“So much of health is visual” – Peter Hansell, co-founder of ISLA on visual data in healthcare

Peter Hansell, co-founder of ISLA, chatted to HTN about its image sharing platform – which enables patients to safely and securely share health-related photos and video content with their clinicians.

With the tagline ‘building the visual component to the healthcare record’, the company has bold ambitions centred around helping empower clinicians to deliver ‘responsive care with fewer appointments’.

The last year has obviously seen a huge surge in demand for remote technologies, such as those offered by ISLA. And the company has partners across the country, stretching from NHS trusts in London, all the way to hospitals in Nottingham and Liverpool.

HTN also recently reported on Chelsea and Westminster Hospital NHS Foundation Trust’s announcement that it’s now set to roll-out ISLA’s remote imaging technology across north west London, following a successful trial during the pandemic.

With this news in mind, it seemed the perfect time to share Peter’s thoughts on the past 12 months and his explanation of how the platform can work for patients and health professionals…

Hi Peter, tell us about ISLA’s platform

One of the things we are really passionate about is, as [many] ‘new-age’ tech companies are, trying to break down barriers between organisations and even in hospitals with teams and how they work.

We believe we are filling a gap in the market for using visual data properly. If you think about photos and videos, they are not really used in healthcare and so much of health is visual, so it doesn’t make sense.

On the platform, as you go into a patient, you are met with a list of what we call collections; collections are a filing system for keeping and organising patient images. It could typically be a range of motion post-surgery [images] for a hand, or a skin rash on the lower leg, so we have different collections for different sorts of streams of data. You are able to pull out all that visual data and see it chronologically in order to track the condition and see how it is progressing over time. You can then review that, and submissions can be made by health professionals or by patients themselves. 

The system sends a text message out to you which has a secure link on it. So [there are] two parts to it, one is capture and the other is display. That link should ask for you to confirm that you are [the patient], that should take you to your camera but within the browser so we haven’t had to go out into your camera app. That means it can be very seamless for the patient. Once you upload the image, it is there for [a clinician] to come in and view. We try to keep it – from a patient perspective – pretty low friction, so no downloading or anything.    

Are you piloting this functionality or is it live anywhere? 

Across different sites it is at different stages. COVID has been very helpful for us because there is this requirement that has come to the fore a lot. We are piloting now. Chelsea and Westminister, Nottingham, Central London, the Royal Brompton – they are the four major sites at the moment. 

What are some of the use cases? 

It’s anything with a visual component. In Westminster, they would use this for dermatology; any lesion or rash can be looked at immediately. One introduction to the platform is that you can click into a schedule to say, for example, “I want the patient to submit one photo per week for the next eight weeks”.

There is a whole range. Nottingham has gone live with neurology and they want to allow patients to send in videos of seizures they’ve had at home, to be reviewed. When we heard that, I immediately thought that patients wouldn’t be videoing their seizures but [it] actually would be good clinical practice if they do. [It means] you don’t have to drive across the country six months later – you just immediately ping [the video] across. 

What else are you working on? 

There’s some really exciting bits; the work we are doing with the Royal Brompton is quite cutting-edge, we are working on their AI lab. One of the challenges as patients start to submit [photos] are blurry and low quality images, so the focus area at the Brompton is a blurred section AI intervention. The AI scans for blurred edges in the image, so if the computer can make out lots of edges then it is a clear indication it is a good quality photo – if you can’t set edges we can then send it back to the patient and ask them to re-submit. That’s our approach to AI.

They are using AI for wound management – Royal Brompton does a lot of cardiac and thoracic surgery which leaves big scars down the sternum. We are rolling out surveillance, so that when a patient is discharged the nurse takes a photo and fills out a short form and then 28 days later the patient submits a photo of the same wound. Then we are able to track whether it is healing as it should, or not.

The term is ‘digitising the surveillance process’ and bringing visual data into that. We also put in a bid to replicate that model across London, so that would be really cool if we can get that going. It is competitive.    

What will the future bring? 

From a business perspective I think we have done a very good job of getting pilots started and some of those are real big name trusts, which is very helpful for us. We are moving into this delivery phase where the platform is loved by the clinicians using it, but we really need to now demonstrate there’s a business case to support it.

The thing that I’m pushing the business on at the moment is delivery; coming out of all these pilots with a real clear “here’s the benefit and this is how we measure it”, which I think puts us in a great position to start scaling up. That’s the true focus, and alongside that is how we build on the platform to really create links and ways of collaboration across parts of healthcare that have never existed.

So if you are are a carer seeing a patient and they have a pressure ulcer, you’re one of the people who is closest to that and you’ll have an understanding of how that wound is recovering. Linking you up in a team with the nurse at the community trust and the GP, where all have visibility of the same thing, would be ground-breaking.

There’s a lot said about health and social integration, where we want it to be a ‘bottom-up’ approach where we can say “there’s a problem here, a group of people in social care who are really close to that problem, and there’s a group of people over here in healthcare who can help steer what we do with it”. I’d love to see some real examples of that coming through which are driven by the platform. 

Any other projects to talk about? 

Royal Brompton have done this visual surveillance piece where they are tackling surgical site infection, so if people have discharged from hospital but then have an infection in their wound, that’s very expensive  – as well as being potentially very dangerous. You might be sat at home and your wound is infected, then you get readmitted back to hospital, and a lot of time could have been lost going through that process.

Hospitals are moving more to this surveillance model, so we keep tabs as to how that patient is recovering. We have wrapped that up into a neat little flow through the main product.

How are you finding running a health-tech startup? 

Between myself and my co-founder [James Jurkiewicz], we are lucky in that our skill-sets differ. James came from a company which does identity verification; takes a photo of your face and driving licence and matches up the two things. He really leads on product and engineering, and manages all the resources to get that done.

I’m much more on the delivery and business development side, helped by my previous role at DrDoctor where I built a lot of those relationships. Marketing falls into no man’s land and I try to pick that up the best I can. As we move to generate revenue, there’ll be gaps we look to fill. 

What’s the best thing about running a health tech start-up and what’s the most challenging? 

The best thing is, in healthcare, the vast majority of people who work in it are basically involved because they think they are helping people, and the vast majority are doing that.

It is a comforting backbone to the way you wake up and think about your work every day because you’re working in a space where you’re surrounded by a group that are making things better for other people. Ultimately you are all pulling in the right direction, despite it being challenging and stressful and slow at times.

The benefits of that are huge. As we’ve been hiring, you tend to be interviewing with people who are nice people who you want to have a conversation with anyway because healthcare is self-filtering for compassionate people.

A lowlight as a tech founder [is] you try to hold yourself to a standard of moving fast, developing the business quickly, and in health you have to temper that with also moving at the speed of big complex systems. There are a lot of stakeholders involved and gains to be made – you might be waiting for the board meeting next month.

And so I think it is that pace because, as a small business, you can respond to stuff really quickly and we can get a product built and shipped and be weeks ahead of the other party we are waiting for –  so that can be frustrating. A lot of people say that and I don’t want to join the ranks of ‘the NHS is slow and needs to move faster’ but it is complex and things have to be done responsibly and in a kind of steady way because the stakes are very high.

My sanity and head space comes from getting out running or on a bike in the country; if I’m feeling low or frustrated that’s my go-to, an exercise session. 

We started this business because we believe there’s a missing chunk of clinical data that is visual. We started this to organise visual data to give clinicians that context when reviewing a patient and we are [now] trying to give this third option of checking up [later].