 Hi everybody, welcome back to London. You're watching theCUBE and we have a special coverage here of the pre-day at AWS headquarters in London. I'm Dave Vellante and theCUBE, we go out to the events, we extract the signal from the noise. Alistair Allen is here, he's the Chief Technical Officer of Healthcare Canos software. It's a Belfast based company, publicly traded company. Alistair, welcome to theCUBE. Great to see you, thanks for coming on. You were downstairs earlier addressing the audience, we're going to talk about that, but first of all, tell us about Canos. So Canos, Belfast based company, formed in the late eighties, a spin out of Queens University in Belfast. We've grown to now over 1300 people and we build digital technology to help people work faster, smarter and better. There's two things we do, we provide digital services, we've spoke services for public and private sector organizations across the world and we provide digital platforms for workday customers and also for healthcare organizations. So when you say digital platforms, what exactly do you mean by that? Tell our audience. So our digital platforms in healthcare is something that we can talk about. So platforms to enable both hospitals to digitize their workflows and also regions, so CCGs, STPs within the NHS to bring information together using a platform normalizing that data and making it available to clinicians and patients. And this is, your flagship product is called Evolve, correct, and you're one of the sort of founders or inventors of Evolve. Tell us more about Evolve. So Evolve originated just over 10 years ago, our first customer was Ipswich Hospital and Ipswich had a big problem with paper, the large medical records library and they asked us to come in and help them digitize that and make it available and easy to view accessible format for their clinicians. So tell me more about that. So you digitize it, you take all this mounds of paper and then what does that do other than reduce the mounds of paper? Does it make it searchable or is it? Yeah, so we index, yeah we index the content, we apply metadata whenever we capture it, trying to make it accessible for clinicians. I think when you digitize paper, the one good thing paper had going for it was, you could pick it up and it was tactile. So we've done a lot of work to try and make it mobile, make it accessible, make it searchable. And increasingly now with some of the services that AWS provide, we're able to look at taking that even further and getting more information out of that content. Add some color to that. So how has the AWS cloud affected your ability to deliver these capabilities to your customers? Well, I think the breadth and depth of services that AWS provide enables us to be able to innovate quickly, to use services like I've mentioned like Comprehend Medical that take the heavy lifting away from us and helps us focus on delivering better applications for our customers. So part of what you do is you architected the software and it's running on the cloud. Can you talk a little bit about the architecture? What you guys have built? I presumably, the cloud allows you to scale and take advantage of more innovations, but discuss the architecture if you would. So the product that I originally talked about in 2009 and about four years ago in 2015, we decided to re-platform for the cloud. And that was in response to a number of problems that we were seeing in the market. I moved to patient-centric care. I drive to try and standardize care away from the variable nature that was there. And also to get away from closed silos of information. We decided at that point to create our platform natively in the cloud and using the services of Amazon web services. So we created a microservices-based architecture that runs in a multi-tenant cloud native way within AWS that allows us to adopt disciplines like continuous delivery and cultures like DevOps. Being able to release value quickly and often. So was it a total rewrite of the platform? Yes. So we started again from scratch and we developed that using the modern cloud services. And we've used that then for all our use cases as well. So we've moved beyond just settings within a hospital and been able to take that beyond the walls of a hospital out into the community, into primary care, mental health, and delivering solutions like that across regions within the NHS to join up information where before clinicians would simply not have had access to those. In the sense that you're migrating your existing install-based to the cloud-based platform, as I presume it's a SaaS-based platform, is that right? So evolved integrated care is the platform, it's a SaaS-based platform. So we run it, we monitor it, we maintain it, and we deliver that as a service to our customers. And so your existing customers now have an opportunity to migrate and how does that all work? Yeah, so we're talking to our existing customers about how they can leverage the cloud-based platform and the breadth of different services that it provides. We very much see an opportunity for helping to digitize a hospital. So how do you optimize the flow of patients through a hospital? Making sure that clinicians have access to the information. Many of our customers have hundreds of applications, information spread across their estate, bringing that together and orchestrating the workflow for particular pathways or particular conditions. Plus they have to manage their own infrastructure, I presume. Absolutely, and they want, like we want to build applications quickly, they want to focus on delivering healthcare. They don't want to focus on managing tin and server rooms within their hospitals. So our move to the cloud really came about because of our customers telling us that they're struggling to manage this infrastructure. They wanted us to take some of that burden away from them and to help them with some of their security challenges, availability challenges. Quite often their local infrastructure was not very resilient. And by moving to AWS, we were able to use native cloud services to address many of those challenges. So you've taken away that heavy lifting for them. AWS takes it away for you in large regard as well. Well, your engineers obviously can program the infrastructure but how have you seen the customers that have moved and taken advantage of this? What has it done for their business specifically? What's the impact? So what I think it frees up people within their organization to scale up in other areas, to do other things. It frees up physical space as well in many cases. It takes away risk and we've all heard of some of the recent security incidents. WannaCry was a huge thing in the NHS not so long ago. Coming around from just simple things like not patching servers and workstations. So by taking on that responsibility, we're freeing up those hospital systems to focus on what they do best. How do they do that? Do they retrain folks? What's that been like? Is it, was it, I presume it wasn't frictionless but it's an opportunity for people to advance their careers of you. Do you have any visibility on how your customers have handled that? To be honest, not a huge amount, not a huge amount. It has, I would agree, there has been some friction there. It's not always an easy journey because there's a whole mindset change of what people used to do before and the types of activity that they'll do tomorrow. And it's something that our customers are still on a journey on. So we're quite early on in that process. But I would say to folks in the IT community, if your expertise is managing storage arrays, there's probably a better future for you if you can move up the stack and learn more about applications, data, machine intelligence and what. Absolutely, higher up the value chain and getting closer to the user, closer to the customer. I mean, that's where the difference is. And it's particularly in healthcare, right? You're trying to balance the cost of healthcare. Everybody's aware of the rising cost of healthcare with the patient outcomes and technology is a way to address that problem, isn't it? Absolutely, and I think never before, I think it's just a great time to work in health IT. You know, we've now got access to some fantastic services. The rise of artificial intelligence and machine learning has never before been so available and really helping organizations such as ourselves to really solve those problems that our customers have and introduce those efficiencies and ultimately better patient outcomes. So how are you using the data that lives in Evolve? I presume you're looking at applying our artificial intelligence and the like. Talk about that, but also how do you ensure security, privacy, et cetera? So a couple of things on data. I think one of the things we've done recently is the adoption of the FIRE standard within healthcare and all the data that we aggregate from the various clinical systems. We normalize that down into a single FIRE data profile and that really helps us then have a common data model that our application can use, but that's only the start. That creates the potential then to use that for secondary usage such as population health, data analytics and ultimately machine learning. And we're looking at a number of areas in machine learning. I think there are some ethical challenges there to be aware of. And we've started with a recent examples of understanding how we could use machine learning to try and get that structured data out of the documents. That's something that we're working on with the AWS team at the minute to leverage a lot of that scanned content that we have in Evolve and being able to create the structured outcome. Really to make it easier for clinicians to find information within the medical record. So with AWS re-invent last fall, SageMaker was of course buzzing. Is that something that you're looking at? It's something, so we haven't used it in Evolve so far, but within KENOS we have an AI practice. And we have a group of guys that are focused on the AI capability evaluating those tools, working with AWS and helping us understand how we can use that technology to solve the problems of our customers. Yeah, it's early days. So you talk about helping solve the problems of the customers. Summarize for us that the key problems that you see machine intelligence, AI solving. I think there's probably different categories of how you could use it. There's the diagnostic sort of use case where you could use AI to help process imagery, to help with the diagnostic process. There's been able to add personalization to whether that be to patients or to clinicians helping to provide insight into whatever the use case may be. And all the use cases similar to that. Last word. So you were addressing the pre-day healthcare forum that's going on here at AWS. What's that like? What's going on downstairs? What did you tell the audience? Yeah, great there. So we had a group of healthcare professionals across the NHS in Ireland. Very interesting group. We spoke this morning, I spoke with our customer, Gloucestershire CCG, and we talked about the shared care record solution that we've delivered into Gloucester. So that's bringing information together for over 600,000 patients across the region. And providing information in a single joined up view that was not available before. So great feedback, great interaction, lots of questions afterwards. So looking forward to going back down and selling some more to the grip. Actually, hard to do that without the cloud, I would imagine. You know, you accommodate all 600,000 customers, right? Not possible. Alistair, thanks so much for coming on theCUBE. Thanks, Dave. Appreciate it. All right, thanks for watching everybody. Keep it right there. We'll be back with our next guest. You're watching theCUBE from AWS headquarters in London. We'll be right back.