Medical imaging data, such as X-rays, MRIs, and CT scans, are essential tools in diagnosing and treating patients. Proper storage and secure acces to these diagnostic data ensures healthcare providers have access to comprehensive patient histories. This leads to better diagnosis and more effective treatment plans. Additionally, proper storage reduces the risk of data loss or corruption, which means patients do not need to undergo unnecessary repeat imaging, reducing their exposure to additional radiation or stress.
Moreover, proper storage helps healthcare providers comply with legal and regulatory requirements, such as the Health Insurance Portability and Accountability Act (HIPAA) in the U.S. Efficient storage systems also facilitate the sharing of medical imaging data among different healthcare providers and specialists, improving collaboration and coordination in patient care. Imaging data is also a valuable resource for medical research and education. Researchers can use historical data to study disease patterns, while medical students can learn from real-world examples and nowadays provides access to large sets of curated dat for AI development and machine learning.
The Agora Care platform (agoracare.ch ) developed by a multidisciplinary team in Switzerland offers a secure and cost-effective solution for patients for long-term storage and easy access to patients’ medical imaging data. It aims to shift the paradigm of data ownership by giving patients direct access to their imaging records and allowing them to store and share their data with healthcare providers. Agora Care also aims to create a large database for medical research and clinical trials, encouraging patients to contribute to medical research and benefit from innovative treatments.
This platform, developed by Osman Ratib and Joël Spaltenstein, founders of the company, is a unique solution that finally helps resolve a chronic problem in medicine due to a lack of communication and access to the patient’s records. Medicine has always worked in “silos” trying to keep the patients captive in a closed healthcare system. This is even more prominent in the competition between academic institutions and private healthcare networks.
“After decades of trying to develop ”open” solutions to the problem through scientific communities, research grants and European funds, I failed to create a universal platform like Agora Care that could be used by everyone. This motivated me to create my own startup to develop a unique web-based and highly secure “bank” of medical data allowing every patient to retrieve, store and share their personal data,” says Osman Ratib as he explains the motivation behind establishing the company.
The Pioneering Leader
Before starting his entrepreneurial journey, Osman served as a professor at the University Hospital of Geneva where he was chairman of Radiology for over 10 years, and before that he was vice-chair of Radiology Department at UCLA in Los Angeles for about 8 years. Having dedicated his career to medical imaging technologies, he also invested a large part of his efforts and research in the development of computer platforms for the management and analysis of medical images.
Osman started this new project of the Agora Care platform for patients with his team three years ago and they have implemented and tested it in several centers in Switzerland (recruiting over 12’000 patients and >20 million images so far). The platform is developed with his partner and cofounder Joël Spaltenstein, who is also an MD and worked with him on numerous med IT projects in the last 15 or 20 years. An example is their popular Open-Source platform OSIRIX which Osman started when he was at UCLA (https://en.wikipedia.org/wiki/OsiriX), and the data sharing platform KHEOPS (www.kheops.online), now used at many academic institutions in Switzerland and around the world.
Overcoming Initial Hurdles
After a long academic career, managing large departments and contributing to very large development projects such as the construction of flagship hospitals (like the Ronald Regan Hospital at UCLA) Osman acquired enough expertise and knowledge of how the healthcare system has evolved today and the importance of state-of-the art medIT infrastructures supporting the growing challenges of healtcare today. However, he did not have the skills and tools to launch a company and succeed in the very competitive field of fundraising and marketing strategy in a very challenging field of MedTech. To acquire these skills, he had to go back to classes and get appropriate training but most importantly he was able to rely on world-class experts and advisors to help him launch his company and succeed.
The key to Agora’s success resides in the excellence and the skills of Osman’s team of software engineers and data analysis experts who followed him in this adventure after years of experience in developing medical software in the field of medical imaging. The platform is built on decades of expertise acquired by members of the team and a long track of success in developing Open-Source software platforms that are used worldwide. This unique multidisciplinary expertise of the group allowed them to develop innovative software platform that exceeds by far any existing system on the market today.
“It is well designed to adapt to the patients and the medical community providing the easiest and simplest user interface combined with the fastest “streaming” system for accessing very large datasets of medical imaging data in seconds compared to traditional systems that will require minutes to retrieve a full set of images of large examination of MRI, CT and nuclear medicine studies,” says Osman.
Staying Aware and Ahead of Technological Advancements
Agora Care, in essence, is at the top of digital technologies and web-based technical infrastructures. It has adopted the latest web technologies also known in the public as “Web 3.0” which differs from earlier web concepts by incorporating concepts such as decentralization, blockchain technologies, and token-based data sharing. The technology adopted and developed for the platform focuses on the ability to manage very large quantities of data in the most efficient and rapid way. The design of the interactive user interface that adapts to all existing platforms such as laptops, tablets and smartphones is unique and was designed to provide a unique user experience for a wide range of users that are not necessarily computer savvy.
In this competitive field, keeping up with the latest technologies constantly seeking innovations and fostering creativity is a key factor of Agora’s competitiveness and success. Osman and his team have been very active in the field of medical imaging for a long time and have connections with the scientific community in the domain of medical imaging as well as close links to the industry. With the participation in large international meetings and conferences, they keep up to date on all new developments in their field. Close collaboration with industry and other startup companies allows them to better adapt to the most recent trends and provide the best solutions using the most up-to-date technologies and tools.
Ensuring Security and Privacy
Data security and patient confidentiality are of the highest importance in the project. Joël, Agora’s CTO is a well-recognized expert in the field and an international member of several communities that are active in developing new strategies to ensure the best data protection. After two years of certification procedures and audits, Agora completed the ISO27001 certification, which is the highest internationally recognized standard to enforce information security. The standard was created and maintained jointly by the International Organization for Standardization (ISO) and the International Electrotechnical Commission (IEC).
“We also rely on a highly secured cloud established in Switzerland, Exoscale is the leading Swiss cloud hosting platform, totally independent from GAFAM solutions that are not compliant with Swiss regulations that require sensitive patient data to be hosted in a secure infrastructure located in Switzerland,” shares Osman.
Medical Imaging – The Evolving Industry
The field of medical imaging is probably the most rapidly growing field of medicine with the constant developments of new imaging techniques allowing us to go beyond the traditional anatomic pictures of the body organs into their biological and metabolic function down to the cell level. Functional imaging and molecular imaging are becoming key in the diagnosis and follow-up of treatments in all domains of medicine. The rapid development of AI tools that can assist in analyzing these images is becoming instrumental in all pathways of patient management.
Agora Care has a huge potential to become a key component of the daily management of medical images in medical practice. Medical practice as well as therapeutic procedures rely heavily today on some kind of imaging procedures. Agora Care platform solves the problem of access to imaging data anywhere anytime when needed for patient management. In its concept, data must follow the patient all along his or her medical journey.
In the Offing
The goal of Agora Care was to provide patients with a simple and secure way to retrieve, store and share their medical imaging data. It is now evolving as a platform that can help care providers and large medical networks to better manage patient data and take appropriate actions and treatments. It also significantly reduces the number of duplicates and unnecessary radiological examines that are often repeated due to lack of access to prior examinations.
Agora Care is now initiating projects with healthcare institutions as well as imaging centers to adopt the platform as a means of data communication replacing existing costly point-to-point communication systems. Agora Care provides universal interoperability through its ability to connect to any existing clinical and radiology systems and has the ability to improve efficiency and reduce the cost of patient care.
Osman and his team are also deploying personalized services to specialists and groups of healthcare practitioners by offering them to sollicit Agora Care to retrieve patients’ data from other institutions before a consult of a treatment. Patients don’t necessarily have to open a personal account but simply approve the transaction. This service of data retrieval dedicated to physicians and healthcare institutions is now adopted for multidisciplinary decision-making staff meetings (such as tumor boards for follow-up of cancer patients) as well as subspecialties such as neurosurgery, orthopaedics and management of neurodegenerative and chronic diseases.
Agra Care is now also pursuing a launch on the US market and several pilot projects with healthcare networks as well as US MedTech companies are in progress. To maintain compliance with differences in regulations and requirement the data of US patients will be hosted on a US cloud network. In collaboration with the Amazon technical team, Agora Care was successfully ported on Amazons’s AWS Healthlake and demonstrated at the international RSNA radiology conference in Chicago in December 2023.
An Empowering Vision
Agora Care’s long-term objective is to become the host and provider of “Real-World Data” (RWD) for research and AI development by soliciting patients to participate in these programs by sharing their data. In its model, patients are informed of any use of their data and must consent to the program that uses the data in any way. This is different from large collections of anonymized data that are now available on the market for research without any link to the patients and their medical context.
Osman sees Agora Care as the first RWD provider with a “link” to the patient. With new regulations about the necessity to provide proof of the origin of the data for any AI tool, this can become a competitive edge of the concept. Agora Care also provides all the necessary software tools for a “pipeline of image analysis” based on a set of open-source platforms for data curation that it developed over the years.
“Besides, we have the ability to promote ongoing research programs and inform our patients of the opportunity to participate in selected programs and benefit from cutting-edge and innovative technologies and treatments,” concludes Osman.
Quote: “Empowering patients and accelerating research”
