Solving Complex Issues in Healthcare with Data with Simon Fitall, Co-Founder & CEO at Galileo Analytics

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: Today I have Simon Fitall. He’s a co-founder and CEO at Galileo Analytics. He’s a specialist in knowledge management with specific interest in a longitudinal patient data, data capture and analysis techniques as well as the assessment and evaluation of IP and pharma and biotech, including all stages of drug development from discovery to death of the product. His expertises is in data integration, modeling and forecasting. Definitely a guy that you would want to have by your side. He is also fantastic at designing and building complex data systems aimed at helping to solve complex issues such as the longitudinal Bayesian analysis of patient data. Simon is a member of the Global Advisory Council to the Interprofessional Healthcare Workers Institute also known as I H W I at Rosalind Franklin University as well as being a member of the education committee of Intelius. He is a leader and a fantastic contributor to Health Care and it’s such a pleasure to have him on the podcast. Welcome to the show Simon.

: Thank you very much indeed.

: So Simon, what is it that got you interested in healthcare to begin?

: I kind of fell into it. It found me rather than me finding it.

: Is that right? Yeah that happened.

: My first job, I mean this is long long time ago, my first proper job was working for AC Nielsen in market research. Besides doing the television audience measurement stuff that they’ve been most famous for they also used to run a retail business unit basically looked to product sales across all different sectors and in those days this was before scanning before barcodes if you can think about that and they had hundreds of people who would go around the country to samples of stools and they would collect the data. So it will be manually calculated all kind of say thinks some of you will be going way way way back. But anyway, they have a client service operation. And I got a job in that kind of set of operation and one of my clients was an over the counter medicines company and they were looking to expand. And I developed a really good relationship with them and they ended up offering me a job as a product manager. So I took it went into that. Then from there I went into market research in a different field looking for a company called Tyler Nelson. Now part of Cantle and from there I set up a consultancy and from there my first major client was a big international pharmaceutical company and was working on one project with them got friendly with another guy in the department who was really interested in modelling, modelling and forecasting. And quite literally over pizza and beer with. We went where we were in Switzerland. This was an organization that used to be called Sandoz now called Novartis and we’re sitting in a pizzeria which is no longer with one of those paper tablecloths and we were talking about trying to solve some problem, we ended up drawing the design of a modeling system on this tablecloth.

: Awesome.

: And at the end of the meal to the tablecloth and then that was what really goes with.

: Was it a proper tablecloth?

: Made of paper.

: OK. Oh wow that was courageous you took the tablecloth.

: And that was where I got sucked into it and wow I started to realize..

: That’s a great story.

: About how important some of this stuff is because we were talking about that particular time I’m talking about a new drug for early stage Alzheimer’s. Now the drug didn’t actually go anywhere but in the process of learning about that product and then working on other projects with the same company and then developing small business with other big pharma companies which basically go completely and utterly hooked on healthcare.

: Wow. Talk about a you did fell into it in a very interesting way.

: Yeah yeah it was one of those things where you know I’ve been a product manager and I was really cocky because in those days over the counter was a really hot thing and I’d been on over the counter product manager for a few years so I figured I could set up consultancy and do over the counter consulting and I never got a single account a consulting job. The first that first project with sandals which was a description drug development turned into more and more and more prescription drug development projects and didn’t do a single over the counter project my entire time.

: And so well fast forward to today. You’re doing some fascinating mark had Galileo, if you had to simplify it for the listeners who don’t know as much as we do about the company. Would you say the problem that you guys solve and who do you solve for?

: The problem that we solve is sort of two sides of the same coin segmenting and sequencing segmented is understanding all of the different types of patients that there are and sequencing is looking at all of the different things that happened to those patients had done for those patients in order to either fix them improve they just broadly speaking improving their health status whether that’s aiming towards a specific outcome or preventing a specific outcome. The segmenting as you said in your introduction most of the work that we do now is with longitudinal patient data. It’s very granular. It’s I hate describing it as anything like big day because that there is no such thing but let’s not go there. There are large datasets to cover whether it be medical records clinical trials, claims data or combinations of all of those three. And what we know and everyone in healthcare knows that patients are really complicated things and what we’re able to do with this much more granular data than we previously had available is we’re actually able to characterize and quantify the differences between those patients and we can then use those differences to look at the way in which those patients come into become patients and what treatment patterns and pathways they go through that aren’t just related to the specific disease that you might be interested in but it’s related to the patient’s complete condition.

: Yeah, for sure and offering some very deep insights on what may at first not be apparent.

: Very much so. One of the things we found very early on I say we most of our clientele up in pharma bio companies will not work elsewhere but that’s the majority of our business and the pharma bio industry tended to have a disease specific focus. You’re developing a drug for Parkinson’s disease, you’re really interested in Parkinson’s disease. Your focus is on Parkinson’s disease COPD or breast cancer. Breast cancer has a slightly different but you’re focused on the disease and what tends to happen is you frequently forget the fact that the vast majority of your patients that have got COPD for example, half of them have got anxiety or depression. A third of them have got cancer. Another third of them have got rheumatoid arthritis. So those sorts of coma abilities and they overlap so much that you end up with four or five or six or eight different conditions all of which are trying to be managed. And what we’re able to do is to look at the way in which that combination of coma abilities creates a creates difficulties for the treating physicians but also creates in many cases conflict conflict of outcomes conflict of treatment because you might be physicians trying to treat one condition might be wanting to use drugs or procedures that are actually going to be if not beneficial possibly harmful to other conditions that the same patient has got.

: For sure. So this in-depth look. And the sad part Simon is that as much as we try it seems like we have such a difficult time in doing what you’re saying. What would you say the biggest thing that’s holding would there be providers or medtech companies. What’s the biggest thing that’s standing in the way of being able to see all of the insights versus just kind of being that siloed one track mind?

: At the macro level quarterly reporting because you have to report quarterly. Have shareholders that you’re worried about therefore your quarterly results are important. Therefore all of your decisions end up being made on a short term basis. It sort of cascades through the entire system and so you end up with managers who are more than capable of seeing the bigger picture because of the short term focus they end up focusing on the things that are right in front of them every day. At the same time they are trying to make strategic decisions obviously drug development processes is a hugely strategic issue which means you then trying to forecast out 5 10 15 sometimes 20 years which is extremely difficult to do at the best of times. And when you then overlay on that the fact that you’ve got a market that you think of as having three or four patient segments and you then realize that it’s got so 10 or 14 patient segments. The complexity of that becomes overwhelming and it’s actually easier to say you know what we’re not going to worry about that today. We’re going to stick with our 3 or 4 segments. We’re going to concern ourselves with that group for the time being and we’ll deal with everything else later. And part of the problem is all too often later never actually comes.

: Yeah, that’s so interesting you know and it does happen and that is a big challenge Simon, I mean even at hospitals right, publicly traded hospitals which is not a majority of them but you know a good segment of them were faced with definitely at the company level. You know the fact that we are held to quarterly results and taking that big picture approach is not always incentivized so how do we get the incentives in place to encourage people to take this thoughtful and insightful approach?

: It’s very difficult again at the macro level you have to think about the way in which we we fund healthcare as is fairly obvious from my accent on British originally. And so I have a very positive experience of single payer healthcare and where we see single payer health care working within the U.S. system which it does and we’ve got a couple of very, very good examples of single payer systems Kaiser Permanente is probably the biggest commercial single payer system that exists only in single payer in the context that they may not only manage the money like all of the insurance companies but they also employ the physicians they and the hospitals and so on and so forth. I mean they’re even setting up their own medical school so they are a single payer system. They get really good results and they do that by having the beneficial feedback loop of looking at the data good not only looking at it from a financial perspective looking at it from a patient outcomes perspective and that feeds back into procedures and processes across the board whether it be using checklists or training processes or team protocols at the individual hospital unit level. They identify ways in which they can beneficially manage patients and then quantify that that turns into incentives that turns into measurement protocols and the whole thing becomes this large snowball because the continuously looking for ways of improving the process because they’ve got the incentives to do it because they are a single payer system where you’ve got individual physicians who are coming under increasing pressure from reimbursement that forces them to think in terms of spending less and less time with their patients more and more time thinking about how do I maximize my my reimbursable time. We end up in the process where we’re doing too many tests because there’s an incentive to do tests. We are probably treating too often because there’s an incentive to treat were not following enough because there isn’t an incentive to follow up on it being very broad and there are lots of examples of ways in which there are all sorts of really good things going on in the system. Broadly speaking we’ve got an incentive system that is built around physicians and hospitals doing stuff because they get reimbursed for the stuff that they do.

: Right.

: When we all know that there will be huge benefit from actually doing nothing. The problem is how do you get people to pay other people for doing nothing.

: That’s the nature of the beast.

: It is it’s the nature of the beast. So you end up with these misaligned incentives. That’s something that I’m always looking for whenever we work with hospital groups or with patient advocacy groups. We’re always looking for areas where we can properly align the incentives as opposed to the current broadly misaligned incentive.

: Now you bring up some great points Simon and here’s a thought. What about approaching payers. Right. Because I think employers are also their own insurance providers. They’re interested in aligning and ensuring that their patient populations are being treated well and it’s in their best interest to keep them healthy. Have you guys approached employers in this space?

: We have and where we get the positive outcome generated motivation. And if I can use that phrase There’s a very high level of acceptance of the ideas. You’re absolutely right. The large employers who are interested about genuinely interested in both the health benefits for their employees and their families as well as of course the financial benefits for the corporation. Very interested in this whole approach. And there are some super examples of companies that run really effective systems that do have an impact. The problem that we have from a system one perspective of course is that although employer based insurance is still a huge part of the market the vast majority of the employers are too small to be able to have their own healthcare unit working centrally doing the research doing the assessments and so on and so forth and then not in a position to be able to to fund additional research outside that. So again there’s a there’s a complex limitation there as well.

: Makes a lot of sense. I was just curious about what that look like sounds like you guys have gone down that path and seems like maybe not not the right amount of traction because of the capabilities that the employer has.

: I don’t think there’s an area in healthcare at the moment where isn’t some interest in a process of improving the way in which we manage healthcare the way in which we manage patience the way in which we we strike out with the objective of achieving better outcomes. Everyone’s looking for that. But all the different places that you look they’ve all got their own constraints that in many many cases prevent them getting to where they really need to get.

: For sure. So what would you say. Simon is a time when you had a setback. I feel like we learned more from our setbacks than our victories. What did you learn from that setback that you had?

: Oh basically there’s no such thing as an irrelevant variable. There are variables that do and don’t affect the outcome that you’re looking at. Just about everything is at some point in the in the equation going to turn out to be relevant and this specific example I thought of was that there was a situation where I was running a business development project for a client and we’d gone through thorough analysis of the market products all the players. We got a strong recommendation and they rejected it because there was some critical internal issues that had been considered but they had been determined by the team as not relevant to the project. The problem was that there were other people higher up who consider them to be important and relevant to the project and so the proposal got rejected. There was nothing wrong with the proposal it was the way in which we managed the process that was wrong and essentially the thing that that taught me more than anything else was make sure that you’ve asked all the questions at your briefing and don’t make any assumptions about what you’ve been briefed. If there’s a gap there’s any sort of perception of a gap in what you think you’ve been briefed. Go back and confirm because there’s a good chance that there’s a bear trap there and if you miss a bear trap you could be in trouble.

: That’s a great call. Simon ask your questions. Make sure you definitely don’t leave any bear traps uncovered. The expertise here being shared by Simon from Galileo Analytics. It’s crucial folks so definitely keep yourself tuned into this episode. Now tell me about Galileo thermometer?

: Oh that’s a product. The idea is very simple. We created an analytical approach that we call Galileo Cosmos and when we apply that to data sets, we’re able to do some analyses really very quickly very much more quickly than traditional methods. So what we did was we said in the business development world we very frequently running up against extremely short deadlines, it’s possible to do a much more detailed appraisal of the data prior to making your Bidi decision. If you use a system that combines good quality data with fast and detailed analytics and that’s the idea behind thermometer.

: Very cool. So listeners if you’re on the provider side or the business side, we’re looking at some pretty advanced ways to analyze your number one be it variability if you’re in the clinical space or if you’re simply a company looking to vet out what you’re doing to provide value to the market rather than sinking millions of dollars in, maybe worth a Galileo thermometer on your idea where they take a look at demographic’s psychographics. diagnoses, treatments et cetera. And it’s a fascinating way to get short term results on your idea and decide whether or not it’s something worthwhile to pursue or not. Super fascinating things that you guys are doing there. SIMON What would you say an exciting project or focus that you you’re working on today?

: A couple of really interesting things going on at the moment but I’m not allowed to talk about them publicly so I’ll talk generally. The red space is one that’s a lot of interest around the industry at the moment particularly with all from drug sites as being something that people are seeking out because it has significant benefits. But in the process by definition you’ve got a disease that has relatively few patients. And so one of the major questions that comes up is how do we find those patients in order to analyze them and what we found, again using Cosmos very efficiently is that if you have a large claims or medical record dataset probability is that you’ll find some of these patients as well because if you go to a disease that might be a subset of depression for example if you’ve got a dataset that covers patients with depression then you’ve almost certainly got patients with your subset. And what we’re able to do is to find those patients very specifically and then analyze them in the context of not just the subset of patients themselves but also in the context of other patients who are quite like them but don’t actually have the rare disease that you’re particularly interested in. So you can get a good picture of the way in which those patients are managed if they’re being managed at all what the opportunity looks like. But also what the opportunity just immediately around looks like which can make a big difference when it comes to the way in which you communicate to physicians because frequently with these diseases they are conditions that physicians are very very unaware of. And if you can describe the patient these patients look very much like one of these other patients but they’re not quite. And the reason of the different is because of this this this these particular characteristics. You can help the communication which helps the physicians to understand what it is that they’re looking for because the rare condition that you’re dealing with is something that is rare some by definition. Most physicians haven’t seen very many of.

: That’s fascinating Simon. And listeners one of the key insights that Mr. Fitall is offering us here is that oftentimes we don’t look at the missing pieces of information. You have certain data sets and you assume that maybe this isn’t it. The reality is that maybe it is what you’re looking for and the capabilities that Simon and his team over at Galileo Analytics have put together. They really offer you the ability to look beyond the what would be apparent. And so Simon this is really great. I think you guys are doing some fantastic work to help improve outcomes and I’m excited to see where your new projects take you. It’s definitely exciting work.

: Yeah we were enjoying it. In another area that we’re getting involved in as you mentioned in my bio The Interprofessional Healthcare Workforce Institute. What we’re looking at there is ways in which we can improve the quality of the workforce in healthcare beyond the traditional training lab technicians for example. They are very well trained to be lab technicians but they also need an understanding of data analysis. Now they don’t need to be data scientists but they do need to have a good understanding of the data that they’re dealing with on a day to day basis. So one of the things that the I H W I is looking at is internationally recognized certification programs that expand the professional training of individuals in healthcare. So that’s another area that we’ll be getting involved in which is fascinating.

: It really is. It really is folks if you have any curiosity about the things that we’re discussing just go to galileoanalytics.com you know fine. Now the things that Simon and his team are working on to provide that insight that is certainly required in healthcare to take the next steps to get the results that we have gotten before and improve outcomes. David getting close to the end here. We’ve got some lightning round questions and a book that you recommend to the listeners. This is what I’d call the 101 of Simon and so how do you make analytics work for you and healthcare. So here are the four questions for you. Lightning round style. What’s the best way to improve healthcare outcomes?

: True sharing of data are across all disciplines and locations.

: What’s the biggest mistake or pitfall to avoid?

: Falling for the latest fad-old buzzword at the moment. It’s artificial intelligence and machine learning.

: I love it. I love it, straight to the points.

: Three years ago it was big data.

: Yeah yeah I love it. How do you stay relevant as an organization despite constant change?

: Well I think you just have to treat change as the only constant. It’s the only thing that never changes is the fact that we always have changed. If you accept that and build that into your thinking then you have a better chance of coming out the other side.

: Wise words. What’s one area of focus should drive everything in a health organization?

: From our perspective quite simply yes. Creating analytical capabilities that genuinely affect results.

: Fantastic. And what would you say your all time favorite book is?

: This is a good one. You very kindly sent this through. I was thinking of things like thriving on chaos by Tom Peters and the creative gap on the Joro and books like that kiss or shake hands is a terrific book on international cultures. But I ended up coming back all the time to a book that I read many many times and it’s all about how we treat each other and how we think about the world rather than a specific business thing. And funnily enough it’s Winnie the Pooh.

: Really. Yeah. All right now is there one particular book. Because I’ve seen many books on Winnie the Pooh out there.

: Yeah. The best one. There’s an anthology. Basically there are two books one is cool Winnie the Pooh and the other one is called The house in Pooh’s Corner and they’re based on this very simple philosophy of a relatively simplistic way of looking at the world but actually what you derive from it is the kind of understanding of the way in which personal relationships should be managed in order to essentially foster the kind relationships that can lead to success and in health care the one thing that’s true of healthcare more than anything else is that it is both local and personal. The only person who truly cares about my health is me and the same applies to everybody. But when I’m dealing with I’m dealing with a CEO of a big pharma company we’re talking about drugs to treat tens of thousands hundreds millions of people and each one of those individuals is an individual. And if we can keep that philosophy in the back of our minds I believe we end up making better decisions.

: Outstanding. What a great point and an off the beaten path recommendation on the book. I really appreciate that Simon.

: It’s just one of the things that I’d love to do is reading stuff that isn’t business related because everything I read you end up with thinking about when I like reading books some physics for example and it just helps you broaden the way in which you’re thinking about stuff and it allows your subconscious to be working on the things that you have to work on.

: What a great message listeners for the show notes the transcript link to the things that we’ve discussed just go to outcomerocket.health/galileo and you’ll be able to find all the things that we’ve talked about today. Simon, I wish we had more time to chat but I’d love if you could just share a closing thought with the listeners and then the best place where they could get in touch with you.

: Well take the the last one first. The easiest way to get hold of me is simon.fitall@galileoanalytics.com. And I’m pretty good at picking up most of those e-mails. I’m also on LinkedIn as you’d imagine so please connect. No, I think my closing thought, I appreciate the invitation to come on I’ve enjoyed it very much indeed. And it’s actually made me think about some things I don’t normally think about. Point I was making just now about the subconscious is the ability of the brain to work on an issue without consciously thinking about it is something I think that’s very important. It allows me to take a break when things aren’t working properly. I’ll take a break. Go for a walk, go get a coffee. Don’t even think about the work because the work will catch up with you and if you force it you end up forcing the thinking which frequently are more frequently and in my experience ends up with a bad decision.

: What a great call out there and as leaders that want to affect change we tend to take the opposite end of that and focus even more. And I think Simon’s words of wisdom here will definitely do us well. So do as Simon says. Simon, this has been a pleasure my friend. I really enjoyed our time together and I just want to say thank you so much for spending time with us.

: It’s my great pleasure. Thank you.

Thanks tuning in to the outcomes rocket podcast. If you want the show notes, inspiration, transcripts, and everything that we talked about on this episode just go to outcomesrocket.health. And again don’t forget to check out the amazing healthcare thinkathon where we could get together to form the blueprint for the future of healthcare. You can find more information on that and how to get involved in our theme which is implementation is innovation. Just go to outcomesrocket.health/conference that’s outcomesrocket.health/conference and be one of the 200 that will participate. Looking forward to seeing you there.

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