SAVSNET: Developing the research potential of veterinary health informatics in the UK through growth, partnership and collaboration.

Illness of pets (cats, dogs, rabbits etc.) impacts not just on their welfare, but also on that of humans. Despite this, we often have poor understanding of what makes individual animals unwell, and what makes their owners take them to the vet. One area of research revolutionising such understanding of human illness is "health informatics", where large volumes of electronic patient health records (EHRs) are anonymised and compiled into a "Big data" resource, allowing new research insights and discoveries. Whilst medical informatics has been seen a rapid recent expansion, catalysed by the establishment of a national research network (the Farr Institute), veterinary health informatics remains a relatively unexplored opportunity.
SAVSNET (Small Animal Veterinary Surveillance NETwork; www.savsnet.co.uk) is pioneering such data resources for pets. In just over 2 years, we have collected health records in real-time from diagnostic laboratories (~80,000 tests/day) and 166 veterinary practices (~3000 consultation records/day) from across the UK. This has allowed us to create two large data resources (>900,000 EHRs, >40million test results) that are updated and growing daily. Our novel software allows the attending veterinary surgeon or nurse with a single key stroke to indicate the main reason the animal was seen, and in return, allows the same vets and nurses to analyse their own data. These data are being used to provide freely-accessible disease information and surveillance updates, along with a growing portfolio of new and novel research collaborations including studies on population demographics, preventative health care, antibacterial use, rabbit disease, as well as kidney, respiratory and gastrointestinal diseases. SAVSNET is now recognised as an international leader in this new area of veterinary health informatics research.
The aim of this proposal is to increase the amount of research carried out using SAVSNET data. We will capitalise and build on our strong foundation, maximising the opportunities for these data to inform new research with a wide group of collaborators, all with the intention of improving both animal and human health and wellbeing.
The objectives of this application are to:
1: Enable more laboratories and veterinary practices to contribute data. The resultant increase in data volumes will help ensure our data is representative of the whole of the UK, and allow the study of even rare diseases.
2: Strengthen our databases to ensure they can cope with the large data volumes and growing number of users.
3: Build a web based "one-stop-shop" for researchers (e-Research Portal), to make the data more accessible, easier to understand and increase its use in research and publication.
4: Develop a world leading veterinary health informatics research base through strengthening collaboration with medical health informatics colleagues at the Farr Institute, University of Manchester.
5: Develop and showcase new data analyses tools, cascading these to other users via the SAVSNET e-Research Portal. Text mining, where computers are taught how to extract useful meaning from unstructured writing, will be used to unlock the research potential of the clinical narrative entered by vets and nurses. These tools will be developed in the context of two strategically important research projects; 1) factors associated with use of antibacterials and 2) seasonal tick activity in the context of climate.
6: Diversify data use, developing a business model for future SAVSNET sustainability. With BBSRC support, we will grow our user base and funding from academia and industry, to allow SAVSNET to become self-funding.
At the end of the project, we will have established a sustainable international centre of excellence for veterinary health informatics research, developing innovative software solutions, to answer some of the critical real-world animal and human health problems of the 21st century.

Illness in pet animals impacts both on their welfare, and on that of their owners and the wider public. The Small Animal Veterinary Surveillance NETwork (SAVSNET) is pioneering the use of electronic health records (EHRs) at scale to better understand the real-world of clinical veterinary practice. SAVSNET has assembled a strong coalition of collaborators allowing us to collect UK data in real-time from commercial diagnostic laboratories (~80,000 test results/day) and a sentinel network of 166 veterinary practices (~3000 EHRs/day). We have a mature innovative infrastructure to collect and store these data, and to feedback results to our collaborators, in near real-time. Our use of these data has rapidly grown, supporting education, real-time disease surveillance, and a growing number of nascent research collaborations, with innovative informatics solutions already informing human as well as animal health.
In this proposal, we will consolidate and build on our recent advances to maximise the research potential of these data to the widest scientific community. Our key objectives are to:
1: Increase the statistical power and representativeness of SAVSNET by enabling more laboratories and veterinary practices to contribute data.
2: Future-proof our database for both growing data volumes and increasing numbers of users.
3: Facilitate and enrich data use, research and collaboration through an "e-Research Portal".
4: Develop a world leading veterinary health informatics research base in partnership with Farr@HeRC.
5: Through two research packages (risk factors for antibacterial use and seasonality of tick activity), develop and showcase innovative informatics resources, cascading these to other users.
6: Diversify data use, developing a business model for future sustainability.
We have made rapid progress since our core team was put in place. This gives us confidence we can establish SAVSNET as a world leading resource for research into animal and human health.

The SAVSNET data has appeal and value to end a wide variety of end-users. The benefits and impacts that can be delivered are numerous and the examples highlighted below are intended to illustrate their diversity.

1) Animal health industry. There are estimated 10 million cats and 10 million dogs in the UK with approximately 24%, 17% and 2% of UK households owning a dog, cat or rabbit respectively. This degree of human animal contact has considerable economic, social benefits, as well as occasional negative effects. SAVSNET collects large volumes of data across all health areas, from anal furunculosis to zoonosis, from Afghan hounds to Yorkshire terriers. As such we can impact on all areas of animal health management and research with recent projects on infection, kidney disease, and osteoarthritis.

2) Medical Health informatics. SAVSNET has close links with the Farr Institute through Farr@HeRC (Manchester). SAVSNET data is more accessible for method development and testing than equivalent human health data.

2) Researchers employed by pharmaceutical companies are beginning to recognise the value of SAVSNET data for market research either on specific products, or background animal health data that can inform commercial decisions. Many pharmaceutical companies are multinational and whilst SAVSNET data is currently focussed on UK companion animal populations, there is recognition that the research has commercial benefits worldwide. SAVSNET is becoming recognised as a centre of global excellence for such research, and already realising opportunities for inward investment to the UK.

3) Data providers (practices and laboratories) benefit directly from participation in SAVSNET through access to secure, web-based summaries of the data they have submitted. The portals have been released but need to be regularly updated and refined to ensure the information is useful and relevant. The veterinary profession as a whole will also benefit as SAVSNET will provide data to support evidence-based veterinary medicine and inform clinical decisions.

4) Government has responsibility for disease surveillance in animal populations. SAVSNET will enable cost-effective surveillance of diagnosed diseases or presenting syndromes in companion animals. In addition, the novel methods and tools developed by SAVSNET will be cascaded to farm animal researchers to facilitate alternative, cost-effective surveillance (see APHA LoS).

5) National Health Service and Public Health England (see PHE LoS). Studying zoonotic diseases in pets, risk factors for canine aggression, understanding how and why veterinary surgeons prescribe antibiotics, and identifying associations between disease outbreaks in pets and humans will all have a positive impact on human health. Radford leads the Risk Theme of the National Institute of Health, Research Health Protection Research Unit in Emerging and Zoonotic Infection, and this is already providing opportunities for SAVSNET data to impact human health (e.g. surveying tick removal in pets to develop a warning system to reduce Lyme borreliosis in humans).

6) Charities feature strongly in companion animal care in the UK, helping control stray animals, providing health care to lower income families, providing Assistance Animals, and our funders BSAVA, whose aim is to promote excellence in animal care through teaching and research. We have already helped PDSA change their charitable objectives (see PDSA LoS), and contribute education material to vets through BSAVA.

7) SAVSNET will impact on the general public and wider society by promoting improved health in pets, reducing disease burden, improving quality of veterinary care and improving understanding of the role of the veterinary profession in AMR. Our developing web site (SAVSNET.co.uk) provides one way to achieve this.