Fishawack Health’s mission is to shape and affect connections between patients and life-enhancing therapies, empowering them with the knowledge and the motivation needed to improve outcomes. Beyond the Molecule translates our mission onto a different platform and gives you, the listener, a peek into what it takes to commercialize a product or service as we hold conversations with key, decision-making stakeholders in the healthcare industry.
This season on Beyond the Molecule, we continued to do what we do best— uncover the untold stories of healthcare innovation with a few upgrades to the podcast. We established a striking new look, onboarded a new host, and explored ever more complex challenges and cutting-edge innovations.
Each episode featured scientists, drug developers, and healthcare tech entrepreneurs across the industry to map their journey from ideation to execution and discover how they succeeded in an industry where 90% of products fail.
Here are our 5 key learnings from the season.
PATIENT EXPECTATIONS ARE CHANGING
The notion of customer-driven acquisition and retention is far from novel. Most recently, the pandemic has catapulted uptake of the well-established online retail and food service marketplace—meaning that people have become accustomed to the well-established, customer‑driven attitude of retail, bringing a new standard of accessibility to consumers.
But this has shifted expectations, not only in retail and food services but also in healthcare. With soaring numbers of healthcare technology applications coming to market in the last 5 years on app stores, the distinction between clinical care and consumer products is blurring. In addition to the continued rising costs of healthcare, patients are shifting their expectations and demanding more value in the service, quality, efficiency, and value of care to match the experience delivered in consumer products and services.
In episode 1 of the latest series, Michelle Longmire, founder of Medable, describes how we can adapt our traditional ways of working to bring patients the experience they are demanding with on-demand clinical trials—and how it draws a parallel to the current consumer experience where convenience in access can be enabled in almost every aspect of one’s life where the first point of care is “digital-first”.
She explains, “The idea is that research shouldn’t be limited to the walls of very few clinics. But those researchers and those clinical experts can connect with someone anywhere in the world. And we can execute that research through technology in a way that enables people to participate, who don’t live right next to those clinics.”
Bringing the best of the traditional consumer experience to clinical trials, including servicing convenience by removing patients out of the traditional paradigm of a healthcare setting can help to meet patient needs more effectively. But it’s not about the service itself that is being performed, but how it is delivered to the patient. Electronic consent and remote real-time patient monitoring, rapid responses and personalized optimization of care improves the patient experience by meeting patients where they are, better addressing their needs, and broadening accessibility to enroll in clinical trials.
2. THERE REMAINS PERSISTING INEQUALITIES IN OUR HEALTHCARE SYSTEMS TODAY
The truth is that there are persisting healthcare inequalities: there remains mistrust in the system, myths that need to be busted, a lack of diversity in clinical research, and lack of communication with under-represented communities.
However, hope is not lost, as several of our guests have identified this need and are implementing programs to tackle these inequalities head-on.
Karen Peterson, patient advocate, and founder of Karen’s Club, joined our hosts on episode 5 to share her story. Through her personal experience overcoming advanced triple-negative breast cancer with a 4% chance of survival, she found that, not only was there a lack of diversity in clinical trials, but there was a striking lack of trust, communication, and understanding between healthcare professionals and underrepresented communities—it was like they spoke different languages.
Karen’s Club, a consultation service for patients of color who are diagnosed with advanced cancer, aims to bust the healthcare myths in communities and empower patients to participate in clinical trials. The idea emerged from her search for answers during her own clinical trial journey, including the barriers to accessing alternative treatment options and information on safety and benefits.
Whilst concerns vary by patient, one thing rings true for them all. There is skepticism about participating in clinical trials. She explains, “Those two words [clinical trials] bring a lot of anxiety, fear, and a sort of distrust when you talk about clinical trials because of the history of atrocities that are put upon us in our community. So, it’s important to have patient advocates who’ve gone through the experience, who look like us, who sound like us, and who can speak to the experience—because that builds trust.”
Mistrust stems from historical events, including the Tuskegee syphilis study, reinforced by innate issues within health systems and discriminatory events that continue today. In her work, Karen is incorporating strategies to reduce mistrust by equipping the patients with the information they need to make an informed decision about their care and encourage clinical trial enrollment.
For life science companies, understanding these key barriers to diversity in clinical trial enrollment is an opportunity to collaborate with patient advocacy groups who can speak to their past experiences with potential research candidates and bust long-standing misconceptions in healthcare research.
Another driving force behind addressing diversity in clinical trials is Nicole Richie, Global Head of Health Equity and Population Science at Roche and Genentech, who we spoke to in Episode 3 of the series. She noticed the lack of diversity in genomics, as well as clinical research at large. To rectify this, Nicole implemented a healthcare equity program that addresses multiple different barriers across the lifecycle of drug development.
She reveals, “We have really put together a program that addresses the different barriers across the life cycle of development—and they certainly exist on many different levels. It starts at the beginning with how we develop our clinical process and protocols—but also how we think about engaging patients, how we enable site access, and how we partner with investigators and physicians. So, it’s really the continuum of the life cycle that is a focus for this type of effort.”
Oncology and genomics are just 2 areas that are crying out for more representation across healthcare research. However, it is crucial to have more representation of marginalized populations to accurately assess efficacy, effectiveness, and safety to new therapies in every therapy area from dermatology to cardiology.
3. EQUALITY IN HEALTHCARE IS ALSO HINDERED BY DIGITAL ILLITERACY, ESPECIALLY FOR THOSE IN NEED
We are in an era where new healthcare technologies are abundant, such as technologies that promote access to and uptake of healthcare, or technologies that provide real-time care management. However, the population with the greatest need for technologies that provides consistent care and monitoring, are simultaneously the group who struggles to use them.
Improving digital literacy in those in need was a running theme across several episodes in this series. In episode 3, Vanessa Lemarié, Director of Life Sciences Business Development and Program Owner of Rare Disease Initiative at Ada Health, discussed the challenges of promoting uptake with users aged 45+. Millennials and Gen Z are digital natives by nature, intuitively picking up new technologies as they adapt. Users over 45 don’t always experience the same ease in uptake. The problem doesn’t stem from unwillingness or mistrust in digital applications—but competence, access (ie, to smartphones, wearables, and sensors), and being equipped with the right tools to get them started.
In episode 1, Michelle spoke about how working with pharmaceutical companies in the early phases of drug development enables seamless delivery of clinical technology to patients. She adds, “One of the wonderful things about clinical development [in collaboration with pharmaceutical companies] is that the way we conduct it enables us to have the funding to bring these technologies to participants.” This includes onboarding and ensuring digital literacy in participants, with the ability to provide patients with resources to the right training and tools to ensure they can manage and monitor their own health under the guidance of healthcare professionals.
The good news is that the pandemic has organically resulted in traction, with the realization that many healthcare solutions are now “digital-first”, and allow both safety, efficacy, and convenience from the comfort of your own home.
4. COLLABORATION IS KEY FOR DISRUPTING THE STATUS QUO IN HEALTHCARE
The modern mindset is, undoubtedly, egocentric. We all have our own personal development goals, aspirations, and achievements. However, throughout this series of the podcast, there was a recurring theme: If you really want to drive innovation and disrupt the status quo in the field of healthcare, you cannot do it alone.
In Episode 4, Frank Jaskulke, Vice President of Intelligence at The Medical Alley Association, discusses the importance of encouraging collaboration, especially between stakeholders who may think differently, despite sharing a common goal. A prime example is the ‘language barrier’ between politicians and scientists/engineers. Alone, neither group can implement the changes needed for science and technology to advance at its full potential; however, together, barriers can be broken down, and both teams can ensure the work they do aligns with the common goal.
Professor Emma Morris emphasized this in episode 6, speaking about her experience as one of the 6 scientific founders of Quell Therapeutics. Together, they carried an idea from lab-based concept to commercial reality, each bringing their own set of skills and attributes to the table. Together, they knew when the time had come to hand over the reins, bringing in Iain McGill, now CEO of the biotechnology company, to drive the commercialization with his acute business acumen. Together, they have brought life-changing therapies to patients in need—but this would never have happened had they been in it alone.
5. HIGH-RISK, HIGH REWARD IS AN INEVITABLE PART OF HEALTHCARE INNOVATION
Every one of our guests took risks and reaped the benefits. But change is not an easy thing to implement, especially in a field where a person’s health and life are dependent upon every decision that is made. The risk your therapy or technology won’t work, or is unsafe, is perhaps most scary, but, even if it is successful, turning that into a thriving business is burdened with risks along every step of the way.
There will come a day when a therapy that has been trialed and tested in the lab, will, inevitably, be used to treat the first patient—a person with a life, dreams, and aspirations. Professor Emma Morris talks about what it is like, as a researcher and clinician, to take this leap—and how essential it is to really believe and trust in the science—because. if successful, as it was in Emma’s case, it can have truly life-changing consequences for patients.
She reveals, “If you inhabit a world that is stem cell transplantation, cellular therapy and gene therapy in a clinical setting—and you’re looking after patients using these biological therapies which have all been developed within the last 5 to 10 years, you are de-facto future-facing … you can’t really get more forward-facing than that. When you are actually, essentially, the first people to test a new approach in patients.”
Frank Jaskulke knows, firsthand, from his experience at The Medical Alley Association, how risky building a healthcare start-up is, meaning that getting funding from investors is often problematic and a barrier to entry. The work Frank and his team do, ultimately, minimizes risk as much as possible, streamlining the process from idea to a therapy with life-changing effects on patients.
The high-risk nature of innovation in healthcare. ultimately means that failure is inevitable. There will be barriers, problems, and negativity, but learning from these—implementing changes, and moving on, is essential.