Can Big Pharmas hiring of digital execs actually ‘reimagine medicine’?

Reimagination or hallucination? In recent weeks, both Glaxo Smith Kline and now Novartis have hired digital analytics and marketing executives out of non-healthcare businesses to lead their digital transformation. For GSK, Karenann Terrell joined in the new position of chief digital and technology officer from six years as chief information officer for Walmart and CIO for pharma Baxter International. From Sainsbury’s Argos, Bertrand Bodson will be assuming the chief digital officer title at Novartis without any previous healthcare experience.

Both are expected to be transformative, disruptive, and ‘reimagine medicine’. Ms. Terrell’s experience and accomplishments appear to be the closest fit to her GSK’s job expectations of integrating digital, data, and analytics strategy with enhancing clinical trials and drug discovery, as well as improving professional and consumer interactions. Novartis’ mission for Mr. Bodson aims even higher. In addition to these, he will be ‘transforming our business model using digital technologies’, ‘reimagine (sic) medicine by leveraging digital on behalf of millions of patients and practitioners’, and ‘leading cultural change’.

Both companies have good starts in advanced technologies–GSK in AI, sensor technologies for managing COPD, and a medical device mobile app; Novartis with ‘smart pill’ Proteus, a pilot with heart medication Entresto tied to monitoring and coaching, and through its Alcon subsidiary with Google, a wired-up contact lens that detects blood glucose [TTA 17 July 14]. However, this last appears to be stalled in trials and Alcon on the block. According to the FT, Novartis is feeling the pressure to develop more digital partnerships, such as Novo Nordisk’s teaming with Glooko and Sanofi with Verily Life, all in diabetic management. Acquisitions may also be the way forward.

A significant impediment to all this integration is consumer and professional trust. If too closely tied to a pharmaceutical company or appearing to be too self-serving, remote monitoring and counseling may not be trusted to be in the patient’s (or doctor’s) best interest or objective as to better approaches. The overuse of analytics, for instance in counseling or patient direction, may be perceived as violating patient privacy–creeping out the patient isn’t helpful. The bottom line: will these digital technologies serve the patient and maintain medical best practices–or best serve the pharmaceutical company’s interests?

This Editor doesn’t question these individuals’ ability, but the organizations’ capability for change. But count this Editor as a skeptic on whether one or two digital execs can marshal the bandwidth and the internal credibility to transform these lumbering, complex, regulated, and long cycle businesses. Big Retail is fast moving by comparison. PMLive 31 July (GSK), 13 Sept (Novartis)  Hat tip to TTA alumna Toni Bunting

Beyond Proteus, delaying medication release in the body–almost all the way

How to deliver medication reliably, well into the colon, to treat gastrointestinal disease most effectively? Purdue University researchers have developed an electronic drug capsule that delivers medication far into the digestive system. When triggered by the magnetic switch or electronic implant, it ‘detonates’ the capsule, releasing the medication. This delivery mechanism was tested through the stomach and into 20 feet of the small intestine. The promise is that it can deliver targeted medications farther into the colon, cost-effectively, to better treat IBS, Crohn’s and bacterial infections. The Purdue team is currently partnering with a biomedical company to take this into clinical trials. This takes the idea of Proteus’ ingested sensor to track medication one step further. Smart capsule to target colon diseases (Reuters)

2014: a few quotes

As a coda to yesterday’s review of our predictions for 2014, here are a few quotes that particularly struck this editor as of interest in 2014, sometimes because of what was said and sometimes because of who was saying it – it’s left to the reader to decide which.

Arthur L. Caplan, Director of Medical Ethics at the New York University Langone Medical Center at the end of an interesting piece in the New York Times on the finer points of genetic testing said:

If you want to spend wisely to protect your health and you have a few hundred dollars to spare, buy a scale, stand on it, and act accordingly.

Three months later, Anne Wojcicki, the founder of 23andme – one of the genetic testing organisations mentioned in the last clip – was quoted in this Medcity News piece as saying: (more…)

That comfy sensor patch gets a bit closer (US/BE)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/07/Baby_with_Biostamp.png” thumb_width=”180″ /][grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/07/MC10_Biostamp-small.jpg” thumb_width=”150″ /]Perhaps we should be adding to our sidebar lexicon ‘conformal electronics’. Boston-based wearable health technology developer MC10 is partnering with Brussels-based biopharmaceutical company UCB S.A. to develop MC10’s Biostamp platform for treating those with severe neurological disorders. MC10 developed a seamless, disposable sensing sticker with thin film batteries (right above) which is currently in use in the Reebok Checklight to determine sports-related concussion risk [TTA 16 May, “Brain Games”] and in beta for infant temperature sensing (left above). It seems clear from the announcement today and further remarks (see below) that the objective is not drug delivery, but for patient monitoring and disease management. MC10 commercializes John Rogers’ work in stretchable sensor patches and batteries [TTA 10 April]. The Biostamp does not have FDA approval but the partnership may be a way to fast-track CE approval. MC10 release, Fast Company (also reviews Proteus, Corventis, Given Imaging), Mobihealthnews with comments from Ben Schlatka, MC10 cofounder.

Ka-ching! Mid-year digital health funding hits $2.3 B: Rock Health

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/07/stick_figure_push_up_arrow_400_clr.png” thumb_width=”120″ /]It’s geometric! Rock Health’s total of $2.3 billion in digital health funding as of June 2014 just rocketed through the $1.97 billion 2013 full year total. Year over year to date, it’s up over 16 percent. And there’s stardust on every sub-sector: software, digital health, biotech and even medical device, the laggard (negative growth) in previous reports. Funding rounds must have taken vitamins, because they are 50 percent larger on average at $15 million versus last year’s $10 million. But there’s the same concentration on big deals like NantHealth, Flatiron Health, Alignment Healthcare and Proteus, heavily skewed towards payer administration, digital health devices, data analytics and healthcare consumer engagement. But the clouds on the horizon are there. Last year’s disproportion in seed/Series A accelerates, and the ‘down the line’ weakness continues with proportionally fewer companies reaching B, C and D rounds. Crowdfunding has also lost its luster–50 percent off with Indiegogo dominating–but its blowout with Healbe GoBe [TTA 26 June, CEWeek] accounted for 41 percent of total crowdfunding dollars; MedStartr stayed in the game at a distant second. IPOs haven’t been great, the ‘digital health index’ is an underperform yet funders are still itchy to cash out multi-round companies like Practice Fusion (EHR/billing), Proteus and ZocDoc via IPO. VentureBeat. Rock Health report on Slideshare.

Monday’s ‘in the news’ briefs

Proteus raises $120 million from “major new institutional investors based in the United States, Europe and Asia” for further development of its ‘smart pills’. Mobihealthnews. Previously in TTA here (starting in 2009!) It’s a long way from ‘tattletale pills’…..InTouch Health now has an FDA-cleared iPad app, CS for iPad, to support a digital stethoscope component on the mobile devices. The app is designed to assess heart and lung sounds in real time in acute-care settings particularly tele-ICU. MedCityNews…..In the mood to read your brainwaves? The Muse is here to help with neurofeedback. MedCityNews takes it on a test drive and if you don’t mind wiping your head down to get a good connection, it definitely points to the future of controlling computers with brain waves and in the meantime, pairing up health apps to get a correlation with those waves….And finally a ‘think piece’ in HeartSisters by Carolyn Thomas“To just be a person, and not a patient anymore” is largely an impossible dream for those with chronic disease. It’s part of the basis behind non-compliance and other patient behavior that doctors have difficulty understanding. The experience of the patient–the frustration (the ‘perpetual battle of Stalingrad’) and the burden that person carries is the argument behind ‘Minimally Disruptive Medicine’. Must reading as those same patients will be pressed now even more to Quantify Themselves and also to keep track of every fluctuation in vital signs on their iPhone.

Proteus to build UK plant, work with NHS; PM’s 5G may save the day

The Proteus smart pill, once found to be so ‘creepy’, is making its first significant international move by planning to build a UK plant ultimately capable of turning out 10 billion units annually, and also partnering with several NHS-affiliated groups: Eastern Academic Health Science Network (EAHSN), The Northern Health Science Alliance (NHSA) and Oxford University, Oxford University Hospitals NHS Trust and Oxford Academic Health Science Network (OAHSN). According to their CEO Andrew Thompson (quoted in Mobihealthnews), this starts the long NHS tendering and commissioning process. Beyond the sensors in the Proteus pill, the signal is picked up by a disposable patch receiver which transmits via Bluetooth to a smartphone and a tracking app. The business model in their current and future projected digital health devices is based on delivering an outcome, providing vital information about medication-taking behaviors and how your body is responding, not selling the device. How this will blend with the NHS model is a good guess, but the article points out that this may take up some of the loss of pharmaceutical manufacturing business in the UK–a big plus.

And all the bandwidth that Proteus will take up will be no problem, since UK and Germany will be jointly developing 5G wireless networks in the next two years which verily will gulp down all that data, along with having all your devices share the IOT (Internet of Things) chat line while you fast forward that 800 MB movie. The team consists of the University of Dresden, King’s College University in London and the University of Surrey. Note PM David Cameron’s writing pad versus Chancellor Angela Merkel’s tablet/folder combo at the photo taken at the CeBIT 2014 announcement. Daily Mail. Hat tip on both items to reader Mike Short and our own Editor Charles Lowe.

Body computing, sensors and all that data

This past week’s Body Computing Conference at University of Southern California (USC) had three sessions focusing on wearable sensors and the big names such as the well-financed Fitbit, Jawbone, BodyMedia, the ingestible sensor Proteus and Zephyr. The panels were split between the medical-grade and the consumer oriented with this report indicating some friction between the two. The notion of the Quantified Self died hard, even with Basis Science’s Marco Della Torre noting that 80% of health app users abandon them within two weeks, so the discussion moved to form factor and the ‘holy grail’ of getting the 90% of never-ever QSers to pay some attention. Of course, it’s the flood of data that has to somehow be processed (one of the FBQs) even though the doctors appear to be unconvinced of the evidence…but the ‘big data’ may be proving it after the fact. The future of wearable sensors in healthcare (iMedicalApps)

The pill spot – Proteus’s first trial and FDA approval for the next generation PillCam (US)

One of the greatest misconceptions I had when I first got involved in telecare was that the main reason that people don’t adhere to their medication regime is that they forget to take their medicine – therefore all they need is an automated pill dispenser or perhaps even an alerting system and all will be well.  If only it was so simple!

In reality there are all sorts of reasons, such as (more…)

FDA goes a bit easier on digital pill classification (US)

Good news for digital pill developers such as Proteus and Carnegie-Mellon’s digestible devices [TTA 15 April]. In FDA’s final order issued 16 May in the Federal Register, ‘ingestible event markers’ (IEM) are now classified as a Class II medical device, which does not require the premarket approval and the longer approval cycle that new devices (‘de novo’) under Class III must have. According to The Hill’s’ regulation blog ‘RegWatch’, “FDA granted the device class 2 status shortly after its approval in 2012, but the legal order sets a permanent standard for the technology.” Proteus’ FDA approval for their IEM was granted in July 2012 [TTA 2 Aug 12] and this now formalizes subsequent IEM classification. iHealthBeat

Proteus 2.0: more edible monitoring

From what only 2.5 years ago wags dubbed ‘creepy’ pills and now is the accepted Proteus Digital Health pill/transmitter/smartphone model, there had to be more in the same vein–or alimentary canal. Teams at Carnegie Mellon University in Pittsburgh are working on digestible devices which have flexible polymer electrodes and are powered by a sodium ion electrochemical cell, to scrutinize for biomarkers or gastric problems. According to the CMU release, “The battery also could be used to stimulate damaged tissue or help in targeted drug delivery for certain types of cancer.” Health tech monitoring mavens may want to be in touch with… Carnegie Mellon’s Christopher Bettinger Develops Edible Electronics for Medical Device Industry