have the capacity to evaluate the same piece of technology 20 times. So, why don’t we do it once, do it well, do it collectively, and then spread it.
MobiHealthNews: Going back to CLM, you recently raised £2.1m in a pre-Series A funding round and hired a senior management team with vast experience in the life sciences field. What can you tell our readers about CLM’s plans?
Yadi: CLM is founded by four founders, myself, Dr Paul Goldsmith (chief innovation officer), Dr David Cox (chief digital officer), Dr Felicity Sartain (chief operations officer), and it is very much focused on this concept that intervention and innovation in the NHS and in every health system globally is siloed. You have companies that sell drugs, you have companies that have developed and sell health tech, you have companies that have developed and sell apps, wearables, but no one is looking at the integration of these as a pathway.
So, what CLM is doing is looking at a therapeutic area at a time, and building integrated care packages. These packages combine known drugs with our own proprietary digital therapeutics (software as a medical device) with relevant devices to the pathway -, so at the point of prescription, you get everything you need to be able to truly personalise that care.
MobiHealthNews: You also recently announced that you would be working on a project with specialists from the William Harvey Research Centre at Queen Mary University of London, which is partly-funded by your investors and the government through UK Research and Innovation. What stage is the project currently at, and what can we expect?
Yadi: The project we’re running at Queen Mary’s and the William Harvey Cardiovascular Research Centre, which is part-funded by our investors and part-funded by Innovate UK, is one exemplar of this integration, where we are taking a drug for hypertension, combining it with a digital intervention around lifestyle, diet, exercise, mindfulness, and a blood pressure monitor. So there you have a drug therapy, you have a behavioural therapy, and a medical device. What we are trialling is whether or not that combination of those different therapeutic interventions is better than being able to take only one in isolation. This is a study that will be going through to the end of next year. We started the project in May this year, but the actual clinical trial, which we anticipate being a 100 patient interventional trial, will start at the beginning of next year. But the project has started.
Hakim Yadi will be speaking at the HETT show in London on 1-2 October at the ExCel centre. HIMSS, owner of MobiHealthNews, is the official knowledge partner for HETT. More information about the event can be found here.