>>Hello. I'm Professor Toru Suzuki Cherif cardiovascular medicine on associate dean of the College of Life Sciences at the University of Leicester in the United Kingdom, where I'm also director of the Lester Life Sciences accelerator. I'm also honorary consultant cardiologist within our university hospitals. It's part of the national health system NHS Trust. Today, I'd like to talk to you about our Lester Clinical Data Science Initiative. Now brief background on Lester. It's university in hospitals. Lester is in the center of England. The national health system is divided depending on the countries. The United Kingdom, which is comprised of, uh, England, Scotland to the north, whales to the west and Northern Ireland is another part in a different island. But national health system of England is what will be predominantly be discussed. Today has a history of about 70 years now, owing to the fact that we're basically in the center of England. Although this is only about one hour north of London, we have a catchment of about 100 miles, which takes us from the eastern coast of England, bordering with Birmingham to the west north just south of Liverpool, Manchester and just south to the tip of London. We have one of the busiest national health system trust in the United Kingdom, with a catchment about 100 miles and one million patients a year. Our main hospital, the General Hospital, which is actually called the Royal Infirmary, which can has an accident and emergency, which means Emergency Department is that has one of the busiest emergency departments in the nation. I work at Glen Field Hospital, which is one of the main cardiovascular hospitals of the United Kingdom and Europe. Academically, the Medical School of the University of Leicester is ranked 20th in the world on Lee, behind Cambridge, Oxford Imperial College and University College London. For the UK, this is very research. Waited, uh, ranking is Therefore we are very research focused universities as well for the cardiovascular research groups, with it mainly within Glenn Field Hospital, we are ranked as the 29th Independent research institution in the world which places us. A Suffield waited within our group. As you can see those their top ranked this is regardless of cardiology, include institutes like the Broad Institute and Whitehead Institute. Mitt Welcome Trust Sanger, Howard Hughes Medical Institute, Kemble, Cold Spring Harbor and as a hospital we rank within ah in this field in a relatively competitive manner as well. Therefore, we're very research focused. Hospital is well now to give you the unique selling points of Leicester. We're we're the largest and busiest national health system trust in the United Kingdom, but we also have a very large and stable as well as ethnically diverse population. The population ranges often into three generations, which allows us to do a lot of cohort based studies which allows us for the primary and secondary care cohorts, lot of which are well characterized and focused on genomics. In the past. We also have a biomedical research center focusing on chronic diseases, which is funded by the National Institutes of Health Research, which funds clinical research the hospitals of United Kingdom on we also have a very rich regional life science cluster, including med techs and small and medium sized enterprises. Now for this, the bottom line is that I am the director of the letter site left Sciences accelerator, >>which is tasked with industrial engagement in the local national sectors but not excluding the international sectors as well. Broadly, we have academics and clinicians with interest in health care, which includes science and engineering as well as non clinical researchers. And prior to the cove it outbreak, the government announced the £450 million investment into our university hospitals, which I hope will be going forward now to give you a brief background on where the scientific strategy the United Kingdom lies. Three industrial strategy was brought out a za part of the process which involved exiting the European Union, and part of that was the life science sector deal. And among this, as you will see, there were four grand challenges that were put in place a I and data economy, future of mobility, clean growth and aging society and as a medical research institute. A lot of the focus that we have been transitioning with within my group are projects are focused on using data and analytics using artificial intelligence, but also understanding how chronic diseases evolved as part of the aging society, and therefore we will be able to address these grand challenges for the country. Additionally, the national health system also has its long term plans, which we align to. One of those is digitally enabled care and that this hope you're going mainstream over the next 10 years. And to do this, what is envision will be The clinicians will be able to access and interact with patient records and care plants wherever they are with ready access to decision support and artificial intelligence, and that this will enable predictive techniques, which include linking with clinical genomic as well as other data supports, such as image ing a new medical breakthroughs. There has been what's called the Topol Review that discusses the future of health care in the United Kingdom and preparing the health care workforce for the delivery of the digital future, which clearly discusses in the end that we would be using automated image interpretation. Is using artificial intelligence predictive analytics using artificial intelligence as mentioned in the long term plans. That is part of that. We will also be engaging natural language processing speech recognition. I'm reading the genome amusing. Genomic announced this as well. We are in what is called the Midland's. As I mentioned previously, the Midland's comprised the East Midlands, where we are as Lester, other places such as Nottingham. We're here. The West Midland involves Birmingham, and here is ah collective. We are the Midlands. Here we comprise what is called the Midlands engine on the Midland's engine focuses on transport, accelerating innovation, trading with the world as well as the ultra connected region. And therefore our work will also involve connectivity moving forward. And it's part of that. It's part of our health care plans. We hope to also enable total digital connectivity moving forward and that will allow us to embrace digital data as well as collectivity. These three key words will ah Linkous our health care systems for the future. Now, to give you a vision for the future of medicine vision that there will be a very complex data set that we will need to work on, which will involve genomics Phanom ICS image ing which will called, uh oh mix analysis. But this is just meaning that is, uh complex data sets that we need to work on. This will integrate with our clinical data Platforms are bioinformatics, and we'll also get real time information of physiology through interfaces and wearables. Important for this is that we have computing, uh, processes that will now allow this kind of complex data analysis in real time using artificial intelligence and machine learning based applications to allow visualization Analytics, which could be out, put it through various user interfaces to the clinician and others. One of the characteristics of the United Kingdom is that the NHS is that we embrace data and captured data from when most citizens have been born from the cradle toe when they die to the grave. And it's important that we were able to link this data up to understand the journey of that patient. Over time. When they come to hospital, which is secondary care data, we will get disease data when they go to their primary care general practitioner, we will be able to get early check up data is Paula's follow monitoring monitoring, but also social care data. If this could be linked, allow us to understand how aging and deterioration as well as frailty, uh, encompasses thes patients. And to do this, we have many, many numerous data sets available, including clinical letters, blood tests, more advanced tests, which is genetics and imaging, which we can possibly, um, integrate into a patient journey which will allow us to understand the digital journey of that patient. I have called this the digital twin patient cohort to do a digital simulation of patient health journeys using data integration and analytics. This is a technique that has often been used in industrial manufacturing to understand the maintenance and service points for hardware and instruments. But we would be using this to stratify predict diseases. This'll would also be monitored and refined, using wearables and other types of complex data analysis to allow for, in the end, preemptive intervention to allow paradigm shifting. How we undertake medicine at this time, which is more reactive rather than proactive as infrastructure we are presently working on putting together what's it called the Data Safe haven or trusted research environment? One which with in the clinical environment, the university hospitals and curated and data manner, which allows us to enable data mining off the databases or, I should say, the trusted research environment within the clinical environment. Hopefully, we will then be able to anonymous that to allow ah used by academics and possibly also, uh, partnering industry to do further data mining and tool development, which we could then further field test again using our real world data base of patients that will be continually, uh, updating in our system. In the cardiovascular group, we have what's called the bricks cohort, which means biomedical research. Informatics Center for Cardiovascular Science, which was done, started long time even before I joined, uh, in 2010 which has today almost captured about 10,000 patients arm or who come through to Glenn Field Hospital for various treatments or and even those who have not on. We asked for their consent to their blood for genetics, but also for blood tests, uh, genomics testing, but also image ing as well as other consent. Hable medical information s so far there about 10,000 patients and we've been trying to extract and curate their data accordingly. Again, a za reminder of what the strengths of Leicester are. We have one of the largest and busiest trust with the very large, uh, patient cohort Ah, focused dr at the university, which allows for chronic diseases such as heart disease. I just mentioned our efforts on heart disease, uh which are about 10,000 patients ongoing right now. But we would wish thio include further chronic diseases such as diabetes, respiratory diseases, renal disease and further to understand the multi modality between these diseases so that we can understand how they >>interact as well. Finally, I like to talk about the lesser life science accelerator as well. This is a new project that was funded by >>the U started this January for three years. I'm the director for this and all the groups within the College of Life Sciences that are involved with healthcare but also clinical work are involved. And through this we hope to support innovative industrial partnerships and collaborations in the region, a swells nationally and further on into internationally as well. I realized that today is a talked to um, or business and commercial oriented audience. And we would welcome interest from your companies and partners to come to Leicester toe work with us on, uh, clinical health care data and to drive our agenda forward for this so that we can enable innovative research but also product development in partnership with you moving forward. Thank you for your time.

>>LA from Las Vegas. It's the cube covering AWS reinvent 2019 brought to you by Amazon web services and they don't play along with its ecosystem partners. >>Well, welcome back live in Las Vegas. We're here on the cube. Continue our coverage here of day two of AWS. Raven 2019 in fact, it took me to the last interview on the second day to be paired up with my guy. Still many minutes to what happened is this is the first interview we've done this way. >>John, you know, I've not been out playing golf >>well and I wouldn't mind if I was, it'd be all right Brandon. You know Brandon, you play golf. Brandon Young? I do. I play college golf so, and I have a, you can't see them, but I have some trousers that might match there and prove that I have done a few times. Paint shirt would be, he would very proud granted to VP of alliances to get lab. And where'd you play college golf by the way. I split some time in Oklahoma and down at rice down in Houston. Oh you, yes. Wow. Be a sooner. How back that has some pretty good golfers there. They do. Um, let's first off, let's talk about, um, VP of alliances sure. And get like what do you do? So what does that encompass? What's that all about? Covers a bunch of pieces. Uh, covers all of the big key partnerships with us. >>So that's going to be obviously Amazon, other big cloud providers, a lot of strategic technology partnerships and then all your system integrators, man service providers, resellers, um, and then functionally anything else that comes in. So also we're bringing the open source space. So lead a lot of our open source engagement, uh, uh, in as well. What kind of customer base we're talking about here? I mean for, for you guys, sorry, cause it's pretty significant. It's, um, so in the space we've got roughly to two to 3 million users that use get lab and count on it for building, deploying and securing their code. Uh, and somewhere between a hundred thousand and 200,000 companies, uh, that get loud is, uh, is being used. Now. >>Brennan, you're not dealing with get lab. You're also on the board for the Linux foundation. And you know, we're, we're getting close to 2020. So I even, I saw some people looking back at where open source has come in the last decade. And you know, get, of course is one of the predominant drivers the proliferation of opensource. So maybe tell us a little bit about, you know, what your customers come to. Uh, w you know, why, why get lab is so critical to what, >>sure. Yeah. Because if we look at history, it kind of makes naturally in get lab we're getting, so that was where our, our base was, uh, when we started in 2012, 2013. Um, as it's evolved, so in get continues to be that core piece you need. So whether you're doing get ops infrastructure is code application development, you've got to have state, you've got to store your issues, you've got to take care of that. That's just one Oh one in software development or infrastructure management. Um, so that's got to where we started. And then, you know, a couple of years later, we picked up and did a bunch of stuff in the CIC space. Initially we had them separate, uh, and customers kept saying, God, these might work well together and to the Linux world has always been single tool, very sharp, very narrow. Uh, so we held off on that for a long time. >>Um, finally said, Oh, we're going to give it a go, shift them together. And that's kind of led to where we are now, which is we think of, you know, get lab as a single tool for the entire dev ops life cycle. And that makes it easy for someone to get started to build it, secure it, ship it, all of that from idea to production in the shortest possible time. And so that's kind of how it evolved. And yeah, we've grown up with the open source world ever since. And um, it's an awesome place. All right, so you've got the alliances and we're here at the biggest cloud show there. So help us connect the dots. Get lab AWS. Yeah. Perfect. So if we kind of look back and we go, ah, look at the keynote, right? So Andy talked a whole bunch, front keynote, Goldman Sachs, big talk with Verizon, a lot around the services, new stuff with arm new chips, new, um, a lot of new databases. >>Um, all of that rolled out. Those are services as Amazon looked at it. Our goal, our job is to get those customers onto the Amazon services. We're the tool that helps them develop and deploy those applications. Goldman, huge customer, Verizon, huge customer. So the majority of the keynotes you'd get lab to get to Amazon. So we're that tool that does the application security deployment and um, you know, lets those devs really take advantage of the great services that Amazon delivers. You know, you talk about security is it, is it, um, and obviously it's increased in terms of its importance. We recognize we've, we've seen how vulnerable apps can be and, and these invasion points, is that being reflected in budgets? Are we seeing that? Are people making these kinds of investments or is there still some lip service being paid to it and maybe they need a little more money where their mouth is. >>There's not a shortage of dollars, so I'll be be real straight forward. That is for us, the big growth area is uh, application security in a pipeline. The notion of shift left, um, and it's been, it's actually one of the easier conversations because the CSOs really want to make sure that every piece of code is tested, be it static code, dynamic code, license scanning, all the above. Um, the way they've had to do that and traditionally done it is at the end of a pipeline and they make every dev on happy because they throw it all the way back to the front with the dev. And then I was like, Oh, thank you so much. I did that two weeks ago and now I have to go, why didn't we do it on the front side instead of the back side? You kill the most important thing, which is cycle time, right? >>Cycle time is time from idea to Chimp. So by shifting it left, there's plenty of money and the CSOs love it because just want you to spend it. It's where they spend it. Right. And so now they get all the code tested. The devs love it because they get feedback instead of the CSO saying this is broken. The two old, the second they hit command a couple minutes later, Oh it's broken. They go fix it, make another commit. They're going to move way faster much. Um, so that's really what we get at and yeah, but no short in dollars, the security still the windows, the spend happens, you're saying right on the front side instead of the back shop and try and get full coverage. So a lot of times otherwise if you're trying to do security after someone's developed it, you're not sure. Like are you getting every code, all a piece of code that was developed? Are you getting just a lot of it as you talked about web apps, a lot of it is the focus. Oh the web apps. Cause that's the front end. But intrusion, once it passed the front end, it's a soft interior. You've got to do every single piece of code has to be tested. >>Yeah. It's Brandon. So you know what I've heard, especially from, I mean, you know, my peers in the security industry, you know, security needs to be considered the entire way. Security is everyone's job chair's responsibility. I need to think about it. But the other thing that really has changed for people is you talk about CIC. D I need to move fast. Well hold on. The security team's got to review everything. One of the core principles of dev ops is you want to bake it in the process, you need to get them involved. And then there's DevSecOps which pulls all of these pieces together. So tell, tell us how those trends are going and that, you know, speed and security actually go together not opposed. >>Oh yeah. And because, and it's how you measure the, the speed. Cause I think sometimes the question is all back to what is it from it. It's, it's a life cycle. And if that's what you're measuring, being able to do the security earlier is so much faster because you're not having to iterate, um, later. But, um, it's continues to increase. Devs are getting more and more say that's not gonna change anytime soon. Um, empowering those devs to own the security, uh, empowering those devs through the pipeline to be able to deploy into Lambda, into far gate. They love that. And if you could give that and give the security, the visibility, the dashboarding, the understanding of what just went in, um, what code they're using, what the licenses are, that visibility is huge and that allows you to move fast cause it's trust. >>I mean actually, uh, I love the researchers at Dora, you know, do the annual survey, uh, on dev ops and they said, actually if you are a company that tends to deploy less often, it tends to take you much longer to recover and you're not geared to be able to do it. Uh, you know, my background networking and you think about, you know, security is one of those things like, well wait, I want to keep my things stable and not changing for a while, but that means you're less and less secure cause I need to be on the latest patch. I need to be able to update things there. So, uh, you know, CIC D I think leads to should lead to greater security. Do you have some stats around that for your customer as to, you know, how they measure that? >>We have some pretty good velocity. Um, so Goldman went with us and this is real public is they, they started with us and went from about a two week release cycle down to tens, 20 a hundred times a day. Um, and that, I mean that's a company that does a great job in dev, um, but can also be like smaller companies like wag labs that we talked with earlier and they same kind of thing. They went often from a week down to they were doing, they typically do 20 to 30 deployments a day. And again, it just makes you break the pieces smaller, less likely that you're going to introduce dependencies that break something and all that process builds on each other as the door is stuff. If you haven't read, you've read it obviously, but if the users haven't great place to get started and understand how this works. >>Has testing changed or is testing changing in terms of when you establish the criteria, what you're looking for in terms of I guess you have a lot of new capabilities so you've got to change, I assumed your criteria up front do have a little proper, a little more accurate evaluation is that environment it's changed somewhat. I mean testing in application testing it is pretty specific to every comfy. So tools continue to get better. Um, ways of review have gotten a lot better. So, uh, there's now a lot of capabilities that at the point that you're going to go into deployment, one of the harder pieces is doing, um, your user acceptance testing is like, God, am I going to see the same thing that a user will? Right. And a lot of these have gotten to a point like we have a one click at the end of the deploy, a review app. >>Anyone in the company can look at exactly rebuild everything you're going to bought to deploy. So there's some tools that make it faster. Um, but in terms of what your load balancing in terms of your user acceptance testing, a lot of those principles continue to be pretty girl. Uh, one of the big things we heard from Andy Jassy is talking about transformation and he said you can't just do it incrementally and you need, you know, clear leadership and commitment. We want to hear how, you know, you're hearing about this from your customers. How is get live helping customers along those transformation journeys. Sure. Um, so totally agree that, I mean, it's a cultural piece, uh, without question. I think there's a couple of places, there's the obviously the tool piece and just getting everyone on the same page. And we, we all know this intuitively is we've seen what w when you go from a word doc to a Google doc and everyone can edit the same time, that's transformation goes, you know what everyone's working on, uh, and you're not duplicating effort. >>And that, that's really in many ways that's what get lab is doing is just helping the front end. I, you know, product manager know exactly what's going on in the infrastructure side and you communicate in a similar language. Um, the other piece of that we are working a lot in is because, um, get lamb operates an extremely open culture. So we publish how we run the company in a handbook that's 2,500 pages. We're always updating it. So, uh, we do reviews every time we release, we release every single month for the last 120 months in a row. We go through, here's what the release is going to be. It's on YouTube. Everyone can see it when things go wrong, we publish it. So we have an outage, we will, we have live broadcast, how we get back out from an outage and we publish all of it for someone to understand. >>And so one of the other things, there's a lot of our customers are getting started on that journey. There's one thing for a deck that says, here's what you do for your transformation for your company. That's another thing when you can literally jump in on Monday morning under the get lab call and watch, get lab go through a post-mortem of when we had a small outage. Oh that's what a no blame looks like. Okay, now I understand that, Hey, what, what didn't we release that we could have done better? And those are processes that you can have it on a piece of paper, but it's a different thing when you can walk through that with the company. And it's even better when you're watching the company that's doing the same product, the same tool that you're using. So I mean that's a, that's a cultural decision. >>Yes. I mean it's gotta be right. Yeah. I love the no blame. Right. Cause you're saying instead of finger pointing, great or castigating, you know, we're, we're going to learn from this. And how do you think, what impact does that have on a customer when they see you in real time solving your problems? They know that. They know that if they have a question for us, that we both take it seriously and that we're going to do it in a way that they know when it's going to be resolved. And that doesn't mean that we always deliver at the same time that a customer asks. But that level of transparency breeds both trust. And it also helps a customer quantify what do they want, helps us huge amount of communication because they know what we're prioritizing and they understand why. And that isn't something that is typical to come, but it's always typically very hard unless you're broadcast everything like we do to know, well, why are they making that decision? >>Um, and so that's one of the real big reasons that our customers work with us. That's where we get 10,000 plus additional contributors to get lab as an open source project. And that helps massively of course. So the velocity is because there's no difference between a get labber or the thousand get lappers in 64 countries or any one of the 10,000 contributors or our biggest competitors that regularly make contributions to, uh, our, um, our landscape. So we have a landscape that's, how does dev ops work? Who does stuff well? Hey, have no shame if they delivered something better. I want to know that I make that commit. We will share it with the world that we are not good at that and you are better at it and you know what? We'll get better. Right. It's a winning formula. It's good. It's been working really well. I appreciate the time brand. A good saying. You can love the slacks. Wish we could show them of course. But next time, thanks for having us. All right. You're watching Carvery Cherif AWS reinvent 2019 on the queue.