Healthcare Agency Roundtable 2018

 

Leadership representing the 2018 Manny Award agency and network winners and finalists share their views on various healthcare industry trends and developments.

 

1. What are your thoughts about PhRMA recently updating direct-to-consumer ad guidelines to include pricing information?

Sharon Callahan, CEO,TBWA\WorldHealth: Transparency is always a good thing, more information on therapies rather than less, if the information is accurate and credible. I think the PhRMA initiative is useful. Whereas the CMS proposal takes one metric (list price) that everyone knows is totally misleading and fits it into a 60-second TV commercial with zero context. Conversely, the PhRMA initiative provides more meaningful information (average price paid) and some valuable context.

Wendy Blackburn, Executive Vice President, Intouch Group: While there are many questions yet to be answered, it’s clear that a focus on pricing and pricing transparency is here to stay. Pharmaceutical manufacturers need to be prepared for this new reality, whether it’s the recent PhRMA guidelines, the CMS mandate, or future regulation to be announced. But I see it as an opportunity – an opportunity to be more patient-centric. For years, research has pointed to a desire from both consumers and HCPs for clearer pricing information. Now is the time to fill this need and demonstrate pharma’s commitment to transparency – going beyond, even, what the industry and government are mandating – to provide more clarity.

Steve Hamburg, Managing Partner, Chief Creative Officer, Calcium: The requirement to include pricing information in DTC television advertising, including the “list price and average, estimated or typical patient out-of-pocket costs, or other context about the potential cost of the medicine” is arguably the most controversial and problematic of the updated PhRMA “principles.” This principle, along with several others, is expected to be adopted on April 15, 2019, in response to the administration’s efforts to lower drug prices and in an effort avert further legislative action.
While intended to provide increased transparency, this new requirement will, in practice, create an added level of complexity to the already information-packed landscape of the typical DTC spot. There are other issues as well. First of all, prices don’t necessarily correlate with value; what may appear to be expensive simply on a cost basis could be invaluable on a therapeutic basis. Cost is only one dimension – and arguably not the most important dimension – of a drug’s potential value to a patient’s life.
What’s more, list prices themselves don’t necessarily indicate what patients will actually pay at the pharmacy counter, since insurers typically determine the “out of pocket” costs. Moreover, list prices don’t reflect the discounts and rebates often negotiated by insurers and PBMs. And, most chillingly of all, list prices could act as a deterrent or disincentive for consumers to seek additional information and dialogue about the latest drugs that could potentially improve or even save their lives.
Transparency is a good thing, and information is empowering to healthcare consumers. Yet, when that information is too narrow and simplistic, and is delivered without enough context, the result can be even greater complexity, confusion, and disempowerment. And that’s not a healthy for anyone.

Mark Willmann, Head of Fingerpaint’s Morristown, NJ, Office: We’re fortunate to work with partners that are transparent in every part of their business. This recent change in guidelines will provide consumers access to information ranging from clinical trial recruiting, real-time registrational trial results, and now, brand list price.
PhRMA’s decision to add context to the information by providing an estimated out-of-pocket expense and details on patient-assistance programs will help patients understand the financial aspects of taking their medicine.
This recent update, along with modernizing the inefficient supply chain, is a step in the right direction as we find better ways to spend our limited healthcare dollars.

Eric Densmore, SVP, Account Director, AbelsonTaylor: a. Proponents of the amendment claim they want consumers to be more informed and consider the price of a drug, just like they’d consider the price of car. Those purchases don’t seem all that similar to me, but let’s see how it plays out.
b. Motivation: When people buy a car, it’s often an emotional decision. A new car can be a status symbol, so spending a bit than you can afford isn’t uncommon. When considering a new drug, it’s likely because you or a loved one suffer from the condition being discussed and hope it might be able to help. Both emotional, but not the same.
c. The Bait: Car dealers focus on making the offer seem “too good to be true”. Drug ads focus on the benefit/risk of the drug to appeal to viewers (or their loved ones) that suffer from a condition to talk to their doctor to see if might be able to help them. Not the same.
d. The Gate Keeper: Last time I was in a car dealership, the salesmen didn’t seem too concerned about what was best for me. His focus was on upselling me to 4WD and a rich Corinthian leather interior. Conversely, doctors are concerned about what’s best for you and if the drug you saw the ad for isn’t right for you, we can trust them to suggest something that is. Not the same.
e. The Price: How much does a car cost? Certainly not the sticker price and not the advertised price either. Manufacturer rebates, loyalty rebates and good old fashion negotiation make it hard to pin down the “real” price. What number would we suggest flashing on a commercial to “educate” consumers on the cost of a drug? AMP? WAC? Or just the amount the patient would pay with a co-pay card? This aspect of the experience is the same. Clear as mud, but, unfortunately, the same.
f. The Outcome: If the price of a car scares you, you don’t buy a car and life goes on. If the price of a drug scares you, you don’t talk to a doctor and, in some cases, life might not go on. That’s not at all the same and, in my opinion, reason enough to NOT include drug prices in ads.
g. I want patients to have more conversations with their doctors about their health and I don’t think including drug prices will help with that.

Dan Sontupe, EVP Payer Strategy, The Bloc Value Builders: The theory behind increased transparency on pricing is a valid one; however, the challenge lies in the definition of “pricing”. What CMS is trying to do, by including the “list price” of each drug, will create wholesale confusion. Is there a consumer anywhere in the United States who actually pays for a product at list price? In fact, does anyone pay list price for anything in this country? To that end, why do we even put sticker prices on cars? Essentially, if you put list prices on DTC ads, we run the risk of scaring patients away from actually going to the pharmacy to get their prescriptions.
A more feasible approach to this development may be that, once the patient pays their co-pay, perhaps the insurer and the Medicare Part D plan should improve transparency by making sure patients understand “their cost” (co-pay or coinsurance or deductible) for a drug? Perhaps there should be a requirement for the PBM to disclose that part of drug pricing where they are receiving a 50% to 60% rebate off the list price, simply for allowing a particular brand to appear on the list. How do we explain this to consumers when providing a list price in a DTC ad? And if we spend all of these resources explaining “list price” in a DTC ad, how can we actually rationalize the value and importance of the drug in a 45-second or 60-second commercial?
The current model of our healthcare system is broken – informing patients of a drug’s list price is akin to applying a Band-Aid over an area that isn’t wounded.

Susan Kornetsky, VP, Payer Strategy, Entrée Health New York: The recent voluntary adoption of enhancements to DTC Principles is important and necessary to address heightened attention from the media and the Trump Administration on the cost of pharmaceuticals. It is worth noting that PhRMA previously adopted a similar self-regulation strategy with its “Code on Interactions with Healthcare Professionals” about a decade ago in order to maintain sales representative access to physicians.

Scott Roberts, SVP, Payer Strategist, Provaluate, an Entrée Health Company: Drug pricing is highly complex. In recent years even biopharm CEOs have struggled publicly to address questions about drug pricing and transparency. Biopharm manufacturers must continue to create patient services programs to effectively triage and respond to patient concerns about drug pricing and access.
PhRMA is right to address this issue publicly and begin to counter the perception that there was a lack of transparency to consumers. It should continue to build out and promote the value of medications. Pricing concerns can be mitigated with a more effective story about the value of investment in drug therapies.

Kitty Ravenhall, EVP, Executive Director of Strategic Planning, FCB Health New York: Many patients already avoid or delay care because they assume medication will be too expensive, and might require them to make unacceptable trade-offs. We’ve talked to patients who feel they have to choose between meds and groceries; meds and the heating bill; even meds and college for their kids – and the last thing we want is for “list price” to exacerbate this feeling. However, the PhRMA guidelines open the door for us to turn the HHS mandate into a positive, and help patients improve their self-efficacy when it comes to affordability and access.
Our challenge, and opportunity, is to contextualize pricing information based on patients’ needs and skills. No one model is applicable to all medications or disease states, and we start with a thorough needs assessment, led by our Health Educators, to develop a learning design to meet those needs. Price disclosure is only the starting point – we need to guide patients through the steps necessary to make an informed decision about their care, via the proper framing, education and tools. Our ongoing research helps us tailor this learning design to make sure we don’t lose patients due to misperceptions or incomplete information.

Hilary Gentile, Chief Strategy Officer, McCann Health North America: The sentiment of transparency is applauded but the vehicle in which we are implementing that transparency may be counterproductive. If the goal is to achieve greater clarity for consumers, we will not achieve this, with this action. The list price is often not the actual price paid for a drug as it makes its way through the steps, supply chain to the consumer. And in 30 seconds, there’s no way a commercial will be able to share all the intricacies which would be warranted.
Also, the shear shock of the price of some products, rare diseases, oncology products, and biologics could negate the goal of communication. It may drive further distrust of pharma, at large, add to the confusion, of an already confusing health marketplace.
The bigger question is that the objective of bringing transparency was to bring the costs of healthcare down, would it really help? Or it will also become an initiative to provide access of information to patients in the ‘so-called’ patient centric healthcare.
That said, this may force us to leap into the future with our communication strategy. Pharma has been known to be ultra conservative with smart marketing approaches. Alternate ways to connect, educate, build relationships with consumers will be paramount.

Emily Poe, Global Practice Leader, Healthcare Communications, W2O: Transparency around important aspects of a medicine, including its pricing, should be our industry’s goal. PhRMA’s recently revised Guiding Principles on Direct to Consumer Advertisements about Prescription Medicines that state that branded DTC television ads should send consumers to a place, such as a company-developed website, where they can get cost of the medicine is a fair approach to try to address questions about a medicine’s price. The reality of implementing the guidelines may be challenging, but how consumers understand and act on the information included could have unintended consequences. As communicators and marketers, it will be inherent on us to educate the public on just what the information means. More broadly, these guidelines, however, are unlikely to truly address the broader public and political concerns about pharmaceutical pricing in the U.S. Affecting widespread change is not an easy solve, and no number of company-developed websites will change the underlying payer, policy and other issues that impact U.S. pharmaceutical medicine prices and a patient’s ability to afford his or her medicine.

Rita Glaze, Practice Leader, U.S. Market Access, W2O: Identifying ways for people to have additional information and context around drug pricing is a critical path for all of us who work in and around the healthcare system. There is a craving in the market for transparency, but transparency alone may not help people translate this information into their benefit design, co-pay schemes, deductibles, what does this mean when I go the pharmacy counter or answer the ultimate question on people’s minds – can I afford this? It is an important step and will definitely drive accountability in new ways and could probably add fuel to the already fiery dialogue around drug pricing – but it may have limited value in the short term for people who are facing ongoing affordability challenges.

Adam Cossman, Chief Digital Officer, W2O: This was certainly an interesting move, and while I completely agree with the intent in doing so, I fear it may cause more confusion than benefit for consumers. As we all know, pricing for drugs is not consistent or easy to understand; it’s not like pricing for a consumer product. The variety of insurance providers, plans, tiers, and geographic considerations that can impact price is vast. Stating a price is going to be very tough, and in many cases I can see the price stated in advertising not being what the consumer will actually end up paying at the pharmacy or during treatment. That said, I think the better approach would be providing formulary look-up solutions embedded in brand.com experiences that allow patients to explore cost specific to their unique coverage.

 

2. What are your thoughts regarding President Trump recently signing into legislation an anti-opioid abuse package in a rare bipartisan step that expands access to substance abuse treatment in Medicaid, cracks down on mailed shipments of illicit drugs such as fentanyl, and provides a host of new federal grants to address the opioid crisis?

Christopher Tobias, PhD, President, Dudnyk: The opioid crisis is one of the most gripping public policy and medical challenges facing our society today. The rate of opioid overdose deaths each year has been drastically climbing across the US, yet only in the past 2 years has a strong national conscience emerged to give voice to the staggering impact on our families, communities, and society. Unlike with other medical disorders, the treatment for opioid addiction is compromised by incredible social, behavioral, legal, and political complexities. I believe that the totality of these complexities has created a lack of compassion for addiction as a disease and a passive acceptance that too readily labels opioid addicts as “society’s disposable people” (Dr. Mark Tyndall quote, TEDMED 2017).
Implementation of an anti-opioid abuse package, the expansion of substance abuse treatment in Medicaid, and the prevention of illegal opioid shipments of fentanyl are a start, but turning the tide on this epidemic will require a sustained multifaceted realization of its complexities in order to prioritize the value of every human life that is addicted to opioids. The answers are not simple, or clear, but exploring some of the obstacles may help us achieve a better understanding as a society, and therefore arrive at a solution that can consistently decrease overdose deaths, provide greater access to comprehensive rehabilitation support programs, treat opioid addiction with the lens and approach of a medical disease, and champion the belief that any death due to opioid addiction is unacceptable.
One of the most controversial approaches to decreasing overdose deaths and increasing the participation in rehabilitation programs has occurred over the past 2 decades in Vancouver, BC, Canada through the work of Dr. Mark Tyndall in the establishment of harm reduction clinics. These clinics provide a safe zone for supervised opioid injections, clean needle usage and exchange, on-site counseling to support rehabilitation, and safety from criminal punishment. The results of these “insight clinics” established with Canadian public funding are resoundingly positive: more than 3.5 million supervised injections conducted over 8 years and 0 deaths from an overdose; hundreds and hundreds of patients entering rehabilitation programs; and the support by the Canadian Supreme Court to uphold the funding to continue the program. As encouraging as these data are, the complexity surrounding establishment of harm reduction clinics in the US has been met with great scrutiny, aversion, and resistance. This is where the vision to decrease deaths due to opioid addiction meets real world protectors of criminal justice and enraged communities where proposed sites for harm reduction clinics are to be established.
Implementation of a solution like this is complicated when taken individually. First, the evidence from Vancouver harm reduction clinics may not translate to the first identified site in the US (a region of Philadelphia called Kensington). It turns out that perhaps only 20% of the open-air freedom of drug use currently in Kensington is conducted by actual Kensington residents (city councilwoman Maria Quinonez-Sanchez, 2018 Thinkfest). The vast majority of opioid use, overdoses, overdose deaths, and homelessness in Kensington is derived from individuals who have traveled from other surrounding regions of Philadelphia, including the suburbs. So, Kensington residents are reticent about shining an even greater spotlight that would attract opioid users to their community, even when they understand the goal is to reduce overdoses, reduce violence, reduce death, reduce homelessness, and make Kensington a safer community over time. Philadelphia city council representatives suggest a Kensington harm reduction clinic could only work if many surrounding regions also establish harm reduction clinics to address each community opioid challenge where it exists. Sadly, finding the political and community will to establish multiple harm reduction sites to address this challenge appears far from within reach.
Next, our current laws on opioid use prevent the legal administration in a “harm reduction” setting without fundamental changes to these laws to allow for safe oversight of an administration in a supervised setting (similar to methadone clinics). Moreover, 30+ years of law enforcement that focuses on supply reduction and incarceration for opioid crimes has not decreased usage, not decreased opioid overdoses, and not decreased opioid deaths. The philosophy of prohibition, punishment, and denial have only increased these statistics while law enforcement professionals have worked extremely hard often with the best intentions – but addiction is not a criminal problem, it is a medical disease.
Finally, recognition that opioid addiction is not a choice, but a medical disease that deserves to be seen and treated as one is a complexity within itself. Opioids have a powerful and important place in pain control for those living with and exposed to severe and chronic pain. Yet, when people become addicted to opioids, they do not stop being a patient, they just stop being themselves. Although it is true that opioid-addicted patients may commit crimes, steal, lie, and strain family ties, we should try to recognize that the source of their illness is intimately tied to their behavior. We should not justify their actions, but try to focus the attention on the medical disease itself, which requires incredible patience, persistent support, and time to get an opioid- addicted patient through the rehabilitation pathway and back to who they once were. Diabetes, infectious diseases, mental illness, and even specific forms of cancer were once thought to be diseases that patients choose. We know better today, and our treatment support, approach, and philosophy reflect that change in belief. So, by spending more time dissecting and collaborating on the complexity of opioid addiction, may we develop the conviction and strength to implement a multifaceted solution to achieve the universal goal of eliminating deaths due to opioid addiction.

Ken Begasse Jr., Founder and CEO, Concentric Health Experience: I think it’s a much needed first step that, I hope, allows the industry and federal and state governments to identify and quickly assemble a host of educational and judicial actions to halt the crisis while freeing up funds, services and access for those who are battling addiction. I believe this is an issue that transcends all borders, beliefs and affiliations and will take commitment from everyone to solve. In my opinion, it will take the collective de-stigmatization of addiction, changing the view of addiction to one of disease, the rise of community education and integrated, specialized support networks that coordinate care and access to quality treatment programs, all without fear of future ramifications. This is the only way to combat this endemic. It began as a community issue; it is going to take a community effort to solve it.

Jay Carter, EVP, Chief Strategy Officer, AbelsonTaylor: I listened with interest at the last Coalition for Healthcare Communication briefing in May to a variety of Washington insiders, including an official from FDA, flail about with a variety of potential solutions to an incredibly complex problem. The truth is that 115 people die every day from an opioid overdose; the bulk of those overdoses are caused by highly potent synthetic opioids, likely manufactured illicitly. Meanwhile, millions of hydrocodone tablets are taken legitimately every year, because there isn’t a cost-effective pain solution superior to hydrocodone and oxycodone available. I think that all the actions taken are potentially useful, but none attack the core need: better/safer agents for pain. That’s a job for the pharmaceutical industry. I would hope that the federal government might consider a larger investment in the basic science of pain, and that it also create legislative incentives to a pharma that can solve this problem better.

Julia Phelan, EVP, Executive Director, FCB Health New York: The legislation commonly referred to as “Support for Patients and Communities Act” is a welcome and necessary step in the right direction to help combat the opioid crisis facing our nation. However, experts agree that in order to truly address this public health crisis, more comprehensive and longer-term funding is needed. Specifically, we need to ensure long-term quality care for people battling addiction, as well as adequate insurance coverage and reimbursement for addiction treatment. And, while the bill provides some incentive to advance medical research in non-opioid pain relief options, we also need to mandate continuing education for physicians on appropriate opioid prescribing patterns. Similarly, broad-scale consumer education is needed for people being prescribed opioids. Many people do not realize that addiction often begins with people taking prescription opioids for pain relief, and that an opioid overdose can happen to anyone at any time, even if they are taking the medicine exactly as prescribed. In sum, this bipartisan legislation is a good start, but an epidemic of this magnitude requires a broad-scale, sustained effort, well beyond what is currently supported.

Dina Steinfurth, EVP, Director of Strategic Services, Entrée Health New York: We applaud this effort to expand access to substance abuse treatment in Medicaid. However, it is worth noting that there are still states that have not expanded Medicaid to cover single adults, leaving an important part of the at-risk population without access to this lifesaving treatment.

Charlie Scammell, SVP, Payer Strategist, Entrée Health Princeton: Opioids have been a key part of the pain armamentarium for providers over the last 10 years. New abuse-deterrent options represent clinical progress but are not without limitations. We have been surprised in our research by how much need there is for basic provider education on how to discuss pain management options with patients. From the payer side, quantity limits and limited mail order have long been recognized as ways to curb abuse, misuse and diversion of opioids, but have not been deployed broadly and effectively.
This legislation is a positive step but given the scope of the public health crisis now unfolding, we believe more resources will be needed to effect lasting change. Treatment resources and therapeutic alternatives for those struggling with opioid addiction remain inadequate.

Katya Petrova, US Managing Director, The Bloc: It’s hard to overestimate the havoc opioid addiction inflicts on our communities. We had over 70,000 deaths related to overdoses in 2017. The scope of this epidemic is comparable to battling the early stages of the HIV/AIDS epidemic, with the required resources and expediency to match. This is the crux of the public debate around the new legislation: have enough money and resources been committed to make a measurable impact on this opioid epidemic?
The new legislation, which remarkably enjoyed broad bipartisan support, is a step in the right direction. It draws our attention to this human crisis of epic proportions, which often hides in plain sight. But we must do more. Achieving success requires a significant shift in the public mindset. We need to adopt the notion of treating opioid addiction as a chronic disease, making it part of the healthcare system algorithm; and destigmatize the condition and increase focus on expanding counseling and treatment options. We often see patients making great strides toward achieving independence from opioids, only to fall through the cracks of a system not set up to protect their recovery effectively. Even limited funds can go further on the local level, when the ecosystem of the required intervention and support is clearly mapped and the points of maximum impact are established. The main challenge will be to ensure the system is prepared to “digest” all the funding, without delay, and deploy it effectively.

Tracy Blackwell, Creative, Fingerpaint: There’s no question that the opioid epidemic has become one of the biggest public health challenges of our time. And people fail to realize that opioid use disorder is a brain disease – not a moral failing – so medication should absolutely be part of recovery. It’s frankly about time that we take a bipartisan approach to both reducing the overprescribing of opioids and helping people get access to treatment that dramatically increases their likelihood of a successful recovery.

Boris Kushkuley, Executive Vice President, Intouch Group: Over-prescription of opioids and the crisis related to their abuse continues to increase despite the efforts of previous and current administrations. Regulation can help, but I see even greater opportunity coming from the use of patients’ electronic medical records and data analysis to pinpoint suspicious levels of provider opioid prescription behaviors or lack of correlation between patient tests/diagnosis and prescriptions. Treatment protocols, enforced through EMRs, can make a huge difference to avoid abuse or criminal behaviors. This will shift the policy from government regulations to proactive real-time evidence-based and long-term outcomes-focused approach to combating the opioid epidemic.

Ujwal Pyati, Practice Leader, Scientific Strategy, Practice Leader, Scientific Strategy, W2O: I think this is tremendously positive, and long overdue. This epidemic affects everyone everywhere, and we need to take steps as a society to ensure that we don’t further destroy the lives of people who are often initially prescribed painkillers for a real condition, then spiral into opioid addiction subsequently. We’ve made it too easy to cater to this addiction, whether for corporate profits or other motivations, and a federal intervention of this nature was certainly much needed.

Adam Cossman: This was a bold and much-needed step to ensure we control this epidemic. If the government doesn’t step in in these instances, we run the risk of the type of abuse we’ve experienced. This isn’t to say that drugs like fentanyl don’t have a place in treating pain. They certainly do – breakthrough cancer pain is a great example of where opioids can make a big difference. However, they’re massively overprescribed and uncontrolled despite their drug class.

Sharon Callahan: I think that the opioid bill is nothing more than a rare bipartisan achievement that gave incumbent candidates something to talk about as they campaigned for the midterms. The bill is incremental at best and it doesn’t really address what’s needed and is extremely underfunded. If you compare our government’s response to the AIDS crisis in the 90s, this bill is a failure.
It doesn’t address the real investment needed to truly stop the regular pattern of overdose deaths and provide effective treatment on demand. The model for this bill, and our government’s response to the opioid epidemic should be the Ryan White Care Act, a bipartisan bill that Congress passed in 1990, which has allowed for billions of dollars in treatment and other support for people with AIDS, including antiretroviral drugs for anyone without insurance.

 

3. How can the industry improve upon the use of predictive analytics and modeling to improve patient outcomes and cut costs across healthcare?

Sonja Foster-Storch, President, GSW-North America, a Syneos Health company: Continuously accelerating healthcare costs highlight the need for intervention. There are a number of factors identified in studies that have sought after root causes and while some factors may be reliant on market pressures (physician salaries, pharmaceutical prices), data analytics may be uniquely positioned to drive innovation around key patient challenges. We’ve seen activity driving at some of the unhealthy behaviors that lead to chronic conditions, and the consistent understanding of behaviors and risk factors could tell us predictively how to defer disease onset.
We see a real opportunity for machine learning to drive patient empowerment as uncoordinated care, lack of cost-based decision-making, and administrative tasks can lead to unfortunate outcomes and higher overall costs. And the solution may take recognizable forms – we might look to utilize a ”virtual healthcare assistant” (think Cortana the Caregiver) to take on common caregiver tasks, from coordinating routine visits (and requesting specialist referrals), to integrating test results with genome and behavioral data, to recommending alternate paths to treatment. Additionally, a convergence of care coordination and empowerment may see blockchain technologies allow the patient to claim ownership of a portable patient record, easing administrative burden on the office while alleviating redundancy for the patient.

Christina Kim, Executive Vice President, Omnicom Health Group: The increasing pressure on outcomes, the movement from “sick” care to “well” care, and the volume and reach of data is expanding at breakneck speed. With it comes the ability to use technology-derived analytics to deliver fresh insights and guide decisions at virtually every point of the industry product cycle, from prevention to treatment and ultimately, to outcomes. Customizing care and treatment to those who will derive the most benefit is a promise of precision medicine that predictive analytics can help deliver. Eliminating overtreatment and identifying tailored therapies based on the individual’s needs can optimize the treatment plan, coordinate care across the care team, and generate insights to allow for interventions that can materially impact outcomes.
One significant adoption of predictive analytics is happening in the prevention of suicides. We have recently partnered with a machine learning company which has recently analyzed social conversations to predict when an individual might be at risk for suicide. The implications of this are profound. Healthcare has often had the challenge of identifying the right intervention points. The application of predictive analytics models like this, not only in mental health but across the spectrum of health conditions, means that we could even calculate risk scores personally or at a population level, and gather the right resources to intercede and affect lives.
Applying predictive analytics to the age-old question of adherence may reverse non-adherence trends. Utilizing data from EMRs, tracking prescription pick-up/usage/refills, healthcare visitation, out of office trackers (like wearables, medical devices, and other care delivery solutions), and other data sources allows us to uncover patterns and variations in what patients do with the information they obtain from physicians. Predictive analytics models, in these cases, can enhance of-the-moment communications and advance the development of solutions to promote continuous care and manage episodic care in a more holistic way.

Megan Hall, EVP, Creative Director, Entrée Health New York: As EMR data gets both more widely used and more sophisticated, there’s a huge opportunity for data science to find correlations in unexpected corners – and we can use that to help both populations and individual patients. For example, at a health data hackathon last fall, some researchers found that LGBTQ patients have smaller provider referral networks than non-LGBTQ patients, and that those smaller networks are associated with worse health outcomes. That’s not something anyone expected to see, but now we can work on expanding referral networks among subpopulations to improve health and decrease costs.

Ken Beatty, EVP, Managing Director, Solve(d), an FCB Health Network company: Some healthcare marketers have a love-hate relationship with analytics. On the one hand, they are at least generally familiar with the power and robustness that analytical tools have in other categories, such as consumer products, CPG, etc. But on the other hand, there is a great amount of caution because of uncertainty in how these tools may fit into the regulatory environment, not to mention a general perception about the sparseness of data that can support such efforts. Admittedly, there is a great deal more access to data in the US, but that should suggest re-engineering data-capture strategies, not abandoning them.
The terms “predictive analytics” and “modeling” are broad depictions of machine-learning techniques that data scientists are bringing forward in more applications within healthcare. The details of such techniques are best left for other forums, but predictive analytics may have a role in the areas of targeting, messaging and optimization.
Targeting and messaging strategies can apply to consumers (where such marketing is permitted) and HCPs, but still with regulatory constraints. Depending on the application, modeling can be at the individual level, the aggregate level, or a geographic level. Examples of such modeling could predict propensity to prescribe a particular brand, attrition from CRM programs, next best action (what type of communication is most likely to elicit a response to a particular call to action), segment membership, etc. Individual-level modeling is more difficult for consumers/patients, easier for HCPs, and generally possible at geographic levels. It is important to keep in mind, however, that when using predictive modeling, the models are typically probabilistic, with the intent being to improve likelihood of success, and not specifically identifying “who will vs who won’t.”
Shifting to the optimization applications of predictive modeling, the most apparent uses are in marketing-mix modeling and attribution modeling. These models are quite useful in estimating the contributions to value of multichannel marketing or digital advertising. These techniques require a bit more special consideration than in typical consumer applications, given the journey involved – see an ad, research the brand, schedule an appointment with the doctor, perhaps undergo testing or rounds of office visits, and then the ultimate prescription and fulfillment. Therefore, quite a bit of time could pass between stimulus and response.
Another type of predictive modeling that isn’t often considered in healthcare is the practice of simulation, such as Monte Carlo simulations or other techniques such as agent-based modeling. These techniques can actually be quite successful in scenario testing or forecasting results that can then be used for decision support and rapid response in marketing. Such scenarios might include estimating the impact of a competitor increasing or decreasing its share of voice in response to a new brand, or the impact of a payer changing the access protocol for a particular brand. Similarly, by forecasting uptake of a particular brand, there can be a benchmark against which actual performance can be compared and then adjustments made to capitalize on success, optimize substandard performance, or reduce failures.
While some of these techniques are relatively new, others are “tried and true” in other, non-healthcare categories. With some creative thinking and a dedication to humanizing the techniques and associated data, healthcare marketing may be at an inflection point in realizing the value of predictive modeling and machine learning.

Nick Megjugorac, Strategy, Fingerpaint: Our client assignments have allowed us to be true partners in bringing predictive analytics to the marketplace. Part of our stewardship mandates that we continue to be bold in our advocacy for the use of these tools where applicable. Specifically, the application of behavioral science allows us to identify patient needs early and to tailor services that support that individual.

Aaron Uydess, Executive Vice President, Customer Experience & Analytics, Intouch Group: Data has the potential to be the “oil” of healthcare marketing and healthcare management – not only is data the most valuable commodity of the 21st century, like oil, it has to be “refined,” i.e., segmented, analyzed in order for it to be useful. We know that prevention is cheaper than managing conditions after they mature, and that adherence has the same effect. Data can tell us who is at risk and can inform us who is not adherent. But once we know the “who,” we need to determine “what” it would take to prevent and “what” it would take to adhere. Data needs to inform us of “who” but also “what” will change behaviors. To cut costs you need that 1-2 punch of who and what.

Gordon Clark, VP, Director, Engagement, McCann Health New Jersey: By-and-large, the healthcare industry tends to view a person’s “patient-ness”, how they think, react, and behave as it pertains to their condition, without regard to how those processes function, and impact, the other parts of that person’s life. Now, by combining the seeming disparate minutia available in big data, and the cognitive problem solving capacity in AI platforms, like IBM Watson, we are able to correlate macro trends, and identify predictive patterns of behavior. For instance, if we were to examine the health behaviors of GI patients, and overlay their entire data footprint – shopper data, (grocery, automotive, fashion), employment data (job type, commute info), and credit data (payment histories, purchase trends) – what new picture would develop? Could we, potentially, predict how well a patient was doing on therapy from their shopping basket data? Or that patients with an average commute of 90+ minutes tended to have reduced symptom improvement? Could we predict which patients would, or would not, be persistent with their treatment based on their credit card payment history, or their gym memberships? These are the areas, and types of questions, we need to be asking of the data in order to realize true predictive methodologies and design programs that will help improve patient outcomes.

Rita Glaze: Healthcare has scratched the surface on using predictive analytics and modeling that other sectors like retail and financial services have at the core of their business model. We are witnessing traction in using these capabilities to increase targeting accuracy and throughput from a discovery and clinical trial perspective. And now we are also at a wonderful tipping point where we can harness these capabilities on the commercial and delivery side of the business. Beginning to use the power of transactional data (codes, claims and Rx) plus the growing ability to drive insights from behavioral data (online social behaviors, affinity groups) to bring relevance to consumers.
For us, relevance is aligning the beliefs and expectations of consumers (or patients) with what organizations are looking for as outcomes – to find the sweet spot – that will drive engagement, action and lead to health investment optimization. The ability to find and be relevant, as proven across other sectors, can be the key in healthcare to unlocking deeper engagement in health, improved experience with and around the healthcare system and value across a fragmented universe of stakeholders.

Ujwal Pyati: I think the more we can generate predictions about who will benefit from which therapies, the more we can tailor specific treatment programs to specific patients, hence improving individual outcomes and limiting unnecessary spend on treatments that won’t work or will generate unacceptable side effects. With the explosion of new treatments being developed every year, it is becoming more and more difficult for treaters to make decisions about which therapy to prescribe for which patient. Through predictive analytics, if we can utilize the vast amounts of data from biomarkers, individual patient characteristics, family history, etc. to make decisions about specific therapies that will/won’t work at a specific time for each individual patient, we can cut costs across the healthcare continuum and spare patients the burdens of unnecessary treatments, while maximizing the chances of treatment success.

Sharon Callahan: While the pharmaceutical industry has traditionally developed medications for the masses, predictive analytics is and will make it financially viable to develop therapies for smaller groups as analytics helps companies to understand exactly who is able to benefit from them. And if we know which medication will work on which person before it’s prescribed a lot of waste through trial and error will be eliminated – resulting in better patient outcomes and lower costs.

Ken Begasse Jr.: I believe this is one of the most exciting and tangible opportunities for the industry. We now have the ability to move beyond demographics and identify psychographics. With each passing day, our “digital life” data volume reaches unprecedented levels. Across all ages, data are being captured in our native environment, allowing us to comprehend both explicit and implicit sentiment through what we call behavioral data signaling. These signals can be grouped into “digital phenotypes” that we can identify and use to model patient and physician behavior so that we can inform positive health experiences, improve well-being and positively impact outcomes – all areas currently limited by the typical data capture of interactions in a healthcare journey.

 

4. How is AI disrupting an industry that has been slow to adopt new technologies?

Andy Hayley, Managing Partner and Lottie Walter, Account Director, TBWA\WorldHealth: In short, the world of AI, VR, ER, MR (and all other short acronyms found in MedTech) are forcing much needed disruption in the healthcare industry.
This MedTech world is, trend-setting, eye-opening, savvy and dynamic.
These are not words often associated with the healthcare industry. In the UK, the National Health Service was recently reported to have ‘stubborn’ resistance to new technology, credited with being the world’s biggest fax machine buyer. That pretty much says it all.
However, the MedTech world is forcing change in this industry. Weekly announcements are showing how AI speeding up change in all parts of the healthcare world. From the clinical, such as the FDA’s recent approval of the first AI diagnostic system in diabetic retinography. To the meaningful, such as the chatbot currently being trialled in Boston which offers emotional guidance to terminally ill patients. Both are examples of where AI is making inroads into the healthcare world and aiding in all sides of a healthcare professional’s role. This disruption will inevitably only speed up in time.
It’s this inevitable speed which is causing us all to look at the space differently. In an attempt to keep-up with this changing landscape, healthcare companies risk falling behind and all starting to sound the same. More than this, they risk not having a voice of value in an evolving landscape.
Finding that voice requires healthcare companies to look sideways at their peers; forward at the market; inwards at their culture; straight-on at their customers. And, most importantly, look underneath it all at the reason they’re in this place to start with – to aid patients at the end of the journey.
So, in answer to the question: AI is shaking up the healthcare industry from a practical innovation perspective, but also in making sure the industry questions and defines its real value in this evolving landscape.

Prodeep Bose, EVP Growth & Innovation, The Bloc: Gartner’s Hype Cycle graph was born 18 years ago, which posited that most technological innovation must go through cycles of inflated expectations, disillusionment, periods of enlightenment, and then advance along a more gradual plateau of productivity.
AI seems to be well past the peak expectations of IBM’s Watson being a breakthrough decision support system in oncology and advancing toward the trough of disillusionment for AI having any health utility at all. As always, futility is often a predecessor to utility. AI today has three powerful undercurrents that are driving incremental learnings to place it on the plateau of productivity: genomics, imaging, and operational triggers for healthcare networks and health systems.
Genomics is only as useful as its findings. AI is perfectly positioned to deliver on the massive amounts of data correlation required to drive a hypothesis-free approach to discovery. This is happening every day – the cancer genome atlas and a number of public and private initiatives from the National Health Service’s partnership with Illumina in the UK to Guardant Health, Foundation medicine, and others who are leveraging AI for data analytics are shaping the present.
AI is already proving to be quite valuable in radiology as well. Imaging analysis is, after all, about pattern recognition, which is truly a core strength of computing systems. The chronic shortage of radiologists in most countries of the world is a rate-limiting factor to the use of advanced imaging systems, even more so than cost, which also will see a decline due to automation. This application of AI alone is projected to become a $2 billion industry. In the longer term, this has the possibility of positioning advanced imaging systems in a preventive and screening role, given the parallel advancements across imaging and computing. What imaging will do to the practice of medicine is akin to what digital video did to the making of movies – you can see what you’re shooting in real time.
The other application of AI, which is not nearly as sexy, is likely to have an even more dramatic impact behind the scenes – specifically around how hospitals triage and how health systems arbitrage benefits. Being able to predict if a patient goes into sepsis, or exactly when an OB-GYN might be required, and a multitude of other clinically related operational decisions are, and will, increasingly be triggered by AI systems. Health coverage is another area of multi-factorial complexity that is massively statistical in nature. AI may not replace the doctor, but may certainly replace the health administrator.

Chris Seda, SVP, Product Design Director, FCB Health New York: The most important thing to note about artificial intelligence (AI) is that labeling it as a “gimmick” – as naysayers have done in the past – is the best way to get left behind.
At first, the notion of using a quirky virtual assistant to help supplement features like customer support or FAQs on a website may have seemed like something that would’ve been short lived. However, with the advent of machine learning and natural language processing, the next evolution of AI has opened our eyes to just how powerful an experience can become within a brand’s digital property when applied properly. We’re seeing how the implementation of some form of AI can truly help the user complete tasks along their journey. Through machine learning, our AI-powered chatbots and devices can become smarter by codifying all of the queries and conversations they have with users on a daily basis.
The applications in healthcare for autonomous self-teaching AI are now virtually limitless. There are millions of users out there already engaging with a device enabled with some form of AI. The voice assistants in Alexa, Google, Cortana, and Siri being omnipresent in our lives – on our mobile devices or on our smart appliances at home – have enabled us to submit queries for information or content without lifting a finger. As a result, we, as users, now expect that all brands must have a voice in the ecosystem, otherwise their competition will.
From a healthcare standpoint, this also has tremendous benefits to users with limited mobility or the ability to utilize a computer. Now, with AI and ambient computing, accessibility limitations can potentially become less of a barrier. Conversational UI (user interface) and AI enable any patient to use only their voice to prompt their AI assistant, in order to consume the content they’re looking for, without relying on any other input device.
The disruption happens when we remember the importance of a broad reach as well as access to care; and brands are realizing it’s not only about being progressive or cutting edge, but also about being discoverable, scalable, accessible, and contextually relevant.
AI can provide a means to get there, enabling brands to be available to their customers 24/7; giving them the on-demand responses they’re seeking in the privacy of their homes; or even as a way to streamline the typical doctor’s office visit. Even if the healthcare industry is a bit slow to adopt new technologies, there’s still time in some cases to earn first-mover status with AI; or at the very least become a fast follower in order to stay relevant. And as marketers, we’re thrilled about the idea to help get them there.

Rob Zand, SVP, Experience Strategist, McCann Health New York: Nothing more clearly represents AI’s influence on traditional healthcare than the mere announcement from Amazon, JPMorgan Chase, and Berkshire Hathaway that they would enter the health world with an aim of “reducing wasteful spending”. Their collective data prowess in the consumer product space created vast speculation as to their aims. Further fueling those expectations are the numerous healthcare startups applying AI to change almost every aspect of patient health, from diagnosis, to adherence, to the testing of new treatments.
DIAGNOSIS: Voice technology can recognize disease progression and reduce hospital readmission in COPD patients. Heart rate monitoring apps are detecting irregular heartbeats. Chatbots are engaging with patients and providing diagnosis with approximately 80% accuracy. By aggregating vast amounts of data – x-ray and scans, EHRs, trial results – and testing predictive algorithms against known historical outcomes, AI is able to contemplate a broader array of potential ailments than humanly possible. While massive HCP job loss is not an immediate concern, it is reasonable to assume patients will increasingly come to appointments armed with better, data-informed health narratives; increased quality-of-life expectations – “Will I sleep better?”, “Will my resting heart rate decline?”, “Will I be able to take more steps daily?”; and even life expectancy predictions owing in large-part to ubiquitous data informed insights and recommendations. Doctors can expect their role to continue to evolve.
ADHERENCE: The promise of better health, through greater insight, plied by incentives from Amazon gift cards to Apple Watches, is encouraging patients to submit to greater monitoring of daily behaviors to promote better health outcomes. Experiments in new forms of clinics, promoting daily maintenance rather than care for a problem have begun. Starting from a technology fueled baseline, these clinics surface relevant insights based on genetic makeup, past history, and patient goals, and attempt to offer patients and doctors “real-time”, actionable health insights. AI plays a critical role in understanding what information to surface, and when to surface it. Clinics are not alone in monitoring their patients. Insurance companies – both establishment and startup – are offering incentives to patients to report real-time health information to them. AI helps companies evaluate their patient pools overall health, and to tailor incentives personally and overall. Indirectly, AI is influencing the types of health and health insurance entities and offerings made available.
NEW TREATMENTS: The establishment of vast platforms of data, coming from known parties with known existing conditions, is fueling broad research into potential treatments for chronic and incurable conditions. One of the most significant influences AI has had on traditional pharma is the acquisition of one platform, Flatiron Health, by Roche. Flatiron is a player in the oncology space that aggregates vast amounts of structured and unstructured data to find qualified clinical trial participants and consequently speed the clinical trial process. Noteworthy in this acquisition is the fact that Roche has decided to leave the platform available to the broader oncology community, while simultaneously using the platform for proprietary advantage. By enabling and promoting a communal effort, AI has taken a step towards upending traditional approaches.

Paul Balagot, Chief Experience Officer, precisioneffect: Although the healthcare industry has been notoriously slow to adopt new technologies, the business of artificial intelligence is not waiting to be adopted. Rather it is pushing its way into the healthcare industry.
There are countless stories of how AI companies are working to disrupt healthcare. Some of them are extremely promising and some are smoke and mirrors. But what remains true is that this proactive push by AI companies is forcing the healthcare industry to rethink and question the way it is operating and delivering care. For example, Amazon continues to add to its list of HIPAA-eligible machine-learning tools to better support its healthcare customers and improve patient interactions.
At precisioneffect, we’ve leveraged Amazon’s LEX platform to create AI branded chatbots that provide treatment support for patients at scale. The impact of AI will be far reaching, and we believe it will ultimately translate into greater efficiency and optimized workflows in the fields of research, diagnosis, patient management, and support to name a few.

Tracy Blackwell: The use of artificial intelligence is inspiring one of the most exciting transformations in healthcare that we’ve ever seen. We collect all kinds of data through smart phones, wearables, even electronic health records. Now, we’re beginning to have the ability to leverage AI to analyze this information, which undoubtedly will bridge gaps in healthcare professional/patient communications and ultimately, patient outcomes. It’s also very exciting to think about how AI might improve care for underserved populations inside and outside of the United States. From diagnosing, treating, and monitoring patients, AI will enable us to bring best-in-class care where it has never before been possible.

Wendy Blackburn: In operations, we’re seeing AI being used to automate existing processes and drive efficiencies, as well as digesting and filtering huge amounts of data in ways never seen before. On the commercial side, AI is helping provide patient-assistance services such as verifying insurance, automating customer service through chatbots, and creating predictions at scale to deliver the ultimate personalized experience to customers. The possibilities are endless; we’re just getting started.

Aaron Uydess: AI is perceived as riskier than social media. Pharma was slow to adopt social because they could not control the conversation and were worried about FDA warning letters. AI is a more abstract concept than social with pharma not defining how it could be used.

Christina Kim: Artificial intelligence is already a fluid part of our lives, from voice response technologies (think Siri) to recommendation engines (think Amazon and Netflix). As these technologies become ever more pervasive, the need to adopt this across every sector will be table stakes for any organization. Recent research indicates that the healthcare industry is the primary driver when it comes to investment in AI research and applications with the market exceeding $10B by 2024 (according to a report by Global Market Insights). The major tech giants are innovating in this space (Google DeepMind, Amazon Health in prescription delivery, Apple Health Kit, etc.) and healthcare is already seeing value from AI.
Artificial intelligence is well known for advancing precision medicine and more recently, genomic analytics. In Japan, doctors used IBM Watson to diagnose a patient with a rare form of leukemia. Use of AI allowed them to diagnose the oncology patient and identify a lifesaving therapy much faster than if they had used traditional methods by manually examining the patient’s genetic data. The researchers had to supply genetic data from the patient and then Watson crosschecked it with a database of previous patients. Watson was then able to detect gene mutations that are unique to a particular type of leukemia.
The opportunity to reduce growing healthcare costs is another area that AI can dramatically impact. AI can be used for administrative-heavy tasks like transcription by automatically converting voice to text and releasing physicians’ times spent away from patient care. Google’s DeepMind has partnered with the UK’s national health system by developing AI algorithms to read medical scans and make recommendations for doctors.

Adam Cossman: AI’s role in healthcare is in its infancy, and from what I’m seeing, it isn’t being adopted to any significant degree; after all, we’re still trying to get healthcare marketers to adopt more modern-day analytics approaches. From a marketer’s perspective, AI can be instrumental in areas such as:
• Using machine learning to more deterministically ID and understand targets
• Customizing messages so that our communications with patients and HCPs are more relevant, timely, and impactful
• Uncovering digital behaviors that would indicate when a patient becomes more or less compliant with therapy

Sonja Foster-Storch: AI is becoming a crucial accelerator to the life science industry throughout the product lifecycle, bringing efficiency in both time and money.
• Drug Discovery – Merck, GSK, Sanofi and AstraZeneca are just a few companies who are using AI to expedite drug discovery. Some efforts are focused on identifying new uses of existing molecules, while other efforts are using AI to identify new therapeutic opportunities and work through potential molecule candidates in record time.
• Clinical Trials – AI is expediting recruitment by identifying patients in EMR systems who match trial criteria. Meanwhile, AI is helping unlock greater insights in clinical trial data.
• Commercial Activities – We are used to seeing molecules approved with companion diagnostics. We are now entering the world of AI as companion clinical decision support tools, with the FDA approving the first AI-based CDS tools this year. In addition, AI is creating an opportunity for marketing teams to deploy just-in-time marketing materials to doctor’s offices with patients who would benefit from their molecules, such as the efforts done by Alnylam Pharmaceuticals. Predictably, we are also seeing conversion of customer support materials to automated Chatbots across all channel types. Perhaps one of the biggest efforts to deploy AI is being done by Celgene’s Pharmacovigilance team to create a highly automated drug-safety system that allows rapid collection, collation, and automated analysis of high volumes of data to identify potential drug safety signals.
AI is also changing the interface of healthcare delivery. General expectations of consumer-brand interaction are being fundamentally reshaped thanks to AI. Those expectations are carrying over into healthcare interactions, as well. Almost 60% of consumers expect that their healthcare interactions today will become more like their shopping experiences with Amazon. This change in expectations of healthcare creates a significant opportunity for companies to re-think how they design interactions with their customers, patients, and HCPs alike. We conducted a survey of ~1,000 patients in the US and EU to find out what they thought about AI in healthcare. We learned that patients understand that there is a role for AI in the healthcare delivery continuum. 64% of respondents are comfortable with an AI triage or nurse assistant, much like what the NHS has deployed with Babylon Health in the UK for over 1.2 million people. But, they want doctors on the other side of the algorithm making the final decisions. Furthermore, they want doctors playing a key role in the development of the AI tools created – a cautionary message we shared at JPM/Biotech with investors seeking to capitalize on AI technology in healthcare.
At GSW, a Syneos Health company, we continue to double down on leveraging predictive analytics to inform everything from commercialization strategy to messaging and channel mix optimization with our clients. Our approach allows us to create intelligent models that enable clients to de-risk the process by virtually war gaming decisions in record time without having to invest a single dollar outside of the modeling effort. Our teams continue to stay in sync with the changing interface of healthcare driven by AI – such as using natural language processing and sentiment analysis to uncover emotional insights, leveraging chat interfaces to help customers find actionable information quickly across multichannel ecosystems, and automating patient support processes to onboard patients to new medications via Chabot assistants.

 

5. How are your agency and clients incorporating AR, VR and/or MR into improving business operations?

Graham Johnson, EVP, Chief Product Officer, FCB Health Network: AR, VR, and MR have been among the most promising emerging technologies for years. VR (virtual reality) has been around the longest, but is just entering the mainstream due to affordable headsets like the $199 Oculus Go. AR (augmented reality) is becoming more widely available on recent iOS devices that support ARKit and Android devices that support ARCore. Mixed Reality or MR, gives us the ability to blend our real world with virtual worlds, adding completely new levels of interactivity and engagement; as well as new levels of possibility.
We have successfully used VR for years. One of its main selling points early on was simply that it was new and attracted a lot of attention (much like the current interest in AR), so it’s been used a lot at conventions and congresses. If you have spent any time wearing a VR headset, the immersive technology has the ability to transport you to another world. We’ve found it’s incredibly useful to illustrate the mechanism of action of a drug or to provide empathy around a disease state. You can virtually walk a mile in someone else’s shoes.
As VR becomes more mainstream – it’s increasingly being used as a welcome distraction for patients who need to relax before undergoing a procedure, seek an escape during a treatment like chemotherapy, or want to tune out chronic conditions like pain. It’s also a marvelous tool for education. But if you own an Oculus Go, you’ll find it’s still fairly limited, especially around health and wellness. So, there are enormous opportunities surrounding healthcare professionals, patients, caretakers, and consumers at large.
Case studies for AR are emerging. The main difference between AR and VR is that, with AR, you’re not escaping to a different world but rather layering experiences on top of your existing one. AR will share many usages with VR, namely education, but it will offer different advantages. You won’t need bulky equipment, for example; but more importantly, it can provide valuable context. VR might show you how a disease progresses in a virtual world, but AR could offer a window into your own body in real-time, providing a more immediate and deeper connection and understanding.
The next level of fun begins when we start mixing these technologies and creating a hybrid version of physical and digital realities. With MR, we are able to do just that. However, because of the level of effort, plus hardware support necessary to bring MR to life, we’re only still just seeing mostly concepts and prototypes to demonstrate what MR can become. Luckily for us, technology is always advancing and making itself more readily available to the everyday person, so we anticipate it’s only a matter of time until we see mobile devices with add-on peripherals (or built in hardware) enabling us to mix that which is real, with that which is made up of 1s and 0s.
If we’re to forecast how this tech can improve overall business operations, think prototyping and how a hybrid of realities will allow us to engineer, making something virtual more tangible to examine and explore before we invest in physically building it. This can apply to any type of research and development, improving workflows and overall operations.

Bryan O’Malley, Interactive, Fingerpaint: Honestly, we’re pushing into that direction. For example, AR is really interesting for MOA. Imagine being able to show a trachea in 3-D on a desk and walk around it with your iPhone or iPad and see it in amazing detail, then zoom in to the point of impact for a drug and watch the MOA play out in vivid 3-D animation. We’re doing that, which is a hell of a lot more engaging than a printed CVA or nine-minute video – and really that’s just the beginning.

Rob Coolican, Director, Client Development, GMR Marketing: We work with our clients every day to help solve a wide range of challenges with new technology. They are leveraging the power of VR to improve everything from the way that they conduct market research with patients to the ways that they engage professionals at conventions and out in the field, showing how conditions effect the body, how an MOA will work and empowering them to drill in as much or little as they want into the things that matter most to them.
Augmented Reality is highly scalable as it is available to everyone via app download on a phone or a table device and our clients are largely utilizing it to bring life to static displays for patients and professionals (data visualizations, key content callouts, etc). The use of Mixed Reality (eg. Microsoft HoloLens) is still in its early stages of adoption, but the potential for MR to help businesses from the factory floor out to the field is only limited by one’s imagination…and, of course, budget!

Erik Gorka, Senior Interactive Designer, Link9: At Omnicom Health Group, we’ve recently leveraged AR technology to help one of our top clientsstand out in the cancer immunotherapy space – by elevating the MOA of the immunotherapy. We debuted our convention experience, at a recent medical conference, ASCO 2017, featuring the Microsoft Hololens – a Mixed Reality visor that allows users to view and interact with 3D virtual elements or “holograms” in their real-world environment.
Using the HoloLens, we created an immersive 3D MOA experience, allowing HCPs to directly interact with the cancer immunity cycle and the unique properties of the therapy. Once a booth attendee put on the Hololens headset and aimed their view at a physical pedestal in the booth, a 3D “hologram” of the MOA emerged and animated on top of the pedestal. Users could walk around the pedestal, view the animation from all angles, and use gestures to explore the visual, advance through the chapters of the MOA, and select different options from the menu. At its ASCO premiere, congress attendees described the experience as: “Star Wars meets Immunotherapy. An absolutely fabulous experience in terms of seeing visually the mechanism of action, and so interactive.”

Adam Cossman: AR and VR are great tools to leverage in specific circumstances to drive deeper levels of engagement in educational opportunities. In particular, they can be helpful in educating doctors in high-science applications where clinicians are less familiar with the MOD or MOA; in training primary care physicians, who are increasingly more strapped for time, on how to more quickly ID patients ideally suited for certain therapies; and even in training sales teams to better articulate the unique benefits of a brand.

Sonja Foster-Storch: We’ve seen quite an influx in AR requests from clients in the last couple years as Apple has released ARKit and Google launched ARCore in 2017. We have incorporated AR into internal demos to fuel ideas for our creative department as well as client demos to open their minds to possibilities they were not considering. In the healthcare space, specifically the device space, we’ve notice how powerful AR can be when it’s used to put a device in front of someone who otherwise wouldn’t be able to see it in action. Now with iOS 12 released, Apple has opened the doors to multi-user AR experiences, which brings new possibilities to explore.
As for VR, we have seen outstanding results as it relates to empathy, giving you the ability to fully immerse someone in the shoes of a patient or caregiver. In 2016, we used VR to allow healthcare providers to experience what it would be like to come to consciousness in a busy restaurant after a seizure. This debuted at the AES conference and is still in use around the world today. Many people step away from that experience with a new understanding of what their patients are dealing with every day. VR is quickly evolving with the more recent release of closed systems like the Oculus Go and the Magic Leap One, which no longer necessitate an external device. This portability opens a lot of new doors for clients and consumers alike.

Gordon Clark: AR/VR/MR continue to be a topic of great interest with clients, and the main barriers continue to be cost and time-to-development. Each component has the ability to provide a visceral experience that can enhance learning, and message acceptance. AR/VR/MR all have particular scenarios where they excel, such as AR for an enhanced sales call or VR/MR for an extended convention booth, or symposium experience. Each platform has reached a level of maturity where the technology itself is no longer a draw, and we are actively working on prototypes that can function as frameworks for typical scenarios, and then allow us leverage our experience as content and experience experts to match the desired clinical or emotional impact.

 

6. Please discuss the impact of “external market disrupters” to the healthcare industry such as Amazon, Apple, Google, etc.

Leo Tarkovsky, President, McCann Health New York: In my opinion, these are not disruptors but rather enablers and as they will enable a fundamental industry transformation from the functional, product outcome world to that of customer experience. For marketers, these technology-based solutions will help drive customization and targeting, and for consumers/patients – they will drive convenience and facilitate access to diagnostic tools and even therapeutic options.
On a more fundamental level, these enablers will work to create a greater degree of engagement of consumers with their own health, whether it be prevention, earlier diagnosis, and/or greater compliance for better outcomes. The technological solutions will also have the potential for taking the cost out of the system by putting tools and choices in the hands of those most vested in optimal outcomes. And they will also serve to automate on-going management of certain health needs (transient/OTC or monitoring) and thus free up other resources needed for managing more complex and costly chronic conditions. In summary, these technology-based enablers stand to accelerate the movement of the industry in the direction that it has already professed it wants to move towards – that of greater patient centricity.

Jesse Johanson, President, McCann Health Echo: At first blush, we look at the list of companies above and focus on the distribution of healthcare services, medications or apps that will alter our engagement with health. Nevertheless, I believe the true power these companies bring to healthcare is in the field of informatics. Each is making significant investments in artificial intelligence and natural language processing. These capabilities, with time, could lead to massive improvements in how we detect, diagnose and treat diseases in far more effective and efficient means than today. AI could transform the massive quantities of healthcare data into true innovations in how we manage the hospitalized patient or use medications treat diseases we once thought completely distinct (It was recently shown that HIV therapies may have a positive impact on Alzheimer’s).
Privacy issues will continue to complicate efforts to harness medical records. Facebook’s continued missteps in privacy issues draws a spotlight to the use of our personal data. While these are critically important debates, the link to polarizing political issues may slow progress.
While informatics is more difficult to understand than an Amazon Pharmacy or a highly effective Apple Health App, it will have far greater impact on the quality of health and healthcare in the decades to come.

Nina Manasan Greenberg, PhD, Executive Creative Director, Entrée Health Network: For years, payers have been the most untouchable and stalwart of health care institutions. While we’ve certainly been seeing some market change – as a result of the rise of accountable care organizations and IDNs, and even the major influence of walk-in clinics – how these organizations behave has been
pretty predictable. For years at Entrée Health, we’ve prognosticated about “someone like Amazon” disrupting buying and distribution. Now we see that we were short-sighted. Amazon plus Berkshire Hathaway plus JP Morgan Chase feels like when Indiana Jones pulled out a gun in the middle of a swordfight. The rules are about to change dramatically.

Jason Dineen, SVP, Creative Director, Copy, Entrée Health Princeton: I think we have seen an Amazon effect. (But not related the new Amazon-Berkshire-Chase venture – just yet). While still in the doctor’s office, patients now break out their phones to shop for online copay support, hub services, and (unfortunately) search for any front-page headlines about price hikes for the prescription they have just received. When we think about “the patient as payer,” digital empowerment can impact prescribing if patients are informed of out-of-pocket costs in the moment. Cue a cacophany of waiting room “Hey Siri, what’s the cheapest insulin pen?”

Garth McCallum-Keeler, Managing Partner, Chief Strategy Office, Calcium: While ‘disruption’ has been the omnipresent label of anything having to do with the intersection of healthcare and tech (or ‘‘HealthTech’), what this intersection really represents is a ‘facilitation’ of the ability to organize and make sense of the seemingly unlimited information now available.
The amount of data in healthcare (be it on mechanisms of action, to drug-drug interactions, to genomic sequencing, to HEOR) has and continues to grow at an exponential rate. The sheer volume of data and information available is at a level that is well beyond the threshold that the human brain is equipped to comprehend. The practice of medicine is often said to be both a science as well as an art. Without tools to make sense and find order in the vastness of the data universe, the practice of medicine could become increasingly narrow in area of expertise and more reliant on belief over proof. However, the pace of technological and analytic advancement has given healthcare the data ‘facilitators’ that it needs. Google AI and IBM’s Watson both have a keen focus on improving healthcare decision-making – patent assessment and diagnosis will inevitably be reliant and ultimately supplant HCPs as the trusted source for decisions across all of patient care.
Likewise, patient empowerment and engagement in healthcare decision-making has been growing as information has become more readily available. Technologies primarily driven by AI (i.e. Alexa/Siri) and ‘simple’ algorithms (e.g. Google search) can help expedite patient understanding of disease state and personalized treatment approaches. These data search tools co-exist with the growth of the ownership of personal data. Personal data collected through ongoing monitoring (e.g. Apple Watch, medical wearables) and genetic testing and family health histories are consolidated into Personal Health Records (PHRs) that will serve as the foundation for personalized care.
The next level of ‘facilitation’ will require the intersection and synthesis of public Big Data and private PHR in ways that are fluent, seamless, and trusted.

Chris Panetta, SVP, Group Account Director, The Bloc: External market disrupters are beginning to exert an influence on the healthcare industry. It’s a trend that is difficult to ignore, and has become a common point of discussion with clients as they seek to identify opportunities to complement their offerings and drive more positive outcomes. Two examples of where these disrupters are having an immediate impact in healthcare includes the accessibility of data and the increasing trend of acquisitions and partnerships.
Today patients and caregivers are more empowered than ever to take control of their health. This is tied to having greater access to relevant information and personalized health data. Implementation of electronic health data has been a positive step forward, but slow to create accessibility to centralized patient data. However, Apple’s partnership earlier this year with 13 prominent health systems is doing exactly that. With patient permission, Apple is providing electronic health data through their various devices. Behind us are the days of Kramer needing to steal Elaine’s medical charts (for those Seinfeld fans). In addition, having access to this data while integrating with Apple and Google’s health-tracking apps will allow physicians to have greater visibility into the patient behaviors, which will only improve outcomes.
Greater access to data, predictive analytics and AI continue to steadily grow in parallel with the progression of acquisitions and partnerships. While each of these disrupters are true problem solvers, they still recognize the opportunity for partnerships that naturally supplement their offerings and that will improve health management for patients. The Amazon acquisition of PillPack is a perfect example. I’m personally looking forward to hitting the dash button to reorder my monthly prescription and coordinate all necessary health payments while having my health app data shared with my physician.

Mark Willmann: Having watched and participated in the healthcare industry from early-stage drug development through healthcare marketing for more than two decades, I’m excited by all the changes that are underway. We’re at the intersection of the widespread adoption of EMR, deep learning machines, like IBM Watson, and “simple” AI assistants, like Amazon Echo.
Recent opinions point to Amazon being the primary agent of change within the healthcare industry. Amazon has the partnerships, resources, and established brand loyalty to revolutionize the delivery of healthcare. In fact, it’s already begun, with many providers starting to use certain Amazon technologies, such as Alexa voice recognition software and the Amazon Business purchasing platform.
Regardless of the disrupter, we’re all eagerly anticipating the future in healthcare, with better informed clinical decision-making, lower costs for patients, and delivery of better patient outcomes by catching illness earlier, or even preventing disease.

Aaron Uydess: The days of creating something in-house for a client are over. Clients don’t want to recreate the wheel and continuously invest in maintaining and innovating something that already exists out of the box with companies like Amazon, Google, etc. As these companies begin focusing on healthcare, the ability to adapt and tailor those solutions will allow pharma to innovate faster and put things out in the market place with lower overhead.

Paul Balagot: The full impact of disruptors such as Amazon, Apple, and Google is yet to be seen. However, what make these companies so influential are their persistent connectivity with the customer and their data proficiency. These two ingredients provide the platform to generate deeper insight into patient behavior, and in an evidence-driven industry like healthcare, the opportunity to effect change will be significant.
Healthcare and clinical personnel are to needed to unlock this potential and translate these deep insights into meaningful healthcare products and services. Apple and Amazon have been building their health teams for some time, and just recently Google announced the hiring of Geisinger Health CEO David Feinberg to help shape Google’s strategy into healthcare. As tech companies scale their healthcare teams, their ability to impact clinical trial recruitment, patient management, and treatment decision-making will be extensive.

Sharon Callahan: It’s time to start imagining a world where health care is truly owned by these proven, forward-thinking, and disruptive companies because they are quickly finding ways to deliver the personalized experiences that customers have been yearning for. Do you fill your prescription with your Amazon Prime account, see the doctor on your Apple phone, triage your condition through Google, and call an Uber instead of an ambulance when you need to go to the hospital? I think it’s much bigger!

Sonja Foster-Storch: The interest from and entry of players like Amazon suggests that healthcare may be even riper for disruption than it appears. While we’re encouraged by the changing dynamics this brings to our category, it also means we need to radically change how we think and operate. Like it or not, we now live in an age of accelerations and we must continually evaluate the landscape to understand new expectations, new models, and new pressures. Understanding this shifting market increases our chances to win. It means we don’t change one thing, one time – we keep actively changing a lot of things at the right times.

Adam Cossman: We’ve already experienced indicators in terms of how external technology disruptors are changing healthcare. Google, for example, changed how well-informed patients and caregivers are by providing a search engine to explore symptoms, treatments, and side effects. It’s become the go-to resource for anyone suffering from any symptom/condition, and that has consequently changed how patients engage with their healthcare professionals. Apple changed how patients engage with their doctors in the exam room by putting a smartphone in their hands. And Amazon is likely to change how they order/purchase medication. This disruption continues with the likes of modern-day concierge medicine providers like One Medical Group, which has eliminated front- and back-office experiences in the practice and provided a more streamlined, self-service, high-touch experience that simplifies medicine. All of these are simple yet highly relevant indicators of how the healthcare ecosystem will evolve in the future.

Graham Johnson: Amazon recently spent $1 billion to acquire PillPack, who offers a really smart way of packaging and dispensing drugs that’s especially valuable to anyone who takes a regimen of medication. Amazon not only acquired their innovative business model, but their existing infrastructure and licenses to deliver drugs via mail. In another development, Amazon announced a partnership with J.P. Morgan and Berkshire Hathaway to look for new, innovative ways to lower the healthcare costs of their ~1.2 million employees. They also have the industry-leading smart speaker, Amazon Echo, which is increasingly being programmed for a variety of health and wellness uses. The only thing stopping adoption in many instances is the lack of HIPAA compliance, which should arrive soon.
Apple is building a medical assistant. Cars’ useful lives have more than doubled, due in part to the check-engine light. Simply put, that’s what Apple is building for us through their smart devices. It’s more than counting steps. Smartwatches and smartphone apps offer holistic programs to monitor physical activity, sleep, mindfulness, and nutrition. And this doesn’t mean merely a dashboard that tracks and displays data, but an assistant that interprets these data and makes proactive recommendations to produce better health outcomes for the user. This is part of a larger trend of digital therapeutics geared toward well-being and specific disease states.
Alphabet, the parent company of Google, has a life sciences division called Verily that is making big bets across healthcare using a large and varied portfolio. One particularly interesting initiative is a partnership with Nikon to develop new, low-cost cameras that can take a picture of the back of your eyeballs. The camera provides an unobstructed view into your vascular system and the resulting images are being analyzed using algorithms to immediately diagnose a host of diseases including diabetic retinopathy and macular edema, which are the leading causes of blindness in the US. Verily’s vision is to put these devices in high-traffic, consumer outlets and tie the immediate, resulting diagnoses into your Google account.
All of these initiatives are blips on the radar, but together show the top consumer technology companies have taking a keen interest in healthcare and are making long-term investments that, over time, will radically alter the landscape.

 

7. Please discuss the best ways how patients are increasingly using digital tools to make health decisions.

Laura Catalusci, SVP, Group Director, Health Education Strategy, FCB Health New York: The complexity of making health decisions falls not only on the patient but the care team they are interacting with. The more information that is available, the better decisions that can be made, and thus, better health outcomes achieved. Digital tools encompassing interactive web-based conversation guides to apps with predictive behavior capabilities based on data collection may be the keys to unlocking the future of health decision making. They hold the opportunity to activate a shared decision making (SDM) process that is more than a SHARED assessment – it can be an INFORMED dialogue.
However, it is important to recognize that at this time, these digital tools are only as good as the data they are built to collect and the actual data collected. Skills in the form of digital, numerical, and informational literacy still challenge people who are leveraging digital tools to either understand or improve their health – and in many cases, both. Developing digital tools that are easy to understand, easy to use, and easy to take action from make these tools indispensable to patients and their care teams. Better decision making will come from the correlations that these tools can make from the information they collect.

John Deely, Executive Vice President, Director of Digital Experience, Patients & Purpose: In our recent research with patients, we’ve heard about a wide spectrum of digital tools being used for decision making around health. As you’d expect, the tools vary by demographic and disease state, but one common denominator has been the smartphone. It is the “magic box” that is the gateway to education, connection, support, utility, and ultimately empowerment.
In the past few years, social media has become a core digital channel for patients to get educated on their condition and treatment options. Whether it’s from brands, advocacy groups, or organic patient groups, people are flocking to social to get the information they need. It’s important for brands to remember to show up in a way that’s authentic to the space.
Patients are also growing accustom to newer technologies, such as voice assistants and automated messaging (chatbots). As they use these newer technologies in their everyday lives, they are starting to tap into them to help better manage their health conditions. These channels, when used purposefully, can be a great way to provide patient education and support.

Marcus Sigurdsson, Chief Digital Officer, McCann Health: Consumerization of health tech has basically exploded in the last few years. The most famous example is probably Apple Watch, probably the first device that is both a FDA Class II cleared medical device as well as a fashion item. Anytime, anywhere, any device is becoming real and AI and machine learning are enabling new opportunities.
Most common uses are different types of trackers for exercise and diet but more capable devices such as AliveCor and Apple Watch 4 are likely to become more common as FDA is more open and faster to review new tech than in the past.
The real game changers are apps such as SkinVision or Babylon that are giving indications and then connect with a human health care provider for an online consultation. And as algorithms and tech gets better so will the value delivered by digital tools. But unfortunately, the possibilities are also causing a bit of a misdirected debate around how patients should use digital tools and the role of the physician. Technology is not a magic wand that solves any problem and just like the thermometer didn’t make the physician obsolete, neither will digital tools. But it will helps live healthier lives.
One category that is just starting is digital therapeutics which are clinically validated, software based interventions that will allow patients to go from indication to treatment without logging off… And digital tools are getting more advanced, patients will start to generate clinically grade data, blockchain will allow them to control their data and take a more active part in their treatment.
With proliferation of digital tools along patient journey, clear communication and optimal user experience will be more important for driving a positive health outcome than ever and Comms agencies will start to play a new and more important role than ever. With our in-depth knowledge of patient behavior and expertise in science as well as consumer tech we’re uniquely placed to support the pharma industry to create digital tools that delivers a holistic patient experience.
The three key pieces of advice we give our clients when we start planning digital tools are:
1. Approach digital tools and health tech from the patient perspective. If possible, involve them in the process.
2. Be aware of any emotional aspects of the content and experience.
3. Think long term and use data to continuously optimize the experience.

Adam Cossman: Patients are now triangulating multiple sources of data to learn about their condition and help make treatment decisions. No longer is the HCP the sole resource for determining which path a patient may travel. Rather, search, endemic health sites, mobile resources, and social and digital influencers are all highly leveraged to make more informed decisions. It makes sense; after all, doctors are more pressed for time than ever and don’t always have all the answers, and real-life data and experiences may be able to fill key voids.

Ujwal Pyati: Obviously tools like the AppleWatch, Fitbit, etc. are making people much more aware of their day-to-day health and even incentivizing them to adopt healthy habits through competition and other means. But increasingly, the opportunities for community forums and support via virtual exercise classes, weight loss programs, etc are changing the nature of how we approach activity and diet. These have been tremendously successful and impactful for many people I know and have created a tremendous market of their own.

Paul Balagot: There is a new wave of digital tools being made available to patients, taking the age of the “empowered patient” to an entirely new level. I’m talking about the field of digital therapeutics, which can simply be defined as evidence-based therapeutic software programs that can prevent, manage, or treat a variety of conditions.
Companies like Propeller Health and Pear Therapeutics are leading the charge. What sets digital therapeutics apart from first-generation medical health apps that patients would download but rarely use is they carry a much higher degree of clinical rigor – and in some cases require a prescription. This enables these digital tools or therapeutics to track patient data in a much more sophisticated manner and provide greater value and impact to the patient. These characteristics help patients become not just empowered but much more informed about the intricacies of their individual disease.

Sonja Foster-Storch: Around this topic, many traditionally think about the ways in which patients seek out medical information or self-diagnose with Dr. Google. These are valid and established patterns of behavior, but they won’t substantially move the needle for today’s life sciences leaders. Voice technology represents an opportunity to reimagine and redesign the services we offer to be conversational. Consider that 73% of people with voice assistants have made a purchase directly through the device. This signals that conversational interfaces are already well on the way to being universally intuitive and accessible. Digital therapeutics is another interesting area and a growing medical trend that offers behavioral interventions to people where they live via digital technology. Within the next ten years, we expect to see a boom in new treatment approaches that place digital coaching at the core. Benefits include scalability, lower barriers to access, and the ability to rapidly test what works best for different users.

Nick Megjugorac: In short, the “best” part is the simple reality that people are adopting digital resources and becoming more involved in their own healthcare. In an industry notoriously slow to change, new tools have enabled better access, reliability, and data usability. Conceivably, though, the most effective applications are those that have allowed for the shift in mindset, from a patient who is the bystander recipient of information, to one who can be a proactive advocate for their own wellness. As the number of technological innovations brought into healthcare increase, we see the need for a commensurate rise in solutions and education to drive behavior changes that allow consumers to utilize them effectively.

Wendy Blackburn: Over the past few years, we’ve seen a sharp increase in people’s interest in and use of digital health tools like online physician and healthcare facility reviews, wearables, health and fitness apps, telemedicine and at-home testing devices, but there’s also disparity in who is using the tools. Chronically ill older patients – those who might most benefit from digital health tool use – are least likely to use the tools, while health-conscious young adults, the so-called “worried well,” are more enthusiastic adopters. The greatest challenge facing makers of digital tools like apps and wearables is user abandonment, which means that future tools need to be flexible, easy to use, and they must offer a seamless experience and value over the long term. With the recent announcement by the FDA that it plans to make it easier for biopharma companies to embrace mobile and other digital tools, we hope to see more players jump in to provide apps that truly make a difference in patient’s lives.

Sharon Callahan: Consumers are increasingly leveraging digital resources to both prepare for appointments and validate physician recommendations – moving beyond diagnosis to become more active in their own treatment decisions. People are now informed about their genetic profile, the disease they have or might get, and their options for the best treatment. This leads to new expectations for a more personal healthcare experience.

Prodeep Bose: The patient tools of today used to be the physician tools of yesterday, and that trend doesn’t end with weight, pulse, blood pressure, sleep sensors and EKGs. The combination of software tools and the increasingly powerful mobile computer has set the stage for the future of patient-reported outcomes that play a critical part in clinical decision-making.
Two main factors that make or break any digital health tool are clinical utility and ease of use – as patient tools. The Multiple Sclerosis Performance Test is one such test that uses an iPad to test for well-established criteria for disease progression in MS. Whether spirometry for lung function using an iPhone, Proteus’ nanochip technology encoded pills that track compliance, or voice tremors predicting Parkinson’s Disease, the future of care is powered by the future of patient-reported outcomes powered by portable hardware, software, and cloud computing systems.

 

8. Please discuss the role that blockchain technology will play in the long-term transformation of U.S. healthcare.

Jennifer Matthews, President, The Bloc: Blockchain technology will transform the healthcare landscape by providing a more secure method of tracking data – it will just take some time. The obvious opportunities are with electronic health records and overcoming the inherent fragmentation of existing platforms. There is also meaningful opportunity to implement in clinical trial management and overall compliance tracking. The relevance for healthcare providers is clear and adoption will be driven by those organizations that are more technologically mature and possess the infrastructure to implement.

Don Feiler, Managing Partner, Chief Digital Officer, Calcium: Managing and sharing patient and disease state data is a major challenge for the US healthcare market. Sprawling, unwieldy, proprietary systems struggle to communicate with one another, making the goal of universal data exchange seem a pipe dream. Blockchain technology may present a path forward toward universal record keeping for the US healthcare industry.
Blockchain systems are large, ever-growing lists of records. “Blocks” of information are “chained” together with cryptographic hashes. Any change to any piece of data in a block results in a new hash that breaks the chain, making tampering with records virtually impossible. Modifications can be easily tracked and repaired. Unlike traditional databases that have a central storage location and owner, blockchains are distributed among all users and therefore are not susceptible to any one point of failure.
The group-sourced, secure data gathering made possible by blockchains has great potential to improve public health in the US. Blockchains could record and make publicly accessible such data sets as disease outbreaks, vaccination data, or even opioid overdose records. With many contributors nationwide making real-time additions to the data sets, public health officials will be able to leverage the data to spot and address major outbreaks and other public health crises. These efforts are near on the horizon.
Further down the road, blockchain technology has the potential to bring about universal digital health records that are interchangeable among stakeholders and controlled by patients. This is something of a holy grail in US healthcare. We have not found it yet, but blockchain technology is putting us on a path to universally accessible and shareable patient data. Privacy is an obvious obstacle (think HIPAA) that must and can be addressed before blockchains can manage ePHI. An even larger obstacle is the so-called “last mile” issue. Currently there is no way to tie a digital record to an offline entity with the same certainty and integrity that blockchain brings to data sets. Until we find a way to match a humans to data records (implanted microchips, retina scans, etc.) the last link between data and human beings is based solely on trusted intermediaries and can be manipulated.

Ken Begasse Jr.: The possibilities are numerous, while the exact long-term impact remains unknown. The use of blockchain technology can be a catalyst to address many of the ailments that plague our healthcare system today, such as fragmented data platforms or elongated drug discovery processes, eliminating billing fraud and data security weaknesses. Simply put, blockchain can become the common language of healthcare, allowing for a more holistic perspective on how we discover, manage and measure our disease impact on a global level. How does it come together? Nobody can say for sure, but blockchain can certainly convert the transactional nature of our healthcare experience into a more modern, transformational health experience for all stakeholders.

Nick Megjugorac: As expected, the innovation lies with the application of this technology, not the tech itself. By understanding what problems it can solve, we can see how blockchain is poised to have broad utilization across healthcare. From a manufacturing and supply chain perspective, tighter control and better insights are possible over product life (including medicine and devices), from inception to consumption. This knowledge can provide valuable data for patients, HCPs, manufacturers, and payers. For example, tracking down the individual pill level enables the healthcare system to ask and answer worthwhile questions about compliance, outcomes, and real-world experience.
One of the overarching themes blockchain represents is trust, so how is it that this ideal can be commodified in the short-term? This concept may lie at the heart of the ultimate answer to this question. Perhaps an early impact will be felt administratively, as the focus intensifies on efficiencies in healthcare. This includes fraud and privacy concerns, who has seen or shared a patient’s records, and where the data ultimately end up. Solving these issues then opens the door for an evolution of thinking for how we may approach the next set of challenges.
By evaluating the current challenges our healthcare system is experiencing around trust, we can explore the benefits of applying blockchain technology to address concerns with privacy, fraud, interoperability, supply chain, and more.

Sharon Callahan: Blockchain technology will transform the overall healthcare experience by connecting disparate systems and data while ensuring privacy – and allowing individuals to own their own health data. This data in aggregate will be the foundation for discovering potential solutions to our most complex health problems.

Sonja Foster-Storch: When we think about patients’ health data, there are two concerns that are inextricably linked, both of which blockchain has the potential to alleviate: 1) data needs to be kept private and secure, and 2) when diagnosing, having more data can be a significant advantage.
There are a few additional areas in which we see potential for blockchain to make the healthcare ecosystem more fluid: 1) Medical Records – ensuring greater security around updates to the record over time and preventing untrackable changes or deletions; 2) Consent Management & Patient Centricity – empowering the patient with a greater degree of control in sharing their information; 3) Micro-Exchanges – incenting patients for adherence or rewarding them for contributing their data or experience to clinical trials and research.

Boris Kushkuley: Blockchain technology can solve one of the key problems of US healthcare system – distributed nature of electronic medical records. Every doctor, hospital, lab facility has its own way to record and store information about the patient. In spite of all attempts, they do not talk with each other and when it comes to ability to create a 360-degree picture of patient health to provide the best care, there is no one place to go. The inherit features of the blockchain ledger offer straightforward solution to this problem. If patient’s medical records will be saved using blockchain technology, this will create a secure and easily accessible distributed repository that is centrally governed but not “owned” by any specific entity. We have in our reach an effective tool that can drastically improve treatment outcomes while reducing physician errors.

Marcus Sigurdsson: It’s always tricky to talk about the long-term effect of a rapidly evolving tech that is just starting to see commercial implementation. But I think it is safe to say that blockchain and Distributed Ledger Technology (DLT) are likely to play a large role in the long-term transformation of U.S. healthcare.
The ability to connect fragmented systems around shared, trusted data across multiple organizations will help to better assess the value of care and will be essential for outcome-based healthcare.
The first areas to be affected by blockchain will be non-patient related activities such as supply chain safety and back office. We’re already starting to see some of that.
Then there will be more patient participation as in increased ability to owning one’s health and data in the form of consent management – recording consent for purposes of data sharing and micro payments to reward healthy behavior and e.g. contribution of data to studies.
Long term is where you will see the big changes around patients, their data and care coordination. The combination of more mature implementations of blockchain and patients generating their own clinically grade data devices and genomics will shift from e-HR to p-HR (personal health records) combining patient data from multiple systems. Once we can safely combine data, from genetic profile to response to treatments we’ll start to see “digital twin”, a virtual representation of you, based on your data. This “In silico” patient will allow for faster, cheaper and a safer way to develop and test drugs as well as optimize patient specific treatment plans.
But it is important to keep in mind that we are still in an early stages. It will take a commitment from the whole healthcare ecosystem to maximize the value of DLT. There are a number of areas that need to be addressed such as GDPR, security and privacy, lack of standards and system interoperability and regulatory approval.
To some extent, the current stakeholders are disincentivized to solve the problems that blockchain is tackling and the big transformation will start to happen when there is an outcome-based healthcare business model in place.

Gordon Clark: Blockchain clearly has the potential to finally make healthcare data secure, permanent, and, just as important, portable. Instead of hundreds, or thousands, of isolated pieces of data making up a patient’s health history, all that information can be uniquely tied to an individual, and instantly accessible to healthcare providers anywhere.
• Blockchain’s permanence means that records can’t be tampered with, or altered – only appended – providing healthcare identity security, but that process also provides the ability to review health data over time
• Security allows blockchain data to be more easily stored in cloud-based data libraries, making them accessible from anywhere; patients will no longer have to organize information from multiple HCPs, testing facilities, or even apps
• Broad accessibility will push the industry to data uniformity, an issue that currently prevents most health data from being shared between systems, or sometimes even providers within the same system

Christina Kim: Data proliferation exposes vulnerable grounds for data exploitation. The seemingly opposing requirements of transparency in healthcare data to promote better treatment and outcomes stands in stark contrast to the increasing concern regarding privacy and security of our data. Especially in the context of digital health care, the openness between the patient, health care provider (HCP), and marketer can foster a relationship of trust, leading to beneficence on all ends. According to a report by HFMA and Humana, 70% of HCPs believe joint data sharing models are essential for successful value-based care. Blockchain technology allows for anonymous and decentralized record of transactions, built on the ability to track, record, and validate transactions, promoting accuracy.
Moreover, the recent news among the tech giants and questions regarding trust with data sharing between Google, Amazon, Facebook, and the consumer can be further mitigated by the transparency of blockchain because the transaction of data is always viewable and impossible to replicate. The use of tokens (blockchain cryptocurrencies) can also bring the seller to the same level as the consumer, offering a shared responsibility of communication and ownership. With the help of industry regulations, all the big players now accept safety tags, and with the help of the GDPR, universal audience tags required by blockchain may soon be adopted.

 

9. How is your organization achieving gender parity and diversity in leadership positions?

Dawn Serra, Regional Talent Director, McCann Health North America: Across McCann Health North America, we are proud of the fact that more than 50% of our Senior Leadership Team is female. We are committed to ensuring a diverse workforce, and specifically aim to achieve more diversity in leadership ranks. To that end, this year, we implemented a leadership & empowerment program targeted for our diverse employee base. The ultimate goal is to differentially develop employees from diverse backgrounds to help them grow into leadership roles.
This year, we also required all of our top 50 leaders across the network to take Unconscious Bias training to help ensure key talent decisions are made appropriately. Our Presidents were also tasked with building their networks outside of the traditional candidate pipeline, in an effort to bring in more candidates from diverse backgrounds.
As part of our gender parity efforts, we conduct regular compensation analyses to ensure parity globally.

Carolyn Bartholdson, Chief Human Resources Officer, Omnicom Health Group and Ayaunna Bibb, Human Resources Director, TBWA\WorldHealth: TBWA has a global initiative, Project 20\20, which was launched in summer 2015 as challenge to increase women in leadership roles across the TBWA network by 20% by the year 2020. The initiative, challenges each TBWA office to bring awareness, spark conversations and make concrete strides to achieve more balanced workplace. Project 20/20 was born out of observations that, despite the recent and welcomed surge of female-focused equality initiatives, the advertising industry continues to lack the critical mass of male counterparts to champion the cause for equality. At TBWA gender parity isn’t a women’s issue, it’s everyone’s issue.
Project 20/20 is on track with TBWA\WorldHealth making robust advances in increasing leadership roles within the agency. As of July 2018, 59.6% of senior leadership (VP and above) at TBWA\ WorldHealth are women with an overall retention rate of women is 89%.
A powerful example of a campaign that’s come out of Project 20/20 was in conjunction with International Women’s Day to stress the importance of recognizing women’s issues as everyone’s issues. The campaign branded “Take The Lead,” includes a poignant 2 minute film featuring men from around the global TBWA network, from all levels, specialties and backgrounds, reciting actual quotes from their female peers. The quotes were solicited via an anonymous global survey in which women in the industry were asked to voice some of the issues and injustices they have faced, or expect to face, throughout their advertising careers.

Jo Ann Saitta, Chief Digital Officer, Omnicom Health Group: Diversity has to be part of a company’s DNA if you are going to be successful long-term. At Omnicom Health Group our commitment starts from the top and workplace equality is a priority for our business. In addition to Omniwomen, our industry leading global organization to promotes female leadership we also have both formal and informal mentoring programs. Our company also commits to mandatory learning and development that fosters inclusion at all levels.

Christopher Tobias: Over the past 20 years, our industry on a whole, and especially our agency (~65% women for the past 5 years) has developed into a workforce that almost always has a greater number of women than men in any meeting room – except in the most senior leadership roles in organizations. This is progress, but it is clearly not enough, especially when diversity in our industry and in leadership are not reflective of our societal makeup. Leadership positions require a blend of great life experiences, a humbleness surrounding learning from failure, an innate ability to form a trusting connection, the capacity to achieve success against the greatest odds, and recognizing that leadership is earned from your team or company, not bestowed on anyone. These attributes are not solely contained to one gender, or one race. So, why are these statistics the way they are? Simply put, those who place people in leadership positions must have the conviction, belief, and strength to find those leaders and support their rise in a company. Our organization has worked hard to recognize the next level of leaders as we have doubled in size over the last 2 years. These efforts have championed the promotion of four female leaders to VP roles, and our senior executive team is so very fortunate to consist of two dynamic female EVPs, but that is still just 33% of the team. So, we need to do more. In order for us to continue this work to achieve gender parity and diversity in our leadership positions, we must ensure that these opportunities are presented, discussed, and championed without bias or reticence, and joyously celebrated because they make our company, our offering, and our culture stronger.

Nina Manasan Greenberg: We’re hiring and role-modeling the idea that difference of all sorts is great for business; we know that sameness breeds sameness, and that’s not particularly helpful for fresh ideas or approaches. Across the Entrée Health network, our leadership has been majority female for years, and we’re ensuring that our colleagues have strong leadership role models. It’s equally critical to help young people see a place for themselves at Entrée Health. That’s why we’re great supporters of ADCOLOR and MAIP. And why we chose Queer Health Access, a project of the Tegan and Sara foundation, as our pro bono client. Everyone deserves access to the healthcare they need, and that includes culturally competent healthcare.

Tracy Blackwell: Fingerpaint has a very clear focus on achieving gender parity and diversity, not only in leadership positions, but throughout our agencies. If you look across our five offices, you’ll find many women in positions of leadership. Like most of the advertising industry, we’re challenged with attracting more diverse talent. But this is a responsibility we take very seriously, and we need to look at creative ways in which to reach a more distinct talent pool, like actively recruiting at universities with more diverse student populations. The truth is, we know more diverse opinions and experiences make us better.

Emily Poe: A particular area of focus for W2O as we take efforts to improve diversity not only here at W2O, but also more broadly within the healthcare marketing and communications spaces are around our partnership with The LAGRANT Foundation, a nonprofit organization that has successfully provided professional development and career opportunities for ethnic minority students within the advertising, marketing and PR fields. We very much support their mission to increase the number of ethnic minorities in advertising, marketing and PR. Jim Weiss is personally quite involved, and sits on LAGRANT’s board with the goal to help make a real impact in addressing the clear diversity gap in our industry.
In 2016, W2O and LAGRANT formed what we believe is a first-of-its-kind partnership to address the lack of diversity within the PR/marketing industry. We created a healthcare communications diversity fellowship program called the Future Leaders in Healthcare Fellowship, which was launched through a donation from W2O. It was meant to deliver real impact through the following:
• Providing opportunities for minorities interested in healthcare communications. As a firm grounded in the healthcare space, W2O’s ensuring the next generation of healthcare communications leaders are ready for the challenges ahead while supporting LAGRANT’s mission.
• Increasing diversity specifically within the W2O team. We believe this type of program is critical to increase our own team diversity, allowing us to bring more balance, perspective and authenticity to the communications we deliver our clients.
• Building a pipeline of talent across the industry. As we all know, finding top-tier talent continues to be a struggle within the marketing communications area and our program is designed to bring more high-potential talent into the recruiting mix.
The Fellowship places two Fellows from LAGRANT in one of W2O’s primary offices each summer, and is designed to support opportunities for minority professionals and to develop the next generation of healthcare communications and marketing professionals to meet the current and growing demand. In the past two years, we’ve had 6 interns from the program across multiple offices within our firm, and are looking at ways to continue to broaden and deepen the program. Of course, this program is certainly not a complete solution, but it is one example of our commitment to making strides in our recruiting and in supporting stronger minority inclusion in the industry.

Adam Cossman: I’m very proud of what W2O has done to promote female leaders and strive for gender parity, especially in leadership positions. In addition to the President of the W2O Group (Jennifer Gottlieb), 7 other core members of our executive team are women, including 3 of the 5 operating company presidents. I’m honored to be in an organization where I have the opportunity to be surrounded by so many impressive female leaders in healthcare marketing and communications. What’s further, most of my female colleagues balance the demands of the job with those of being a mom, and that is truly impressive.

Sonja Foster-Storch: GSW’s name represents our founders (Gerbig, Snell, and Weisheimer). Recently, it has evolved to also represent the unique talents each of our employees brings to our business – Greatness Starts Within. Greatness Starts Within captures our collective culture, goals, and standards for excellence. It is because of our employees’ passion and quest for excellence that GSW has been able to create stories of positive impact for so many healthcare brands. GSW is passionate about building and maintaining a dynamic and diverse workforce of people with unique backgrounds and expertise that sparks new ideas and groundbreaking work. This only happens when we reflect equality in all parts of our company, including our decision-making process in hiring, compensation, corporate initiatives and among our leadership. At Syneos Health we have almost 23,000 employees; 65% of those are women. At GSW alone, half of our employees are women and a little over a third of those women are VPs or above. As a woman in a senior leadership position here at GSW, I will continue to lead by example, and this goes across gender and diversity. It is imperative that the culture in which we work continues to be a collaborative and open environment where people are free to share their thoughts and challenge one another to arrive at the best outcome.
Jennifer Matthews: As a woman-owned agency, we’ve embraced gender parity since the doors opened over 18 years ago. Our Executive Leadership team is 50% female and 50% male and this is reflected in our overall staff mix that is 51% female to 49% male, although gender is just one way of looking at it. Diversity is one of our core values because we believe that diversity of thought creates bigger and better thinking. And that becomes possible when you bring together teams that have different backgrounds and different life experiences. I’m proud that 41% of our staff are composed of people identifying as African-American, Hispanic, Asian or a combination thereof. Such diversity ensures that we reflect the communities we serve.

 

10. What are your industry predictions for 2019 and/or beyond?

Josh Prince, Chief Marketing Officer, Omnicom Health Group and Chief Executive Officer, DDB Health: I have three predictions for the coming year, having to do with complexity, agility, and creativity. First, medicine is becoming radically more complex. Innovations like immunotherapy, CAR-T therapy, and gene therapy are nothing like traditional pharmaceuticals or even biologics. They’re super complex in how they work, how they’re operationalized, how they’ll be paid for…and how they need to be marketed.
Which gets to agility. In this complex, multi-customer, multi-channel world, agencies are going to have to become much more agile to really serve the needs of innovative new brands. They have to be able to partner widely, coordinate effectively, and use data collaboratively. No single agency or offering can be the “uber-expert” across all customers and channels. But the best will be the most agile, bringing diverse parties together to solve complex challenges.
Lastly, I think creativity will be increasingly valued. There’s been a lot of focus on the power of data to transform marketing, and in many ways it has. But what we share – how we engage, involve and inspire people – is still at least as important as whom we share with. And creativity is the key to that. It’s a real business accelerator, and smart clients will treat it that way.

Kim Wishnow-Per, President, McCann Health Managed Markets:
Market Forces Reshaping the Future of Healthcare: The US healthcare system will continue to evolve and focus on driving needed improvements in patient centered care – with key dynamics being the driving force behind this.
Value-based Healthcare: The market will continue to shift from a volume based fee for service model to that of value based care – with a greater focus on assuming risk and being held accountable for population health management, improving outcomes, reducing and managing the total cost of care as well as providing an optimized patient experience.
Rise of Consumerism: As patient out of pocket costs rise and healthcare information becomes more accessible and manageable, patients will become more empowered and engaged in their health care as “consumers” and active decision makers rather than just passive participants. Furthermore, patient’s expectations for an enhanced consumer “experience” throughout their care continuum will grow in importance and rise to new levels.
Consolidation and Integration: As the shift to value based care and consumerism strengthens, there will be an ever growing need for more organized and coordinated care across stakeholders in the healthcare ecosystem. This market need will drive further consolidation as well as horizontal and vertical integration among key healthcare players. This will result in the emergence of more sophisticated care models across health plans, PBMs, integrated delivery networks (IDNs), providers and pharmacies – and shape how healthcare is delivered.

Andrew Gottfried, President, Entrée Health Network: So many of our clients are exploring value-based agreements with their customers. While this has been the buzz for the past couple of years, we are seeing more and more that manufacturers and payers /organized customers are actually creating these kinds of arrangements. As scrutiny continues to grow around pricing, we will see manufacturers are going taking on increased risk and standing behind their products to gain additional traction in the market.

Randi Baerson, EVP, Director of Client Services, Entrée Health New York: Scrutiny around drug pricing – You can’t open the newspaper, turn on the TV, or browse the web without coming across something speaking to the drug pricing issues in America today. We are starting to see shifts in payer behaviors around increased healthcare management, including CMS, that will ultimately force manufacturers to take action in order to ensure that their products remain successful. Across the board, it is anticipated that the market is going to experience a period of readjustment, where manufacturers need to react to the increased pressures from the industry, the government and the public.

Cora Meese, SVP, Client Service Director, Entrée Health Princeton: We have to keep an eye on technology. Is EMR the end all? I don’t think so. What if a patient needs to move between networks/IDNs? Today, too much information value is held up in individual healthcare systems, and EMRs are still disparate and don’t talk to each other. We know that a patient’s care is so much better when simple answers travel with them. (What were they last treated for? How were they treated? What was the outcome of a recent blood test?) If a patient goes to even a single doctor outside of a shared record system, too much value is lost. I predict this will be solved in the next few years, so that efficiency can bring patients, providers and payers together.

Laurie Bartolomeo, EVP, Creative Director, Dudnyk: 2019 will be a year of unprecedented innovation in molecular medicine, which will result in even more approvals of life-changing therapies for families living with rare disease. Already, we have seen exon skipping and stop codon readthrough technologies come to fruition, as well as the approval of the first gene therapy to treat a rare form of blindness. Antisense oligonucleotide therapy and RNA interference technology are making amazing strides for patients and caregivers dealing with rare disease – and this is only the beginning.
As more and more ground-breaking treatments are approved, the focus will be on people living with rare diseases – finding them, diagnosing them, and getting them to the right specialist who can treat them. This is not an easy task. It requires a completely different approach to marketing than those deployed in traditional pharmaceutical categories. First, the role of the patient becomes priority number one. Patients and/or their families are the ones that know the most about their conditions. They are online, in support groups, and in constant pursuit of a correct diagnosis and of the right physician who can help them. They are the ones doing the educating, as well as the advocating, for their condition. Knowing where they are and how they are searching for answers is a continuing challenge and one that we need to get better at overcoming.
Additionally, with many rare diseases being genetic in nature, access to genetic testing will take center stage in the quest to find these patients. Today, the availability of genetic testing can be somewhat limited due to financial constraints and limited coverage, but next year and in the years to come, those barriers will begin to crumble. We will see more patients undergoing larger genetic panels, and even whole genome sequencing. There are also groups researching and fighting for the approval of newborn screening for rare diseases.
In oncology, rare forms of cancers are driving the development of targeted, immune-optimized treatments that are helping patients live longer than ever. And now, living longer is not just about more quality of time with friends and family, it’s about potentially living long enough to see an even greater scientific advancement or new therapy that could change outcomes more drastically than we could have imagined.
It is an exciting time for medicine, and for medical marketers focused in the rare disease space. We are moving beyond traditional marketing methods and continuously looking for new and innovative ways to reach patients, educate healthcare professionals, and ensure a better life for the hundreds of thousands of people affected by rare diseases.

Adam Cossman: I finally see the days of digital vs. traditional agencies falling by the wayside. Moving forward it’s not going to be about the channel, but rather about focusing on how we leverage the right data to inform our creative campaigns, targeting strategies, and measurement models. What’s important is how we leverage an ecosystem to find patients, caregivers, and healthcare professionals at influential moments in their journeys to drive measurable performance for them and for our clients. Data, AI, and blockchain are the new buzzwords for today, like programmatic and digital were before them. The question is how quickly and effectively healthcare companies will embrace these technologies to drive improvements in how they connect with their audiences. I hope that we see marketers embrace modern-day methods more quickly than they have in the past so that we can learn from what has worked so well in other industries and improve the way we engage with our audiences.

Ujwal Pyati: I think there will be increasing restrictions on drug pricing, and the pharma/biotech industry will be under further pressure to generate more compelling value propositions to convince payers that the cost of treatment is worth the potential outcome. This will be more akin to countries ex-US, where pricing pressure can dictate completely different treatment algorithms, making true innovation in areas of unmet need paramount vs. generating me-too drugs in saturated markets.

Hilary Gentile: Stakeholders who drive treatment decisions will shift … the doctor has been the lynchpin; now patients, payers, health extenders, technology and health systems are all key stakeholders in the health ecosystem. Telehealth will continue.
Technology avalanche and defragmentation, as well as new players will force us to evaluate our current demand generation models. Intermediaries (including advocacy) are harnessing their own data more and more, and will be critical to assessing demand generation in the future.
Focus on digestion data to drive better decision making. Synthesis and interoperability of data and technology will be paramount. Human (emotional, societal, financial, etc.) and clinical data must be gathered to paint the full picture of our stakeholders. These “collective” data will be the new currency, enabling predictive and productive treatment paths and richer relationships with our stakeholders. 90% of the world’s health data has been collected in the past 2 years, but only 0.5% has been analyzed. Clinical symptomatology and prevention are table stakes – quality measures, happiness, and livability are new metrics of success.

Jo Ann Saitta: My prediction in 2019 and beyond is that healthcare companies will show continued commitment and major progress in leveraging their own data, artificial intelligence technologies, and connected platforms to break down silos and unleash new insights about both the patient and the healthcare professional.
The process of gathering and analyzing information on our customers has been vastly transformed by digital, big data, small data, and technologies like artificial intelligence. Never before has the view into the customer’s detailed activities, provided companies an opportunity to analyze these activities to build deeper and more effective customer relationships, improved-decision making, and business outcomes. Equally important, these opportunities will have a profound impact on the way in which we communicate in healthcare.
It’s no longer about “big” data but “good” data to help solve the business challenge at hand. With good, organized, and connected data, technologies like machine learning, natural language processing, and automation will change the game in healthcare marketing and redefine 1:1 customer experiences.
Healthcare and specifically Pharma companies, are getting their data house in order with agile data management platforms, tracking of digital behaviors, and connecting platforms to enable an omnichannel presence their big brands. True business advantage and personalization at scale will be realized when companies connect their siloed customer data.

Mark Willmann: With the sustained rise of healthcare consumerism, pharma and biotech clients continue to unify their message across all audiences, including payer, patient, pharmacist, and HCP to allow for a seamless brand voice. This is only bolstered by the convergence of consumer technologies and content consumption.
This dynamic environment is driving clients to partner with smaller, more nimble agencies that deliver a higher-quality product on a shortened timeline. These partnerships are creating new strategic initiatives and tactical approaches.
Patients are also looking for more flexible solutions for healthcare and flocking toward telemedicine, with an expected 15 to 20 percent growth rate.

Sharon Callahan: Medicine will be more predictive, preventative, personalized, and participatory because all stakeholders will be armed with data that will transform diagnosis and treatment and outcomes will improve. And then, the world’s healthcare systems will transition to a value-based model based on outcomes. These models will be data-driven risk sharing frameworks that benefit both providers and payers.
Regulators will have to adapt to this new reality as disruptive technologies challenge the traditional way that we assess the quality, safety, and efficacy of medicines – they will also have to adopt a data-driven approach based on patient outcomes.

Sonja Foster-Storch: For the ninth year Syneos Health released our very popular trend reports, read by thousands across healthcare and marketing. Over 200+ collaborators – including experts from GSW and our colleagues from across the global enterprise of Syneos Health – contributed to the report, sharing clues, observations, and individual stories about the changing experience of health and healthcare.
For 2019, we have identified 10 critical shifts (each with underlying dynamics) that will change how we test and commercialize novel therapies and innovations in the years ahead. 2019 will be a year of change, with innovation and challenges ahead. We enter this new year inspired by the power of science, the persistence of patients, and the success of survivors. Data is taking on science; the need for bold launches is greater than ever; companies are retooling, rethinking, and recruiting; the profession of provider is radically changed; we expect to see old and new players stepping in with strategies and services that reduce friction, complexity and inconvenience across the clinical and commercial landscape; and the patient experience – from everyday health to clinical trial inclusion – will be more transient, opportunistic, and data-connected. We live in truly incredible times. And as remarkable as this new era is, it also challenges us as an industry. In this report, we sought to dive deep into all the aspects of change 2019 has in store. We’re asking new questions with the goal of co-creating new solutions that help us all deliver on the possibilities of science.
These predictions are published at trends.health.

Wendy Blackburn: In terms of governance, the current administration has kept the industry on its toes, and 2019 will be no different. I expect the pricing transparency discussion to continue and even escalate. Consumers and HCPs alike will expect more and more from ALL of the companies from which they make purchases – pharma does not get a free pass here. Pharma marketers will move out of pilots into full-scale programs that include AI, automation, and voice technology – all with customer-centricity at the core.

Aaron Uydess: Excitement and pain. 2019 and 2020 will be an exciting time in healthcare. With innovations in AI and expansion of capabilities on platforms like Salesforce and Adobe, marketers will have more tools in their toolbelt to work with. The “pain” will come as companies will no longer accept digital as a cost of doing business but hold accountable marketers to show how digital can scale and drive the business. Accountability for results in multichannel execution will be more consistent across channels like sales, web, email and media. Pain is in making smarter decisions, faster and with greater accountability, and what it will take to get there.

Prodeep Bose: If prevention and cure are the two faces of healthcare, then the most pressing needs lie in the better management of diabetes and metabolic syndrome, and finding improved approaches to cancer care.
The role of technology enabled remote care, from telemedicine and remote consults, to always-on monitoring is critical to improving outcomes in co-morbid patients.
The broad adoption of genomics and precision oncology is leading to a gene-specific and tumor-agnostic mindset that will shape not only how cancer is identified and treated, but how specializations within oncology develop at centers of excellence. What oncology does in 2019, other disease categories will do beyond.

Jay Carter: Both 2018 and 2019 are years of the specialist. Of the 51 agents approved in 2018 by FDA, 38 were for use by specialists in relatively small patient groups. Fourteen were for cancer. This trend is driven by where the unmet need in our marketplace resides; the primary care audience is fairly well served for their “bread and butter” needs surrounding hypertension, hyperlipidemia, congestive heart failure, asthma, and COPD. There remains need for better solutions for pain, especially osteoarthritis in an aging Boomer population, and in diabetes, where the average HBA1c level in patients with diabetes was 7.5% (among patients with health insurance) and 8.6% (for those without health insurance.) Our society seeking healthcare is also becoming increasingly digitally savvy. Consumers demand more of their healthcare providers, and routinely research their maladies. With this information in mind, agencies that service the pharma industry will need to continue to specialize, and to understand and relate to a growing number of small but serious diseases, because that’s where the spending dwells.