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Just show up

Thank you for reading my blog. I appreciate it. 

Today, I’ d love your feedback. Please tell me why you read my blog. What aspects do you enjoy? Would you prefer a narrower focus? And are four topics too many? I  am considering splitting the coaching and leadership topics into separate posts and I would value your opinion here too. 

I appreciate any and all feedback. Also, If you do enjoy the content I would sincerely appreciate it if you share it with your network. Thank you!

Today’s topics:

  • On the ethics of using artificial intelligence 
  • GenAI and medical information
  • The using AI = more free time fallacy
  • Leadership: Just show up

On the ethics of using artificial intelligence 

AI can accelerate research outcomes and knowledge generation. AI can review huge datasets, predict the binding properties of antibodies, propose ideal molecule structures, support with image analysis, review scientific literature, write grant proposals and scientific articles, or as recently shared by a press release on Moderna’s use of AI, calculate dosing schedules for clinical trials.

That said, the foundation of ethical scientific research remains the same:  transparency regarding the data, materials and methods used. Honest reporting of the findings and a differentiated discussion and the authors’ accountability for the findings they publish.

Authors David B. Resnik and Mohammed Hosseini, share their thoughts on “The ethics of using artificial intelligence in scientific research: new guidance needed for a new tool” in an article published in the Journal of AI and Ethics in May 27, 2024 (Link). While the authors focus on AI in research, I believe the recommendations apply across disciplines and are worth reflecting on:

  • AI is a new tool and new guidance is needed from legislators especially beyond GenAI
  • The use of artificial intelligence and its limitations should be transparently disclosed wherever it is used
  • AI should not be listed as an authors, inventors, or copyright holders
  • Employee training should include discussions on the ethical use of AI
  • And a point I never tire of making:  when using AI or designing AI models a broad population of impacted stakeholders should be engaged to anticipate and avoid potential bias

Transparency regarding the use of AI and in communicating it in such a way that it is understandable for a non-expert is critical. While the above publication focuses on research uses of AI, and is truly worth reading, another article, the EFPIA position paper on the use of AI, with considerations focused on the pharmaceutical industry, can be found here, the themes are broadly similar.

Key take-away:  As you introduce AI ensure you have guidelines on compliant use, reporting, transparency of use, and guidance on quality control for content generated as well as employee training in place.

GenAI and medical information

Some Medical Information teams are exploring the use of GenAI to generate content to provide  Medical Information services across channels. There is a lot of interest and many abstracts on the topic have been submitted for September’s DIA Medical Information meeting in London (Sign up here).

While there are risks when using GenAI including the perpetuation of bias and stereotypes,  and the generation of hallucinations and falsifications, both of which need managing, the potential for content provision support is significant. Like everything it needs implementing in the correct way.

Some questions to ask before implementing GenAI to develop content:

  • Do you have access to high-quality content?
  • Do you have access to large volumes of content?
  • Could multiple teams/channels benefit from GenAI on the identified content?
  • Does your business case – products, volume, indications, enquiries support the implementation of Gen AI? E.g. if you sell an orphan product with highly specific customer enquiries the effort to train and maintain models is unlikely to be warranted.
  • What are the costs/cost savings over time?
  • Do you have the foundation, processes, and volume to make the investment reasonable?
  • What other teams are already working on this? Can you tag team?

Ask yourself “Why us? Why now?” 

A friend and fellow programme committee member recently said to me “think about it, when email was invented, did Medical Information teams invent email or use it? I think AI is similar, it’s a valid tool for business, but I don’t think everyone needs to develop their own model”

Key take-away: AI models need investment to implement, train and maintain, invest wisely.

Why AI will not free your time

On the afternoons when I switch off my phone to read or write without distraction, I feel incredibly calm and productive. Does the idea that technology “gobbles up your time” resonate with you?
A recent comment on a GenAI chatgroup I am on made me think about the promise of technology further. The comment was:  “I think it is thought provoking to think about what we will do with the time we have freed up? If my AI enabled works saves me two hours a day. What do I do with that time? What does the CFO and CEO expect me to do with that time?”
The answer is of course, sadly, that there will be no free time. All time saved will be reinvested. Friends of mine who are physicians are expected to see more patients now that AI assisted note taking has been implemented, no matter that this does not work well with oncology patient files. Yuval Harari wrote about the fallacy that the more we advance,  the more free time we have, in his book “Sapiens – a brief history of humankind.”  Instead, of having more time, we just experience acceleration. In the past we wrote letters, and we waited for a response. Then we wrote emails and waited. Now we write text messages and if a response/blue tick is not seen within an hour, we call to find out whether the message was read.

Or we send a text message and in parallel an email to ensure the message is received. One of my family members often checks in with me a few hours after a text message has been sent to make sure it arrived and to ask in a roundabout way what my response is. 
So instead of having more time, we spend more time managing the barrage of information we receive, speeding up to manage this, while also being more available.
It is a vicious cycle.
In most jobs we calculate productivity in hours, however,  unless you work in a fruit packing plant, or on a car assembly line, back when they were not automated, this formula does not hold true.

For all white-collar jobs that I can think of this equation has no relevance. In fact, for most jobs I think this equation has little relevance. 

The belief that hours worked = value produced needs addressing if we are to escape the cycle. 
Key take-away: Use AI and speed up at your peril but do not expect to leave earlier or to be rewarded for it.

Leadership: Just show up

Last week I had family visiting from New Zealand. I took them to a city near me with the caveat that I have to be back at my desk for meetings in the afternoon. When I got to my computer both  meetings had been cancelled. 

The cancellations were short notice, within an hour of the meeting, so I could not adapt my schedule to spend more time with my family. Instead, I was at my desk.

After these two cancellations I started taking notice. In the past two weeks, eight people have adapted meetings that have been on calendar for a long time last minute. Some individuals did not show up, some rescheduled without comment, some remembered conflicting appointments.  Two apologised, this is apparently the exception rather than the rule.

Always curious I have asked colleagues and friends for their experience. Employees tell me that no-shows, late cancellations, and last-minute rescheduling is the new normal. Consultants tell me that their clients cancel entire workshops two days and coaching sessions minutes ahead. They pay the fee without complaint and reschedule for two months later.

Flakiness is more the rule than the exception nowadays it seems. 

My hypothesis is that the more technology people have at their disposal for managing their time, the more accepted last minute text messages are for cancelling, the more people tend to commit and overcommit while not actually feeling committed. Every appointment scheduled becomes an option rather than a priority. 

Unfortunately this behaviour has a domino effect. If you reschedule the person you were going to meet has to do so too, which impacts calendars, and potentially other people down the line. 

Naturally unexpected things happen to good people and sometimes cancellations are unavoidable. When that happens try to give notice when it happens, it is easy to forget if you don’t act fast.

In situations where you know you don’t want to make an appointment with someone, aim to tell them upfront politely. If you do make an appointment, try to show up,  if you cannot show up, alert others ahead of time, reschedule if it makes sense and consider adding an apology. A little courtesy goes a long way. 

Key take-away: All you have to do is show up. In an era where good manners have become optional, even the bare minimum will put you ahead. 

If you missed the panel discussion on digital islands with Peter Shone and Wolfgang Schwerdt you can find it here: 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: MJH Shikder @unsplash

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

AI see you

The leaves are turning yellow, the temperatures are cooler now, and my favourite season, fall, has finally arrived.

I have come across some interesting AI use cases that I wanted to share with you.

Today’s topics:

-AI see you
-AI generated images and copyright
-Business: AI generated content and human preference
-Leadership: Why you cannot divide and conquer in pharma

AI see you

You must leave your shopping trolley in the centre aisle” the security guard said as I entered the pharmacy. When I asked why he said “It’s to help prevent theft. People used to steal items by walking out with unpaid items in their trolleys. When we stopped them they expressed surprise and said the items must have fallen into the trolley as they brushed past them while walking past the shelf”.  

We have a new system in place now though” he said, pulling out his phone and indicating the cameras on the ceiling. He continued “the camera feed is monitored by AI, when there is suspicious activity, I receive a video clip”.  He pulled up some clips to demonstrate. In one a man took a product out of its packaging and slipped it into his pocket leaving the empty box on the shelf.  In another a couple leaving the pharmacy with purchased items exchanged the package contents with more expensive products they had placed close to the exit.

He said, “the system is good, but it is also learning all the time, I validate every clip I get to identify false positives, for example when someone puts their phone in their bag”, adding “of course I can’t personally stop everyone, but as the camera feeds from the shop, the mall and the parking lot are integrated, we can track people to their cars and get their number plates, at that point we involve the police and they take it from there”.

Key takeaways: 1) Everyone you meet can teach you something if you listen 2) The lower the margins the faster AI is adopted 3) Have a good business case for AI adoption and you will likely get funding.  

AI generated images and copyright

Needing an image to illustrate a post I thought I would try text to image system Dall E3. I had a clear image in my mind and after providing many prompts and failing to get the quality I was hoping for I finally resorted to adding “generate an image in the style of Magritte and Dali”. Many images were provided, but they either fell short of my expectations, or looked like collages made using other people’s work which had me worried about copyright infringements.

When using ChatGPT I ask for source documents, which I check to validate content veracity and origin. This isn’t possible with text to image systems which are typically trained using millions of images that may or may not be in the public domain. While trying to identify the training data set for Dall-E I couldn’t find the desired information on the providers website, but I did find some text telling me that any images I generate are mine to use as I wish.

However,  in 2023 several companies using AI to generate art have been sued for copyright infringement, in one case by visual artists in another by Getty images for using images to train AI models without permission or compensation (Ref 1, 2). And while I am not sure what this means for the end user I prefer to use content that I know I can reuse without any issues at all.

Further interesting reading can be found at the Verge – the scary truth about AI copyright is nobody knows what will happen next (3).  

Key takeaways: The field is moving quickly, whenever you use online generative AI tools with a view to sharing the content, consider carefully, and check multiple sources for guidance on use. Also for business use get guidance from your legal team and other internal experts. 

Reference articles:

1) Lawsuits accuse AI content creators of misusing copyrighted work, Blake Brittain, 17 Jan 2023 Reuters  2) Getty Image, 2023s AI art generator Stable Diffusion in the US for copyright infringement; James Vincent, 6 Feb 2023, the Verge  3)The scary truth about AI copyright is nobody knows what will happen next 15 Nov 2022; James Vincent, the Verge 

Business: AI generated content and human preference

There is widespread excitement about the potential to improve business efficiencies by using generative AI for example when writing scientific responses for customers. However, whenever optimisation is looked at it is important to take the human element into account.  

A recent article by researchers at the Massachusetts Institute of Technology (MIT) did just that, exploring people’s perceptions, and bias, toward generative AI in the article “Human Favoritism, Not AI Aversion: People’s Perceptions (and Bias) Toward Generative AI, Human Experts, and Human-GAI Collaboration in Persuasive Content Generation” by Yunhao Zhang, Renee Gosline, published in 2023 (link). An article on the MIT website by Dylan Walsh posted in October 2023 outlines the key points (link), I have put together a short summary for your convenience below: 

The authors Zhang and Gosline performed the study with the goal of identifying how people perceive content depending on whether it was generated by AI, humans or a combination of both, eliminating bias in some of the assessors by blinding them to how the content they were evaluating had been created. 

The content was generated in one of four ways

1) Professional human authors only
2) GPT-4 generated ideas shaped into final content by professional human authors
3) Human generated initial content completed by GPT-4  
4) GPT-4 only generated content.

The content was assessed by three groups: Group 1 was unaware of different content generation approaches; Group 2 was told about the four different approaches and the Group 3 knew which  approach was responsible for the content they reviewed. 

When reviewers didn’t know how content had been generated they preferred AI generated content. However, assessments of content improved when reviewers were told that a human had been involved in its generation, showing what the study authors called “human favoritism”, however, knowing a text had been generated by AI only did not diminish reviewer’s initial assessments.  

From Dylan Walsh’s article: “The most direct implication is that consumers really don’t mind content that’s produced by AI. They’re generally OK with it,” Zhang said. “At the same time, there’s great benefit in knowing that humans are involved somewhere along the line — that their fingerprint is present. Companies shouldn’t be looking to fully automate people out of the process.”

Key takeaway: Generative AI is set to revolutionise content generation. Consider how you can balance process improvements with customer preference in your specific area as well as how to assess customer satisfaction objectively. 

Leadership: Why you cannot divide and conquer when engaging with customers in pharma

A while back I was caught in the rain as I biked to the recycling plant. Stopping at a tram shelter I passed the time by separating my disintegrated paper bag from my recycling bottles and throwing the bits of paper into the trash. A tram came to a stop, and far ahead, the driver got out of his cabin. He walked up to me and handing me a large plastic bag said, “it looks like this might come in handy”.

I was touched by that simple act of human kindness from an employee of the tram company.

In many professions I have worked in there has been an us versus them mentality. The belief that one team has the customers best interests at heart, while another team does not.  For example, when I was a physician, the nurses said “we truly care for patients, whereas you doctors just come and go”.

In pharma, medical affairs teams may feel commercial just cares about numbers, while commercial team members have been know to think that medical affairs colleagues slow them down and lack creativity and customer centricity.

While an employee’s specific department is significant to them, most customers are primarily concerned with resolving their issues. A patient who departs the hospital in good health typically appreciates all the staff they’ve encountered. Similarly, a healthcare professional’s perception of a pharmaceutical company is shaped by her interactions with its employees, regardless of whether they work in sales, medical, or clinical development.

Case in point, I feel positively disposed towards the entire tram company because of a single positive interaction with an employee that made a huge difference for me.

So, while I have seen leaders build strong teams using an “us versus them” dynamic, I think instead of fighting for the “customers’ favour” it makes more sense to identify customer needs and then to work together across functions to meet those needs. 

Key takeaway: Customers perceive a company as a whole and company employees as company brand ambassadors, regardless of the individual employee’s function. 

Thank you for reading, I enjoy sharing my thoughts and I love hearing what piqued your interest or any feedback. If you are currently working on a project in the fields of medical, digital, systems, analytics, channels, or facing any team or personal challenges, feel free to reach out to me for a chat. I am always happy to explore how I might be able to support you.

Best wishes

Isabelle C. Widmer MD

Image credit: Alex Knight @unsplash

Medical Information: don’t get lost in transformation

After a week in Brussels, I am now happily back home.

Last week’s DIA Medical Information and Communications meeting was fabulous, we had more attendees than ever before, the event was a success from beginning to end, great shares, some wonderful new contacts and inspiring presentations.

It will take me some time to process it all but I will share my key takeaways from the meeting with you in future blog posts.

Today’s topics:

-Metrics and insights – a vending machine example
-Medical Information transformation – how not to get lost
-Business: Are you using tech to bridge or block your customers’ path?
-Leadership: effective transformations

Metrics and insights – a vending machine example

At the airport two vending machines stood, side by side. They were stocked with similar items, only one was full, and one was empty. Both machines are managed by the same company.

If the performance of the machines is monitored independently, with different teams involved, they might not connect the information. One team may overlook any issues with the fully stocked machine, or incorrectly conclude that stock is not moving, because of the location of the machine, or unappealing products, while another team, focused on the empty machine, could mistakenly attribute it to their superior product selection.

Both teams would be looking at simple metrics, trying to draw relevant business conclusions from that data set. This is a frequent occurrence in companies when data sets of interactions with the same customer group are not integrated and are assessed in isolation.

Wanting some water, I approached the machines. The full machine had the product I wanted, but it didn’t take credit cards. Like many people nowadays I rarely carry cash, so I couldn’t buy anything. Unfortunately, the empty machine didn’t have what I needed, so no sale was made, despite there being a willing customer with a credit card on hand.

The reason the vending machine was full was simple: customers couldn’t access the products.

Key takeaways: If you look at your data in isolation you can neither understand your business environment nor adapt your strategy to enhance your business. Metrics represent raw data, while insights emerge when you combine this data with your understanding of additional factors from diverse sources, revealing what truly matters.

Medical Information Transformation – how not to get lost

Last week I got lost between Brussels airport and the hotel. It’s embarrassing I know.

I hopped on a train. Because I was distracted by thoughts of my lost luggage and the conference ahead it took me a while to note that the train was speeding through open countryside. This seemed odd, so I asked a couple on the train to confirm my direction of travel. They confirmed that “yes, you are heading towards Brussels”. When we got to Leuven it became apparent that I was not.

As the next station was fast approaching decisions on next steps needed to be taken fast. Luckily another local helped me: he identified the stop I should get off at, the train I needed to switch to and which platform I would take it from. With little time to spare his help was invaluable in helping me course correct.

I used this example when talking about implementing changes in companies. Often the roadmap seems straightforward, the task appears manageable and the topics clear, whether it be the implementation of a new IT system, working with different cultures and languages, content revision strategies, cross-functional collaboration or any one of the other myriad topics that teams face when improving how they work.

However, even if what you want to do seems simple, if you don’t know the terrain it can be more challenging that you might imagine. This is why people hire guides and city maps have circles with “you are here” I have experienced this many times, the first time I take a route I ask for directions, and I still sometimes get lost, but once I know the route I can do it blindfolded at midnight.

Key takeaways: Even if you know where you are and where you are going, and you have a map to follow, if you haven’t taken the path before, you are more likely to get lost. Plan in extra time and budget and hire a guide if you don’t have the experience you need in your team.

Business: Are you using tech to bridge or block your customers’ path?

Last week at Brussels airport travelers clapped as their luggage arrived. It struck me then that we now celebrate things we used to take for granted.

While the world celebrates automation, and conference presentations are all about efficiency gains through digital means and the power of AI to improve things beyond recognition, my customer experience in the real world is often unsatisfactory.

Technological advances can be wonderful, provided they are used intelligently and they are used in conjunction with a customer service foundation that works. Unfortunately, often tech is implemented before processes have been improved in order to support it, or it is used as a barrier instead of as a bridge. A classic example is that new customers can always reach the sales team fast, while existing customers often struggle to reach anyone.

Beyond using tech as a barrier, companies often also use tech to provide services that do not serve the customer. A key consideration here is “just because it is easy and cheap to implement, and it keeps you in constant contact with your customer, it may not serve your customer and your customer can tell.”

Classic examples of services that do not serve include daily reminders that I booked a restaurant or that I will soon be staying in a hotel, or the invitation to download a hotel app so I can check in ahead of time, which, according to a colleague changed her check-in experience at the hotel not at all.

Ultimately what customers want is straightforward and identical across industries: a fast tailored solution to their problem without extra mental load.

I experienced an almost perfect example – Lufthansa put my luggage on a later flight, they sent me a text message telling me where it was and when to expect it, they also sent a link so I could register my delivery location. I was impressed. Only the app didn’t work, so I went to a service kiosk, entered all my data and then was told that delivery may take nine days. The gentleman at the kiosk recommended I pick my luggage up myself.

Key takeaways: Technological solutions cannot compensate for underlying system errors so ensure your business foundation is solid before you implement. Make sure whatever you implement works. Automation cannot replace a human connection, automate with care.

Leadership: effectively leading transformations

Last week during the DIA Medical Information conference I ran a workshop on operational excellence and strategic alignment. I provided participants with a tool to self-assess digital and harmonization maturity within their function and organization.

A participant said, “from the perspective of the global team we are fully harmonized and digitally mature, from the perspective of the non-global teams the situation is very different”.

The situation highlights something that happens frequently when transformation programs are run from the “head” downwards. If your head, or global organization, sees a goal on the horizon and decides that that is the destination, but the “body” and the “feet” and the “gut brain” of the organization, i.e. everyone else, is not informed nor involved in designing and charting the journey, what happens is the head believes that a change has occurred, because it has “thought” its way there, whereas the rest of the organism has remained exactly where it was before, growing disengaged and frustrated in the process.

If this is where you landed, the problem is, you may not even be aware of it. Also, if after a long time of running a transformation programme this is where you are at, it will take a big effort to get back on track.

Key takeaways: Good transformation programs take time, the involvement of all stakeholders and clarity of vision and approach. Be clear on how you will approach your transformation and ask anyone consulting to you or supporting you how they approach and monitor transformation success.

Thank you for reading, I enjoy sharing my thoughts and I love hearing what piqued your interest or any feedback. If you are currently working on a demanding project in the fields of medical, digital, systems, analytics, channels, or facing any team or personal challenges, feel free to reach out to me for a chat. I am always happy to explore how I might be able to support you.

Best wishes

Isabelle C. Widmer MD

Photo credit: Isabelle C. Widmer – Airport Basel-Mulhouse

Intelligent Health 2023, African healthcare innovations and melanoma detection

In an attempt to enjoy the last weeks of summer I have been swimming in the local river in addition to work activities like attending an AI in healthcare meeting and getting ready for the DIA Medical Information and Communications meeting in Brussels. If you plan to be there, drop me a line,so we can set up a meeting.

Today’s topics:

– Intelligent Health 2023 – learning about healthcare access from African Startups
-Pitching to your audience – how to build trust and how to lose it
-How to ensure your customer engagement channels are fit for purpose
-Leadership: Don’t blame your minions, read on to find out why

Intelligent Health 2023 – learning about healthcare access from African Startups

Last week I went to the Intelligent health 2023 conference in Basel run by Inspired Minds.

The talks range from the general “How AI is revolutionizing healthcare” to the practical “Revolutionizing surgery with surgical operating systems: The future of integrated healthcare” by Ozanan Meireles, director of the Surgical Artificial Intelligence and Innovation Laboratory (SAIIL) at the Massachusetts General Hospital.

Beyond main session presentations, I particularly enjoyed pitches by African startups because when limited resource meets huge medical need the only solution is innovation, which may provide some insights for struggling Western healthcare systems.

In conversations about African healthcare systems I was reminded that in most countries outside of a few regions including the US, Canada and Europe, patients pay for treatment out of pocket and upon admission to a healthcare facility. That standards of care are different, and that this in turn means that operating techniques are different, which translates to the fact that training materials or medication guides that are not generated with an African context in mind are unlikely to provide the desired value.

Presentations that stayed with me included providing patients with a zero interest credit card that gives them immediate access to healthcare when they need it, rather than when they have saved sufficient funds. A diagnostic tool that facilitates breast cancer and cervical cancer diagnosis, and two telemedicine services, one that provides clinics an online presence making it easier for patients to access medical consultations both online and in person with a physician of their choice and that also handles all payment related aspects so that healthcare providers and hospitals can focus on their core activity, providing healthcare. And the second that provides Ethiopian women with access to information and tools regarding sexual and reproductive health.There were also pitches on managing non-communicable diseases including hypertension and diabetes.

While not all the solutions presented can be implemented as is in other geographical regions, many of them harbour a seed that could, with minimal adaptation, grow elsewhere.

Key takeaway: When facing a challenge, look around for inspiration from other teams, departments, or systems. While unique contexts may yield specific solutions, with the right adjustments, these can often have broader applicability.

Pitching to your audience – how to build trust and how to potentially lose it

No, but it’s not really a problem, as darker skinned people don’t really get skin cancer” the presenter said, after some reflection, he added, “well only rarely” in response to an enquiry from an audience member on whether the melanoma app he was presenting is able to detect malignancies in brown, dark brown and black skin. He did qualify his statement with the information that for the trials they had run on his software they hadn’t had sufficient individuals with darker skin on which to train the application and that they would be remedying this soon, clarifying that this is in focus.

Up to that point the presentation had focused very much on the brilliance of the product, the fact that the product is much better than the competition, the size of the global market, projected patients in the years to come and in general on the great earning potential of this app; in short why investing in it would be a wonderful thing. It was a pitch after all.

However, following that comment, as I listened, I reflected on what I know about skin cancer and AI, which included: AI for facial recognition is known to perform better in white skinned individuals than in darker skinned individuals “because it is trained that way” (link WEF). Tech solutions are often designed to serve Caucasian populations. And, while the incidence of skin cancers in those with darker skins may be lower, they also often present with more advanced disease, and at a higher risk of lesions being misidentified and underdiagnosed due to a lack of awareness by health care professionals and patients alike.

Once at home I investigated further. The publication “Disparities in Dermatology AI Performance on a Diverse, Curated Clinical Image Set” published in August 2022 in the Journal Science Advances by Roxana Daneshjou et al, from Stanford University, with co-authors from the Sloan Kettering Cancer center, amongst others, on AI performance in the diagnosis of dermatological lesions, identifies three key issues when using/training AI algorithms to detect skin cancer including, the third of which is a human factor “there are differences in dermatologist visual consensus label performance, which is commonly used to train AI models, across skin tones and uncommon conditions”. The publication also noted that “access to dermatological care is a major issue with an estimated 3 billion people lacking access to care globally” (Link).

While the product might be wonderful, what stayed with me was the presenter’s statement about detecting skin cancer in non-white individuals.

Key takeaways: It is hard to predict what your audience will take away from your presentation; but being prepared, thoughtful, knowledgeable and transparent about the strengths and weaknesses of your product goes a long way to building trust.

How to ensure your customer engagement channels are fit for purpose

A friend of mine, who recently moved to the states tells me that her most frequent sentence when engaging with company contact channels is “I want to speak to a human”. I too often try this sentence, tragically the response is often “I didn’t understand, please rephrase”.

This raises the following question:

When considering how advanced and effective your customer engagement strategy is, do you look at the channels you have implemented, and say, we are well set up? Or do you look at how the channels perform to meet customer needs?

Many companies measure their success by the fact they have transitioned from a multichannel to an omni-channel approach, by the fact that customers seem to be using these channels and by the number of channels that are available to customers.

However, what really matters is that the channels work.

I recently tried to contact an international service provider using a web form. When I didn’t hear back, I called the help-desk. After waiting on hold for a while, I was informed that the lines were unmanned and instructed to leave a message. However, the mailbox was full, and the call was subsequently disconnected. After failing to reach the company both via web form and phone I finally went the personal route, messaging a LinkedIn connection at the company. I received a response within an hour.

This is but one example of many. If you are the sole provider of a product or service clients will persevere in their attempts to contact you, for everyone else, it’s worth making it easy for customers to engage with you.

Key take ways: Regularly evaluate your customer engagement channels for functionality and user-friendliness. Regularly monitor your service for underperformance, check for technical issues, see if you can enhance usability, and review customer engagement

Leadership: Don’t blame your minions, read on to find out why

Whether you are in the UK, and interested in the UK health system or not, you currently read about it every two weeks courtesy of my musings. This week I am intrigued by Prime Minister Rishi Sunak’s approach to evolving NHS wait times.

In January 2023 Sunak reportedly said, “NHS waiting lists will fall and people will get the care they need more quickly,” a promise he has unsurprisingly, considering the challenge, failed to deliver upon.

What is surprising, however, is that in an article by Chris Mason, published on the BBC.com website on the 15 September 2023 Mason writes this about Sunak’s self-assessment on performance against goals: according to Sunak “the government was making “very good progress” before the strikes. And without them, he (Sunak) reckons, he would have kept his promise”. Link.

In not so many words Sunak lays the blame for his failure at the feet of junior doctors and consultants who are going on strike for a pay rise.

To quote Chris Mason: “It sets up an invitation for you to decide who you blame: Medics on picket lines or the prime minister?”

The NHS, a cornerstone of UK health, has faced criticism for years. From long waiting lists for treatment and prolonged A&E wait times to a scarcity of healthcare professionals—a situation worsened by Brexit. News articles recounting infant deaths and subpar clinical care in numerous trusts bear testimony to the system’s struggles. The system cannot be fixed without the help of the healthcare professionals, naturally the strikes are impacting NHS wait times, but the strikes are not the reason for the wait times. The junior doctors did not break the system.

What is astonishing in a situation as clear cut as this is that a leader would attempt to shirk accountability. When leaders fault juniors instead of leading them to find solutions, they show their true limitations as a leader. Moreover, if such behavior is evident in clear-cut situations, it likely reflects a habitual approach, which does not foster trust.

Key takeaway: How you treat others says a lot about you: never blame your minions.

Thank you for reading, I enjoy sharing my thoughts and I love hearing what piqued your interest or any feedback and thoughts. If you are currently working on a demanding project in the fields of medical, digital, systems, analytics, channels, or facing any team or personal challenges, feel free to reach out to me for an informal chat. I am always happy to explore how I might be able to support you.

Best wishes

Isabelle C. Widmer MD

Photo Credit: Francisco Venancio @ Unsplash