Author Archives: Isabelle Widmer

My new tattoo

I have just returned from Morocco. Working away from home while immersing myself in a different world reminded me how distance can create perspective and how new environments teach new skills.

Today’s topics:

  • Decision driven analytics
  • Beware of the data
  • AI will interview you now
  • Leadership: Gifts and henna

Decision driven analytics

Luc De Langhe, co-founder of CEL for pharma, recently shared a book recommendation with me: the “Four Pillars of Decision-Driven Analytics.” Link to an overview here. The authors recommend putting the  data in the background and starting instead with  the decisions and decision alternatives that need to be made(Pillar I),  then formulating the questions that need answering(Pillar 2),  then assessing the data generating mechanism and approach (Pillar 3) and finally finding the answers (Pillar 4). This last one, should, if the previous steps were done correctly, be straightforward. The goal is to make informed choices instead of just processing lots of data.
 
While the book was only published recently, and I have yet to read it, the summary I have read is compelling. I have always advocated starting any problem-solving activity with finding answers to the following questions “What am I trying to achieve? What do I need to do? What do I need to know in order to solve my challenges” instead of with “Let’s analyse all the data we have and hope we find something relevant to follow up on.”
 
Anyone with a science background will agree with the premise that not all problems can be solved using the available data. Data helps solve some problems, but some problems can only be solved with better theory, better diagnostic capabilities, a different way of thinking. To paraphrase the authors, “Some situations can be solved with better observations, but some can only be solved with better theory, by thinking without data.”

To add to this, you will not always immediately know which problem is which, so it pays to be open-minded. 
 
In a business climate where the quote “you cannot manage what you cannot measure” is, regrettably,  ubiquitous and where leaders ask their IT teams “Can we use AI to tell us what we should be looking for?” being willing and able to contemplate thinking without data requires courage, an open mind and good connections to senior stakeholders.
 
If you are curious about the origin of the popular phrase “if you can’t measure it you can’t manage it” and you want to know why I disagree, find my thoughts here in the last paragraph.

Key take-away: When looking for solutions,  begin with the decisions and questions that need addressing, only then identify how best to address them
 

Beware of the data

Often teams are under pressure to design and implement solutions to frequent business problems quickly. Some examples:  the inefficient use of IT or human resources, substandard customer service, supply chain issues, inefficient trial site recruiting….. etc. These time pressures may mislead teams into undertaking problem-solving activities based on historical data instead of considering the bigger picture such as the current, evolving and future business  environment.

In my experience, when teams start with data, it narrows their gaze, and they risk  solving the wrong problem. Instead, it is worth investing time to understand all aspects of the problem and how the evolution of the business may influence it in the future. I recommend doing this through discussions, exchanging experiences, and ideally using whiteboards and flipcharts to allow for unrestricted thinking.

It helps to avoid charts and graphs in the initial step because they show you what you already know and they are, in some ways, the “children” of the past, which may lead to blinkered thinking.

Key takeaway: In general, whatever the situation it helps to “zoom out” and take a broader view.

AI will interview you now
 
For most business applications AI is placed firmly in a supporting role. So when I came across an article on AI being used to screen candidates for jobs I was intrigued (Link May 10 2024). Apriora, a US start-up company, is developing AI technology to interview candidates, and to write an assessment and provide this back to the HR department. While AI is frequently used to screen CVs, using it to perform job interviews is new.
 
The benefits would ideally be that companies can screen more applicants; more candidates are selected for interviews and human, human resource, resources, can be selectively deployed.
 
While it is interesting, I think before implementing this model, the following question needs asking:  How many candidates do you need to assess to fill a position? Is more always better? Or put another way, does the quality of your candidates increase dramatically if you interview five-thousand individuals, instead of twelve? Might the ability to interview more people mean that employers expand the list of ideal criteria they would like an employee to fulfil increasing the complexity of the hiring process without necessarily improving the outcome?
 
By implementing this process, the startup founders say companies will screen more broadly and look at a wider talent base. However, as always what comes out at the bottom depends on the model that was used for screening. Ultimately, unless the individuals tasked with identifying the perfect candidates are open-minded and consciously identify attributes that will add value to their organisations, outside the typical “box,” AI will just deliver more of what the organisation had in the past.
 
Years ago, a senior leader told me “It is getting hard for me to hire a candidate without multiple degrees. If I really like a candidate, whether she has an MBA is not relevant to me, however it is becoming harder to justify picking a candidate, who on paper appears less qualified, if other candidates who have applied have more qualifications.”
 
In a wonderful book “The Art of Choosing” by Sheena Iyengar the author reports on an experiment regarding how humans deal with choice: customers are given the option to try a selection of jams placed on a table near the entrance of a grocery store. On one day only a limited selection is made available, say five jams, on another a much larger selection, let us say, fifteen jams are placed on the table. The data consistently showed that when faced with less choice customers were more likely to buy one of the jams they had tried upon entering the store. Less complexity led to better outcomes.
 
Society teaches us to believe more is better, more choices in every area of life including more candidates for open positions, is better.  Current thinking teaches us that AI will make everything more efficient.  However, by introducing more choices, while keeping all other variables the same,  there is the risk that complexity is added without enhancing performance.
 
It is also important to ask how AI will assess the “chemistry” and potential fit of a candidate, which arguably is one of the best predictors of performance in a later role. 
 
Key takeaway: More choices lead to more complexity which may lead to more costs unless proactively managed.
 

Leadership: Gifts and henna
 
I recently spent time in Morocco. It was a  great reminder that my cultural norms are not universal, that what works here, does not work there, and that being openminded, willing to talk to everyone, and incessantly curious, has upsides and downsides.
 
The upside is that I have wonderful experiences wherever I go. On the penultimate day of my stay in Morocco the chief of staff of the hotel presented me with a gift, saying “all the staff know you; they talk about Madame Isabelle, we want to give you a gift for you to remember us by” it brought tears to my eyes. On another occasion in Cairo, a girl wearing a hijab invited me to her house for dinner, after which we danced together in the living room.
 
The downside can be that wherever I am people come to talk to me about Christianity, Islam, the Mormon faith and Scientology, which is often really interesting, however pushy salespeople also love talking to me, tourists ask me for directions and in Morocco snake charmers, monkey grinders and henna artists found me irresistible. I once asked someone why out of all the people walking down the road he had stopped me, his answer “you looked friendly and I didn’t think you would be abrasive.”
 
While the upsides of being approachable far outweigh the downsides it did mean that I needed to adapt while in Morocco. After a while, and one unwanted henna tattoo,  I was able navigate the city, all engagements, and sales discussions confidently, competently and with pleasure. The process was interesting while also reminding me of who I am and who I choose to be.

When we engage with the same people every day, and do the same thing every day, it is sometimes hard to remember what we struggle with, what we excel at, where we are challenged and that how we are and how we live is a choice.

Context switching can be useful to remind us who we are and help us to discover things about ourselves. This can be at work, at home, on a trip, with a new hobby, or trying out a new sport.
 
Key takeaway: Try new things often to keep growing. Remind yourself that how you engage the world is often your personal choice, embrace it, accept it, or change it. 

If you haven’t yet seen it,  watch the panel discussion on digital islands below

Link

I hope my posts provide you with useful insights. If  you need support with a project, or are interested in coaching, why not give me a call to see how I can help. Find out what clients say about working with me here link.
My very best wishes

Isabelle C. Widmer MD

Image credit: Isabelle Widmer, Majorelle gardens, Marrakech

The future of healthcare, digitalisation and health equity

Sunny beautiful May, plants on my balcony are blossoming. It is almost summer. Almost a month ago, I went to the first BOOM summit, run by DayOne in Basel, and MC’d by the fabulously impressive DayOne Director of Innovation: Caoimhe Vallely-Gilroy.  The topic of the event? Igniting the Health-tech revolution. There were many fascinating presentations, however, a few things stayed top of mind which I wanted to share with you. A testimony to the fact that great things stay in our minds, even months after we hear them. 

Today’s Topics:

  • BOOM Summit takeaway 1: GenAI and sustainability
  • BOOM Summit takeaway 2: How to bridge gaps and build futures
  • BOOM Summit takeaway 3: Health equity and digital transformation in the WHO EU region
  • Leadership: The traits of an inspiring leader

BOOM Summit Takeaway 1: GenAI and sustainability

The BOOM summit had some stellar presenters, brilliant presentations, deep subject matter expertise and competent, engaging delivery. There was so much content that it is impossible to share it all here, but there are certain topics that were raised, that I think of every day.

The first topic was water and energy consumption of Generative AI.

Samantha Gordine, Sustainability Solutions Lead, Arcondis, Switzerland shared that

  • ChatGPT uses 0.5 litres for every 20-30 questions it processes and that by 2027 AI’s water demand could be 50% of the UK’s national demand
  • GenAI uses 4-5x more energy than a conventional web search and that within years, large AI systems are likely to need as much energy as entire nations.

I think about this every time I use GenAI, or read about companies adopting GenAI across the globe, and I wonder.

A nature article posted on Feb 20th, 2024, addresses this topic in more depth “Generative AI’s environmental costs are soaring – and mostly secret (Link)

Key takeaway: My personal take-away is to ask myself when I need GenAI and when a regular search will do.

BOOM Summit Takeaway 2: How to bridge gaps and build futures

In the session: Bridging gaps, building futures: The intersection of Health Tech,
Gender, Medicine, and Additive Manufacturing Naomi Nathan, Head of Medical, Mobility, Medical goes Additive e.V., Germany shared her thoughts.

What stayed with me from her talk was the exhortation to the audience to do the following:

  • Break silos: bring together experts from diverse fields, healthcare, technology, engineering and beyond to cross-pollinate and tackle challenges from different angles.
  • Co-Creation: patients, clinicians, researchers, industry partners should co-create new health tech products.
  • Share knowledge: create collaborative ecosystems and avoid reinventing the wheel
  • Scalable solutions: interdisciplinary teams enable the development of solutions that can be deployed across diverse healthcare settings and communities.

I readily admit that in my case Naomi was preaching to the choir and my enthusiasm for her suggestions stems from my not only wholeheartedly agreeing with everything she said, but my also having said the same things over the years, repeatedly. My first panel discussion on digital islands was a case in point, both panelists have a broad background, they code, they are data scientists, they understand data, data science and systems but they also understand business from fintech, to NGO, to pharma, to CRO, national intelligence and beyond. It is easier than ever to bring thinkers together, all it needs is the willingness to explore different ways of thinking and working and to take nothing for granted.

Hopefully, these ideas are now becoming mainstream.

Key take-away: Accelerate towards success by integrating ideas across industries, countries and cultures and making something new.

BOOM Summit Takeaway 3: Health equity and digital transformation in the WHO EU region

Clayton Hamilton representing the DATA, Digital Health and Evidence WHO Regional office for Europe spoke about health equity and provided the following definition of health inequities: health inequities are differences in health status or in the distribution of health resources between different population groups, arising from the social conditions in which people are born, grow, live, work and age.

He asked the following questions:

  1. What impact is digitalisation having on health equity?
  2. Why does this matter?
  3. What can we do to shape the future of digital healthcare that is available, accessible, and affordable for all – and make sure that we do not lose the humanity in medicine?

From a patient perspective it is easy to understand that a lack of digital literacy and digital access impacts health outcomes. In addition, underserved and marginalised populations, could benefit hugely from access to digital health tools.

An aspect I did not consider is that if underserved population data is not captured, any AI solutions that are built using the data that is captured, once again, only represents a subsegment of the population further impacting how underserved populations healthcare needs are managed.

While we focus on patients, thinking of the charity I volunteer for, there are also clinical officers around the world serving patients, these clinical officers also do not have the same access to internet and digital health information as their peers. Who has access to data, when and to what quality and volume, is relevant not only for patients but also for physicians.

About ten years ago I was doing some work to design a training course on market access, and I remember looking up a McKinsey or PWC report on smart-phone use worldwide amongst HCPs – the topic was – when and how do doctors consume information. At around the same time pharma companies were providing physicians in South America with access to international scientific publications because of the cost of these publications making them less accessible to physicians in certain populations.

We are so used to having access to everything online all the time that it is easy to forget that this is not a global reality.

There was so much more content that Clayton shared, and I cannot go into it here, however, he shared a link to a WHO Online introductory course on Ethics and governance for AI for health, you can find the link here.

Key take-away: If we don’t address digital health inequity, health inequities and social disparities will grow.

Leadership: The traits of an inspiring leader

Leadership,  is as much, if not more about managing yourself, than it is about leading others.

In a nutshell, if you can manage yourself—your emotions, your engagement, your energy levels—and if you know what you can and cannot do, bringing in others with complementary skill sets without begrudging them their abilities, then you are already in a great position.

If you can work with others who possess diverse skills, delegate effectively, temper any need to micromanage, can offer praise but also provide candid, fair, and constructive feedback, and communicate honestly about what you can change and what you cannot, your position is further strengthened.

Finally,  you need to be able to make difficult decisions, avoid blaming others when things go wrong, take accountability, and be honest and human to the point of recognising and accepting you have strengths and weaknesses. Know that it is easier, and I believe more sensible, to build on a strength than it is to fix a weakness. Whatever the topic of your end of the year review.

The traits described above, I believe, are those of potentially great leaders, who can inspire loyalty in others and the desire in them to follow you.

Naturally, you also need to be able to communicate effectively, set goals, have a meaningful vision, and manage all the business aspects.

Key take-away: learn from others but know you are a unique leadership instrument, and you need to find out who you are as a leader, of one, or of many, yourself.

I hope my post provides you with useful insights. If  you need support with a project, or are interested in coaching, why not give me a call to see how I can help. Find out what clients say about working with me here link.

My very best wishes

Isabelle C. Widmer MD

Image credit: Jason Dent @Unsplash

GenAI and regulatory document review and the role of loyalty in personal and professional growth

Many new experiences in the past weeks. I worked on a publication on social dreaming during the pandemic, did a 21km walk in preparation for a 50km event later in the year and ran my company’s first webinar/panel discussion on the topic digital islands. The experience was fun and attendance was good. Beyond participation on the day,  28 people have watched the recording since the event, which is excellent.

Today’s topics:

  • Marooned on a Digital island panel discussion reflections
  • GenAI and regulatory document review
  • Moderna rolls out GenAI
  • Leadership: The role of loyalty in personal and professional growth

Marooned on a Digital island panel discussion reflections
 
Last week I ran my first panel discussion with my company. It was not part of a larger event run by a conference organiser.  I was joined by two friends, data scientists and brilliant thinkers Wolfgang Schwerdt, who is a Data Science Manager at the ICRC and Peter Shone, who is Chief Technology Officer at iEthico. I am immensely proud that Krystal Ellison from 3Sided Cube,  volunteered to help me. Without her support I do not think this would have come to fruition.
 
Strangely, although I have known both Wolfgang and Peter for years, they still manage to impress me, when I talk to them, both share concrete examples from the work they have done.
 
Upon being asked why digital islands still exist, although we have technology, knowledge on how to avoid them, and theoretical ability, Wolfgang answered “I think it just happens organically and is unavoidable.”  He then shared an example of a startup he was in, where three years after the company was founded, there were five thousand systems across the entire organisation.
 
We covered topics including why organisations struggle, what to do about it, key drivers for change, infrastructure, data mesh/data lakes and, of course, AI.
 
If you missed it, and you struggle with marooned data, don’t know your mesh from your lake yet, and find pragmatic solutions more attractive than waffle, watch the “Marooned on a Digital island panel discussion” here: Link
 
Key takeaway: You are not alone, if you want proof, and better yet,  solutions, watch the discussion on the Link. We received some great feedback.

GenAI and regulatory document review a case study
 
Enthusiasm does not trump accuracy. AI reminds me of a puppy, I throw a stick, the puppy brings me a similar looking stick. If the puppy is super enthusiastic, I may not notice.
 
In the past week I have reviewed regulatory documents from many markets including Israel, India, and Hong Kong. Documents included pharmaceutical industry codes of practice, regulations on medicines for human use, GDPR and other data privacy related regulations, EU directives and regulations, legislation governing promotional activity or transfers of value and legislation on consumer rights.
 
Many of these documents are lengthy, and manually searching them is time-consuming.
Fortunately, I was looking for specific information in each document, I know the subject area intimately, and most of the documents are available in English. 
 
From initial manual reviews, my approach evolved to using AI to support with searching the documents, prompting it to provide the text in original language, where it was not available in English, with a translation directly underneath and the exact article number and page numbers. This approach enabled me to review the original text, which I can do well enough to spot inaccurate translations in Spanish, Italian, French, German and English. This approach was usually not needed, however, as documents are often available, in bilingual versions, e.g. Hong Kong, or else in English as non-legally binding copies. The one outlier was Israel, I was unable to find the regulatory document I was interested in in English, ChatGPT made up answers, possibly due to a hebrew challenge,  and the translation engine I gave the task to last night is still translating. 
 
What struck me repeatedly was how often, even when I had provided ChatGPT with a full-length regulatory document, and asked specific questions on that exact document, the answers I received were wrong. They sounded reasonable, they made sense in the universe I live in, but being a sceptical soul I checked each answer, and quickly learned to ask for the exact original text snippet and the precise location in the document to check the responses I had received. Invariably I ended up getting this answer again and again “I am but a lowly large language model, I shouldn’t make stuff up, but I aim to serve”
 
I submitted the above text to ChatGPT4 and asked for its opinion: its feedback was this “Your experience highlights that accuracy is paramount and the verification of AI outputs is critical. The “happy puppy” analogy illustrates the risk of AI delivering incorrect answers that seem plausible. While AI can enhance efficiency in managing vast data volumes, its outputs must be thoroughly checked. Underscoring the need for collaboration between AI users and developers to improve accuracy. The key takeaway: enthusiasm does not diminish the importance of verification to ensure accuracy.”
 
Key take-away: Beware the happy puppy. If you send your puppy into the woods after a stick you threw, it may bring you an old boot, instead. Make sure you check because enthusiasm does not trump accuracy.

Moderna rolls out GenAI

In light of my experience above, I found this recent article in the Wall Steet Journal fascinating “At Moderna, OpenAI’s GPTs Are Changing Almost Everything” (Source Wall Street Journal, Isabelle Bousquette, April 24, 2024,(Link). According to the article “Moderna employees have created 750 unique tailored versions of OpenAI’s ChatGPT, that are designed to facilitate specific tasks or processes across the business. Some of these GPTs help select the optimal doses for clinical trials and help draft responses to questions from regulators

This is an interesting approach.  

What I am curious about, but what the article doesn’t go into, is how the models are trained, how the accuracy and precision of the implemented tools is managed, how recommendations are verified by experts, what governance has been put in place to manage this approach and how the data that is used for training is prepared.

The basis of any good AI model is clean data, clarity on what is being put in, training and monitoring of the output, and this is important, quality control, in this type of situation where the stakes are extremely high, ideally by an uninvested third party.

Key take-away
: We live in interesting times.

Leadership: The role of loyalty in personal and professional growth
 
Loyalty is regarded highly. Having a sense of commitment to the organisation you work for, the country you live in, the background you come from, or your team provides stability and a sense of belonging.
 
However, sometimes a sense of loyalty holds us back. For example, when I was still an employee, I did not apply for a newly created position to head up our team, because I would have been competing with my manager. It felt disloyal to apply. I remember how astonished some people were. We are still close friends; we both have different jobs, and it was the right decision for me at the time.
 
In the above example I was conscious of my loyalties. However, sometimes they are hidden.
 
As a coach the thought that unreflected loyalties can inhibit progress fascinates me.

Some obvious examples are loyalties to organisational structures, which have been reimagined, or old ways of working. At a much deeper level, unidentified loyalty to previous familial generations can sometimes also inhibit progress. Examples might include individuals with enormous potential, who do not progress in organisations, or do not finish university, because on a subconscious level, successfully achieving these goals, would make them feel disloyal to a family member, who was unable or did not have the opportunity to realise their own potential.
 
Many coachees I have discussed this with have found the idea resonates and have shared personal examples.
 
Key takeaway: If you feel unable to reach a personal goal, or you keep delaying something, ask yourself “who or what am I being loyal to in not reaching this goal?” Or “who, or what would I be disloyal to, if I reached this goal.”

Reminder, watch the panel discussion on digital islands

Link

I hope my post provides you with useful insights. If  you need support with a project, or are interested in coaching, why not give me a call to see how I can help. Find out what clients say about working with me here link.
My very best wishes

Isabelle C. Widmer MD

Image credit: Krystal Ellison

Navigating the regulatory jungle – don’t advertise magic remedies

I have a busy week behind me with participation in the Boom Summit in Basel, which was great, and a busy work week coming up. Beyond work spring has sprung, the weather is beautiful and I have new strawberry plants on my balcony. I have also  soaked chilhuacle nero  chili seeds in tea, and a batch in water in order to compare performance,  before putting them onto a heating pad to germinate. 

  • BOOM Summit: Improving healthcare access and technology
  • Bad workman, bad tools or neither? Me, my bike and I 
  • Navigating the regulatory jungle – don’t advertise magic remedies
  • Leadership: Lessons from a consultant

BOOM Summit: Improving healthcare access and technology

Imagine you have no health insurance; no internet access and you cannot afford the bus fare to get to your nearest physician. Perhaps you are one of the 2.9 billion people, 37% of the world’s population, that has never used the internet (Source: United Nations Website, 2021).

How would technology help you? When I prepared for the panel discussion on improving health care accessibility through technology, that I took part in at Boom Summit last week, it became clear to me that I want to share my passion for technology and equitable access to healthcare, while remembering that 50% of the world’s population does not have access to the healthcare they need (Source) and that, depending on location, needs are dramatically different.  I realised I wanted to focus on healthcare access/intervention and context first, and modality, e.g. technology, second. Tech is fantastic, but it is not always the answer. Below my recommendations for how to approach improving healthcare access with and without technology.  

  1. Patients: Engage patients, involve patients. listen to all patients and don’t forget that patients are also doctors and nurses, physiotherapists, and computer programmers, molecular biologists, and lawyers. They know their disease, they know the science, they have programmed solutions where the industry has not provided what was needed.
  2. Identify the problem: the presenting problem is often, in fact, almost never in my experience as a consultant, the main problem you need to solve. Ensure you have understood the issue, and you understand the context, key stakeholders, and patient needs. Reality check this. A great example of what happens when you don’t understand the problem can be found in Ernesto Sirolli’s Ted talk: want to help someone, shut up and listen
  3. Identify the ideal solution in the context you are in:  For example, to provide stigma free access to mental health support, a psychiatrist rolled out friendship benches in Zimbabwe. Benches are placed in parks, they are staffed by community elders, who listen to and potentially triage individuals needing mental health support to practicing clinicians, thus lowering the barrier to ask for help, while implementing a cost-effective solution.
  4. Fast-track your approach: learn from other industries and others in your field. 
  5. Smart solutions can have a huge impact even if they don’t seem exciting:  Game changers that can save money and ideally support systems to reallocate funds where they are most needed, include: implementing better processes in managing the patient’s journey and health records and ensuring all treating physicians have access to the data. Allocating physicians to cases based on expertise and adapting on a case by case basis as a day in the clinic evolves. And AI supported diagnostic solutions.
  6. In many indications in the mental health arena the need is great: aging populations including patients in mental decline, and those who are confused and disoriented, will at some point overwhelm the available resources in healthcare systems in the Western world. I remember a patient I met while I was a medical student. He had dementia and he spent his day restrained in his chair. He seemed lonely. I drew a board game and got some buttons. I tried to engage him.  This was many years ago, but this man’s situation, and the situation of many others like him around the world,  still make me feel sad. Tech solutions like Paro the therapeutic seal, view a video: here.  can help patients feel more connected and less afraid. Another success story is the app Stigma, which “aims to foster a supportive community while breaking down societal stigmas associated with mental health”

My fellow panellists also shared many ideas including the following: 

Ventsislav Dobrev recommended you start small and develop your solution in increments, Brian Li Han Wong, stressed the importance of implementing solutions that match the environment you are operating in, sharing a story about failed healthcare initiatives when high-tech solutions were implemented in an environment unable to maintain them, and Sara Schmachtenberg spoke about the problem with too many apps which makes managing health difficult for multimorbid patients and that when tech investors are hesitant creative tech developers will stand out from the crowd. Julie Cheu led us through the panel discussion and was widely acclaimed afterwards as a fantastic moderator by audience members I spoke to. 

Key takeaway: Here, as everywhere, knowing what you are doing is critical: shiny, golden tech solutions have no legs if all they are is golden and shiny.

Bad workman, bad tools or neither? Me, my bike and I
 
There is an English saying: “a bad workman blames his tools.”  However, sometimes ensuring you have tailored tools for the job can be the difference between success and failure.
 
Last weekend, I cycled up a series of hills. The steepest incline was 16%, which, for me, is steep. In the past, I would not have had the ability or the desire to attempt it. However, last Saturday I really enjoyed the challenge and the satisfaction of cycling a difficult route.
 
So, what has changed? My fitness? A little, but mainly my motivation and my equipment have changed; I had my bicycle adapted to make hill cycling easier and I bought a bicycle computer that tracks where I am on an incline and collects data. When I started cycling, other cyclists often overtook me, whenever I cycled up a hill. I assumed it was because the cyclists were much better than me; I did not think to question my equipment. Then an avid cyclist looked my bicycle over and explained the issue.
 
Key takeawayYou may not always see key performance predictors if you are not well-versed in a subject. Properly equipping yourself and aligning with your personal motivators can improve performance more effectively than merely training harder.

Leadership: Lessons from a consultant

When I began consulting in 2013, I was tempted to manage every aspect of my business myself. It seemed manageable and sensible for someone just starting out. However, my father, who passed away recently, often told me, “Do what you are good at, delegate the rest.”

It took me a while to embrace his advice, but now I apply his wisdom in every area of my life. If someone else is better at a task, if the task is highly time-consuming and my time would be better spent elsewhere, or if I simply do not enjoy it, or the thought of doing it causes me anguish, I hire someone else to do it. The joy I get from seeing something taken care of well, and knowing I did not have to do it, is incredible.

In addition, this approach frees me up to focus on what truly matters to me: consulting, coaching, learning, participating in industry events, making new connections, engaging in charity work, cycling, hiking, spending time in nature and with my friends and family.

Key take-away: Energy is finite. Delegate where you can and focus your energies, the rewards are immense.

Reminder, Sign up for the panel discussion  on digital islands and AI on April 24th

Don’t forget to sign up for the panel discussion on digital islands I will be joined by Wolfgang Schwerdt and Peter Shone, both experienced data scientists. All information in the link below.

Sign up for the panel discussion on April 24th at 2 pm GMT, 3 pm CET, and 9 am EST: “Are you stranded on a digital island in a sea of data?”

I hope my blog provides you with useful insights. If  you need support with a project, or are interested in coaching, why not contact me to see how I can help. Find out what clients say about working with me here link.


My very best wishes

Isabelle C. Widmer MD

Image credit: Michelle Bridenbaker

Medical Information delivery – navigating legislation and language

You may remember that I play lacrosse, not well, but with enthusiasm. Last weekend was  a game weekend, the teams played sixes. The teams have thirty seconds to score, then the ball changes hands

It’s fun, it is fast, it needs someone to manage the clock. That was me. Sadly, it was cold, it was raining, and the trackpad on the computer I was using was not registering my frantic taps, or the computer would freeze, or I would lose the window, and as it was not my computer it was tricky. The experience reminded me that even simple tasks can be daunting when you are under pressure to perform, you are not familiar with the material, or you are cold and wet, or in an unfriendly environment. Reminder: when judging substandard performance always consider the context.

Today’s topics:

  • Medical Information delivery – navigating legislation and language
  • Optimising content localisation: balancing global, regional and local requirements
  • The essentials of effective program management
  • Leadership: Diagnose then treat

Medical Information delivery – navigating legislation and language
 
Leading international pharmaceutical firms with a presence in nearly every market typically offer all customer services in the local language(s). However, many mid-sized or smaller companies, particularly those focused on orphan indications,  do not have the resources or global reach necessary to provide every service in every local language.
 
This issue is particularly pronounced in departments like Medical Information, which provide scientific responses to unsolicited queries. Here, the dual requirement for responders to be both scientifically knowledgeable and native speakers significantly compounds the challenge
 
While it is reasonable to anticipate that information provided to customers is provided in local language, this expectation is not widely found in legislation, perhaps because national legislators historically took this for granted.  This absence challenges companies to identify bespoke solutions for each market that are compliant, financially viable and pragmatic, while also meeting customer needs.
 
Solutions to the challenge should consider the business significance of each market, now and in the future and factor in a company’s product portfolio, pipeline, upcoming launches and anticipated market presence and resources.
 
In markets with lower inquiry volumes where scientifically trained native speakers are unavailable for direct customer interactions translation services often bridge the gap. Translators can be utilized to assist on calls, provided stringent quality checks are in place, or queries can be addressed in writing in the local language.
 
Key take-away: A market specific, strategic approach to providing scientific information on medicines to customers in line with codes of conduct and national legislation, as well as business considerations, is important.  Language is just one factor.
 

Optimising content localisation: balancing global, regional, and local requirements
 
“We never use the global materials, because they don’t work in our market” I have heard this many times. The amount of energy expended in generating materials that are not used in local markets is immense. Content is generated, slide kits are shared, yet often, either due to perception or reality, the materials generated by global teams fail to hit the mark.
 
Sometimes this is because global teams operate in a silo, sometimes it is because the needs of smaller markets are not taken into consideration, sometimes it is because speed is in focus and materials are produced in isolation, and sometimes processes describing the adaptation of global materials for use in local markets are not outlined and systems to manage these documents are not implemented.
 
Despite the difficulties in achieving harmonised content, the rationale for centralised generation of content is easy to understand. When it works, there is an increase in efficiency, in effectiveness, a reduction of effort expended in markets, and no reinventing the wheel. With the exception of necessary content adaptations for example to ensure adherence to local legislation and the local label, or in some cases translations of content, local teams can focus on market engagement, instead of on content creation. As customer engagement is led by local teams, and engagement preference varies across markets, the format of content provided by global teams should be flexible to accommodate different audiences, stakeholders, and modalities.

The rationale for a harmonised look and feel across company materials also makes sense as many physicians interact with multiple product teams from the same pharmaceutical firm. Furthermore, especially for companies that are active globally the provision of disparate information from market to market looks unprofessional.
 
While teams often lament the loss of individuality when faced with centralised content generation in reality written content only represents a small part of a relatioship between a pharmaceutical company employee and the stakedholders she engages. ^While “the science is the science” personal engagement, scientific conversations, and relationship management, is provided by individuals hence customers benefit from the best of both worlds a personal touch, individual conversations focused on science and harmonised scientific materials.

Key take-aways: An optimised approach to content benefits all stakeholders, by freeing resource to provide value where it makes a difference

The essentials of effective programme management

Programme management is the coordinated management of multiple projects to achieve the desired outcomes. As the programme lead, you are the conductor of an orchestra. Using this analogy, ensure that everyone in your orchestra knows what instrument they are playing and when. Each section of your orchestra has a leader, for example, the first violin, with responsibility for that section. These are your project managers and sometimes working group leads, depending. Limit the size of working groups so that they remain functional and can make recommendations. Select participants judiciously.

Ensure that everyone’s eyes are on you so that efforts are coordinated. The orchestra is the operational part of your programme. Beyond the operational teams, you also need strategic leadership. The manager of your orchestra, who manages the business aspects of your programme, where you will play next, etc. The strategic team manages the big picture.

In pharma, this means having a steering committee of senior leaders. This is a small team that does not get involved in operational aspects; they are your sounding board, manage other senior stakeholders in the organisation and are accountable for final decisions and the overall direction. While programme management is simple, in theory, often projects gain momentum and complexity, as aspects that were initially forgotten are added in later.

Key takeaway: Effective programme management depends on clear roles, coordination, and strategic oversight to ensure the desired outcomes can be met.

Leadership: Diagnose then treat

 “How many of you in here are CEO’s?” the presenter asked. The video panned to the cowed looking audience, some of whom raised their hands, the presenter said, “you have to be willing to fire your best person, if they are making others unhappy”.

This video is being widely shared and liked on social media.

A word of caution, in my experience, in a dysfunctional team, firing one person, doesn’t solve the underlying problem. It looks easy, but it may not be the right thing to do.

What struck me, more than the presenter’s words, however, was that he was so forceful, that I felt physically uncomfortable just watching a recording of him in my office.

This made me wonder, what if the team leader, or the CEO, is the person everyone is afraid of?  How would you know? Who would tell you? Would you care, and how would you act?

Key take-aways: A leader is also part of a team and influences the team dynamic. Always diagnose then treat.

Reminder, Sign up for the panel discussion  on digital islands and AI on April 24th

Don’t forget to sign up for the panel discussion on digital islands I will be joined by Wolfgang Schwerdt and Peter Shone, both experienced data scientists. All information in the link below.

Sign up for the panel discussion on April 24th at 2 pm GMT, 3 pm CET, and 9 am EST: “Are you stranded on a digital island in a sea of data?”

I hope my blog provides you with useful insights. If  you need support with a project, or are interested in coaching, why not give me a call to see how I can help. Find out what clients say about working with me here link.

My very best wishes

Isabelle C. Widmer MD

Image credit: Isabelle C. Widmer Russia 2006

Data dynamics in medical affairs and sign-up for the panel discussion on digital islands!

The world is a riot of colour, cherry blossoms, crocus, bluebells and daffodils, green shoots, blue skies, and  more hours of sunlight every day. There is a lot of promise in the air. Spring is here, greeted every year with a sense of joy and wonder.

Another event that occurs annually is in preparation: The DIA Medical Information conference, which this year will be held in September in London. Remember, the meeting stays relevant and interesting thanks to your participation. If you have an idea for a submission, please don’t hold back. If you need a pep talk, reach out!

And now some news, something that has not been here before: I will be running and hosting my very first panel discussion with my company. I have done many of these but none without the support of conference staff. Please find the link below!

Today’s blog topics:

  • Medical affairs: unlocking insights and exploring data dynamics 
  • Medical affairs: the benefits of collaboration
  • NEWS: Upcoming panel discussion on digital islands and AI
  • Leadership: Remember to lead with compassion

Medical affairs: unlocking insights and exploring data dynamics 

In 2019, I conducted a survey on the interconnectedness of all things, systems, knowledge, and people in medical affairs. I asked individuals how they manage data, communicate across geographies, and ensure that different teams in the medical affairs sphere, think medical managers, medical directors, medical science liaisons, medical information and beyond, are aware of key information about products, key clients, and services. The survey was global and shared with biotech, pharma, and device manufacturers. Eighty-five respondents shared their knowledge.
 
I asked questions about collaboration across teams and geographies. I inquired about processes, systems, and platforms, as well as whether regular meetings to share data are held and  all processes are described in SOPs and WIS. While almost 50% of respondents reported having meetings to share information across functions, these meetings were mostly on a case-by-case basis, and the approach to information sharing was not described in SOPs and WIS.
 
When asked to identify the biggest challenge to collaboration and data-sharing across teams, respondents selected the following (multiple responses were possible):

  • Lack of knowledge about potential data sharing areas (85% of respondents)
  • Lack of shared processes (90% of respondents)
  • Lack of common platforms (80% of respondents)

 
While AI is often discussed for analysing data within systems, it’s crucial to acknowledge that without proper processes in place to identify and manage data, capitalising on its potential becomes challenging. Furthermore, the absence of common platforms poses a technical obstacle, compounded by variations in taxonomies and ontologies.
In conclusion, many hours are lost in generating new information or reinventing the wheel. With constant reorganisations in the pharmaceutical industry, managing this situation is more important than ever across the board, teams, and geographies.
 
If this topic is of interest to you, stay tuned for a follow-up survey. I am curious to see how the field has evolved.
 
Also, consider signing up for my upcoming panel discussion on digital islands here.
 
Key take-away:
 You don’t know what you don’t know.

Medical affairs: the benefits of collaboration

In the survey mentioned above, beyond asking team leads how they collaborate, what they collaborate on and what processes are in place, I asked them to outline how collaborating across teams, e.g., Medical Directors/Medical Managers, Medical Information, and Medical Science Liaisons, had improved how they work. The precise question was: “What have been the benefits since you started collaborating with other teams?” The answers included: faster identification of issues/opportunities in the markets (65% of respondents), harmonised medical affairs strategy at a local level (63% of respondents), insights from other markets to help us anticipate market needs (58% of respondents), and also, especially relevant in these times of constrained resources, sharing resources has freed up capacity to do other work (41% of respondents).

One respondent said: “From a global perspective, the benefits are better alignment, more efficiency, more room for innovation,” and another stated, “Collaboration helps us anticipate our customers’ information needs.” It is easy to imagine the downstream benefits of these outcomes of better collaboration, for example, better resource management, better customer satisfaction as customers’ needs are anticipated, and enhanced in-field effectiveness, all of which have a positive impact on the business.

Key take-away: cross-team collaboration can add huge value in medical affair through  efficient resource utilisation, reduction of reduplication of efforts and the ability to address topics as they arise ultimately leading to better business outcomes. 

NEWS: Upcoming panel discussion discussion on digital islands and AI

So how about managing data on Jersey then?” a lawyer in the financial sector asked me at a panel discussion I hosted on digital islands last year. Jersey is an island located in the English Channel off the coast of Normandy. I suspect he was disappointed to discover that the islands we focused on were entirely virtual.

I am delighted to share today that I am finally hosting my first virtual panel discussion on digital islands, also virtual, with my company elytra – very real!

I have been speaking at conferences for years, and managed many panel discussions, in this context, but I have always had a hankering to host my own. Now, finally, thanks to Krystal Ellison, who supported me in all things technical, my first panel discussion is here!

I will be joined by Wolfgang Schwerdt and Peter Shone, both experienced data scientists and sailors, so perfectly placed for the subject matter.

Sign up for the panel discussion on April 24th at 2 pm GMT, 3 pm CET, and 9 am EST: Are you stranded on a digital island in a sea of data?”

Come prepared to have all your questions answered.

Key takeaways: My first panel discussion is upcoming, it would be fantastic to see you there.

Leadership: Remember to lead with compassion

During the pandemic, there were many discussions regarding how teams can function without face-to-face interactions and in a state of fear and lock-down. A friend said “I tell my team that not being ok, is ok”.

There were discussions about self- care, how to achieve balance and rituals people put in place to work remotely. The truth of the matter is that many teams work remotely, pandemic or not. However, now the world is back to normal, I anticipate that some of the great ideas people had about managing pressure, or insights about remote working have been lost and forgotten amidst daily work and busy lives.

During the pandemic I put this question to Medical Affairs Leaders  “What has this extreme experience taught you that you are grateful for? How will this knowledge serve you in the future as a leader, or in your personal life?

The five responses I share below are as relevant for today’s world as they were in 2020. regardless of how you are currently engaging with your teams:

  • “Support, empathy and understanding are essential as a manager and be real”
  • “Personal and professional life are intertwined. Each person will react differently as these pieces alter”
  • “To get the best out of people individual circumstances and personalities must be taken account of” 
  • “As someone who would have been a big proponent of a WFH model, I now understand the benefits of working together. I can now also see the importance of trusting your team and giving them flexibility as appropriate to work around their lives”
  • “Some of us may have placed work/company as our driving priority in life. This experience reinforces that professionalism is vital to career success, but relationships outside workplace provide a critical source of connection”

Key take-away: Communication, empathy and trust are crucial when leading teams, regardless of the set-up.  Beyond this, understanding your needs,  striving for balance and self-care are also essential for you to be a strong leader. 

I hope my post provides you with useful insights. If  you need support with a project, or are interested in coaching, why not give me a call to see how I can help. Find out what clients say about working with me here link.


My very best wishes

Isabelle C. Widmer MD

Upcoming Digital Islands and AI webinar, and Leadership: you are not a shark!

This week is the Medical Affairs and Scientific Communications meeting MASC in Orlando. Pre-pandemic I was a regular attendee.  I love the meeting, connecting with old colleagues, many of whom have become friends,  and hearing what everyone has been up to. I am sad that I will miss it this year, and up until Saturday, and even this morning; I was thinking I could just hop on a plane and fly to Orlando. However, having just emerged from a four-month long course on Artificial intelligence that absorbed most of my evenings and weekends, upon reflection, I decided to pause. Find out why in today’s last topic.  

Today’s topics:

  • Upcoming Digital Islands and AI webinar
  • The secret to unlocking the promise of AI
  • Pharma excellence and the rest of the world
  • Leadership: You are not a shark

Upcoming digital islands and AI webinar

A potential client recently asked me “can you find this data for me online or generate it? I think we may have it in system in house somewhere, however, I have no idea where to find it and I don’t have the time”. Unfortunately, many individuals in pharma companies face similar challenges even today. Luckily, often when I am asked to help with this type of challenge, I have a good idea of where and how to find the data that is needed.

When I joined pharma I remember being fascinated and frustrated by the plethora of systems: a clinical trial management system, a customer relationship management system, and as one person told me when I asked them how they managed physician interactions “outlook”.  KOL speaker engagements were managed in another system. Response documents were on SharePoint, as were documents on education and each affiliate used their own tools, standard response documents, customer engagement materials, sometimes based on global documents, sometimes, officially based on global documents but unofficially custom written for local markets “because the global documents won’t work in my market”.

Each affiliate had their own tools. standard response documents, educational documents, training documents etc. Large companies that have existed for many years developed systems organically with each market implementing tools and processes as needed. While we have moved from physical to digital storage, somehow, the mindset of keeping data in siloed systems and thus restricting access to certain teams, remained. Happily, in the past 30 years companies are overhauling the “data in silos landscape” the key driver has been to increase efficiencies.  However, teams faced with historical data in historical systems, still struggle with data marooned on digital islands.

If you want to make the most of your data, whether that is to identify key topics of interest to your customers, understand patterns of engagement, unlock opportunities, analyse customer engagement, identify great clinical trial sites or you want to generate insights across different systems and markets tune it to a complimentary webinar I will be running on the 24th of April at 3pm CET. 

I will be joined by two experts in the field, who can share insights across space, time, and industries:

– Wolfgang Schwerdt, Senior Data Scientist and Project Lead at the International Committee of the Red Cross (ICRC), who has a PhD in econometrics and has worked on predictive analytics at United Health Group’s Optum Analytics overseeing the development of health condition prediction tools, as well as  in Fintech and on the European Central Bank’s Centralized Securities Database infrastructure and who has been engaged in digital and AI projects for the past 20 years.

– Peter Shone, currently Chief Technical Officer at iEthico, who has been engaged in data science with a passion matching mine, for many years before the topic became fashionable. His knowledge is incredible, spanning decades and leadership roles across industries. He was Global Vice President at Rolls Royce and Chief Technical Officer at Parexel and was engaged in the intelligence sector.

I am a big believer in not reinventing the wheel. If you are too, then come learn from industry experts with experience spanning pharma and healthcare as well as other regulated industries such as banking and aviation. And the intelligence secto. Join us for a panel discussion and lively Q&A to explore how we can help solve your current challenges.

Key takeaway: Jumpstart your data analytics journey! Join my free webinar on April 24, 2024, at 3 pm CET to question cross-industry data science and AI experts.

The secret to unlocking the promise of AI

Spoiler alert – it is a very simple secret that I have been advocating for at least twenty years.

Four months ago, I signed up for a no code AI course. My weekends and evenings since then have mainly been dedicated to studying. My motivation? To experience MIT faculty in action, to engage with passionate peers, to acquire the ability to build my own models and to be able to intelligently discuss the difference between AI and Mary Poppins, as the two are frequently confused by hopeful individuals.

The course reminded me just how much I love data. After four months, many  video lectures, several models built, much frustration, and three project submissions for different AI topics, all with perfect scores, of which I am surprisingly proud, I have finally reached the end. While the course wasn’t at all what I had dreamed of it served its purpose. I have acquired new ways of thinking about data, modelling, and websites and which I can use to support teams to better profit from their data, cross-functionally.  

While I learned a lot – too much to pack into a simple text, I want to share just one simple secret to unlocking the promise of AI. Before you do anything with your data, understand its strengths, weaknesses, and gaps, try to identify complimentary data that could be useful, do a preliminary analysis and then identify the best approach to working with that data. It might be AI it might be something else. Either way, according to course trainers, and my extensive experience working with data, 75% of the time spent on any data project, and that includes AI model building,  is ensuring you start with sufficient, clean and well-prepared data.

Key takeaways: Considering AI? Ensure it’s the right tool for the right purpose at the right time. Verify data quality, secure necessary resources, and avoid rushing the process.

Pharma excellence and the rest of the world (ROW)

Anyone, who has worked in the pharmaceutical industry, will have come across the expression ROW (The rest of the world). In more recent years, a more universally acceptable synonym has been adopted: Ex-US or International.

Whatever your naming preferences are, it is important if you are planning to launch your products in markets outside the US, that you consider the local cultural and legal realities of Ex-US markets. These include understanding how country healthcare systems function, what the local regulatory requirements and expectations are, how best to engage with healthcare professionals (HCPs) and non-HCPs, and how international reference pricing works, which will influence country engagement and launch sequencing.

Then there is language, you cannot necessarily expect to engage HCPs in English in every market, or indeed one type of Spanish across different Spanish speaking markets. On the one hand language abilities vary from market to market and between physician specialisations, on the other there may be regulations requiring local language use. Cultural norms and market maturity play an important role when dealing not only with customers but with government healthcare bodies too as do the rules for engaging with patients ex-US.

Finally, if you are a company that is starting out, and you are planning to expand from the US, you need to consider appropriate resourcing levels to deal with the local specificities of the rest of the world. While in the US you may be able to work with a small footprint initially, thanks to homogeneity, in other parts of the world you will need more resources to navigate heterogeneous populations, with potentially more than one language per country, and different cultures. In this situation it is worth considering partnering with an organisation that already has a footprint.

Key takeaway: In conclusion,  what works well in one geographical region will not necessarily work well in another geographical region.

Leadership: You are not a shark 

Sharks die if they stop moving.

This is in fact not true. However, it is true, that humans don’t do well if they never stop to think, to breath to pause. 

I have learned that when I feel compelled to quickly do just one more thing, I stop instead. Hence, when I contemplated buying a ticket to go to MASC on Saturday morning for a quick there and back trip to Orlando, I stopped myself. Because I realised it wasn’t the best thing for me to do right now. 

When I feel the desire to make a fast decision, I will take a walk, read a book, make a phonecall, ride my bike and I will revisit the topic a few hours later or the next day. If someone is awaiting a response, I will let them know that I am reflecting. However, I have also realised that there is generally no need to feel pressure to respond immediately.  I have come to prefer a good answer to a fast answer.  I am always surprised at the many different solutions that present themselves as I mull things over, and at how effortlessly a final approach I am happy with takes shape.

Key takeaway Slower is often faster. And sometimes slower means stop.

I hope my post provides you with useful insights. If  you need support with a project, or are interested in coaching, why not give me a call to see how I can help. Find out what clients say about working with me here link.
My very best wishes

Isabelle C. Widmer MD

Image credit: Dating scout @unsplash.com

AI anecdotes from the clinic

Today marks the first day of Fasnacht in Basel. A three-day event that starts with the  Morgestraich, a magical moment. Imagine a silent, sleeping city, all electrical lights have been extinguished, then suddenly at 4am, the sound of flutes and drums erupts from every medieval street and square in this beautiful city, as small groups of costumed people illuminated by painted lanterns march slowly through the city and the 13th century houses appear to dance in the flickering lantern light.  

Today’s topics:

  • AI anecdotes from the clinic
  • Counting widgets versus value add
  • Do less sooner 
  • Leadership: In times of uncertainty lessons from Basler Fasnacht

AI anecdotes from the clinic

As a student I typed up radiology reports. We had standard text blocks available for all reports. The radiologists would dictate the patient’s name and date of birth and “normal thorax x-ray” or “normal female abdominal ultrasound” for example, and I would enter the corresponding, pre-prepared text-block into the letter template. Documents were ready in minutes.

The potential for AI to improve access to healthcare and healthcare provision is immense. Many authors believe that AI solutions will enable physicians to spend more time with patients. Intent on reducing staff and improving productivity many clinics are implementing AI solutions for admin type roles. In disciplines where training material is plentiful, such as radiology, successful implementation is comparatively straightforward.

However, not all fields lend themselves equally well to AI support. An oncologist shared her experience with me recently. Instead of human admins the team is now supported by a voice to text functionality. While, she said, AI works beautifully for standard content and communications, it is underperforming in her specific setting. There is huge variability between patients, there is a lot of data for each patient and a wide array of available treatment regimens as patients progress. In this specific setting the performance of the voice to text functionality is poor. The oncologist now spends a lot of time proof-reading and correcting the output. Her request for human admin support has been turned down.

It bears saying again. Tools need to be picked to suit a task. AI is a tool not a magic bullet. AI models need  training and training depends on large data sets. The more diverse and complex your content, the more content you will need to train your model successfully and the longer it will take for your model to perform successfully. In the situation above, implementing a solution that is not fit for purpose, and saving the cost of an admin, is ultimately costing the clinic more, as highly trained oncologists revert to performing admin tasks.

Key take-aways: Implement AI wisely, understand your use case, validate your assumptions with your end-users, check whether your solution is performing. Remember it is an iterative process.

Counting widgets versus value add

Widget definition: The word widget is a placeholder name for an object or, more specifically, a mechanical or other manufactured device. It is an abstract unit of production. The Oxford English Dictionary defines it as “An indefinite name for a gadget or mechanical contrivance, esp. a small, manufactured item” and dates this use back to 1931  (Wikipedia).

In my time I have milked cows, sold eggs door to door, worked in a vegetable and fruit packing plant, washed intestines in the slaughterhouse for later use by surgeons to practice their technique and worked in a clothes factory. While there was no financial need for me to do these jobs I was driven by the desire to be financially independent as well as the curiosity to experience as many different life situations as possible. While at medical school I tutored nurses, worked as a nurse aide, and typed medical reports. Wildly disparate jobs – but they all had one thing in common: my productivity was measured in units: days, hours and egg cartons sold. The last one was made sense and I found it rewarding.

Measuring productivity in units is still pervasive in many industries including pharma, where incentive bonuses are concerned, and targets are defined depending on metrics such as how many  customers a sales representative saw, the number of times an MSL spoke with her key opinion leaders, the number of physicians attending an advisory board etc. or where team performance is measured by the increase in numbers of customer contacts, the speed of response provision, or how many documents were created in the past three months, I think it is worth reflecting in each case, whether the measure used makes sense, what is being measured and whether there are better alternatives.

The truth is that assessing performance by unit is easy, but not necessarily meaningful. The question should not be “how many physicians did a rep/MSL etc. visit this year?” – but “were the interactions useful to our customers?” and “what information will tell me whether stakeholder engagements were meaningful and added value?”

Key take-away:  Time is precious, health care professionals are busy, your employees are talented and valuable, make sure you pick meaningful metrics to measure the value add not the time on task. 

Do less sooner

“You need to do less sooner; you’re always doing too much, late.” – Ray Hunt
Ray Hunt’s wisdom extends beyond horsemanship, to leadership, relationships, and business. The underlying principle involves anticipating situations before they arise.

In the pharmaceutical industry, success hinges on a profound understanding of stakeholders, markets, prescribing practices, reimbursement, and regional nuance. Effective product development requires well-designed clinical trials and clinical endpoints that are relevant to patients, healthcare professionals, regulatory authorities, and payers across geographical locations. Customer engagement relies on comprehending stakeholder needs and partnering with the right clinicians and hospitals in a meaningful way. The outcome includes establishing a brand that adds value,  trusting relationships and the foundation for the correct clinical use of medicine.

However, knowledge generation is resource-intensive and is often challenging to directly link to a financial return on investment. In the current economic climate, most organisations are prioritising cost savings and emphasising activities clearly linked to income generation. Unfortunately, this focus often results in reduced budgets and personnel in areas seemingly unrelated to income generation which may prove detrimental to the business in the long term.

Happily, while it is hard to link knowledge acquisition and generation directly to financial gain, it is often quite easy to correlate operating in absence of sufficient knowledge to a financial cost. This provides  an avenue for framing budget requests. Most non-commercial teams submit proposals focusing on the aspects they consider business-critical:  improved compliance, safety, customer engagement, efficiency, effectiveness, customer satisfaction, launch-preparedness, clinical trial recruitment etc. It is essential to highlight  the potential financial impact if a situation is inadequately addressed as the costs can be astronomical. Therefore, I recommend: “do less sooner to avoid doing more later and the risk of major upheaval in the long term.” If you’d like to discuss, give me a call.

Key take-away: Old English saying “a stitch in time, saves nine

Leadership: Leading in times of uncertainty lessons from the Basler Fasnacht

It is Fasnacht in Basel. The event is anticipated with great joy by people of all ages and has been documented since the 14th century. The city is filled with the sound of flutes and drums and marching bands. Small groups of costumed locals march together, playing the same carnival tunes year after year. Children run joyfully through streets that are covered in flowers and confetti. Everyone is welcome to enjoy Fasnacht or join one of the many groups organizing it. There are roles for artists, with many large lanterns hand-painted each year, as well as opportunities for poets, writers, musicians, and those wanting to participate by carrying a lantern or walking ahead of a clique.

Restaurants are bustling, serving the same meals every year, and most of the city’s inhabitants participate in some way. Interestingly, while Fasnacht embraces tradition, including traditional costumes, food, wine, and music, along with poems following a specific style and lanterns adhering to certain rules, a key focus is commenting on current affairs. Participants select a subject and then design costumes, write poems, and paint their lanterns with this theme in mind. Topics may include recent events like the pandemic, the World Economic Forum, NATO, international, national, and local politics or even the British Royal family.

During periods of uncertainty and upheaval, both globally and within the rapidly evolving business landscape, individuals seek comfort and stability in rituals and tradition. Basler Fasnacht is particularly interesting in this context; while firmly rooted in tradition, participants leverage this foundation and stability to comment on current affairs. I think there is an important lesson here for leaders guiding teams through uncertain times.

Many companies have weathered numerous changes over the years, and it can be worth emphasizing that, while the company has fundamentally changed over time, it has also endured and that there is thus a more stable foundation than individuals may perceive at any given moment.

Additionally, establishing fixed reference points for your team in the workplace can help them navigate dynamic environments. Basic practices, such as conducting weekly meetings, with a consistent format and focus, at the same time and in the same location, can provide employees with a reassuring sense of stability. This becomes especially crucial when companies undergo frequent reorganizations and reimagine teams, reporting lines, matrix organizations, and other structures with very loose boundaries

Key takeaways: In times of upheaval, implementing certain fix-points and regular practices, can help provide stability and support teams through change.

I hope my blog provides you with useful insights. If  you need support with a project, or are interested in coaching, why not give me a call to see how I can help? Find out what clients say about working with me via this link.


My very best wishes

Isabelle C. Widmer MD

Image credit: Fabrice Prost, Morgestraich 2024

Good science

Knowledge is the most addictive drug. As my AI course concludes I’m thrilled by how the acquired knowledge is expanding my perspective. My mental library now contains guidance on how to apply concepts such as decision trees, random forest and bootstrap aggregation to name just a few. What makes me happiest, though, is that what I have learned is universally applicable to life. The concepts, above all pruning, can be used to address any topic. This puts a big smile on my face. 

Today’s topics:

  • Science is not a religion
  • Normal distribution
  • NLP and customer engagement
  • Leadership: Appreciation and the value chain

Science is not a religion

Science is the pursuit of knowledge based on data. Good science requires an open mind, curiosity, and the humility to accept that what is true today may not be true tomorrow.  Great science, like coaching and consulting, requires us to be at the same time insatiably curious, and at ease with not knowing.

I have a medical degree, postgraduate training in translational research, was a postdoctoral fellow at the NCI, NIH. I have a diploma of advanced studies in pharmaceutical medicine, and trained in bioethics, personalised medicine, data analytics, market access and executive coaching among other things. I have worked with mRNA and DNA, designed plasmids, purified proteins, injected them into rabbits, and harvested antibodies. I still feel guilty about the rabbits. I have nurtured cell cultures, stained tissue sections and worked as a clinician treating patients. Then came the pharma years working in various roles locally, regionally, and globally. For the past ten years I have consulted and coached. I have a broad range of experience and training across disciplines, cultures and countries and an excellent memory and naturally all that  feeds into everything I do.

Yet, I think,  one of my biggest strengths, beyond being a pretty good cook,  is to be comfortable saying I do not know. I need more information.

I am prompted to write this, because I am concerned at how binary our world is becoming.  Especially in healthcare conversations, in many fields, there is the right path and the wrong path, the believers and the doubters. However, science is not religion. It is a data-based discipline based on current knowledge.

In science, and medicine, we can say “we do not know, the experiments have not been done yet, or the data is inconclusive”, we can say “this is current best practice, or this is my working hypothesis” we can even say, and as a scientist I really used to hate this, “we will treat the patient with this protocol, but we are not sure why it works, but we know it does”.  

In almost every situation the truth is expressed well by that sentence found at the end of every scientific publication “further research is needed” or in my words “science evolves“.

Key-takeaway: Science is data driven, biology is not binary: never or always have no place in scientific discourse, beware anyone who suggests otherwise. 

Normal distribution

I have always loved normal distributions. They apply to every area of life. Your general practitioner, your mechanic, or of course yourself. In a conversation with an HR professional many years ago, I was told that I am excellent at my job and highly productive, which seemed like a compliment, until she said “you do it on purpose to make other people feel bad.

Writing about it now makes me smile. My response centered on normal distributions  “There is a range for everything, where people sit within a range is generally just where they sit, it is not for or against anyone else”. 

Key take-aways: 1) Normal distributions are valuable when reflecting on everyday life situations  2) Not every piece of feedback you receive is valid 

NLP and customer engagement

I think about data. All the time. I always have. About different ways of using it, assessing it, benefiting from it, and using it to improve customer service. Since doing a No-code AI course, I have more ways of thinking about it.

One task we were given was to imagine an industry that could benefit from natural language processing. The first example that came to mind was the airline industry.

As a frequent flyer, I have engaged with airline helpdesks frequently over the years. I will read the FAQs, engage with the chatbot, wait on the phone for hours, and finally end up writing an email. The companies take weeks to respond. Often, the response is not helpful. I have never found the answer I need on the FAQ lists. Imagine, if an airline company categorised customer enquiries by financial impact, importance of customers, and whether a customer had tried to find the answer online. Imagine, if the company then assessed the customers complaints for keywords and hot topics and performed sentiment analysis on the text. And then imagine if they finally mapped out the key topics starting by order of business impact for example, enabling them to identify internal process improvements, update FAQ lists, and automate FAQ responses to submitted enquiries e.g. instead of the typical, we will get back to you in 2 weeks, sit tight, there might be more meat on the bone. In addition, knowing that customers reviewed online FAQs but still submitted an enquiry, will help identify which FAQs need revisions, updating or writing.

A well implemented system would improve resource use, reduce customer frustration, increase the value of phone conversations, when they do occur, and improve processes flows. Oh, and save copious amounts of money.

Imagine the improvements you could achieve if you could do that in a pharmaceutical company. Implementing new solutions is resource intense and whether it is feasible depends on many factors, if you wanted to investigate it from the business side, I’d love to discuss with you.

Key takeaways: Everything evolves, and new solutions are being born every minute.

Leadership: Appreciation and the value chain

As a consultant I have the pleasure of being involved in projects often from strategy to implementation. I stay in contact with teams after a project is finished and so I generally know how things went after I left.  I derive great satisfaction from seeing a plan come to life, from solving complex issues, and from my client’s appreciation for my support on the journey. Recently a client recommended me to a friend, which is the highest compliment a consultant can receive.

Most individuals are motivated by a mix of the following: a job that is meaningful, knowing where they fit in an organisation, the opportunity to grow, seeing that they have added to value creation, recognition, appreciation, praise and financial recompensation and titles.

While I do not believe it is a leaders job to motivate their team to do a good job, I do believe it is a leader’s responsibility to create an environment where employees can thrive. This includes ensuring employees are connected to the value chain, so that they understand, how the work they do benefits the company and the teams objectives as well as celebrating individual and team contributions. 

As a medical student I would manually assess all the EKGs that had been done the day before, I would put them in the resident’s cubby holes, that evening I would do it again. After a week I stopped. A resident said to me “why did you stop; you were doing so well?”. I said, “well there was no feedback, no training, I didn’t know if what I was doing was useful or not, so at some point I didn’t think to continue”.

Key takeaways: individuals who know that the work they do adds value, and why, are likely to find ways to do it better while being intrinsically motivated to contribute

I hope my writing provides you with useful insights if you have a project you need support with or are interested in coaching, please contact me to discuss whether I can support you. To find out what clients and coachees say about working with me, please follow this link.


I look forward to hearing from you,

Isabelle C. Widmer MD

Image credit: NIH @unsplash.com

The co-evolution of healthcare provision and the pharmaceutical industry

A snowy and sunny start to the year here, hopefully you too are off to a good start, despite the global challenges ahead.

Todays blog topics:

  • Healthcare provision is changing, does that change pharma’s stakeholders?
  • Thoughts on Medical Information online resources
  • When a pharmaceutical company is a central point of contact
  • Leadership: The future of remote working

Healthcare provision is changing, does that change pharma’s stakeholders?

Historically pharmaceutical companies focused on research and development, producing medicines, providing information on these products, and closely engaging with physicians to discuss the science, run clinical trials and to develop new products.  Physicians were provided with access to all the information they needed, ensuring, that patients receive the right medicine at the right time. Physicians engaged with patients and pharmacists monitored and filled prescriptions which in turn were reimbursed by the insurance companies. 

However, how healthcare is provided is changing across many markets with historical roles being relaxed and a broader range of individuals engaged in providing healthcare services. 

Key drivers of the change include financial pressures on healthcare systems, insufficient numbers of healthcare professionals in primary care in many markets, and the evolving role and emancipation of patients in research and development. Additionally, patient expectations have changed. Most patients now want to discuss their treatment options, rather than simply being informed of the next steps. Also, used to 24/7 access to services patients are increasingly expecting expanded access to healthcare services and products. This is possible thanks to the internet, and companies providing content online, and telemedicine, which experienced a surge in acceptance  from patients and physicians during the pandemic and is now commonplace. But not only “the what” and “the how” have changed, the key players “the who” have also changed. 

Who provides care has changed. In emergency wards a nurse may admit the patient and perform a first triage of the waiting room. This used to be the remit of a physician. And today, in many countries basic healthcare services, including some vaccinations, blood pressure tests etc. can be provided by a pharmacist and some pharmacists  also provide access to a telemedicine service in their pharmacy. In Switzerland, prescription only medicines can be provided to patients, without a physician’s prescription, at the discretion of a pharmacist, reducing the pressure on emergency services.

As authorities around the world navigate how to provide healthcare to patients, while stabilising costs and reducing pressure on healthcare professionals, pharma companies may need to review their stakeholder engagement approach. And perhaps authorities may reflect on whether there is any value in giving the pharmaceutical industry an expanded role in providing information on medicines with the aim to reduce  pressure on front-line healthcare professionals and improve care. One example might be this: Why hospitals should adopt a Medical Information approach, an article I wrote in 2022 (link) .

Key takeaways: As systems change stakeholders change. Are you ready?

Thoughts on Medical Information online resources including PhactMI and MILE

The internet has changed everything. Patients consult the internet, or ChatGPT, before they consult a physician, and many arrive at their doctor’s practice seeking confirmation, and potentially a prescription, for a condition they have self-diagnosed. 

Medical Information experts have long been concerned about patients being exposed to erroneous medical information online.  This concern prompted collaboration among pharmaceutical industry Medical Information professionals, leading to the formation of two organizations committed to ensuring stakeholders, both patients and healthcare professionals, can access up-to-date and evidence-based drug information. In Europe: Medical Information Leaders Europe (MILE) and in the US the Pharma Collaboration for Transparent Medical Information (PhactMI). 

The idea behind MILE and PhactMI is compelling: provide stakeholders with a single location where they can search for product medical information and then route them directly to the manufacturer’s medical information website, provided the manufacturer is a member of the association. Where the pharmaceutical company is a member the solution provided by both MILE and PhactMI is great. The links directly to the medical information site of the manufacturers are excellent. Where companies are not members their products do not appear, however, so that, for example, a search for a monoclonal antibody on the MILE website returned a single  product from a member company, instead of the many results I was expecting. In this situation, it would have been nice to have a pop-up on the search page reminding me that only member company products are available via MILE. This information can, however, be found elsewhere on the website.  My search in the PhactMI self-search database for the same monoclonal antibody, in combination with “use beyond progression” returned a document for the same product as on the MILE site,  again, only the one, and the use of filters. 

These two hiccups aside, both MILE and PhactMI are evolving and growing. They provide many excellent free materials, provide publications and links to other resources on their websites. In addition, they provide access to a great Medical Information expert network. If you are a Medical Information professional it is worth exploring the MILE and PhactMI website and potential membership if you do not yet know them. 

Beyond MILE and PhactMI in most markets regulatory authority websites provide healthcare professionals and patients with some product specific information. In fact, some markets have extensive product specific offerings in place. In the US the FDA provides information for patients and consumers via MedlinePlus “an easy to use resource for the NIH with side-effects, dosage, special precautions and more for prescription and OTC drugs”. 

If you are looking for a holistic European resource for product information the European Medicines Agency (EMA) has a brilliant site. Their website provides access to information, on medicines for human use, medicines for veterinary use and herbal products that have been approved centrally across the EU. In addition, for products that have been authorised for use only in certain member states, links to national registers are provided. The database is searchable and provides access to the European Public Assessment Reports, which are “specially written to be understandable by patients and members of the general public” and are shorter versions of the full document EPARs that are written for health care providers (link). 

In summary, there are many sources of product specific information. The challenge for non- healthcare provider customers is, that if they don’t know exactly what they are searching for and where to find it, they are unlikely to find and identify a reliable source amidst all the offerings online. 

Key take-away: There is a lot of medical information available online. Make finding and accessing your content easy for your customers.

LillyDirect: When a pharmaceutical company coordinates healthcare

How healthcare is provided and how customers access information is changing. In this context, the LillyDirect website in the US, which is designed as a “one stop solution” for patients with diabetes, migraine, and obesity, is fascinating.

The website states “LillyDirect can be your connection to care. With many services and resources to explore, LillyDirect can help you find care that works best for you.” Using the site patients can find independent healthcare providers for telehealth or face-to-face consultations and order their Lilly medicines directly from a pharmacy. 

All activities are coordinated on one website. The provider states  “LillyDirect is designed to offer simple, direct options for independent online and in-person care services so you can more easily start and stay on your treatment plan for the best results”. From a patient’s perspective managing one site instead of many is compelling. From a company perspective supporting visitors to transition from interested viewer to diagnosed patient that is potentially treated with Lilly products is obviously interesting. From a company perspective, supporting visitors in transitioning from interested viewers to diagnosed patients potentially treated with Lilly products is also obviously interesting. Possibly of even greater relevance is that through offering this service Lilly gains insight into consumer behaviors across target groups of interest and various touchpoints, derived from their usage of the website and the connected services.

Key take-away:  Healthcare access and provision, data use and capture and how pharmaceutical companies and customers engage are co-evolving.  

Leadership: The future of remote working

There have been many discussions on remote work since the pandemic. Some companies have permitted their teams to keep working from home; however, many companies have returned to mainly on-site work. Ultimately, it depends on the type of team you are managing. For co-located teams, the benefits of having them working on site at least some of the time, are obvious. For international teams, who dial in to teleconferences, either from the office, or from home, the benefits are less obvious, especially as these team members often dial into calls late at night or very early in the wee hours of the morning. 

 A recent article from Forbes Advisor looks at remote work statistics and trends in 2024 (link)

Personally, I believe in assessing performance based on productivity, not by hours spent in front of a computer.  I also believe that a manager should know which of her team members is working and productive and which team members are less productive, regardless of where they are seated. 

Key take-away: For remote working there is no one size fits all.

I hope today’s post provided you with useful insights. If you have a project you need support with, or are interested in coaching, please contact me to discuss whether I can support you. To find out what clients and coachees say about working with me, please follow this link.


I look forward to hearing from you,

Isabelle C. Widmer MD

Image credit: Markus Frieauff @unsplash.com