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During this year’s J.P. Morgan Healthcare Conference, I had the opportunity to sit down with Vice President and Head of Communications, Pharmaceuticals at Bayer, Steven Immergut, and PRWeek Vice President and Editorial Director, Steve Barrett, to discuss a wide variety of topics including tax reform, the CVS-Aetna merger, the specter of Amazon and how these industry activities are making a substantial impact on the healthcare mergers and acquisitions (M&A) landscape. Additionally, we chatted about the importance of communications and reputation throughout every stage of M&A.

Check out our discussion via PRWeek’s podcast or read the transcript below (thank you to Bayer for sponsoring!).

Steve: Hi, this is Steve Barrett, editor-in-chief of PRWeek, reporting from San Francisco. We’re in town for the J.P. Morgan Healthcare Conference. We’ve just had a roundtable discussion about M&A and communications supported by Bayer and delighted to introduce Steven Immergut from Bayer who’s head of U.S. Pharma Communications. Hi, Steven.

Steve: We’re also joined by Jim Weiss who is chief executive officer of W2O Group. Jim, welcome. Great discussion. One of the big themes this week, Steven, was tax reform and the impact that that’s going to have on M&A

During this year’s J.P. Morgan Healthcare Conference, I had the opportunity to sit down with Vice President and Head of Communications, Pharmaceuticals at Bayer, Steven Immergut, and PRWeek Vice President and Editorial Director, Steve Barrett, to discuss a wide variety of topics including tax reform, the CVS-Aetna merger, the specter of Amazon and how these industry activities are making a substantial impact on the healthcare mergers and acquisitions (M&A) landscape. Additionally, we chatted about the importance of communications and reputation throughout every stage of M&A.

Check out our discussion via PRWeek’s podcast or read the transcript below (thank you to Bayer for sponsoring!).

Steve: Hi, this is Steve Barrett, editor-in-chief of PRWeek, reporting from San Francisco. We’re in town for the J.P. Morgan Healthcare Conference. We’ve just had a roundtable discussion about M&A and communications supported by Bayer and delighted to introduce Steven Immergut from Bayer who’s head of U.S. Pharma Communications. Hi, Steven.

Steve: We’re also joined by Jim Weiss who is chief executive officer of W2O Group. Jim, welcome. Great discussion. One of the big themes this week, Steven, was tax reform and the impact that that’s going to have on M&A and the logical extension of that for us, for our discussion. Communications over the next 12 months is tax reform. There is repatriation of cash. A lot of companies already may be sitting on a bunch of cash. What’s that going to mean? Is it going to be a big spike in M&A? How are companies going to spend that money?

Steven: Yeah, it was a big theme this week at the conference, Steve. And, you know, it remains to be seen how it’s going to actually play out. I mean it certainly seems like the stage is set for more activity, whether it’s M&A, large-scale M&A, or in-licensing agreements, or bolt-on acquisitions. You know, it kind of remains to be seen. There’s also a lot of talk about investing that cash back into R&D. One of the reasons why we were here as a company this week is to talk about our global innovation program. There’s a lot of investment and longer project, longer-term projects, in the innovation space.

Steve: Jim, what are you seeing from your clients? Because, obviously, the administration has brought in tax reform. It’s the repatriation of cash. They presumably want that to stimulate jobs and maybe even have some impact on drug pricing. I’ve heard a lot of talk about share buybacks and… But what’s your take from talking to your clients and your sort of experience in the sector over many years?

Jim: Well, talking to clients, helping them get ready for this meeting, but also going to many of the presentations and breakouts where many were grilled, “What are you going to do with this cash that will inevitably be there?” I think most of them are planning to stay the course at least for the next year too in terms of how they were going to allocate capital. And what I kept hearing over and over was that would be reinvested into the, you know, R&D function or to strengthen that in the pipeline and their people.

I think where there’s an opportunity to do the share buyback and do other things with the money, they will. But that’s all part of a…you know. And publicly traded global companies have very prescriptive long-term plans for that cash and they’re not… I didn’t hear plans to change that, at least not publicly as much. But like what Steven was saying, I do think companies are here talking about their goals and innovation. They’re talking to very different types of companies. It’s not just talking to other little biotechs which is what a lot of the big pharmas are doing here looking for partnerships or to fill their pipelines.

They’re also talking to health tech companies, digital health companies, companies that are focused on communicating or reaching patients. All of those things are, you know, in play as to what companies are going to do with the money. And I also heard a lot about opening innovation centers, partnership centers, places, incubators, where companies can flourish and grow under, you know, the tutelage and guidance and financing of larger company.

Steve: What does this mean from a corporate reputation and communications point of view, Steven? You know, if the…let’s say a company did invest a load in share buybacks that might not be what the administration was wanting that money to be spent, you may have the danger of a 3:00 a.m. tweak if you’re on the West Coast from the president or something like that. How do you react to these things? How do you prepare yourselves for things like that happening?

Steven: Well, you know, it’s never been a more exciting time to be in this industry, to be honest. The technology is amazing. The opportunities we have for curing diseases is unprecedented right now. And it’s just really exciting. So you focus on the difficult problems, meeting the unmet needs and patience, and investing in research and the science. And that’s what we’re focused on. I think that’s what’s really most important.

The other thing, as Jim mentioned, was a lot of discussion this week on technology and the use of machine learning, artificial intelligence, these kinds of new technologies in healthcare where we’re probably a bit behind the curve compared to other industries. So it’d be really interesting to see how that plays out going forward.

Steve: Jim, what’s your take on it? And this is going to mean cheaper drugs at the end of the day.

Jim: You know, I think the industry is obviously looking at ways to develop drugs that can, you know, not only help patients but also alleviate additional costs on the system. But I don’t think that that’s their foremost goal, right? It’s always been about their pipelines and patients and their people who do that so that I feel like that theme, I kept hearing those three P’s over and over in a lot of the presentations and discussions. I think that, you know, pricing the fourth P matters more than it ever has, and I think it’s the thing that’s keeping the executives up at night in terms of how do we solve this for the patient community and our physician community.

And the payer, another P, payer community, that they’re beginning to really, I think, acknowledge from the beginning. So they’re not developing the drugs the way exactly they used to and they know that an FDA approval does not mean or an approval in Europe does not immediately mean there’s going to be wide-scale use and distribution. They’ve got to work on the whole pattern of reimbursement and distribution and access. And I know that’s a function that we’re very focused on. We’ve created our own media platform called the Value Report that actually is designed to track what the industry is doing in this regard. And it did come up in many many of the presentations I saw.

Steve: Steven, how would you communicate around this issue about this sort of repatriation of cash in tax reform, the extra money in the coffers? How are you going to communicate around that?

Steven: Well, we’re going to continue to talk about innovation and driving value to meet unmet needs long term and even in shorter terms. So we’ve got a very ambitious high-level innovation program that’s tackling the toughest challenges worldwide facing humanity, both on the healthcare side and on the agriculture side. And the layer below that is our R&D program, phase 1 to phase 3.

We’ve got 50-plus projects in development across oncology, cardiovascular disease and others. And so you put those two together plus partnerships that we have in place here in the U.S. on the East Coast and our West Coast innovation centers. And that’s really the most exciting part about our story right now that we’re talking about. It’s to the whole R&D spectrum.

Steve: Jim, if you look at last year, 2017, it wasn’t a great year for marketing services holding companies. They were suggesting that companies were keeping their pocketbooks closed and budgets were under more scrutiny than ever. Do you think this extra cash is going to cause all boats to rise and, from a sort of selfish marketing and communications point of view, they were going to meet larger budgets available from your clients?

Jim: Well, you know, as we talked about in our roundtable earlier, I think the money will go, as it always has been, in pharmaceuticals and biotech into research and development. That’s where it always goes first. I think, you know, more scientists, more partnerships, more investment in innovation. But I think, of course, that will open up opportunities for communications firms like ours to help the companies spend that money wisely. And, you know, the opportunities may be a little bit different.

I think I mentioned that we’re looking at having a stronger clinical trial recruitment capability because, obviously, research and development is the priority of these companies and getting patients enrolled, and sometimes it’s very difficult. To enroll trials is job one. So it’s being nimble and capable of pivoting with the priorities of the industry that we have to be and then we can have the double-digit growth I know we’ve experienced because we’ve done that.

Steve: Yeah. Let’s change the conversation a little bit to general communications around M&As. One of the big themes of the discussions seem to be, Steven, that employee engagement and internal communications was absolutely vital if you’re going to have a successful transaction or merger or acquisition. Just talk us through a little bit why that is so important and some of the top tips that you would offer to our listeners.

Steven: Sure. I mean many…the employees are the key audience, really. They are paramount to the culture and paramount to the success of any integration. So, first and foremost, you need to really understand where they’re coming from, what’s in the hearts and minds of your employees pre-deal and throughout the process. So research is really important to be tracking the sentiments internally and then engagement. And it starts at the top.

So you have to have true genuine engagement from leadership with employees. Not necessarily to give status updates on a given deal, because many times there’s not much you can say, but just engagement. Answering their questions, talking about the status of the company overall, what’s been going on. And that really helps put people to ease. And I think employee engagement, starting at the top, is critical.

Steve: Certainly, you’ve learned during this ongoing months. And so by a deal, it speaks to those things and some of the things you’re doing in your department.

Steven: Yeah, that it helps. I mean when our leadership engages, we hear from employees that they really, really appreciate the effort that they’re taking to stand in front and answer their questions. And, again, not necessarily give an update on the status of the deal but to give an update on the business and where we stand and what’s important and on his mind.

Steve: Because, Jim, the internal messages then become the first line of external communications often [crosstalk] The people really naturally think about, “Well, what does it mean for me? What’s going to happen to my benefits? Where am I going to be working? Will I still have my same seat, same colleagues?” So how does that work from your point of view as an agency supporting clients in terms of helping them out [crosstalk]

Jim: Well, our job, and I was thinking about it when Steven was just talking, listening is probably the…one of the most critical parts of all of this. And I think, you know, this concept of being accessible to the employee population and hearing all of the various concerns because, again, there are many cultures within these very large organizations in tailoring communications and in specifying what you say to different groups is critical. And I think an agency can help analyze and listen to what’s going on, what the concerns are. There are now many more channels where employees can talk about their issues, concerns, questions, without going directly to management.

So we can, you know, track that, bring it to the client in a way that’s actionable. And we’re able to help, I think, in a lot of cases, you know, do a lot of that arms and legs and block-and-tackle work that our internal client is often stuck in meeting after meeting after meeting or traveling a lot. We can keep a certain level of continuity and be that canary in the coal mine if an issue does arise that they can address quickly.

But at the end of the day, listening and having a sense of empathy for the people going through the process of M&A on both sides is really critical. And I think we can play a big role in it.

Steve: Yes, Steven, one of our panelists today said that, actually, they struggle to find that internal communications expertise in some of their agency partners. Is that something you think there’s a…the agency should pay more attention to in terms of offering services to clients?

Steven: Well, I mean I think they do. I think a key role of the agency is to tell us what we don’t want to hear. So open our eyes because very often we’re running around to meetings and head down and writing the next plan.

Steve: Especially during a deal.

Steven: Right. Or talking to external folks, which is always a focus. So we need partners that will sit us down and say, “You need to be paying attention to these issues that are happening inside the company.” And that’s going to be really helpful.

Steve: Let’s finish by looking forward. Another big deal going on at the moment is the CVS Aetna merger. We have talked of Amazon and Walmart coming into this space. What do you expect…just to start with you Jim, what do you expect to see in the next 12 to 18 months with deals like that happening and new players coming into the market?

Jim: Well, I think it, you know, is an exciting time as Steven said. I think it acknowledges the power of the patient and also preventive medicine and wellness and, you know, the evolution of healthcare and how if you can sustain your health, we can reduce costs theoretically by being healthy or longer until a point where, you know, we can pretty much become more masters of our own health.

And I think we are going to see more deals that put the power of medicine into the hands of the patient or the physician or direct caregiver. And it’s a lot easier. And there’s a lot of things you don’t have to go to the doctor for or to the hospital for. Be it flu shots or taking care of some very basic needs. And I do think we’re going to see the continued evolution of that. I mean how far that goes and how fast I think will depend on some regulatory and other factors.

But a very exciting time, you know, to see healthcare finally truly impacted by technology as Steven referred to. So they’re going to have to be more innovative in how they deliver the care and the drugs that they’re…the drugs, devices, and services they’re delivering.

Steve: Steven, a lot of this seems to be driven by convenience and the modern consumer really wants that. They don’t want to have to wait a month to see their physician, for example.

Steven: Yeah, convenience and access. I mean it really is driven by the need for increased access. You do have a much more informed consumer these days about their health care. And so this deal, the Aetna CVS mega-merger, really taps into that more informed consumer, more powerful consumer. And, you know, what they’re talking about is pretty interesting in terms of offering that in a one-stop shop approach where you go into the clinic and also get access to your coverage as well. It’s a pretty interesting model.

Steve: If Amazon does come in, how disruptive do you think that would be to the market? And would it be a net positive or negative?

Steven: Really hard to say but it certainly…you know, Amazon is a platform that basically offers convenience. And, again, back to what is really needed in the marketplace and our focus is access. So when you put that together, it opens up interesting possibilities.

Jim: I think it’s a net positive in every way. Just like I think it’s impacted…you know. I think it’s impacted the growth of local economies and the global economy, and I think it’ll put healthcare, you know, much more front and center with consumers. I think it’s going to have a tremendously positive impact overall and it’s going to help the industry engage in technology. It’s going to probably force that a little faster than they might have ever wanted to.

At the same time, the more things change, the more they’ll stay the same. And, you know, we are still subject to regulatory and scientific hurdles that a lot of other industries aren’t. So nothing will replace good science, nothing will replace a good focus on the patient, and why we’re really here, which is, as Steven said earlier, the potential to cure disease or certainly completely prevent it is still the major goal. And the more players that are in that, the better.

Steve: Well, Steven, Jim, thanks for joining us. It’s been a great discussion here at the panel and on this video. Thanks to Bayer for supporting this program. You can check out more content podcasts and write-ups of this session at PRWeek.com. But this is Steve Barrett signing off from San Francisco.

 

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A little less than three year ago, with minimal fanfare, we began throwing ourselves into the value and access conversation in health care. We’re W2O, so we started by hoovering up hundreds – then thousands – of stories about drug pricing and reimbursement and patient access and sticking them in a huge, searchable database. Then we began producing a weekly newsletter for our clients (shout if you’re not a subscriber, but would like to be on the mailing list).

But all this was low-key, and I was frequently asked why we didn’t do a podcast. My answer was practical: I didn’t think there was an appetite for a public discussion about pharmaceutical value, especially not one led by a strategic communications firm.

I assumed that the audience was limited for a full-on discussion of gross-to-net spreads, point-of-sale rebates, or the proper assessment of health-state utilities in value frameworks. I mean, it’s all important stuff, but it’s no Serial.

But in the past three years, we’ve seen this debate escape its usual confines. It’s not just managed markets folks and formulary committees. Martin Shkreli, EpiPen and gene therapy have meant that these are now conversations for the

A little less than three year ago, with minimal fanfare, we began throwing ourselves into the value and access conversation in health care. We’re W2O, so we started by hoovering up hundreds – then thousands – of stories about drug pricing and reimbursement and patient access and sticking them in a huge, searchable database. Then we began producing a weekly newsletter for our clients (shout if you’re not a subscriber, but would like to be on the mailing list).

But all this was low-key, and I was frequently asked why we didn’t do a podcast. My answer was practical: I didn’t think there was an appetite for a public discussion about pharmaceutical value, especially not one led by a strategic communications firm.

I assumed that the audience was limited for a full-on discussion of gross-to-net spreads, point-of-sale rebates, or the proper assessment of health-state utilities in value frameworks. I mean, it’s all important stuff, but it’s no Serial.

But in the past three years, we’ve seen this debate escape its usual confines. It’s not just managed markets folks and formulary committees. Martin Shkreli, EpiPen and gene therapy have meant that these are now conversations for the water-cooler and the dining-room table. Heck, USA Today dropped a discussion of “spread pricing” into a story this week. This is officially a thing.

So we’re going to be more public about our voice in that discussion. To that end, we launch “Redeeming Value” today. It’s a podcast hosted by me and Rita Glaze, our practice leader for U.S. market access in our Value and Access group.

The first episode focuses on the news – or the lack of news — from the J.P. Morgan Healthcare conference, along with an introduction Rita and what she’ll bring to the firm.

Please give it a listen.

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How real is blockchain’s potential to improve healthcare? “It’s really real,” said Tony Scott – the former chief information officer of the United States and senior advisor for Squire Patton Boggs – at W2O Group’s 4th Annual Digital Health Luncheon. Held in tandem with the J.P. Morgan Healthcare conference (JPM18) – which effectively marks healthcare and life science’s annual pilgrimage to San Francisco, CA – this year’s luncheon explored what practitioners and patients alike can expect from blockchain, AI and genomics, and where we will continue to see the digital health investment dollars flow in 2018.

Jonathan Bush, athenahealth’s chief executive officer, kicked off the event, talking to attendees about how AI can help reduce healthcare’s state of friction. He also spoke about the industry’s tendency to put the cart before the horse when it comes to advancing new technologies.

Jonathan noted that “when we see a break, when we see an invention, when we hear a new keyword, we run with it in our minds so much faster than the gears of society and marketplace can move, that we find ourselves alone on a deserted island, with none of the things that we wanted.” However, he was also

How real is blockchain’s potential to improve healthcare? “It’s really real,” said Tony Scott – the former chief information officer of the United States and senior advisor for Squire Patton Boggs – at W2O Group’s 4th Annual Digital Health Luncheon. Held in tandem with the J.P. Morgan Healthcare conference (JPM18) – which effectively marks healthcare and life science’s annual pilgrimage to San Francisco, CA – this year’s luncheon explored what practitioners and patients alike can expect from blockchain, AI and genomics, and where we will continue to see the digital health investment dollars flow in 2018.

Jonathan Bush, athenahealth’s chief executive officer, kicked off the event, talking to attendees about how AI can help reduce healthcare’s state of friction. He also spoke about the industry’s tendency to put the cart before the horse when it comes to advancing new technologies.

Jonathan noted that “when we see a break, when we see an invention, when we hear a new keyword, we run with it in our minds so much faster than the gears of society and marketplace can move, that we find ourselves alone on a deserted island, with none of the things that we wanted.” However, he was also candid in saying that, when it comes to AI, “it’s okay to get excited.”

“Any time you have millions of examples, and a relatively infinite set of outcomes, you can use machine learning,” said Jonathan, though designing for data flow is a necessary piece of the puzzle. With the right flow of data and application of AI, “we can take tens of thousands of hours of work, and make it instantaneous,” he said.

What about blockchain? As John Moore, founder of Chilmark Research, shared at the start of the panel, “Frankly, there’s a lot of noise and not a hell of a lot of signal,” noting that most people do not yet understand blockchain technology in the context of healthcare.

Chief technology officer and co-founder of PokitDok, Ted Tanner, was clear to make the distinction that blockchain is not bitcoin, explaining that the former is an infrastructure and the latter is a cryptocurrency. Ted described blockchain, a distributed ledger technology, as a distributed database that allows all participants on a network to see operational transactions in a secure digital environment. So secure, Ted said, that blockchain “adds a level of resilience over and above anything that was previously applicable in tech.”

Tony, who was responsible for federal cybersecurity strategy and is credited with creating the first government-wide open source policy, agrees with Ted in terms of blockchain’s potential to disrupt the industry. Tony predicts that blockchain will change the way that the healthcare ecosystem works, highlighting the billions of investment dollars going into the space as one indicator of what is to come.

Something to watch for when it comes to blockchain’s impact on healthcare, said Tony, is elimination of the middle-man. He believes that blockchain will facilitate a more direct connection to the ultimate service provider, cautioning attendees that, “If you’re in the middle, you’re on thin ice.”

Sutter Health’s chief of digital patient experience (how great is that title?), Dr. Albert Chan, introduced the concept of human ROI to the blockchain panel discussion, explaining how blockchain can help combat the crippling effects of physician burnout. “Fifty percent of doctors have more than one sign of burnout,” said Albert, who spoke to the findings of a Sutter Health study that found for every 3.08 hours of patient visits, doctors spend 3.17 hours on a desktop medicine each day.

“You want your doctor doctoring,” said Albert, who discussed how blockchain can take dollars away from transactional and administrative costs and allow those resources to be spent on patient care. He also noted that what the industry really wants is better data utility and access, which blockchain can help facilitate.

Rounding out the discussions, David Ewing Duncan, author of When I’m 164, pondered the future of direct-to-consumer genomics with fellow industry experts Jessica Richman, chief executive officer and co-founder of uBiome, and Dr. Michael Nova, chief innovation officer of Pathway Genomics.

Michael considers medicine to be “a big systems problem”—genetics data cannot be used in a vacuum—and requires “a lot of other systems to make sense out of it.” In 2009, Michael was the doctor of record for the first human that Illumina ever sequenced, which at the time carried a price tag of US $300,000. In 2018, he says that will run a patient around $1,000.

Looking further at how the consumer genomics space has evolved over the past decade, Michael shared that, “When we first started this journey, I used to get a lot of questions,” but that now those questions are simply “who pays, and how much.” Jessica noted that, while wellness genomics tests are covered by insurance about 50 percent of the time, “we had to do a lot to get there.”

Clinicians attitudes and appetites for genomics have increased in recent years, with much of that having to do with patient engagement. “Compliance and patient engagement are two sides of the same coin” said Jessica, who noted that patients coming to their physicians and asking for testing is a good thing. “One in five women don’t get screenings they should,” and any kind of awareness that can drive them to stay engaged with their health over time is a positive.

In looking ahead at what is to come – and where he is focusing his writing these days – David shared that he is looking more at metanomics, or multinomics, which he described as starting with genomics and expanding to other areas, such as the microbiome. David believes that genomics is just the starting point – an important base, but one requiring far more dynamic systems (e.g., the other “omics”) to be built out on top of it.

“I’ve long been a skeptic, as you might be able to tell, of a lot of this data,” said David. But what he is no longer skeptical about today is the technology itself, nor does he feel it is what’s holding progress in genomics back. “In a lot of ways, the technology isn’t the barrier anymore. It’s really how society is going to receive this… It’s policy and politics less than technology, at this point.”

For more information on W2O Group’s 4th Annual Digital Health Luncheon, held in partnership with Squire Patton Boggs, please see the Facebook Live replay and follow #W2ODH18 for updates. Curious what happened at the 3rd Annual Digital Health Luncheon and if the predictions about value-based care driving investments came true? Find out here.

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The JPM Healthcare Conference brings together the best and brightest minds to discuss innovations in healthcare. During this year’s conference we created a lineup of speakers who focused on AI, genomics and blockchain for our 4th Annual Digital Health Luncheon, in partnership with Squire Patton Boggs. Among those speakers is this week’s guest, CEO and Co-Founder of athenahealthJonathan Bush.

Since athenahealth is a client, I am aware of the incredible work they do. It was a pleasure to dive a little deeper into Jonathan’s journey and what it takes to design a frictionless healthcare system. Jonathan was gracious enough to chat with me ahead of his keynote talk which didn’t give him much time to prepare for my questions. Since he didn’t have his book recommendations handy, I wanted to make sure and share them with you here…keep an eye out for the following: The Other Wes Moore: One Name, Two Fates and Frozen in Time: An Epic Story of Survival and a Modern Quest for Lost Heroes of

Don’t miss an episode! Subscribe to our podcast!

The JPM Healthcare Conference brings together the best and brightest minds to discuss innovations in healthcare. During this year’s conference we created a lineup of speakers who focused on AI, genomics and blockchain for our 4th Annual Digital Health Luncheon, in partnership with Squire Patton Boggs. Among those speakers is this week’s guest, CEO and Co-Founder of athenahealthJonathan Bush.

Since athenahealth is a client, I am aware of the incredible work they do. It was a pleasure to dive a little deeper into Jonathan’s journey and what it takes to design a frictionless healthcare system. Jonathan was gracious enough to chat with me ahead of his keynote talk which didn’t give him much time to prepare for my questions. Since he didn’t have his book recommendations handy, I wanted to make sure and share them with you here…keep an eye out for the following: The Other Wes Moore: One Name, Two Fates and Frozen in Time: An Epic Story of Survival and a Modern Quest for Lost Heroes of World War II.

Jonathan is also an author and I encourage you to check out his book, Where Does It Hurt?: An Entrepreneur’s Guide to Fixing Health Care. Plus, we discuss Nathaniel Rateliff & The Night Sweats. Take a listen below.

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As the East Coast struggles with a biting cold that’s threatening travel plans and everyone’s collective sanity, we’re keeping warm as we gear up for W2O Group’s 4th Annual Digital Health Luncheon on Monday, January 8, 2018, in San Francisco, CA, in partnership with Squire Patton Boggs. Bigger and better than before—now three hours of discussion and networking, with nearly two hundred of our closest healthcare, life science and biotech friends—we can’t wait to once again kick off what’s many have started calling J.P Morgan Healthcare week, and we want you to join us!

Last year, we looked at the future of digital health investing in a value-driven era. This year, thought leaders will come together to discuss what’s next for some of today’s most disruptive healthcare technologies, including AI, blockchain and genomics. Tony Scott, the senior data privacy and cybersecurity advisor for Squire Patton Boggs and former U.S. chief information officer, will join a panel of experts to discuss if blockchain really is healthcare’s next great disruptor.

Tony was appointed by President Obama as the federal government’s chief information officer in 2015, where he was responsible

As the East Coast struggles with a biting cold that’s threatening travel plans and everyone’s collective sanity, we’re keeping warm as we gear up for W2O Group’s 4th Annual Digital Health Luncheon on Monday, January 8, 2018, in San Francisco, CA, in partnership with Squire Patton Boggs. Bigger and better than before—now three hours of discussion and networking, with nearly two hundred of our closest healthcare, life science and biotech friends—we can’t wait to once again kick off what’s many have started calling J.P Morgan Healthcare week, and we want you to join us!

Last year, we looked at the future of digital health investing in a value-driven era. This year, thought leaders will come together to discuss what’s next for some of today’s most disruptive healthcare technologies, including AI, blockchain and genomics. Tony Scott, the senior data privacy and cybersecurity advisor for Squire Patton Boggs and former U.S. chief information officer, will join a panel of experts to discuss if blockchain really is healthcare’s next great disruptor.

Tony was appointed by President Obama as the federal government’s chief information officer in 2015, where he was responsible for management guidance, budget oversight, IT governance, cybersecurity coordination and strategy for the Executive Branch. In addition to implementing an overhaul of federal IT policy, Tony is also credited with creating the first government-wide open source policy, and leading the government’s response to the Office of Personnel Management (OPM) cyber intrusions through initiatives that ultimately led to the President’s Cybersecurity National Action Plan.

Ahead of #JPM18, we asked Tony to weigh in on a few questions about the future of blockchain in healthcare, below:

1. Is blockchain worth the hype in terms of its potential to improve/impact healthcare?

There is already strong evidence of the creative use of blockchain based technologies to improve/impact healthcare. Whether these will scale to larger projects, and drive the adoption of industry wide standards is yet to be seen. The fact that billions of dollars of investment is going into this space is one indicator of the potential. Some things will fail, but each of these will result in learnings that will help make the next investment a better one.

2. What areas of healthcare or life sciences are ripest for the application of blockchain, from the clinical to the financial to the administrative?

I think some of the ripest areas are where there are a lot of middlemen and brokers in between the provider and the recipient. It’s likely to be a disruptive technology for those who make money solely on the transaction. Second, there is strong potential for lowering costs if transparency and visibility can help drive greater competition.

3. Best examples in action in either the public and private sectors?

Microsoft and Accenture are building a blockchain based Digital Identity Service that will provide secure and unique identification for over a billion people in underdeveloped countries where no government based identity service functions today. Creating an “identity” is one of the first steps in providing services, whether its healthcare, financial, or basic commerce.

4. What can we expect over the next 2 years? 10 years?

Increased regulation is almost a certainty, but I also expect much greater standardization.   I think it will follow the patterns of the credit card industry where there will be collaborative networks built around segments in the marketplace. I also expect to see much more action in the smart contracts space, where there is a lot of work and investment today. This has the potential to challenge decades old, and even centuries old norms and practices with respect to international trade.

5. Obstacles and challenges with greater adoption in the industry?

I think there are three big challenges:

  1. Cost of service: Today blockchain is a power hungry and compute intense activity. Lots of work needed to bring cost of compute down.
  2. Ease of use/integration: This is not an easy to use/friendly thing today, and lots of investment is going into figuring out how to make “blockchain as a service” more consumable.
  3. Standards: Broad adoption of standards within various industry segments is needed – good news is that many of these discussions are underway and good frameworks will likely emerge.

Be sure to follow #W2ODH18, Tony Scott (@tonyscottcioat), Squire Patton Boggs (@SPB_Global), and @W2OGroup for updates from the 4th Annual Digital Health Luncheon!

Please see below for more information on this year’s event and RSVP here, as space is limited!

W2O Group’s 4th Annual Digital Health Luncheon

In partnership with Squire Patton Boggs

Date/Time: Monday, January 8th, 12:00 PM – 3:00 PM

Location: The St. Regis San Francisco, 125 3rd Street, San Francisco, CA 94103

Space is limited and on a first come, first serve basis. Please RSVP here.

  • AI: The Key to Freeing Up Healthcare’s Friction?
    • Jonathan Bush, CEO, athenahealth (Introduction by Tamara Fraizer, Squire Patton Boggs)
  • Blockchain: Healthcare’s Next Greatest Disrupter?
    • Tony Scott (Senior Advisor, Squire Patton Boggs)
    • Dr. Albert Chan (Chief of Digital Patient Experience, Sutter Health)
    • Ted Tanner (CTO & Co-Founder, PokiDok)
    • Sarah Buhr (Techcrunch)
  • Is There Space for Consumer Genomics?
    • David Ewing Duncan (Journalist/Author of When I’m 164, Moderator)
    • Jessica Richman (CEO & Co-founder, uBiome, Panelist)
    • Michael Nova (Chief Innovation Officer, Pathway Genomics, Panelist)
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Another year of ASH (American Society of Hematology’s Annual Meeting & Exposition) is in the books and the online conversation this year was bigger than ever. There were over 33K total tweets using #ASH17 between 12/9 and 12/12. Using W2O’s proprietary MDigitalLife Health Ecosystem database, we tracked 23,224 tweets from 1,876 unique health stakeholders (HCPs, Advocacy, Patients, Media, Industry, etc.) mentioning #ASH17. For comparison, that was a 6% increase in conversation volume and a 16% increase in unique authors compared to ASH 2016. Check out the chart below to see how each conference has fared since 2014 – notice the massive jump from 2014 to 2015 (89% increase in volume!).

Using MDigitalLife we were able to go a step further to determine how those 1,876 authors broke down by stakeholder type. Unsurprisingly, HCPs led the conversation with over 1,000 unique authors contributing more than 50% of the posts. Healthcare Industry and Advocacy followed with 371 and 188 unique authors contributing 17% & 18% of the conversation, respectively. Media and Patients rounded out the core stakeholder groups contributing 7% and 4% of the

Another year of ASH (American Society of Hematology’s Annual Meeting & Exposition) is in the books and the online conversation this year was bigger than ever. There were over 33K total tweets using #ASH17 between 12/9 and 12/12. Using W2O’s proprietary MDigitalLife Health Ecosystem database, we tracked 23,224 tweets from 1,876 unique health stakeholders (HCPs, Advocacy, Patients, Media, Industry, etc.) mentioning #ASH17. For comparison, that was a 6% increase in conversation volume and a 16% increase in unique authors compared to ASH 2016. Check out the chart below to see how each conference has fared since 2014 – notice the massive jump from 2014 to 2015 (89% increase in volume!).

Using MDigitalLife we were able to go a step further to determine how those 1,876 authors broke down by stakeholder type. Unsurprisingly, HCPs led the conversation with over 1,000 unique authors contributing more than 50% of the posts. Healthcare Industry and Advocacy followed with 371 and 188 unique authors contributing 17% & 18% of the conversation, respectively. Media and Patients rounded out the core stakeholder groups contributing 7% and 4% of the conversation. It is worth calling out that although the Advocacy stakeholders were half the size of Industry, they actually contributed a larger percent of conversation than Industry stakeholders. This heavy advocacy involvement is a good sign for the strength of the Hematology online community.

To get an idea of who was contributing the most conversation from each stakeholder group, we identified the most active authors from HCPs, Advocacy, Industry, Patients & Media in the chart below. At the top we saw a few HCPs we recognize from our work in the Hematology space, like Mike Thompson, an active HemOnc (Hematologist/Oncologist) at Aurora Health Care and one of the leading HCP voices online; Navneet Majhail, a socially active HemOnc and Director of the Blood & Marrow Transplant Program at Cleveland Clinic who even gave his top 5 tips for using social at #ASH17 in this great video and Mohamad Mohty, an engaged professor of Hematology who serves as President of the European Society for Blood and Marrow Transplantation (EBMT).

Others of note include the wonderful @MyelomaTeacher, a myeloma survivor and passionate advocate for cancer patients and research; Robin Tuohy, Senior Director Support Groups at the International Myeloma Foundation and wife to a myeloma survivor and Jacob Plieth, a Senior Reporter at EP Vantage and very active voice in biopharma.

MDigitalLife Data

 

A boatload of tweets from key authors does not mean the conversation was valuable. The true measure of value at any medical conference is the level of connection and exchange between the various stakeholders involved. Is the content being disseminated and discussed by HCPs, Advocates, Patients, etc.? Are the conversations stuck in small silos or are they bridging gaps between core stakeholder groups?  How does the volume of content combined with the quality of the network create a lasting discussion?

These questions pertaining to how we measure the value of an online community are ones we have begun to answer in the past with our Network Scoring Algorithm, which we co-published with prominent social influencers in the journal, Seminars in Hematology earlier this year (to read the abstract and purchase the full text, click here). And for more info on the network scoring algorithm, see this blog from 2015. When we apply this algorithm to ASH conversation this year compared to previous years, we can begin to see how the conversation breaks down. To give a quick overview, the Network Scoring Algorithm measures 5 metrics:

  • Size (a combination of number of posts and number of health ecosystem participants):
  • Audience Diversity (the amount of participation from different health ecosystem stakeholder groups, e.g., doctors, patients, healthcare company execs, caregivers, etc.)
  • Topic Diversity (the breadth of the topics discussed)
  • Quality (the level of connection and conversation engaged in by participants)
  • Impact (The presence of industry “heavy hitters” in the conversation).

For ASH, we can see that 2017 led past years in regard to Size, Quality & Impact. However, it decreased or maintained in Audience and Topic Diversity. Audience Diversity was actually the lowest it has been since we began tracking ASH conversation in 2013. While on the surface this is a negative, the main contributing factor to the decrease in Audience Diversity is the large increase in audience size, specifically the number of HCPs who are activating on social every year. We have seen similar increases in other stakeholder groups participation in ASH social conversation, just at a smaller rate than HCP adoption. The increase in audience size and corresponding shifts in audience diversity will be a important metrics to watch for ASH 2018.

Topic Diversity, the other scoring metric not increasing at ASH 2017, remained the same in comparison to ASH 2016. Topic Diversity has remained fairly steady throughout the years after peaking in 2013. The spread from 2013-2017 is small enough that this does not appear to be of significant concern and is a range we would expect to see for a meeting largely focused on one therapeutic area.

To further understand the level of connectivity and conversation at ASH, we created an interactive network visualization showing those stakeholders who had at least 10 connections (mentions or RTs) within the #ASH17 conversation. The breakdown of stakeholders in this subset of the audience can be seen in the image below. Feel free to explore this network visualization by clicking on the image below.

If you are interested in understanding more about the online ASH conversation and how you can best engage with key health stakeholders online, reach out on our contact us form and we will be in touch!

Follow Steven Cutbirth on twitter @SvenC; Follow MDigitalLife on twitter @MDigitalLife & W2OGroup at @W2OGroup

 To learn more about how the MDigitalLife Online Health Ecosystem database can reshape the way you interact with doctors, patients, the media & all the important stakeholders of your healthcare company, learn more here.

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It is no secret that technology is transforming every facet of healthcare.  The most profound result by far is the transparency, accessibility, and  amplification of information on therapeutic areas allowing patients, physicians, insurance providers, device makers, and facilities with the means to better understand, treat, and prevent disease.  For communications professionals, this new era is forcing a complete rethinking of our role and value in a dynamic now controlled by external audiences.  Gone are the days of a prescriptive culture where information was doled out sparingly across the healthcare spectrum and communications was controlled by pharma organizations and physicians.

Today, the game, so to speak, is being played at the edges with patients dictating the relationship throughout the healthcare system with the impending rise of personal genomic data leading to the decoding of DNA and the rise of new treatments.  Given this move from prevention to regeneration and the increase in extending human life, relationships, engagement, and expectations must be recalibrated.

As a major marketing communications firm involved with healthcare since its inception, we believe there are four critical, strategic questions that must be addressed by healthcare professionals including communications, and organizations now that will direct how the future unfolds:

  1. How

It is no secret that technology is transforming every facet of healthcare.  The most profound result by far is the transparency, accessibility, and  amplification of information on therapeutic areas allowing patients, physicians, insurance providers, device makers, and facilities with the means to better understand, treat, and prevent disease.  For communications professionals, this new era is forcing a complete rethinking of our role and value in a dynamic now controlled by external audiences.  Gone are the days of a prescriptive culture where information was doled out sparingly across the healthcare spectrum and communications was controlled by pharma organizations and physicians.

Today, the game, so to speak, is being played at the edges with patients dictating the relationship throughout the healthcare system with the impending rise of personal genomic data leading to the decoding of DNA and the rise of new treatments.  Given this move from prevention to regeneration and the increase in extending human life, relationships, engagement, and expectations must be recalibrated.

As a major marketing communications firm involved with healthcare since its inception, we believe there are four critical, strategic questions that must be addressed by healthcare professionals including communications, and organizations now that will direct how the future unfolds:

  1. How do you manage expectations in an era that will extend life expectancy?
  2. What is the new efficacy for pharma companies to manage public health vs. treating symptoms?
  3. What are the moral and social implications as medicine moves to performance enhancement?
  4. How can you build and nurture relationships throughout the healthcare continuum in a digital era via mobile and wearables?

Answers to these questions will determine if communications will accelerate the new landscape making sense of it to key audiences and driving new behaviors or be viewed as a tactical means to just conveying information.  The former will involve a deeper comprehension of influence, analytics, strategy formulation, and opinion formation not to mention relevance.

The truth is that every business and profession must adopt a completely different mindset including purpose and values to compete successfully in the future.  Social commerce and digital business have upended traditional conventions in healthcare including a prescriptive culture.  Today, unorthodox conventions are taking hold and the demands of patients, physicians, customers, employees, manufacturers, and the like are dictating the relationship.

In addition to the aforementioned operational and business model changes, the impact of technology on communications, media, and marketing in the healthcare field is nothing short of transformational.

As such, will we be ready?

Moving forward, healthcare will no longer be about “care.”

Rather, it will be about “health.”

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Today, Gleevec® (Glivec® outside the U.S.) is remembered as a medical milestone, a targeted therapy that changed not only the way we treat chronic myelogenous leukemia, but the way that we approached precision medicine across the board.

But in the years leading up to the medicine’s 2001 approval, it was a milestone in how companies dealt with some of the moral challenges of bringing a drug to market. Geoffrey Cooke, global head of external and patient relations for Novartis, recently told the story at the annual Healthcare Businesswomen’s Association conference in Philadelphia.

Cooke, speaking on a panel on global access, sketched out the issue: in an early trial, the drug that would later be known as Gleevec (note: not represented by W2O) showed significant promise to, at the very least, potentially extend life in chronic myeloid leukemia.  Shortly after the announcement of these early data, Novartis began to receive requests for the still very-much-investigational compound from obscure places around the world.

That created instant tension. What might the impact be of giving an unapproved drug outside of a clinical trial? There were scientific questions, regulatory questions, moral questions.

Novartis’ choice was to create the Glivec® International Patient Assistance Program (GIPAP), which may have

Today, Gleevec® (Glivec® outside the U.S.) is remembered as a medical milestone, a targeted therapy that changed not only the way we treat chronic myelogenous leukemia, but the way that we approached precision medicine across the board.

But in the years leading up to the medicine’s 2001 approval, it was a milestone in how companies dealt with some of the moral challenges of bringing a drug to market. Geoffrey Cooke, global head of external and patient relations for Novartis, recently told the story at the annual Healthcare Businesswomen’s Association conference in Philadelphia.

Cooke, speaking on a panel on global access, sketched out the issue: in an early trial, the drug that would later be known as Gleevec (note: not represented by W2O) showed significant promise to, at the very least, potentially extend life in chronic myeloid leukemia.  Shortly after the announcement of these early data, Novartis began to receive requests for the still very-much-investigational compound from obscure places around the world.

That created instant tension. What might the impact be of giving an unapproved drug outside of a clinical trial? There were scientific questions, regulatory questions, moral questions.

Novartis’ choice was to create the Glivec® International Patient Assistance Program (GIPAP), which may have been the first named patient program for compassionate use.  At the time, Cooke said there were critics and naysayers, but, from the top down, it was clear that those at Novartis felt they had “a moral responsibility” to make the drug – then known as imatinib — available to patients, no matter where those patients lived.

Now, there were many different words that Cooke could have used to describe Novartis’ decision-making, ways of sanitizing or “corporatizing” a compassionate use program to make it friendly for review committees and risk-averse stakeholders. But Cooke minced no words. He said access was a “moral responsibility,” a powerful and fully authentic statement.  I wanted to stand and cheer.

I’ve worked in health care for a long time.  And, like many others, I did it because I knew that science and medicine were uniquely important levers to change the world, and I wanted to be a part of that.  I have seen day in and day out that most everyone I have met in this field is trying to do good in the world.  We have a responsibility to do our best each day because we touch very real lives.

We have a favorite statistic here at W2O across the health care practice:  9 percent of Americans believe that pharma puts patients above profits (Harris poll, 2017), while a whopping 15 percent of Americans think bigfoot is real (Public Policy Polling, 2013). What have we done that more people believe in Sasquatch than in patient-centric biopharma companies?

The health care industry, like all others, isn’t perfect.  The system here in the United States and those systems used around the world aren’t perfect. There are unquestionably bad actors who take advantage of the complexities inherent in health care.  I won’t – and can’t – even try to justify some of the actions that have happened.

Because of these bad actors and because of the industry’s imperfections, we have become too afraid that we will cross a legal or ethical line, or that we no longer have the credibility to speak simple truths.  That has sanitized what we say, obscuring our passion for helping people and eliminating the emotions – hope, fear, frustration, curiosity, elation – that drives this industry forward.

As communicators and marketers, we have the opportunity to step up and be the conscience of the industry.  We have the power and ability to help create the real voices of the real people who are working hard each day to improve lives and patient care. We have a responsibility to bring to life the importance of the work that is being done in pharma, in biotech, in digital health and across the spectrum of health care.

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I have heard countless young companies talk about hockey stick growth patterns but over time you learn how rare they actually are. So when mentions of blockchain technology formed a clear hockey stick in our social media trend data, we started paying attention. It is clearly time to take a closer look at some places where this technology may be grabbing a foothold.

Management of Patient Medical Records

What if all patient records from all health providers were available in a unified and unmodifiable form? What if access to these records was controlled by each patient or their legal guardian? What if this system drastically reduced data management costs while improving overall security? This system is possible for a medical records system controlled by a blockchain. Based on this vision, numerous companies have raised a lot of money to try and make this happen.

Unfortunately I see a blockchain based system of this type as being at least a few years away. In the mean time new regulations are forcing hospitals and other medical facilities to move to digital records in the next five to ten months. This is a big problem for those pursuing

I have heard countless young companies talk about hockey stick growth patterns but over time you learn how rare they actually are. So when mentions of blockchain technology formed a clear hockey stick in our social media trend data, we started paying attention. It is clearly time to take a closer look at some places where this technology may be grabbing a foothold.

Management of Patient Medical Records

What if all patient records from all health providers were available in a unified and unmodifiable form? What if access to these records was controlled by each patient or their legal guardian? What if this system drastically reduced data management costs while improving overall security? This system is possible for a medical records system controlled by a blockchain. Based on this vision, numerous companies have raised a lot of money to try and make this happen.

Unfortunately I see a blockchain based system of this type as being at least a few years away. In the mean time new regulations are forcing hospitals and other medical facilities to move to digital records in the next five to ten months. This is a big problem for those pursuing blockchain solutions for health records and is one of the reasons why I do not see blockchain playing a major role in this aspect of healthcare in the short or even the medium term.

To understand why it can take years to create a blockchain solution consider this list of huge challenges:

  • Identity Management
    • To strictly manage control of medical records so that only authorized people can see them we have to be sure that people are who they say they are.
  • Permissions Management
    • We have to have a flexible system for allowing access to records that can handle a huge number of standard and emergency scenarios.
  • Data Management
    • While we want to protect individual’s records, aggregate data across a population can have a huge positive benefits for the industry. Providing a secure solution that protects individual’s records but also accurately reports on populations is not easy but blockchain solutions are in the works such as Project Enigma at the MIT Media Lab.
  • Systems Integration
    • Existing software systems using a staggering variety of protocols and formats for their data. Getting agreement on standards and then creating adapters to conform to those standards is a gigantic enterprise that will require large scale industry cooperation.

So the big prize of Health Care Records on the blockchain seems out of reach for the foreseeable future. Where are the real opportunities for blockchain?

Identity Management

Plugging in a blockchain-based plug-in module to reliably handle the identities of patients and health care professionals could be huge for the industry. Fortunately, this is true for almost every industry and not just healthcare. Accordingly, there are hundreds of companies, large and small, working on this problem.

Last May a huge step forward was taken when Microsoft, Uport and several other companies formed the Decentralized Identity Foundation (http://identity.foundation) to create consensus standards for identity management. Since then another 25 companies have joined the effort including IBM, Accenture and Hyperledger. This unified effort seems to be the best hope for a blockchain-based identity system within a year or so although there is competition from the ICON foundation among others.

Organic Material Supply Chain Management

Tracking the movement and delivery of drugs, organs, blood, tissue and the like is a huge problem area in healthcare. Billions are lost from fraud, theft, and spoilage. Here a blockchain-based solution can serve to track the movement of shipments by adding records to the blockchain at each step of the delivery process. The unmodifiability of the records provides a reliable means to discover exactly where the problem occurred when goods are lost or stolen.

A few months ago we learned that IBM is spearheading a blockchain-based supply chain solution in food delivery along with partners including Walmart, Dole, Kroger, Unilever, Hersheys and other big names in agriculture and food processing. This suggests that blockchain is ready to make a difference today by improving the efficiency and security of the world’s food supply.

It turns out that the leaders of top pharma companies were not ignoring this trend. According to an IEEE report, most are involved with or else thinking about starting pilot projects along these lines. The first public announcement of a blockchain drug supply chain pilot project came on September 21 when Genentech and Pfizer revealed that the MediLedger Project is underway using JP Morgan’s Quorum blockchain.

Of particular note is additional technology provided by a startup company named Chronicled. They provide a portable temperature logger that puts temperature data on the blockchain as well as a tamper-proof sticker that makes recording the movement of drug shipments dirt simple.

A wonderful thing about this use case is that with enough automation at the various shipment checkpoints there may be little need for the people moving the materials to change the way that they perform their work. This makes technical adoption easy.

Summary

At this point it is entirely reasonable to maintain a skeptical attitude towards blockchain-based solutions in healthcare, however the chance for disruption is very real. My assessment is that Supply Chain Management will be the initial ‘killer app’ for blockchain in healthcare, but there are other interesting projects worth knowing about as well. We will present some of these in a future blog post.

If you want to know more about this topic I suggest starting with the recent presentation by the HIMSS Blockchain Work Group entitled ‘Navigating the Blockchain Landscape’ (http://www.himss.org/news/part-1-navigating-blockchain-landscape-opportunities-digital-health).

If you have your own hot story about anything in the healthcare industry, let W2O Group help you build your very own social media hockey stick.

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