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Taming the Technology Beast

ROUNDTABLE

How to use the benefits and solve the challenges technology presents us with.

With moderator NEIL GREENBERG, Editor, Healthcare Sales & Marketing

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And Lead Panelist TIM WHITE Head of Customer Experience Teva Specialty Medicines

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Our panel of experts:

JOSHUA GREENBERG

Director, CapTech Consulting

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DAVID REIM

Chief Product Officer DMD

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PAUL SHAWAH

Vice President of Commercial Cloud Strategy Veeva Systems

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JIAN YANG

IT Director for Emerging Markets Business Unit Eli Lilly and Company We are on the cusp of a change. Oh, really? Obviously, we have been for a while, and the changes just keep coming. Technology is behind, or at least part of, most of the major issues facing the healthcare industry. Patient empowerment? Fueled by the availability of an avalanche of information and greater access to HCPs. Coordination of care? Largely a matter of being able to connect all providers. The ACA? Driven by, among other things, a desire to achieve greater efficiency, which depends largely on EMR implementation. Increasing adherence? Subject to a lot of new tactics, almost all of them digital. Amassing and analyzing data? All technological. What do we know? How much can we share? With whom? How safe is it?

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If you had one of Dr. Who’s tardis devices, basically a time machine, and you transported a physician from 2000 to 2016, you’d have to have a supply of Xanax as well. She wouldn’t recognize her own profession. Capturing Big Data, making sense of it, using it in clinical, organizational, sales and marketing areas, has been somewhat of a blessing, and somewhat of a major conundrum. What’s the temperature of the industry now? To assess that, we invited this panel of commentators, who wrestle with these ideas on a daily basis. Let’s see what they make of this Rubik’s cube of programs and apps, possibilities and challenges.

What have been the major effects on healthcare since the digital revolution over the past five years?

Jian Yang: A new eco-system that connects patients, caregivers, HCPs and healthcare companies is emerging through technologies such as website, mobile app, the cloud and internet of things.

David Reim: One change that I have observed from a front-row seat is the democratization of healthcare information. Prior to the open Internet, healthcare information was relegated to what you learned in high school, what your crazy aunt thought she knew, and low-literacy pamphlets from a doctor’s office. With the advent of WebMD and Wikipedia, among others, a consumer can pretty much get any information they want—from a simple list of symptoms to detailed clinical trial results. The effect of this has been the creation of “partnered” healthcare, where many times the physician, either happily or unhappily, has to view the patient as an informed agent. This democratization has affected physicians too.

Josh Greenberg: Two areas that specifically stand out are the prevalent adoption of mobile, both at the consumer and enterprise levels, and the massive amounts of data readily available for analysis to glean new and actionable insights. These two technologies have provided pharma with a mechanism to more directly engage with patients and target engagement on a much more personal level.

Paul Shawah: Commercial pharma hasn’t truly been disrupted yet. In 2015, the FDA approved 51 drugs, the highest count since 1950. Pressure is mounting for life sciences companies to get more specialized products to market faster, on a much larger, global scale. And, with the increased focus on such targeted and personalized therapies, comes a greater urgency to get the right information to a more diverse set of stakeholders fast. The demand for digital information tailored to all the stakeholders’ needs is growing exponentially. And expectations are for information to be available anytime and anywhere.

The processes and systems put in place for more traditional commercial models are now barriers to meeting the volume, speed, and diversity of information required by today’s stakeholders. This has led to significant needs for and rapid developments of new digital technologies. These dynamics are forcing life sciences organizations to reevaluate many of their existing business processes and adopt new practices to drive operational excellence. Much of the focus is on creating more efficient and agile operations to move with speed in the digital age. Things as basic as online interactions and collaboration between providers and pharma companies are finally coming of age. For life sciences firms, legacy software systems can’t keep up. Digital has given rise to the cloud, as more firms commonly turn to cloud-based services to meet many of their software needs.

Tim White: I see digital disruption in healthcare across three areas. First, advances in machine learning, big data, and real-world evidence generation through social and digital channels have provided new opportunities in the research and development of new treatment options. Second, the rapid development of wearable technology and more advanced mobile applications have caused us to rethink what exactly treatment of a disease or condition means (i.e. looking beyond pure pharmacological treatment). Finally, where I spend most of my time, the digital world has had a massive impact on the ways in which we communicate in or around health. Patients, payers, caregivers, healthcare professionals all have new, digital expectations for the way information is delivered. All three of these digitally driven changes will eventually converge to empower personalized medicine and lead to a far higher level of patient self-management.

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What are the most positive changes, and the ones that have created the most difficulty or havoc?

Jian Yang: Professionals and patients are increasingly looking for information online and there are established online sources. However, because of the complex nature of heath care, professional intervention is needed to help all parties to properly interpret and digest the professional information.

Tim White: The most positive changes are the advancements in actual treatment options for patients. From mobile health solutions to connected devices, I see the treatment of so many different diseases being rethought and the impact that this will have on overall healthcare over the next five to ten years will be immense. These technologies will undoubtedly have a positive impact on both the quality of life and overall life expectancy as time goes on. But, like most things, these new technologies come with new challenges—specifically, in terms how they should be regulated. Think about Apple—since the company can accept or reject certain applications on their devices, it is acting as a de facto regulator of mobile health solutions. On the other hand the FDA, EMA, and others now need to consider regulating things like algorithms and regular software updates, which is an entirely new world for them.

Jian Yang: Most positive changes are all players in the healthcare value chain—patients, caregivers, HCPs and healthcare companies—are very aware the potential of the digital revolution that started with consumer areas. Many players have started their own journey with various levels of success. The difficulty lies in the complexity of healthcare system, and navigating through various legal, privacy and regulatory bodies also takes significant amount of time.

Josh Greenberg: Again, I would say that both mobile and data have created positive changes by affording people with real-time access to the most critical information needed while similarly providing companies with a more astute picture of usage, effectiveness, and intention. Similarly, these changes create a broader need for stewardship that is not readily apparent in most organizations

What are your views on the glut of information, and both professionals’ and patients’ ability to sift through it?

Tim White: A Google search about any health topic will deliver millions of results, yet quite often the entries close to the top of the list aren’t always the most accurate or relevant. This is particularly worrisome when it comes to patients who are sometimes trying to self-diagnose, but it also impacts HCPs. Therefore, it’s of utmost importance that the trusted life sciences companies which are creating the most factual and relevant information take seriously the user experience of their own websites. We need to band together to make it easier for both patients and HCPs to get the reliable treatment information. Further, we should also take greater advantage of new commercial strategies like search engine optimization and social media marketing to ensure that essentially the best content makes its way to the right individuals.

Paul Shawah: The real issue here is not as much about the “glut of information” as it is about the accessibility of it. Life sciences companies have a wealth of drug product information—arguably, more than any other entity on the planet with swaths of research and clinical data. However, accessing it is not always easy—and even cumbersome in some cases—for healthcare professionals or patients. For example, healthcare professionals typically go through multiple steps to access product information, even though most of it is digitized. Even for a single pharmaceutical company, HCPs may have to keep track of multiple user IDs and passwords across various product portals, websites, and apps. Multiply that by the dozen or more companies an HCP works with and the complexity starts to become a barrier. It takes too long, so busy HCPs go elsewhere, where information is easier to access even if it is not as reliable. In fact, one study reports that Wikipedia is the single leading source of drug information for providers and patients, with 50% of physicians saying they consult the community-edited site.

If life sciences companies globally start to view HCPs as a shared customer, they can come together to establish new standards that will make it markedly easier to deliver relevant information to HCPs. Physicians won’t be overwhelmed by a “glut” of information, but rather be enriched by the “right” information at the right time to improve outcomes.

Josh Greenberg: Successful organizations of the future will find ways to operationalize their authenticity to foster a trust in the information they push onto the markets.

David Reim: It is incumbent upon us to learn how to process content on the Internet and how to seek quality information. I believe that the way to process the glut of information on the Internet is to use filtering tools that know something about you and can help you find what you are looking for. Think of Amazon’s recommendation engine: when information providers can identify the health care provider on their website and use this information to serve them relevant and targeted content, it ensures the perfect “fit.”

What kinds of developments are happening now that will move things forward?

David Reim: We need to rely on automated processes to filter the information for us. In the near term, there are new screening technologies that deliver the information that is the most applicable. A little further down the road is machine learning, which is the ability of computers to mine very large piles of data, such as search history, to find patterns that can be applied to future information searches. Some people find the prospect of being guided by a computer as potentially limiting, but it will be the only way that the majority of us will be able to efficiently and effectively find what we are looking for.

Jian Yang: The marriage of digital technology and healthcare is happening now and will have major impact around the world. The most significant positive impact may be happening in developing countries first, such as remote healthcare.

Paul Shawah: As I mentioned earlier, the good news is that industry leaders are starting to embrace the concept of HCPs as a shared customer. Life sciences companies have a new willingness to collaborate to remove barriers and develop novel, more efficient ways to make it easier for HCPs to access valuable information. Align Biopharma is a good example. It’s a new industry standards group of leading life sciences companies focused on making it easier for HCPs to get the information they need. One way is to create a single, common identifier for every HCP that is recognized across all life sciences companies globally. With that, a physician would need to manage only a single user name/ password to log in to every pharmaceutical website, portal, or app. Simple! Additionally, this common HCP identifier could map to information about each HCP’s channel preferences so if a physician makes a request for, say, information about a new indication, the manufacturer knows exactly how to deliver it.

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Going one step further, I can envision the traditional push communications model being reversed whereby HCPs will be able to request the information they want on demand from the industry, regardless of who markets the drug.

Josh Greenberg: The advent of wearable technology will push personal engagement further by creating a level of interaction that surpasses the need for overt transactions. Patients will be able to leverage wearables to get real time feedback on the effectiveness of their health solutions while companies will have access to a granularity of information never before experienced.

Tim White: True. I’m fascinated by Moore’s Law, which states that computing power doubles every two years. This means that, while we’re seeing some very impressive things now, what’s around the corner is even more inspiring. This multiplying computing power will impact—if not enable—predictive medicine, where both wearable sensors as well as the use of the mobile phone will be able to be tracked. Through these predictive algorithms, very early warning signals will be detected to prevent a critical situation. At a previous company, we were working on this very thing to actively predict when a patient with schizophrenia or bipolar disorder was at risk of relapse strictly based on the usage of their mobile phone. As computing power gets stronger, and sensors become more capable, the ability to predict diseases before they show any outward symptoms will have a massive impact on healthcare.

What are the challenges at the moment—what needs the most dedicated attention?

Jian Yang: The establishment of relevant legal/regulatory frame work around digital healthcare.

Josh Greenberg: Data stewardship and governance. Currently there is a mindset to build the tools to help patients and professionals actively engage with their healthcare decisions. By their nature, these tools aggressively capture information that overwhelm existing databases and have the potential to provide personal intelligence people are unaware they’re sharing. Companies will need to embrace new technologies that provide the capacity for enormous amounts of information and the firewalls to ensure privacy.

Where do you see tech taking the industry?

David Reim: Healthcare, more than most markets, is reliant on technology to move the discipline forward. I am particularly interested to see where genetic-based personalized medicine will take us in the next 20 years. This will involve whole new branches of emerging technologies to sample and assess an individual’s genetic makeup and then use big data approaches to develop treatments that are tailored for optimal success with that individual.

Josh Greenberg: Machine learning and artificial intelligence are beginning to become readily accessible. I see the industry taking an aggressive move towards a more analytically-driven culture where decisions are made not from past successes but from what insights the data can offer.

Tim White: There are many discussions about the threat of Google, Apple, Facebook and others to the traditional life sciences industry. I tend to look at it from a different angle, which is that through partnership with these companies we, together, can revolutionize healthcare. The competencies that technology firms like Apple or Veeva Systems—with its modern industry-specific cloud software—can offer are impressive, but the industry also brings some impressive competencies to the table. Therefore, it’s likely to see key partnerships between the sectors where both of our strengths can be best utilized continue to evolve. A good example where this is working at Teva is in our relationship with IBM. We have entered into a three-year research collaboration that integrates with the Watson Health Cloud. The project builds on an existing alliance and will focus on two key areas in healthcare: developing a systematic approach to discovering new uses for existing drugs and improving chronic disease management. Using our therapeutic technologies and Watson’s cognitive computing, we are working to help doctors, patients, and payers better manage chronic conditions like asthma, plus track treatments.

Jian Yang: Tech companies will play a significant role in helping evolve the industry and improve healthcare quality. Two sectors have opportunities to join hands and create win-win situation. Neither will be able to take over the other side’s business.

Paul Shawah: Cloud technology will allow new industry standards groups like Align Biopharma to turn the traditional “push” model for information access upside down, for the better. It will enable a true customer-centric pull model where customers drive the interaction—what information they need, how they need it, and when they need it. In this way, technology will help break down the barriers to fast communications, like having to manage two dozen user-name and password combinations, and put the power in the hands of the HCP. And, when life sciences companies are ready to “push” product information to HCPs, it will be smarter—driven by actual customer data and behaviors so the information will be highly relevant and delivered how the customer prefers.

How does technology help address patient centricity?

Jian Yang: The expectation from patients towards healthcare is changing due to the “instant-on” services they receive through some technology offerings. Waiting for five minutes for the PC to boot up has changed to instant-on with their smart phones. Their expectation towards receiving faster responses on their health-related matters are higher and higher. Understanding this and putting the patient in the center of everything we do is a critical success factor for everyone in the healthcare ecosystem.

David Reim: We are far from having the patient in the “center,” as centricity would imply, but the patient is increasingly involved in their own care via the democratization of health information. The Internet has also provided the opportunity for patients to band together to learn from each other and to even affect policy and research.

Josh Greenberg: Technology provides for companies to create a very intimate experience with their patients to help manage and improve their care in near real time. Patients have the benefit of deep analytical insights into their personal performance at that moment to quickly gauge effectiveness.

How does technology impact on the responsibility of companies to be good stewards?

Paul Shawah: With more targeted treatments aimed at more specific diseases, the access to drug information and services are now as important as access to the drugs themselves. By coupling cloud technology with common ways of doing things, the industry ensures reliable information gets to the right HCPs and, ultimately, patients much faster. In this way, modern technology eliminates barriers and provides a mechanism for open communication, helping life sciences companies ensure that product information is accurate, up-to-date, and easily accessible.

Tim White: In almost every sector, technology has opened doors and, in doing so, placed the burden on companies to be more transparent, responsive, and service-oriented to their customers. Healthcare is no different. For example, now there are websites like treato.com, where patients literally “rate” treatments similar to the way consumers assess a product on Trip Advisor or Amazon, giving it multiple stars. There are similar sites for hospitals and even individual practitioners. As the world becomes even more connected, social and transparent, people can’t just talk about patient-centricity but they must put talk into action. For me, this involves ensuring that we as a company provide a valuable experience in every single interaction. In embracing this, as well the many other opportunities that technology allows, I do believe it will make healthcare better for all and improve the overall reputation of our sector.

David Reim: Although I would like to think that companies are intrinsically motivated to be good stewards, many are not. In those cases, the Internet provides a global fact-checking and community platform that enables all stakeholders to ensure that companies act in the best interest of the people they serve and not just themselves.

An excellent example of this is the lawsuit brought by the state of New York against a Top Five pharmaceutical company. This company, like others, was funding many clinical trials but only reporting the results of those trials that were beneficial to their products (or stopping trials that looked like they would be negative). The resolution of this lawsuit resulted in a precedent for pharmaceutical companies to post all results of clinical trials, partial or otherwise, on the Internet for the public to review.

Josh Greenberg: As consumers more broadly embrace technology through mobile and wearable technology, the current implicit acceptance of data usage will no longer be sufficient. Companies will begin to be held accountable for how they use data and how they not only share data but the insights that can be generated with partner organizations. •

MEET OUR PANEL OF EXPERTS

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JOSHUA GREENBERG

Director, CapTech Consulting

Josh is a proven business leader with over 20 years of experience in delivering transformative solutions for Customer Engagement and Data Intelligence throughout a number of industries. Josh has consulted to large pharmaceutical organizations on Salesforce effectiveness, Master Data Management, Operational process improvement, and Organizational Change Management to both craft business strategy and deliver sustainable improvement.

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JGreenberg@captechconsulting.com  

CapTech Consulting (www.captechconsulting.com) is a national management consulting firm that bridges the gap between business and technology. CapTech delivers transformation, customer engagement, data & analytics, and custom IT solutions for private companies, public companies, and government agencies. The company’s collaborative approach helps organizations grow their business, engage with customers, and turn data into powerful insights.

PAUL SHAWAH

Vice President of Commercial

Cloud Strategy

Veeva Systems

Paul is shaping advances in cloud-based software to enable modern multichannel communications between life sciences companies and healthcare providers. He has been driving digital innovation in the life sciences industry for decades, named one of PharmaVOICE’s Top 100 Industry Innovators in 2012. Shawah is also published in dozens of respected life sciences trade publications and journals and is a regular speaker at industry conferences. At Siebel, Shawah pushed the envelope to incorporate mobile technology in the company’s CRM product that would enable feedback directly from the field during a physician call. He quickly became an evangelist for what is today known as closed loop marketing or CLM, igniting a movement in the life sciences industry as he set out to change the mindset of pharmaceutical marketers and sales operations.

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paul.shawah@veeva.com  

Veeva Systems is a leading provider of industry cloud solutions for the life sciences industry. Our products are designed to help life sciences companies with some of their most critical functions—from R&D to commercial—in bringing products to market faster and more efficiently, marketing and selling them more effectively, and maintaining compliance with government regulations.

Its industry-cloud solutions provide data, software, and services that address a broad range of areas, including multichannel customer relationship management, content management, master data management, and customer data.

DAVID REIM

Chief Product Officer

DMD

A pioneer in applying digital marketing to pharma and healthcare, David Reim is chief product officer at DMD. Prior to DMD, Reim was the president of FanHealth Network, a mobile-app driven health and wellness company. Prior to that, he was president of SimStar, one of the first digital marketing agencies in healthcare. Subsequently, he ran the U.S. business unit for TNS Healthcare, one of the largest healthcare market research providers.

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dreim@dmdconnects.com  

DMD provides the next generation in digital engagement with healthcare professionals. DMD clients have access to the only authenticated database available that can reach, track, and respond to the dynamic digital behavior of fully opted-in physicians and NP/ PA prescribers. Through this database, pharmaceutical marketers, medical marketing agencies, publishers, hospitals, CME organizations, and healthcare recruiters have digital access to more than 90% of physicians with email addresses and real-time data that unlocks precision targeting and engagement capabilities across the most influential healthcare audiences.

TIM WHITE

Head of Customer Experience Teva Specialty Medicines Tim is regarded as one of the foremost thought leaders in customer and patient experience within the pharmaceutical sector with deep expertise in digital and social communications/marketing, mobile health, commercial excellence, and digital brand strategy development. Prior to Teva, White has held senior executive positions at Lundbeck, Novartis, and MSD. White is an active thought leader inside and outside of pharmaceuticals, having delivered over 50 key-note lectures globally on eHealth/Mobile Health, Digital Marketing, Commercial Innovation, and the future of technology in healthcare. He was recently featured in PM360 Magazine as one of the foremost trendsetters in pharmaceuticals today. In 2015, White was named as one of the “Top 100 Talents in Denmark” by Berlingske, the leading Danish business magazine and, most recently, as the youngest ever recipient of the prestigious Emerging Pharma Leader Award given by Pharmaceutical Executive.

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Timothy.White@tevaeu.com.

Teva is committed to increasing access to high-quality healthcare for people across the globe, at every stage of life, by developing, producing and marketing affordable generic drugs as well as innovative and specialty pharmaceuticals and active pharmaceutical ingredients. The company’s line of generic and specialty treatments is backed by global development and manufacturing capabilities. Teva’s participation in a wide range of therapeutic areas and dosage forms is empowered by a unique integration of innovative specialty and generic research.

JIAN YANG

IT Director for Emerging Markets

Business Unit

Eli Lilly and Company

A physician by training with extensive experience in R&D, Medical and Commercial areas, Dr. Yang has keen understanding of the issues, challenges and opportunities in healthcare and pharmaceutical industry. Dr. Yang is passionate about leveraging technology to drive business transformation. He is a result driven leader with global vision and career footprints in the U.S., China, Japan and Singapore. At Lilly, he is responsible for delivering commercial transformation for Emerging Markets Business Unit through a holistic digital strategy and technology innovation. He previously led a high-performance Lilly IT department to provide infrastructure, data, application, research support as well as innovative IT solutions for Lilly Research Labs. He has led the effort to establish Integrated Genomics Platform for Cancer Research and Translational Medicine platforms.Before joining Lilly, Dr. Yang led the effort in designing and managing HIPAA-compliant medical informatics system for medical and epidemiological researches in collaboration with United Nations and US Centers for Disease Control and Prevention.

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yang_jian_jy@lilly.com  

Lilly, founded in 1876 by Colonel Eli Lilly, works to discover and bring life-changing medicines to those who need them, improve the understanding and management of disease, and give back to communities through philanthropy and volunteerism. It makes medicines that help people live longer, healthier, more active lives. Its vision is to make a significant contribution to humanity by improving global health in the 21st century.

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