More from our Pharma Times Interview: Research Studies and the Future of Digital Health

Our Chief Development Officer, Tom Krohn, is a pharma veteran with deep experience in R&D innovation. He was recently interviewed for an interesting article in Pharma Times on the future of digital health. Now, we’re following up with some additional thoughts from Tom on where digital health is heading, who’s leading the way, and advice he has for the industry.

How would you describe the current digital/technology environment in the pharmaceutical industry?

In a word: evolving. Of course, pharma and research studies are highly regulated, and change takes time. But there are other, more complicated factors at play as well. In 2012, the concept of Eroom’s Law was introduced. It states that the cost of developing a drug doubles about every nine years and observes that since the 1980s, as technology has grown by leaps and bounds, drug discovery has become slower and more expensive. These numbers challenge the idea of technological innovation as a type of silver bullet for drug development — and they also show need for realized innovation and change.

I see hope on the horizon. Companies have started to reduce risk, reduce R&D costs, and increase innovation potential. There are a few approaches and principles that I believe could point us in the right direction: driving disruptive innovation (not incremental) where we make things dramatically simpler, faster and cheaper; focusing on creative collaboration, rather than competition; and operating under an open model of innovation, rather than keeping knowledge under lock and key. This is the type of thinking we foster at Antidote.

How would you describe pharma's progress in adopting digital/technology in patient recruitment?

Digital patient recruitment can be traced back to the late 1990s, and I believe the pharma industry is actually quite far along the adoption curve for modern web marketing tactics. While still investigator site-centric, we see many clinical operations teams who are well-versed in the latest platforms and methods, from search engine marketing, to targeted email blasts, to social media, and beyond. Some sponsors have tighter restrictions than others, but it’s more a matter of risk mitigation than tech adoption. At Antidote we recognize the compliance and risk norms of sponsors, and have shaped our services to these standards.

What is still early days, however, is leveraging digital means to change the recruitment paradigm altogether. As eligibility and ineligibility criteria become increasingly particular, many willing trial volunteers are turned away. This is because the recruitment paradigm is trial-centric, not patient-centric. The industry has not yet figured out how to innovate, using models like OpenTable, ZocDoc, or Kayak.com to help volunteers find the right trials for them. This is where we at Antidote believe there is much work to do, and it’ll likely involve an ecosystem of patient communities like Inspire’s, as well as researchers and technologists to affect change.

Is pharma still being sucked in by digital fads, and if so,why? Smartphone apps are one example what others can you give?

I’d argue that smartphone apps are not a fad. There are many examples of apps that absolutely work to improve outcomes (for example MySugr, Omada Health, and One Drop, in the diabetes space). Smartphones are being used to track electronic patient-reported outcomes (ePRO) in clinical trials, as well. Using technology at home is familiar to patients and fits into their lives, and these devices show greater patient compliance, sometimes as high as 97%. In terms of fads, I think it’s easy to mistake new technologies as a fad until an innovator creates something truly useful and usable, from a regulatory perspective. From a pharma perspective, the challenge (and opportunity) is to cross the chasm from pilot experimentation of digital capabilities into scaled adoption and value creation.

Out of all the digital technologies available at the moment, which will be the game changers for the pharmaceutical industry? Why?

Recently, I saw a stat from Rock Health that in the last seven years, $23B has been invested into digital health companies. I’m interested in 2 particular trends. The first is how non-health companies are testing new ways to have an impact on the healthcare space. For example, Uber and Lyft are launching programs to transport patients to providers, and I think this could be applied to clinical trial appointments. Apple’s movement into Health Records is certainly one to watch as well. The second area I’m watching is blockchain. Blockchain’s powerful, unique features of data integrity, trust, disintermediation, smart contracts and auditability are capabilities that are core to research. I’m excited to see how it gets applied in the life science industry.

What digital technologies are on the horizon that should be on pharma's radar? Why are these technologies significant?

Beyond blockchain, I think the convergence of mainstream healthcare with clinical research is one to watch. I like to think about paradigm shifts. What if instead of trying to bring healthcare into research, we brought research to point-of-care? This includes advances in machine learning and artificial intelligence. There are many applications, including disease identification and diagnosis, more personalized treatment plans, better understanding of the underlying mechanisms of disease, smart EHR, and clinical trial matching (Antidote’s focus). Bringing this back to patient care, there are many diseases, notably oncology, where the clinicians and patients should be considering clinical trials. I’m interested and optimistic about how technologies can help bring trial options to point-of-care decision making. I believe this is the best approach to move the low trial participation to a much larger number, serving both researchers and patients.

What is the top challenge the industry still faces when it comes to adopting digital technology? Any advice for the industry?

I think the top challenge the industry faces is finding a path to change in the face of complex and established operations. For example, new technologies may require new personnel; new kinds of IRB reviews; different approaches to regulatory reviews; and new organizational communication flow, e.g. adaptive protocol design’s requiring multiple departments sync with real world data from research sites. I’d advise pharma to look at new technologies not as something that will require an overhaul of current standard operating procedure — but as something that can be applied in a small pilot and, if successful, expanded to accelerate research. A favorite mantra of mine is “think BIG, start small, move fast.”