Digital health is on the rise, with the pandemic only accelerating its demand. While some innovations have been introduced by tech companies, pharma has also been seeking to incorporate digital offerings to enhance value for patients and stakeholders. This is for good reason. The resources, patient data and access that pharma companies bring to the table make them excellent laboratories for health tech innovation. But health tech development is vastly different from drug development. Given pharma’s careful pacing and the sheer size of some companies, how can you successfully marry the rapid iteration and experimentation necessary to develop health tech with pharma’s white-coated, cautious culture? How do you set up a successful tech innovation team within a pharma company?
Late last year, at ZS’s Impact Summit, I had a chance to talk to a leader who’s had success driving cutting-edge innovations and novel technologies for patients in a multinational, biopharmaceutical company. Erich Wohlieter, Amgen’s executive director of digital heath has an interesting background. He was a research chemist before transitioning to corporate strategy and then finally to digital health. I asked him to share some of his experiences and lessons learned.
Erich Wohlhieter: Absolutely. The first example is Remo, a simple physical device, essentially a fancy refrigerator magnet that we developed with the help of patients and HCPs. The problem we're going after is adherence to medication. C. Everett Koop said that “Drugs don't work in patients who don't take them,” so we're nudging patients to take their medications. Once you've programmed it for your medication, it reminds you to take it on time either when you walk into kitchen or by text. You click a button when you take your medicine and it resets itself for next time. If you miss a dose, it might remind you that you need to follow up with your physician. We've tested Remo with patients, and we've seen about a 20% reduction in skipped or late doses over a three-month period, which is intriguing. We're in the process of designing a larger experiment with our partners, and we're looking forward to seeing where this goes next.
The second project is designed to make our field force as effective and efficient as possible. We know many physicians are moderately or severely restricting access to sales reps. So how can we make sure that the reps who are speaking to physicians make the most use of their time? We developed an algorithm that ingests about 50 data streams and predicts which physicians are most likely to prescribe within a time period, and then it comes up with a targeting list. It also helps map out a rep’s route to make sure they're making the most effective use of their time and seeing the highest probability prescribing physicians. An internal study showed that the solution does make our reps more efficient and effective. So that's one of the projects we're very proud of, in part, due to the increase in revenue that we’ve been able to demonstrate.
EW: I break it down into three aspects: Building a diverse team, unleashing that team and establishing trust. So building a diverse team: I’ve been told that our digital health and innovation team is the most diverse at Amgen. We’re diverse by design, not only in terms of people’s background, but also in education, interests and experience.
Number two was about encouraging ideas and we do this a few ways. It starts with what I call crazy ideas. I periodically send my team a crazy idea of my own, not with the intention of pursuing it, but to be provocative and socialize creativity. There's no penalty for coming up with a solution that you wouldn't show to management right away. Then we share ideas inside and outside our group and outside of Amgen as well. Sharing failures is also critically important. Finally, I tell them that successes are all theirs. No matter what you do, if it's a success, you own it. If something goes wrong and it turns out to be a failure, that's mine. I take responsibility for failures and that frees them up to take creative risks.
The last thing is trust. To establish trust in our group, the team went through exercises to help them understand where each is coming from, communication styles, etc. We also empowered two team members to be sympathetic listeners who can help resolve issues with or without escalating to management, so nothing goes without being addressed for too long.
EW: Our team drives experiments to their logical end points with a sense of urgency. Sometimes that’s fast, but our version of fast. I liken it to when I learned to drive a 1987 Isuzu Trooper. It was a super boxy SUV with a small, four-cylinder engine that went zero to 60 in 11 seconds. So my fast in that car is nothing like a Lamborghini Aventador that does zero to 60 in 2.9 seconds. So fast can be a relative term. Tech has the reputation of going fast and breaking things, but that's very difficult to do when you're dealing with people’s health.
EW: It’s important to have a nimble and robust process where you can take these innovative projects that maybe don't have a set return on investment, and “de-risk” them before large, resource decisions are made. We employ a five-step process, which should be familiar to anybody who uses the scientific method. It starts with opportunity identification. How can we frame the problem? What are we trying to accomplish? What opportunities do we see? And once we’ve articulated that opportunity or problem, we can generate ideas for how we address it. Then, as quickly as possible, we set up a minimally viable proof of concept (POC). Once we've determined that POC, we may try a larger-scale experiment, so we can make a wide-scale deployment less risky. That's our five-step process.
You also need a budget. Oftentimes, business stakeholders are wary to risk investment that may not pay off, so being able to bring some funding to the table is helpful. It’s important that your stakeholders bring some of the investment, so they have skin in the game, but helping with costs motivates them to try new things.
It’s of critical importance to have good partnerships with legal, compliance, regulatory, privacy, etc. Make sure they're working with you to address the uncertainties that inevitably arise. We fund several compliance and legal positions on our team’s payroll. They report “solid line” into their respective functions, “dotted line” to us. We always know whom to call with questions, and we know that our issues will be at the top of their list.
EW: I’ll draw on my chemistry roots here. One of the things I find similar about digital health and chemistry is that most of the experiments that you run don’t work. So I would say be resilient. That's necessary to long-term success. I'd also say be entrepreneurial. Oftentimes, when you're trying new things, you’re told “no.” Having conviction that you are in fact on the right path and pursuing the right things and being persistent and not giving up…Those are the are keys to being successful.