About the product
Egrist is a software product that draws on a database of 1.5 million clinician-based risk judgements from psychiatrists, psychologists and mental health nurses, to assess and manage risks associated with mental health problems. On a scale of 0 to 10, it predicts the suicide risk judgement a clinician would make within plus or minus one, with an accuracy of 80%.
Dr Fif Buckingham, CEO and director of Egrist. Credit: Ann Adams
Egrist was developed by researchers at Aston University, led by Dr Christopher (Fif) Buckingham, Reader in Computer Science and director of spin-off company Egrist Ltd. The Economic and Social Research Council (ESRC) provided critical support through a grant investigating health inequalities, which enabled Egrist to continue developing and improving its software.
Below Dr Buckingham talks about his journey from academia to commercialisation.
Research origins
“I spent six years as a theatre porter at Southampton General Hospital, where I was an elected representative of the National Union of Public Employees, now UNISON. While I did not train or work directly in the mental health field, my first degree was in psychology. My trade union representation required understanding the mental health stresses that cause problems at work.
I specialise in building decision support systems linking mathematical analysis of large data sets with the psychological processes humans naturally use to understand their world. I developed the GRiST cloud service, which detects and manages mental health-related risks.”
Addressing the issues
“More than 25% of the 6,000 annual UK suicides present to mental health services shortly before they die. Egrist addresses the problems mental health practitioners have with documenting and evaluating risks accurately.
We use its database of 1.5 million risk judgements to determine the challenges associated with assessments and provide advice on the most critical issues to address to reduce the risks.”
Starting commercialisation
“My research aimed to develop a decision-support system based on mental health practitioners’ knowledge and reasoning processes. The idea was to share the expertise with people without mental health training, but it turned out that secondary care mental health trusts were very interested in the product.
At first, we let trusts use the software for free as part of our research funding. Yet over time, it became clear that managing the system needed a steady source of income.
First, we issued invitations for ‘unrestricted research contributions’, where the trusts provided a grant for GRiST research, enabling them to use the software. These grants had no formal time limit, so we started issuing annual licences that specified the time covered. Yet, there needed to be more licencing agreements to sustain the software support.
Eventually, the problems of keeping developers in post for GRiST within the university setting, with its multitude of other research, teaching, and administrative duties, brought the focus on taking GRiST into a more financially secure environment. And so, we began commercialisation.”
Becoming an independent company
“The first step was providing annual licences, which were still issued and delivered within the university. So, we started looking for grants to help commercialise and engage more with the university’s technology transfer office.
In 2016, we won the European Institute of Innovation and Technology (EIT) Health Knowledge and Innovation Community funding. The commercial key performance indicators of the EIT Health grant led to the university’s technology transfer office establishing Egrist Ltd.
I set up a bank account so that licence fees were paid into this account rather than the university’s research one for GRiST. However, we were still bridging commercial and academic environments. This halfway house was uncomfortable but necessary for keeping GRiST’s finances above water.
It changed when we obtained two Innovation to Commercialisation of University Research (ICURe) grants from Innovate UK, and significant Innovate UK follow-up funding. What made this award of £297,107 unique was that it went to Egrist Ltd, meaning finally we were entirely separate from the university. Egrist was born and fully independent.”
The business model
“Egrist will always be free for self-assessments. People wanting to use it for professional services will need to pay.
We have two funding models:
- with our present model, we issue annual organisational licences based on the number of practitioners in the organisation whose jobs require making risk assessments
- the second model will be a partnership model with patient record companies. Patient record companies are organisations that specialise in providing software solutions and systems for managing and storing electronic patient records
The new digital platform allows for costing each client independently of the others, with their payment relating directly to usage. They pay annually, which covers all upgrades rolled out in that period.
We built Egrist to integrate with other patient record systems. As we go forwards, we want to partner with other companies so they market and sell our services as part of their offer. We’ll agree on a proportion of each client’s contract coming to Egrist.”
Plans for continuing commercialisation
“Our continuing commercialisation plans include the following:
- completing a rebuild of Egrist technology, where the machine learning (ML) functionality is a core operation
- pursuing partnerships with the new Egrist software because of its easier integration with other patient systems
- long term, we are expanding into sectors outside mental health. For example, we have recently submitted a proposal for predicting the condition of pre-stressed concrete water pipes building on the same technologies
Our three-year vision includes supplying mental health risk and safety decision support to most UK mental health services within secondary care, primary care and the community.”
Challenges to commercialisation
“Separating research and development from commercialisation was difficult. Nearly all GRiST funding was through grants with very different goals than developing and selling the software.
One of the primary motivations for commercialising GRiST was to help balance activities with my full-time academic role. Managing interactions with organisations using GRiST alongside all the university teaching, research, and administration was challenging.
The only allowance was for work on research grants, and there needed to be more time to keep GRiST going. It had to be on top of the other jobs, and became a severe strain.
Helped by ESRC funding
“The ESRC Health Disparities and Inequalities grant was beneficial for many reasons. The UK partnership received £254,000 in 2010, with £52,400 for Aston University. The grant enabled us to explore assessment and management decision-making processes involved in depression, from both the clinician and patient perspectives.
The ESRC grant was all about the decision-making flow, and we incorporated this directly within the new Egrist technology. We now use an ‘event store’ database where all answers are stored in the order and with the time they were given.
ESRC funding has helped us initiate and promote this new approach, and we are very keen to build on it as the new Egrist data accumulates.”
Last updated: 4 September 2023