The road to digital innovation in the pharma and healthcare space is going to take players across industries — from tech developers and engineers to researchers and clinicians, according to a panel of digital-focused VPs speaking at BIO 2018 in Boston.
Tech is opening up new avenues in research and development, as well as access to data from EHRs and other databases. In the past, the healthcare industry has had a reputation of its tech moving behind the consumer tech trends. Complicating matters as the “big data revolution” pushes forward, it has become clear that healthcare data often lives in silos, creating roadblocks for innovation.
However, it's not that the tech capability isn’t out there, noted Marta Bralic, vice president of business development at Flatiron Health.
“After these long days I’d get back to the hotel — I was consulting at the time — and be online somewhere, and I would be on any random website and I would see a pair of shoes that I looked at one time three weeks prior follow me around the entire internet, everywhere I went," she said. "It just seemed like this striking moment: it’s not that the technology isn’t available, it’s just that we are spending all of these resources and incredible engineers and technologists trying to figure out when we click on an ad, as opposed to how [to] connect healthcare data and make it useful for decision making."
While it is important to bring the engineers and technologists of other industries into the healthcare game, the speakers stressed that the innovation process shouldn’t be in a silo either.
“In tech we have seen many digital companies coming into the life sciences, some with a quite limited knowledge and understanding of life sciences — the complexity of biology, the complexity of what is a disease, and how you even diagnose a disease,” Luba Greenwood, strategic business development and corporate ventures at Verily, said on the panel. “So putting together the tech piece, the AI and the proper annotation of the data, we are getting to draw meaningful insight and at the same time at a reduced cost, rather than [at] an increased cost to the patient.”
Greenwood said that this collaborations between providers and developers is paramount when it comes to data collection and curation, as uncurated data can lead to incorrect conclusions.
For example, Greenwood cited one study which determined that white men in their 50s who had a high white blood cell count at 3 a.m. were more likely to die sooner than the same demographic who had a white blood cell count at 3 p.m. It turned out, however, that most of the men who had their blood taken at 3 a.m. were in the emergency room, as opposed to those who received testing in the afternoon during a standard visit.
“Where we can change healthcare is good clean data, and data that can be annotated by healthcare professionals. Not software engineers; people in healthcare that actually know what is going on,” Greenwood said.
The idea of collaboration between fields isn’t a radical one. The tech world and the life science realm have been keeping an eye on each other for a while.
In fact, in February pharma giant Roche bought Flatiron — which offers an oncology-specific EHR platform paired with a suite of software products that employ real-world data from these records to uncover cancer research and insights — for $1.9 billion, although Bralic said that collaboration between the two companies stretched back much further than the acquisition.
The relationships between pharma and tech are symbiotic for innovation. Bralic said that implementation of Flatiron data platform in pharma and clinics wouldn't be complete clinical expertise.
“Have machines do what they are really good at, and have humans do what they are really good at, and bring that clinical perspective to curating the datasets,” Braclic said. “If you don’t do that, there is a bunch of missing-ness and a bunch of holes.”
Including other fields also allows experts to focus on their specific job. Iya Khalil, chief commercial officer, executive vice president, and cofounder of GNS Healthcare, which has developed an analytics tool for precision medicine and population health, said she has reached out to organizations for their datasets and expertise.
“For us to be able to apply our algorithms to learn causality means that GNS ... [has to have] partnerships with this foundation which has clinicians and biologists, and itself brings together many clinical centers,” Khalil said.
Having tech and datasets readily available could change the way that pharma and healthcare operates. For example, it could mean taking away the control arm of a study and instead replacing it with readily available datasets.
“Why are we enrolling half of the patients from the clinical trial onto the control arm when, simultaneously, we are collecting standard-of-care data longitudinally for a hundred thousand patients? So why would we need half of the patients in a clinical trial to go on a control arm? Is that even ethical, if there is reason to believe that the experimental drugs could be more effective?” Bralic asked.
The tools could also make physicians' lives easier by helping them sort records and be more efficient. But it isn’t just about helping the industry progress, with the panelists agreeing that the ultimate focus is the needs of the patient.
“We charted out a road map and worked with a number of biopharma companies on defining a road map. People always ask 'Now that you are part of Roche are you going to work with other biopahrama companies?' and the answer to that is such a clear yes,” Bralic said. “We are trying to change the way that drugs are developed in oncology and the way we learn is from the experience of every cancer patient, so we treat the other cancer patients better.”