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Interview: BHF on using cloud and big data to improve heart patient outcomes

The British Heart Foundation (BHF) has set itself the lofty goal of eradicating the fear of developing heart and circulatory disease by 2030, with the help of cloud, big data and personalisation technologies

The British Heart Foundation (BHF) has spent nearly 60 years funding research into the causes, prevention and treatment of heart and circulatory diseases.

While this work is ongoing, the charity has recently set itself another, more prescriptive and time-sensitive target, that will not only serve to shape where it chooses to focus its research and campaign efforts over the next few years, but its technology strategy too.

And that goal is to ensure that, by 2030, people will no longer have to live in a world where they are fearful of developing heart conditions or related cardiovascular disorders and diseases, such as strokes and vascular dementia.

“Going through the 2030 strategy, we recognise that technology can help the British Heart Foundation to achieve this and is a key part of the delivery,” Mary O’Callaghan, director of technology engagement at the BHF, tells Computer Weekly.

“We’re moving from seeing technology as just an enabling function to something that’s actually at the heart of making sure that patients, the general public and people living at risk of heart and circulatory diseases will be able to live without fear in future.”

O’Callaghan has worked at the BHF for three-and-a-half years, but has only been in her current role – which was created specifically to support the technology strand of its 2030 strategy – for about a week at the time of her interview with Computer Weekly.  

“My role is about making sure we’ve got the right partnerships – internally and externally – to identify opportunities, where technology can help deliver the strategy and make sure that we have the right people being mobilised to work together to make that happen,” she says.

Technology as an enabler for change

The organisation already has several examples of where the use of technology is making a difference here. The first is in the creation and delivery of the BHF’s defibrillator location database, known as The Circuit.

The service was borne out of a discovery about the lack of information ambulance crews have about the location of defibrillators that are sited throughout local communities in the UK, says O’Callaghan.

“We’re moving from seeing technology as just an enabling function to something that’s actually at the heart of making sure that people living at risk of heart and circulatory diseases will be able to live without fear in future”

Mary O’Callaghan, British Heart Foundation

“We identified a while ago that Britain has got one of the lowest survival rates from out-of-hospital cardiac arrests in Europe, and one of the contributing factors to that is lack of knowledge of what to do when somebody has an out-of-hospital cardiac arrest,” she says.

Timely access to a defibrillator can be a huge factor in whether or not someone survives an out-of-hospital cardiac arrest, but, when someone calls 999 to report one, the ambulance services do not always know where the nearest defibrillator is to direct callers to.

“At the moment, they do not know where all the defibrillators are in the UK. There are probably about 100,000 defibrillators in the UK, but the ambulance services are only aware of about 30,000 to 40,000 of them.”

To rectify this, the foundation is in the throes of pulling together a database containing the location of every defibrillator in the UK. The database of up-to-date location data will be hosted in the Microsoft Azure public cloud and made accessible to every ambulance service across the UK.

“It’s currently being rolled out to two ambulance services, with a couple more due by the end of this year, and – hopefully – by mid-2020 we will be able to say the ambulance service will be able to direct a bystander to the closest defibrillator and therefore increase the chances of survival from out-of-hospital cardiac arrest.”

O’Callaghan describes The Circuit as a “tangible example” of how technology can make a difference to people’s survival rates from heart and circulatory disease. So, too, she says, is the recently announced BHF Data Science Centre.

The £10m initiative is the result of a collaboration between the BHF and Health Data Research UK, which, in turn, will work with patients, the public, the National Health Service, researchers and clinicians, and use their data to help advance research into heart and circulatory health issues.

Website hosting revamp

The organisation is also revamping its infrastructure setup. This has already seen it embark on a six-month migration of the charity’s website onto the Microsoft Azure cloud, which it completed in February 2019.

The website is an important and valuable part of the organisation, says O’Callaghan. It regularly receives more than a million views a month from people looking for medical information, fundraising ideas and online peer-to-peer support for the heart and circulatory issues they might be suffering, through the charity’s Health Unlocked forum.

“One of the most popular areas of the website, with several hundred thousand visitors [a month], is people enquiring about how they can donate furniture and home goods to our retail stores,” she continues.

“By going with Azure, we’re able to build on the skills of the people that we have here, and it’s kind of a good development opportunity for them”
Mary O’Callaghan, British Heart Foundation

“Our retail income was around £130-134m last year, and about £30m of that was able to be donated to the research, and is a key and growing area for us.”

In light of those figures, it is perhaps no surprise that when its previous hosting provider started to buckle under the weight of BHF’s web traffic, the charity decided to switch up its hosting arrangements.

“We were with a provider that we’d been with for some time and we were really getting too big for them. They could no longer cope with kind of the volumes that we were seeing and they couldn’t provide the resilience and the stability that we needed either. So we had a pressing need to move the website onto a better platform,” she says.

After a three- to four-month procurement process, the organisation opted for Microsoft Azure over the likes of Amazon Web Services (AWS) and the Google Cloud Platform (GCP) – in part because the organisation has always been a “Microsoft house”, according to O’Callaghan.

“We wanted to be on a platform that is common in the market, so that it will be easier for us to get the skills and expertise we need to support it going forward. We already use Microsoft’s productivity software and we have a good working relationship with them,” she says.

“By going with Azure, we’re able to build on the skills of the people that we have here, and it’s kind of a good development opportunity for them.”

Outside support and influence

The organisation has around 150 people working within its technology function. They worked side-by-side with members of Rackspace’s Professional Services team during the migration, who were on hand to provide supplementary support and ensure the organisation had the skills needed in-house to complete the work.

Rackspace said from the very beginning they would work alongside our people, transferring knowledge to them, and providing additional expertise that we didn't already have,” she says.

“We got a strong sense from Rackspace that they would be doing the transformation with us rather than to us”
Mary O’Callaghan, British Heart Foundation

“We got a strong sense from them that they would be doing the transformation with us rather than to us, which was important to us.”

Since the migration completed, the website has been put through its paces on a number of occasions, and has remained up and running during several events that typically result in huge seasonal traffic spikes.

“As a result of the move, we’ve got an increased sense of confidence in the website. We’ve gone through some of our biggest events, like our annual London to Brighton cycle ride, which is primarily managed and fundraised through the website, and we’ve gone through some big branding campaigns that have all generated traffic, and we haven’t had to worry about whether it could cope.”

As a result, O’Callaghan and her technology team can focus on what project to tackle next, rather than be pre-occupied with concerns about site crashes and downtime. “We’re able to focus on the areas where we want to add value, rather than worrying about just, you know, keeping it going.”

Next on the tech to-do list

In terms of what is next on the tech agenda for BHF as it works towards its 2030 goal, there are more migrations on the horizon, with the firm following what O’Callaghan terms a “cloud-first, where appropriate, strategy”.

“We’re planning a migration of everything from our on-premise locations to colocation [facilities], and from there we’ll look at what else we can move to pure cloud locations.”

The organisation is also looking at ways that it can offer people who engage with the charity better, more tailored and personalised support and information about the specific heart and circulatory conditions they might be dealing with or have been told they are at high-risk of developing.

“We’re working with partners to look at more personalised journeys… because at the moment, it tends to be the case that you get told you’ve got these risk factors or a diagnosis, and you might get given a leaflet or a brochure, and then you go away and have to figure out exactly how this advice applies to you,” she says.

“That’s something we’re quite excited about, and is just one of the many things that we’re looking to do, where technology and innovation can come together to help us achieve our goals.”

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