Tag Archives: leadership

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

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

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

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

Healthcare systems in crisis – the NHS as a case study

Only three weeks until the DIA meeting in Brussels, the agenda is final, and I am in the midst of writing presentations and finishing up workshop preparations. We have a large group of attendees from all over the world coming to be with us in Brussels, I hope to see you there. If you’d like to chat with me at the meeting consider dropping me a line so we can plan ahead.

Today’s blog topics:

• Best practice for scientific content provision in an omnichannel environment
• Med Info and Med Comms meeting Brussels 2023
• Healthcare systems in crisis – the NHS as a case study
• Leadership: The role of unconscious bias in the Lucy Letby case

Best practice for scientific content provision in an omnichannel environment

Customer access is a challenge for the pharmaceutical industry. Physicians have limited time and many companies vying for their attention. As access becomes harder, the provision of service on demand via the channels of the customer’s choice is becoming an important business differentiator. In addition, companies are looking to reduce cost and improve impact by making better use of available headcount and by using integrated data analytics to inform strategy. Taken together these factors explain why many pharmaceutical companies are rolling out omnichannel solutions.

Unfortunately, these solutions often fall short of their potential because they don’t factor in the human element. An area where inefficiencies are frequent is content generation, management and harmonisation, which is often managed by different teams. As structures and customer engagement evolves it is worth reflecting on whether the right people are engaged in the right activities at the right time. For example, used well, a Medical Information team can be the beating heart of scientific content generation in a company, working efficiently across teams and departments in the service of all.

Medical information professionals are product experts who excel at communicating scientific information tailored to the customer’s needs, they understand internal and external customers and support internal colleagues, including medical affairs colleagues and sales representatives with scientific enquiries. They write response documents, perform literature searches, and consult with teams including quality and safety. As Medical Information teams receive unsolicited enquiries from a broad range of customers, they are also in tune with customer needs, and able to offer valuable insights.
If you want to find out how best to provide scientific content and how to do more with less join us in Brussels at the Medical Information conference) We will discuss models, channels, solution providers, content generation cross-functional collaboration, pragmatic use of resources and how to generate meaningful metrics and insights

Key take way: As your business model evolves review if you are using your resources effectively and whether you are making the most of your Medical Information team’s ability to free up your in-field team in order to improve overall impact.

Medical Information and Medical Communications meeting Brussels September 2023 – Last call

Preparations are ongoing for the Medical Information and Medical Communications DIA meeting that will take place in Brussels. Thanks to the stellar submissions we received we have put together a great agenda.

Topics cover contact centre management, evolving the medical information structure, the value of medical information, putting theory into practice, digital content, content dissemination, a workshop on navigating medical information and an open microphone session, where we welcome participation from the floor.

If you haven’t signed up yet, do consider coming. You can also still submit a poster to the meeting. Every year a group of experienced individuals in the industry, as well as smaller companies, or biotechnology companies that are identifying how best to meet customers information needs meet, this is a good opportunity to increase your knowledge, share best practice and make connections. The meeting is especially useful for individuals who are new to medical information or who are tasked with building a medical information approach from scratch and want to fast track their efforts.

You can find out more about the speakers, and the agenda as well as sign up here.

Key takeaway: Instead of finding your own path why not stand on the shoulders of those who came before?

Healthcare systems in crisis – the NHS as a case study

During the pandemic health care professionals (HCPs) were celebrated. People stood on balconies clapping. HCPs worked long hours under difficult conditions wearing insufficient or faulty personal protective equipment in the service of patients and the healthcare system. Yet despite being officially feted health care professionals’ working conditions in many countries remain challenging. Frequently, those who provide healthcare to others do not work in a healthy environment which is one of the reasons, I suspect, why there is a global lack of healthcare staff.

In the UK the situation has come to a head as junior doctors and consultants prepare to strike. A 2022 survey by the British Medical Association of 4000 junior doctors, who are in the first 6-10 years of training after getting their degrees, showed that almost 90% are concerned about the impact of the rising cost of living on their personal situation. More than half the respondents said they had struggled to pay for utilities and lighting in 2022 and 45% said they struggled to pay for commuting, essential travel and rents and mortgage. Eighty percent of those surveyed reported that if they had to reduce their income at all they wouldn’t be able to meet their essential outgoings.

Almost 80% of respondents are considering, and 65% have actively researched, leaving the NHS in the past 12 months. A third of these is planning to work abroad. More than three quarters of respondents had friends and colleagues who had already left the NHS and gone to work as a doctor in a different country. Reasons for considering to leave the NHS include pay and pension schemes, deteriorating working conditions and personal well-being, increased workload, lack of recognition, workforce supply shortages and a lack of flexible working patterns.

The NHS is already in crisis: according to a recent article in the Times “More than half of people who died in England last year were on an NHS waiting list. The estimated toll of 340,000 was up from 240,000 five years before, a 42 per cent rise. The figure represented more than 60 per cent of all deaths in England, according to data provided to The Times by NHS trusts under freedom of information laws”. Patients are already being affected but now the doctors’ strikes will further compound the problem. While the leading issue cited in the media is salary, the BMA survey highlights many other topics, that are relevant for the UK but also beyond the UK’s borders.

An article written in the (Swiss Medical Weekly) by three Switzerland based physicians with experience of the NHS. discusses the results of the BMA survey. Although they acknowledge that young Swiss doctors are in a better position than their UK peers, they note that according to survey data, junior doctors working in the Swiss healthcare system experience similar areas of dissatisfaction. Their conclusion matches mine: the BMA survey results are worth paying attention to. As we face a global shortage of HCPs, and HCPs vote with their feet moving to locations with more favourable working conditions and salaries, the challenges in accessing healthcare faced by underserved populations, such as those in Africa increase.

While recruiting HCPs from other countries may temporarily address developed nations’ healthcare system woes, in the absence of a change of strategy to solve this problem we are heading into challenging times.

Key take-away: The situation in the NHS may seem relevant only for the UK, however, doctors the world over are turning their backs on local clinical practice to work overseas. In many cases the drivers underlying this decision will match those highlighted by the BMA survey. If we want patients to have access to healthcare, we need to reinvent healthcare provision.

Leadership: The role of unconscious bias in the Lucy Letby case

Last week British nurse Lucy Letby was convicted of murdering infants in her care. While widely covered in UK media it was not widely covered by the media elsewhere so I will summarise some key aspects.

The case is tragic because initial concerns about the nurse were raised in the month after the first child was killed, yet it took another year, four more murdered babies, and six known murder attempts until action was taken.

Physicians working at the hospital raised concerns about the nurse repeatedly during this time as she was the single common denominator in each case. Autopsies were not performed in every case and some autopsy results were lost in the post, absent a digitalised system. The head nurse and clinic manager defended the young nurse and the doctors who raised concerns were threatened with sanctions by the management team and forced to apologize. There are currently other cases ongoing in the NHS where physicians have been suspended for raising concerns with the quality of care provided to patients.

The reason I am highlighting this case is because there are some important lessons to be learned here. The first is about unconscious bias, where we tend to trust those who are like us, and there is a risk that we protect those who appear to need it most. In this case a young female nurse, who was the subject of complaints by the entire team of senior male physicians. In addition, there are different reporting lines in hospitals, nurses report into a senior nurse, doctors report in through a different structure, this can lead to an “us” versus “them” mentality and a protection of “one’s own”. The lack of availability of objective data, in this case autopsy reports, which would have confirmed suspicions, is a systemic process error. And lastly, it appears that senior leadership was reluctant to promptly investigate the allegations, possibly due to the anticipated consequences if the claims were verified; while this hesitancy was likely unconscious, it had very real impact on many lives. The NHS is now reviewing its whistleblowing policy.

Key takeaway: Companies value an external perspective when new individuals join their teams. In conflict situations, or situations where team members’ mental health is at stake, or allegations are serious, it is worth bringing in an external individual to support, mediate, moderate and assess as it is impossible to be unbiased as a leader in this situation.

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: National Cancer Institute @ Unsplash

Fixing the healthcare crisis: patients as equal partners

In addition to visiting doctors, worrying about test results, calling the hospital, and wishing it was not so hot, I have managed to swim in the local river for the first time in years. It was glorious! I hope you too  have found time to something you enjoy as you wait for autumn.

Today’s blog topics:

– Fixing the healthcare crisis: patients as equal partners
– Questions to empower patients
– Data versus assumptions – a personal observation
– Leadership: the importance of role awareness and reflection

Fixing the healthcare crisis: Patients as equal partners

Around the globe healthcare costs are on the rise, limiting access to treatments in many places as governments worldwide seek cost-effective care solutions. In a recent newsletter, I highlighted Singapore’s innovative healthcare model which performs comparably to Switzerland’s system at a quarter of the cost (link to article). The difference? Patients benefit directly if they use less healthcare resources.

However, while beneficial, I don’t believe that focusing solely on financial incentives to consume less will be enough in the longer term. The global shortage of healthcare professionals (HCPs) translates to less time per patient, the risk of mistakes and less time for conversations with patients. Despite everyone’s hopes even if AI does take on routine tasks in the clinic, physicians will be asked to see more patients, not to spend more time with individual patients.

Healthcare professionals do their best, they work under difficult circumstances, but, given that no one is more invested in a patient’s health than the patient themselves, and that pressure on HCPs looks to increase, maybe it is the right time to empower patients to take a more engaged role in their health management by giving them easier access to information. Currently, accessing information beyond prescription details is challenging for non-HCP patients. Whether seeking original clinical trial data and publications, or pre-emptively researching a product, such information is often available online, but the key lies in a patient’s ability to find it. Another resource, pharmaceutical industry medical information departments, often does not cater to complex patient inquiries. Typically, patients who contact pharmaceutical companies with questions about their prescriptions are referred to their clinicians. 

Especially in markets with direct-to-consumer drug marketing, I think it is worth considering that patients are permitted to query pharma companies about products they have been prescribed or that have been proposed as treatment options, so that they can reach an informed position and compile a list of questions before the next appointment with their clinician.

While not every patient will be interested, or indeed able, to manage their health more actively many will be, as shared by patient advocate Suz Schrandt when she told me in 2017 about the information she would like to access as a patient but struggles to do so (link to article medical Information patient needs).  As we navigate a new era in healthcare, I suggest that it is time to give patients the opportunity to take more ownership in managing their health by removing access restrictions to relevant information.

I realise this may be a controversial position, so I am interested to hear your opinions. 

Key takeaway:  Resource constraints limit access to healthcare services as time pressures increase on HCPs.  Engaging patients more actively as managers of their health by giving them access to key information could improve patient health and through patient engagement also potentially improve compliance.  

Questions to empower patients

As a physician I often support friends and family members when they face healthcare challenges, usually once things look as though they are going wrong. This experience has made me think about the questions patients should have ready to ask when meeting their doctors to discuss treatment options. Naturally, the opportunity to ask questions and the available choices will vary depending on local culture, the local healthcare system and other local factors, however, regardless of the system I believe in being prepared.

I recommend the following approach, especially when seeing a new doctor:

Start by making a list before you go to visit your doctor, if your doctor doesn’t have much time, you may otherwise find that you have left the practice without having all your questions answered.

List any recent symptoms you have experienced, what the context was and if they were reproducible. Ensure you have a list of all medications you are taking including any over the counter supplements you take,. If you are being assessed for surgery, ask about alternatives, risk factors, prognoses, the experience of the doctor performing the surgery, how often she has performed this surgery before and what her success rate is. Ask about typical outcomes, risk versus benefit for you personally and what the outcome will be if the operation is not performed. Also ask about timelines for operation, what is the urgency, is there any or can you delay? Also ask about considerations for managing at home post-operation and rehabilitation options. Finally, consider finding out whether doctors are incentivised to perform surgery.

Further questions to ask include whether there are medical treatment guidelines and whether the recommended treatment is in line with these guidelines. Ask whether your doctor thinks his colleagues would recommend the same approach, and potentially whether the doctor would treat his family in the way recommended. Depending on your situation it is also important to weigh the quality of life versus the impacts and benefits of therapy.

If you are receiving a new prescription ask about alternatives, pros and cons, potential interactions with medication you are already on, foods you shouldn’t eat while taking the medication and whether there is anything else you should be aware of, sensitivity to light for example, whether you can still drive and whether your can drink alcohol. Also ask about potential interactions with common over the counter drugs or other medicines you may take periodically such as antihistamines.

Depending on the market you are in, ask whether the prescribed medication is the best one for the condition, or whether it is currently the only one available in your market, or the only one that is financed in your market. If your doctor says there are better, newer products available, but they are currently not available in your market, ask whether you can be included in a clinical trial or whether there are other ways to access the product and whether this is worth looking into.

This isn’t an exhaustive list. If anyone has additional suggestions I would be very interested to read them. Please share them with me.

Key take-away: Nothing beats good preparation.

Data versus assumptions – a personal observation

I recently subscribed to Nature. Having spent years immersed in basic research, analysing promoter regions, experimenting with cell cultures, assessing protein expression levels, and generating antibodies, my love of science is an enduring one. In addition, I’m also a physician. So, when the mRNA vaccines were rolled out, one might have expected me to dive into the research, scrutinize the publications – though of course there wasn’t much available initially – and engage in deep contemplation. Surprisingly, although not within the context of the pandemic, perhaps, I didn’t. I got vaccinated and moved on.

What intrigues me about this situation is how I made many assumptions about the design of the mRNA vaccines, based on my background, only to discover upon reading Nature publications that I was mistaken. This serves as a reminder of how often we draw conclusions based on our unique perspectives without verifying the accuracy of our assumptions, often leading to surprises down the road. For more information on the history of mRNA vaccines Johns Hopkins has an excellent summary here

Key take-away: Data beats assumptions almost every time.

Leadership: The importance of role awareness and reflection

In my work with teams and leaders two recurring themes appear. First, the desire to make a meaningful impact and have contributions recognized. Second, the mismatch between expectations of others and reality. While issues vary, considering roles often offers insights.

Among the many aspects, I will focus on one factor that can be transformative: role awareness.

Role awareness starts with reflecting upon the roles we hold. We are children by birth, parents by choice, doctors by training, in my case, and general managers by successful navigation of the career ladder. Additionally, socialisation and valency prime us for further roles: the outspoken one, the caregiver, the problem solver, the paternal figure, and more. While companies employ tests like Myers Briggs, Belbin, and Insights to enhance performance and self-awareness, the significance of assumed and designated roles, coupled with adeptly handling role shifts, is often overlooked, yet critical for success.

Once you understand the range of roles you embody and adopt it is worth considering your work-related role. This includes assessing whether your understanding of your role aligns with the organization’s perspective. In the event of a mismatch here, or a lack of clarity, future issues are almost certain.

In addition to understanding the roles you inhabit; it is worth considering best practice in role initiation and role relinquishment as your career progresses. In practice, when taking on a new role, consider what this role requires of you and what you need to leave behind. To perform well in one role, you need to fully exit from an old role. If you do not, you risk confusion for yourself and your stakeholders. In addition, as long as you inhabit a role that you have officially left there is no “space” for the new role holder to succeed in it.

When role assumption and relinquishment are an issue, the situation might be viewed as follows by the manager, who was promoted from the role, stating, “I expected better performance and more autonomous decision making from the new role holder” and the new role holder saying, “despite the promotion, he’s still immersed in daily operations, and I cannot make any decisions”.

Key takeaway: Focus fully on the tasks associated with your current role and job title, step away from operative activities related to your old role to allow your successor room to excel. Provide guidance only as appropriate, i.e., if is part of your new role, or you have been asked to mentor

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 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: Annie Spratt @Unsplash