Start-ups move into data and e-learning

Just because an idea starts life in one area does not mean that it has to remain fixed there for ever. And so it is with start-ups and young companies. Some take concepts from one sector and simply transfer them to another, while others adopt an ink-blot approach and allow their idea to spread into new but related areas. Two examples of just these tactics are Sapior and Virtual Tutor. Sapior opened its doors in 2000 providing data integration, data management software and consultancy for financial services organisations, but switched tack to focus on the NHS about six years ago. Rob Navarro, the firm's managing director, explains that the company was "a fusion of my two interests in data management and data privacy". When writing a paper exploring how organisations could effectively share or reuse sensitive information, he realised that it was the health sector rather than financial services that really required a way to tackle the issue because of the "super-sensitive" nature of its data. His own research indicated that in a large teaching hospital, each patient's health record was copied between 10 and 30 times – not for use in direct patient care but for secondary functions such as auditing, research and data analysis. The figure was closer to 10 when records were stored in clinics or specialist facilities. "It was clear that the protection of patient data needed to be increased in line with increased reuse and so we wanted to fill that gap," Navarro said. As a result, the company, which currently employs three people, developed a so-called pseudonymisation system, which replaces identifiers such as name, address or NHS number with pseudonyms to protect patient identities. By the end of 2005, Sapior had signed a nine-year deal with BT, the primary contractor for the NHS Care Records Service. The firm's Redbridge ES offering was used to remove identifying data from between two and 10 million patient records per day held on the central Spine database, so that they could be employed anonymously in the Payment by Results scheme. But Navarro realised that there was "a much bigger need for this kind of thing around the country, not just in the centre. There are many more sources of data to integrate and services to evaluate regionally than would never make their way into the centre". As a result, the company developed a black-box "web-server-like appliance" to cater to this new market. The device sits on an organisation's network and ensures that health records are stored in databases and data warehouses in a de-identified state, although such information can be "re-identified" on demand as required. The move coincided with the Pseudonymisation Implementation Project's mandate that all trusts must start de-identifying their data by 11 March this year for completion by 2011, and Sapior hopes to sign its first customer this quarter. Licences and maintenance charges for a primary care or acute trust with 200,000 patients will be about £16,000, while one-off fees for implementation, which takes between four and six weeks, will cost about the same. The offering will be sold primarily through the firm's partners. They include database vendors, IT services and information governance organisations which undertake the "people training piece", says Navarro. Within three years, however, the aim is to start focusing on the social care market before moving to target local authorities. "It'll be like an ink blot moving from the centre where the first mandate appeared," Navarro explains. Ink-blot approach Another organisation that is taking an ink-blot approach is e-learning provider Virtual Tutor. The company was set up two and a half years ago by director Michael Ter-Berg after being spun out of City University in London. It came into being after Ter-Berg, a seasoned healthcare technology entrepreneur, was introduced to Professor Maggie Nicol at City University's School of Community Health Sciences. She was looking for a simple way to deliver effective intra-venous (IV) pump training to clinicians in general and nurses in particular. Ter-Berg explains the rationale: "IV pumps are the biggest area of medical device liability and more people are seriously hurt or killed with them than anything else. They're complex instruments that are used in intensive care, but the fact that they can be faulty or training can be inadequate means that they generate big clinical issues." On this basis, he hired specialist e-learning software developer Exor to build and support an e-learning system based on input from Nicol as well as other clinicians and educationalists. Exor is now a shareholder in the company alongside City University and Ter-Berg. Some 32 NHS trusts have already taken part in a four month trial, which started at the end of July using Graseby 3100 pumps, with the aim of adding support for Fresenius-based models by the end of March. But while the offering is currently available on an ad hoc basis at a cost of about £1,000 a year for an unlimited site licence, active selling to nurse trainers and junior doctors is not scheduled to start until the middle of the year. The service will be available in either standalone form or integrated into an existing learning management system and will be positioned as complimentary to the Department of Health's e-Learning for Healthcare scheme. The latter targets a wide variety of areas and is intended to be "supportive" in nature, according to Ter-Berg, while Virtual IV Tutor is meant to provide more comprehensive and specialised training. But the eventual aim over time is to provide the "online training portal of choice for all medical devices", he adds.