Jeana Konstantakopoulos, MATTER (00:00:12):

Hello and welcome to MATTER's Reinventing a More Equitable Health Future. My name is Jeana Konstantakopoulos, and I'm the Senior Director of Partner Engagement here at MATTER. And I'm thrilled to have you all. MATTER is a nonprofit healthcare incubator and innovation hub. Started in 2015 with the purpose of accelerating the pace of change of innovation in healthcare. And today we have over 800 startups that have come through our doors and we work with 60 partners. And more importantly, we put on great events. We do a lot in service of our mission to accelerate the pace of change. And part of that lens is looking at the way that healthcare be accessible by all people more easily. And to that extent, we're happy to have a great panel discussion here today. And joining me is Laura Westerkamp, the managing director in Accenture's life sciences and med tech practice, who will be guiding our conversation with our panelists. With that, Laura, I'd like to turn it over to you. Welcome for what will be, I think, a really fascinating discussion around health equity.

Laura Westercamp, Accenture (00:01:27):

Thank you so much for the fantastic introduction. We are so happy that you've all joined us today to start our week with a very critical topic, and that is health equity and exploring the role of digital health and how digital health can help ensure a more equitable future. So if we move to the next slide and thanks for the intro. We'll, we'll get kicked off with a great overview of some recent health equity research from Accenture, from my team Selen who will introduce herself in just a couple moments. We'll go through this incredible research and walk through some of the, in the steps that we believe we can take to ensure a more equitable future. And then we're joined by an absolutely incredible panel who will also introduce themselves in just a few moments after Celine walks us through the research Whit from Merck, Ken from Takeda, sans from Metabo Anker from Accenture, and Alex from Sanofi. We're so glad that you've joined us as well. So without any, anything further, let's get started. And Celine, if you could walk us through the research, we'd really appreciate it. And then we'll move to the panel. Thank you.

Selen Karaca-Griffin, Accenture (00:02:45):

Thanks Laura, for introduction. So, hi everyone. My name is Slan Kaja Griffin. I'm the global life science research lead for Accenture. So as part of my role, I'm responsible for Accenture's industry research across the globe, covering patients therapeutic areas scientific innovation and industry players. I oversee our thought capital agenda for life sciences and frequently publish our research externally covering biopharma, biotech and MedTech sectors. So I'm really excited to present our latest point of view on health equity today. In our report, we analyze the role of US healthcare ecosystem Participants play in, he in health inequities due to race and ethnicity. However, today's focus is going to be broader in terms of demographic profiles and we will reflect on the health and inequities will lens on digital health. So let's go to the next slide. I'll, I'd like to start with an example of disparities in action.

(00:03:44):

There are inequities that patients who are at risk face across the board, but disparities between sickle cell disease and cystic fibrosis are especially dramatic Sickle cell disease, an inherited red blood cell disorder where hemoglobin, which transport oxygen across the body is abnormal. And as a result, there's a shortage of red blood cells. And those that do flow often get stuck in blood's, blood flow, blood flow, which then causes severe pain and other serious complications, and ultimately leads to a very young death. So it's incredibly sad what these patients go through from both a physical perspective, but also from treatment perspective. Many of these patients will experience pain crises and seek pain management from emergency departments, but when they get there, they can often be turned away as there are seen to be addicts looking for drugs zone. And it has gotten to a point where some patients won't even seek treatment for fear of being mistreated.

(00:04:45):

So sickle cell disease and cystic fibrosis are two diseases which are very similar with respect to the fact that they are rare and debilitating. However, sickle cell disease predominantly affects black people where cystic fibrosis is predominantly affecting white people at rough. So similar rates, however, despite cystic fibrosis being far rarer, we have seen standing out pay sickle cell disease funding at pretty much every level. And you see it on, on our in on this slide as well. And as a result, there have been new treatments available to cystic fibrosis patients for a number of years now, however, with heightened awareness of sickle cell disease and actions in the recent years they are paying dividends for both patients and also ecosystem participants as well. So, sickle cell disease therapies are increasingly coming to market, providing patients much needed relief. It's also simultaneously grow growing.

(00:05:48):

 You know, the, the, the supplier of these medicines, pharmaceutical businesses. And we see the growth now and we expect sales from these therapies to reach something about 4 billion in 2028. And additionally, we're beginning to see an increased number of dedicated sickle cell disease care centers open, which are better able to reduce readmissions and increase the use of standard of care treatments such as hydroxyurea. And finally, there is now legislation to fund additional specialty centers, which will be hugely important to get these patients specialty me medicines. So as you can see, everyone in the ecosystem in the healthcare ecosystem from pharmaceutical to provider to public healthcare, public health institutions as well, they are grazing awareness and doing their part to to, to raise the bar on sickle cell disease today. Now, while this example demonstrates health inequities due to race, we recognize that health inequities affect people with multiple demographic profiles.

(00:06:54):

They affect, of course, people of color, but also people with disabilities immigrants, people of lower socioeconomic status, L G B T I Q groups and more. And, you know, systemic racism, social determinants of health, interpersonal biases and other factors lead to stark disparities in people engagement and health outcomes. The gap also results in increased costs for the broader healthcare ecosystem. So health inequities based on race and ethnicity in the US alone, for example, are associated with 93 billion in excess annual healthcare costs. And they cost the economy 42 billion in loss productivity every year. And most importantly, systemic and interpersonal discrimination harms underrepresented communities directly. So ecosystem participants, including biopharma companies, payers, providers, and public health and institutions face an ethical imperative as well as an economic one to actively advance health equity. So let's go to the next slide. Now, given today's panel, I'd like to talk about the implications of digital and digital health as they promise great potential to help close the health equity gap.

(00:08:14):

A few examples are listed on the left of the, of the slide. So first, they can increase access by decreasing healthcare service deserts in rural and urban areas. In addition, it can increase access to services with a perceived stigma such as mental and behavioral healthcare. According to our behavioral health consumer survey, 20% of respondents with common mental health issues had not taken any action to address their condition. So digital health provides an alternative path to these people to seek care. Second, they can alleviate increasing healthcare provider staffing as well. A report by the Association of American Medical Colleges states that there's an expected short shortage of between roughly 40,000 and 125,000 physicians by 2034. So staffing issues are even more endemic in rural settings. And low income urban areas that are underserved clinicals aren't always willing to live in and serve these communities. In fact, only one person of residents who graduated from a US-based medical school would prefer to practice in a town of 25 p thousand people or less.

(00:09:34):

So digital health can provide alternative ways to care to deal with these staffing shortages as well. And last but not least, they can also expand clinical trial participation to have a more diverse patient population and more representative clinical data as well. For example, black and Hispanic patients make up 33% of the US population today, yet they only make up two to 16% of clinical trials depending on indication and phase. So digital health solutions can improve participation by enabling decentralization and improving experience and also adherence to therapy. So while there are great benefits, implementation must be thoughtful to AWA to avoid unintentionally widening the gap because of the unequal access to digital technology. So let's go to the next slide, and I wanna talk about that unequal access a bit. Inequity. Inequity is exist in different forms, and unequal access to digital technology can exacerbate that.

(00:10:41):

So you see some examples, so I'll go over them quickly. For example, according to broadband commission, there are more than 1 billion people who experienced some forms of disability that are left out of digital society due to the, due to a lack of accessible digital solutions. Gender is also another factor. 3 million fewer adult women than men use mobile internet globally. Especially in low and middle income countries, women are 20% less likely to use it compared to men. Socioeconomic factors also play into access to digital health solutions that require into internet connections. So high income groups have four times faster internet speeds, and one and a half times better internet access compared to low income groups, groups, for example. And one third of the population remains still unconnected to the internet. And, and ages has another factor. We see that it's much harder to target the primary consumer consumers of healthcare who are basically 65 years or older with, you know, with digital health solutions.

(00:11:53):

 When we, you know, look at the survey data, 25% of them never reports that they never go online. And finally, most health consumers are concerned about their data privacy. And therefore, while digital technology is an enabler of health equity, historically due to the unequal access to technology, it has unintentionally widened the gap and therefore implementation must be thoughtful. So let's go to the next slide. What should this link recalibration look like? So we looked into this and to understand the human and economic impacts of health equity, we conducted a sleeping analysis of peer reviewed literature and clinical opinion, opinion leader reviews. We also collated insights from extensive client engagements, spoke with subject matter experts from life sciences, healthcare and public health industries. And our research uncovered three core areas that must be considered. And every ecosystem participants who are, you know, we we considered pharma payers, providers, and public health institutions, they all have a role to play in these three core areas.

(00:13:12):

So let's go to the next slide and I'll go over these three core areas. So those are listed here, mitigating bias and data analytics, algorithms, designing inclusive products and services, and creating sustainable structural change. And I'll talk about each slightly here. So first, mitigating bias and data analytics and algorithms. As you all know, data and algorithms are used across the entire healthcare ecosystem. They intend to improve accuracy and efficiency, but have sometimes proven to widen healthcare disparities. The most cited example is the large commercial health decision algorithm that used healthcare costs as a proxy for health needs, which inappropriately led to black and African American patients being labeled as healthier than equally sick white patients. So to advance health equity data analytics and algorithms must, must be inclusive. They must be fair, accountable, transparent, and easily explainable. So these are a must to, to be able to advance the health equity.

(00:14:24):

When we put this into, you know for example for biopharma companies, this includes things like developing equitable, a algorithms by setting organizational diversity standards for data used in research and development, for example, such as clinical trial data and continuously revising algorithm as as new data becomes available. In the second part of this, it's about designing inclusive products and services. So health equity must be considered from the start of the product and service design because inclusive design methods enable and draw on the full spectrum of human diversity and individual experiences to create solutions. This doesn't really mean that a single product or solution meets every person's needs. Instead, it means designing different ways for pe people to receive the same access, experience and outcomes, while also having a sense of belong belonging. So considering health equity at this stage encourages better practices, greater accessibility, and a more inclusive healthcare environment, which drives value for people and also ecosystem participants.

(00:15:39):

For example, in pharmaceutical companies, they should incorporate health equity conservations in early drug development and also at launch planning, including tailored marketing plans or the co-creation of treatment guidelines with underrepresented communities, key opening leader groups. And the third piece of this is about creating sustainable structural change. So to make longlasting meaningful change, participants must ensure that their actions bring about structural change and racism and implicit biases are embedded throughout the ecosystem. So addressing institutional policies such as inclusive hiring practices, the types of partnerships created, and how participants execute clinical treatment and tools will have far-reaching effects on the sustainability of the healthcare healthcare ecosystem. Additionally, ingraining equity as a core tenant of participants foundation will aid in normalizing these activities across the ecosystem. For example, new channels could be created for access to services or treatments, especially fo focusing where communities are disproportionately impacted by lack of pro proximity to care for therapies that require access to large academic centers.

(00:16:58):

Again, going back to the sickle cell disease example, that's a perfect example for an action like this. Now, these three areas are designed for all players, and if everyone is working towards the same goal, this will help address historical inequities. However, we need to remember that some of these issues are extremely complex and no ecosystem participant can really do it alone. They must collaborate with one another and extend their actions across traditional organizational boundaries, which ultimately benefit individuals and allows organizations to derive business and societal value. And as a, and as a result, improving health outcomes, reducing disparities, and creating a more equitable world. So with that, I will hand it over to Laura to kick off the panel.

Laura Westercamp, Accenture (00:17:49):

Thank you so much, Celine. We really appreciate going through this very thoughtful and impactful research, lots to reflect on <laugh>. And before we really start that reflection and hear what the panel has to say, I'd like to just take a quick moment for the panelist all introduce themselves. So Whit, if you could get us started, share a little bit about your role and your passion for health equity and digital health. Whit.

Whit Rawlinson, Merck (00:18:20):

Good afternoon, Laura. And thank you for the opportunity to participate today. So my name is Whit Rawson. I work for Merck in their oncology division leading their digital health practice. And my passion is really about trying to figure out how do we take these technologies that we are developing and really getting them in the hands of these underserved communities who haven't had a voice at the table and now and give them that opportunity to participate and also to overcome some of the challenges they've had in terms of having, you know good health outcomes. So thank you and I'm excited about beyond the panel.

Laura Westercamp, Accenture (00:18:51):

All right, Ken, thank you so much. We, Ken, if you could keep us rolling.

Ken Tubman, Takeda (00:18:55):

All right. So Ken Tubman here. I work at Takeda within the global data, digital and technology team, and I concentrate on digital solutions and software medical devices supporting our patients and caregivers and HCPs. And so my passion is, is very similar to wit and I'm sure we're all gonna say around the same things, but, you know, really looking to provide better access to, to, to everybody, right? And to improve outcomes and, and even quality of life. But very happy to be here. Thank you.

Laura Westercamp, Accenture (00:19:24):

Great, thank you Ken Sans.

Sans Thakur, Medable (00:19:27):

Thank you. Laura Sans Thakur. I am the chief Growth Officer for medable, which is the clinical trials company. My passion is in the acceleration of science. Ultimately working in clinical trials is the beginning of bringing novel products treatments to market and representative ones so that we're really making medicine for everyone. Nice to see you all, and thank you for inviting me.

Laura Westercamp, Accenture (00:19:56):

Absolutely. Thank you. Sans Encore.

Dr. Ankoor Shah, Accenture (00:19:59):

Hi everyone. My name is Dr. Ankoor Shah. I'm Accenture's health equity lead. I am passionate about reducing disparities at scale. In my, my role, I help companies across from pharma, health and governments through health equity strategies that are impactful, measurable, and sustainable, and then execute them using technology as a catalyst. I'm a pediatrician by training and practice in Atlanta. In fact, that's what more household medicine, looking forward to the discussion.

Laura Westercamp, Accenture (00:20:28):

Great. Thank you, Encore. Okay, Alex, if you could round us out, we'd really appreciate it.

Alex Condoleon, Sanofi (00:20:34):

Yeah, pleasure to be here. Laura, Alex Condoleon I work at Sanofi and lead an effort here in the US to launch a digital healthcare business. And really what we are trying to do is to understand how do we solve for the whole healthcare needs of an individual and what happens when you start to personalize care for someone, no matter what challenges they face in life. And this issue of equity is absolutely core to that. So pleasure to be here with with yourself and all the other panelists today.

Laura Westercamp, Accenture (00:21:00):

All right, well thank you Alex, for rounding us out. And you know, what they say last to introduce themselves gets the first question, <laugh>. So, so Alex I think we'll, we'll we'll, we'll dig into this question of, of health equity, digital health with you first, and just given your experience at Sanofi, I, I'd love to get your perspective around, you know, with all these emerging digital health tools and best practices, there's so much promise for health equity. What are your thoughts on some of these tools? What do you see as most promising, and how can we continue to scale these interventions for broader impact? All right, big question, big topic. Alex, if you could take us away.

Alex Condoleon, Sanofi (00:21:45):

So, big, big question and, and let me, let me start with, with a couple of, a couple of thoughts. I think we're dealing with a critically important topic today, and we do have reasons to be optimistic that digital is gonna play a role in getting us to a, a better and more equitable future in, in how we think about healthcare. And I wanna call out sort of three areas where I think we're already starting to see proof points of that progression, but where I really do believe we can go much further, firstly, I think digital, you know, clearly lends itself to broadening equitable access to high quality healthcare services. And that does mean we need to rethink a little bit about what are the services and the interventions that exist in healthcare, and how do we get them to everyone in a fair and equitable manner.

(00:22:32):

The bricks and mortar model that we have today works and serves a really important purpose in healthcare. But you are often seeing centralization of top care. And that centralization doesn't mean that it's accessible. I think that, I'm sure we'll hear from you, Sam later on, but you know, you see all of the life science companies really being committed to wanting to drive innovation for all populations and all people. That means we have to run our studies and, and drive our r and d focus for all the needs of people. And I think decentralization of clinical studies is a really important example of that. How do we make sure that we are taking the latest innovation to all populations so that we can understand and co-develop what solutions look like with all of the people that we're seeking to serve, which has not necessarily been adequately achieved until today.

(00:23:24):

I also look back at the period, we've all lived through this extraordinary period of covid where we all in different ways learned to leverage telemedicine. So this is, I'm just gonna use that as an example. So imagine if you've got this ability to engage in healthcare in a different way, telemedicine is one approach, which especially for people in underserved communities, rural communities, has, is continuing to prove its value. But maybe we also need to rethink how healthcare is delivered. Does it always need to be face-to-face? Can't we go further when we think about asynchronous engagement with, with healthcare systems? I don't know, might that future of asynchronous engagement even involve chat G P T and, and might that actually lead to a really positive uplift and a different style of engagement? So as one first category, I would call that I think digital lent itself magnificently to broadening access as a second category, I'm personally very passionate about and very optimistic.

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The digital technology can help people engage better in healthcare and ultimately empower people to make their own better choices no matter what life circumstance they they face. So let me put that in a in another way. If we've worked out ways that people can spend hours every day on, on TikTok and Instagram and Candy Crush and whatever else you wanna talk to, and they're all, they're all great, right? I mean, I, I use them no doubt. Like many of you, I also think we're gonna find a way and we can't give up the promise of finding a way to make healthcare sticky and engaging, because if we can get people engaged in health, will be able to write, raise, elevate health literacy, whether that is about helping people make the right insurance choices for their realities that they, that they confront, understand symptoms they're experiencing, know when to seek care, or whether it's for someone who is suffering a disease.

(00:25:16):

And how do I know what the lifestyle choice is that I need to make in order to attain the health goal that, that I am after? Just think about all the smart watches and other biometric data that's existing today. That's a great advance, but it's meaningless unless we can make that data interpretable to the person that we're, that we're trying to serve. So I would call out digital engagement as being a powerful tool that is going to improve equity issues. We just need to work out how do we refine that and take that further. And as a third and, and final category that I'm, that I'm personally hopeful about, there are lots of watch outs and I think we should be definitely attentive to the watchouts, but let's also think about the promise I would call, call out. Where can we get to, when we think about data and analytics and how can data and analytics personalize health at every level today?

(00:26:10):

We, we, when we talk about equity, we often talk about the social determinants of health, and I think that's incredibly important. But social determinants of health are still talking about cohorts that we're seeking to address. I hope we come back here in five years time, and we are talking about social determinants of health, but we are talking about it through the frame of addressing the personal determinants of health that we're understanding how to solve for the n equals one person in front of me. Because unless I can solve for every challenge that you are facing, I haven't addressed equity. And I really do think that, that we are going to be able to get to a point where that hyper-personalization state driven by data analytics is going to help improve delivery of healthcare, improve equity, give us promise. We know we've gotta get our data sets more representative.

(00:26:58):

We know we've gotta be, you know, very sensitive to how we undertake that analytics. But I think that that future is there. And maybe just as one or LA two last points, Laura. What are the challenges that we're gonna confront on that journey of recognizing the value of these three areas of innovation with digital and, and others? When it comes to this topic of, of equity? I, I think I think cel dealt with it really nicely. But you know, clearly I think the incentives in the system have to be better aligned to drive innovation in areas. There's, there is a digital divide when it comes to just access to digital technology that has to be addressed. And lastly, there's a major issue when it comes to the trust equation. And that's trust in healthcare. It's also trust in what's happening to my data. If we can address those challenges, I think the upside and the opportunity is, is enormous.

Laura Westercamp, Accenture (00:27:50):

Thank you, Alex. And with everything you've just said, the digital divide, I, I wanna go back to that topic in just a moment, but before I do any other panelists wanna add to what Alex articulated there or expand upon the question?

Ken Tubman, Takeda (00:28:07):

I I think he covered pretty much all of it. The only other thing I, I would add is maybe allowing for more awareness and, and education. I think that's another great way that we can, you know, maybe educate a population maybe about a certain disease set so they can get the, the proper treatment. But no, great job, Alex.

Laura Westercamp, Accenture (00:28:29):

All right. Thanks. Thanks Alex. And Ken. So digital divide. Alex, you mentioned the digital divide. And just to define it the way I often think about it as there are those who have access to digital tools, they're aware of them access as well as education and usability, and there are those who don't. What I would love to get your perspective a little bit more around this digital divide and how digital health can play a role. But we have to be really careful that we're not exacerbating inequities in adding to that digital divide. So would love to get your perspective wi around how do we be very thoughtful around this digital divide when delivering digital health solutions to address health inequities?

Whit Rawlinson, Merck (00:29:17):

Yeah, thank you Laura. And it's, it's a great question, and Alex, thank you for, you know, your comments. They were very powerful. What I'll tell you, you know, just thinking about that. So ensuring equitable access to digitally enabling health interventions is crucial to your point, to avoid the ex exacerbating some of those health and disparities we've talked about. I think there are a couple things we need to think about to be mindful of, not, you know, exacerbating those any further. And I think they come around a couple different things. I think the first thing we have to think about is we have to identify and understanding populations that are most likely to be left behind. And this is gonna require deep understanding of the disparities and the inequities that come into that. We have to know who we're talking about.

(00:29:57):

We have to understand what their needs are. I think the second thing is, as we think about designing those interventions they have to be culturally and appropriate, and that considers the unique needs and preferences of these different populations. It's not a one size fit all. I think we've learned that through, you know, the last couple of years that we have to really be intentional and think about those populations we're trying to reach. And this is gonna require us to work with those communities. We have to be in those communities to understand their needs. And so working with those community-based organizations to help us understand that. I think the third thing we have to think about, it's what, you know Alex touched a little bit, is think about the multiple channels, modalities to deliver health digital health interventions. Not everyone is gonna come to the table the same way.

(00:30:41):

So we have to think about how do we do that? It could be telemedicine, it could be mobile. So we have to really think about what those needs are to make sure that everyone has equitable access to these digital tools that we're developing. I think the third thing, and Alex touched this on this one, which is addressing the issues around affordability and access, right? We can't build these great tools and expect, you know, that everybody's gonna have access. We have to think about like, what are their needs and how do they, how are they gonna have access to it? And that's gonna ensure that we work with, you know, the government and providers to make sure that their financial incentives in place to make sure that they have, they can financially afford it, and also they have access to those things. I think the, the last thing I'll kind of point out is this idea about monitoring, right?

(00:31:21):

So we're gonna build these great digital tools, is we have to understand if they're actually one, reaching the communities that we're trying to to talk to. And two, do they work? And if they're not working, then what do we do to improve upon that? Because we're not gonna build the things right out of the box the first time. That's gonna be, you know, what our communities need. But in working with them, we can get to a place where we're developing those tools that are gonna be beneficial to them. I firmly believe, as you know, Alex mentioned that we made a lot of progress, and I think if we take some of the steps that I just talked about, we can continue to build upon this digital future that we see in front of us and make sure that all the communities are equally taken, have access, and are able to take advantage of it. So that's some of the things that I, I would put on the table.

Laura Westercamp, Accenture (00:32:02):

Yeah. Thanks whit. Gosh, there's a lot to think about there, and I, and I hear all your points. You, you really have to think about the challenge holistically and make sure that you're thinking about the whole human as part of the design and approach. Any other reactions from the panel around the digital divide and some of the challenges that digital health might, might provide or might might cause actually any other, anyone else have a reaction to with's statement?

Alex Condoleon, Sanofi (00:32:34):

I may make a a first comment, you know, cause I, I very much agree with, with all the comments you made wen, and I mean, like, no single industry can solve all these problems, right? And there is a really important role for government and policy makers. I mean, just the fundamentals of accessibility for everyone. And, and yes, sometimes that's got to do with wealth. Sometimes it's just got to be with geographic locations. Sometimes it's got to with language and cultural barriers. But you know, it, I dunno if you have, you know, thoughts on it, but just there, there is a really important role that the government sets the tone here, that sets that foundation, that fundamental accessibility not only for health, but just for digital full stop.

Whit Rawlinson, Merck (00:33:12):

Yeah, I, I would agree with that. And I think we saw, you know, during the pandemic with the affordable Care Act where it actually, you know, put money into the digital divide in terms of making sure that broadband access was available in those communities that traditionally didn't have it. And they, we saw it during covid, which were locked out because they couldn't do the at home learning for their kids, take advantage of telemedicine. So those types of things, to your point, the government sets the tone, right? It's setting the tone and made an investment in terms of making sure that broadband was available, which would enable all of these things to be available to us. So I, I totally agree. Government plays a critical role in addition to government. I think you got patient advocacy groups and foundations that also can play a big role in that.

Dr. Ankoor Shah, Accenture (00:33:54):

I, I would even add thinking about the consortium of all our ecosystem partners, because government does set the tone and can set full regulatory levers, but to execute, we often need a private sector to accelerate a technology to accelerate as well. So how do we align incentives across everyone in the ecosystem from healthcare delivery, health insurance, life sciences, government. And if I were to take a 10,000 foot view, I would say the incentive is a healthier population and reduce disparities. And if we could center on that North star and see how the, these activities of actually working together, we're able to yield a lot more value for society and for our businesses. Those are the partnerships that we see that really drive success and community impact that measurably reduce disparities. So thinking about those non-traditional actors in the broadband example, those telecom that we needed as a strong activation partner for that.

Laura Westercamp, Accenture (00:34:56):

Great. Thanks. Thanks wit Alex and Encore. I do wanna note we see a number of questions coming in through the chat. Keep those coming. We really appreciate them at the very end of the panel we will go through and address all the questions in the chat and make sure that folks who've joined today get the opportunity to ask questions to this incredible panel. So Alex Witten anchor, I think you've set up a really big question, which sans I hope you don't mind. I'm <laugh> I'm going to direct to you. So lots of conversation, systemic challenges, some systemic barriers, incentives potentially being little bit mis potentially incentives, definitely being a little bit misaligned at the moment emerging models. I would love to get your perspective sans. I mean, digital health has evolved so rapidly over the last two years. Five years ago it looked completely different. And here we are today as we bring these different pieces together, the incentives, the challenges where we see digital health evolving in the future, which is something Alex touched on at the beginning as well. What are some of the things that you anticipate and what are some of the, the barriers and challenges that you see that you think ought to be addressed and reformed?

Sans Thakur, Medable (00:36:18):

Yes, thanks Laura. And I've been, I've been listening quite carefully to my colleagues over here before jumping into a startup, which is probably no longer a startup now that we're in 60 countries. You know, I spent 20 years in industry and strategy consulting. So my view of of digital at that time was mostly about innovating and changing the way we were creating value. Now seeing how much groundwork we still have to light to execute on the foundational outcomes that we seek to achieve together, it's very clear to me that we don't have the basics yet committed by the stakeholders in our ecosystem. And I'll give you one simple example. I was lucky enough to be in Geneva for the growth summit last week. I spoke to the F D A, the n i h and five or 10 c-suite leaders in our industry.

(00:37:16):

And all of them had a different definition for health equity. So how about we start with some foundational alignment on what are we measuring together? Who should be part of that formula and how do we intend to seek progress in that over the next many years? Being now in the role of a leader in decentralized clinical trials, it was as if overnight the silver lining of covid gave us the ability to bring a new technology to patients around the world, enable us to get vaccine trials completed. However, it was only a few months ago that a law, I'm sorry, not even a law, a policy was passed that required certain demographics to be requested as part of clinical trials only a few months ago. So truly, even in the last 100 years and in the last five years, we have not had the data by our own merit, by our, our own action required to be a part of the basis of medicine.

(00:38:27):

So how is it that we would then understand the equitable outcome of that medicine? To me, you know, I'm not a technologist scientist, chemist by training and sort of then a life science girl, but technology is the enabler. It's funding in my view, that's the equalizer. And today we are still not equitably funding the right things. We need to make sure that we have those regulations in place that allow us to standardize the right digital tools to enable the 21st century outcomes. And I think we would all agree that the 21st century outcomes include human health, but they also include the health of our planet. And, you know, in my experience, when we can decentralize clinical trials and we can capture 60 to 75% of that data at home, our carbon footprint for that trial is between 30 to 50% less than what it would be originally.

(00:39:27):

So, you know, human health, climate health and of course global productivity, we have yet to unlock two thirds of the planet's productivity as it pertains to humans. Digital can do that. So those are where I would, those are barriers as well as opportunities. Laura backbone of the barrier though, just to answer your direct question in my view, I agree with our panelists, this data, and I, again, the root cause being we're not asking for it. <Laugh>, I'll remind you again, it was just last month where we require now race and demographics to be part of clinical trial data. So if we don't ask for it, we're certainly not gonna get it. And if we don't have the quality data, we're never going to be ma able to manage those equitable outcomes that we're all here speaking about, and then will not have the data <laugh> to do the analysis that we need for the future.

Laura Westercamp, Accenture (00:40:26):

Gosh, sons, I maybe I'm, I, I don't think I'm the only one who got chills when you talked about how we have just not had the data, and it was only a few months ago that this policy was passed and that lens of the last hundred years, how little progress we've made towards health equity and then this acceleration <laugh> over the last couple years, couple months, absolutely have goosebumps over here. Sons thinking about the implications and you know, hey, coming from Accenture, we, we do have a passion for data. We do have a passion for digital. So with that anchor as a practicing physician you see the barriers every single day. I, I'm just wondering if you have any reaction to what sans just talked a little bit about.

Dr. Ankoor Shah, Accenture (00:41:12):

I a hundred percent agree on a few points. One is opening our aperture from human health to really climate and planet health and global productivity. I think that's incredibly thoughtful and, and right on. When it comes to data, the question really kind of then turns to trust as well. How have we earned the right for for an individual to give their race and ethnicity data? How's, how's our history really shown as an industry that we treat that data well, that we are delivering services that meet the need? And I think if all of us, you know, on this panel and probably listening would agree, we've done a poor job across the board. And that kinda goes back to this idea of partnerships knowing that there are in, there are communities, there are institutions are invested, long-term building trust takes time, takes years and then delivering consistently and all, and being able to meet the need.

(00:42:23):

So there is a human aspect to the technology. We talk about, you know, I know we often talk about how, how can we engage with communities? And then we Alex spoke a little earlier about chat sheet and generative ai and our perspective is we really need both. We need human plus machine, so we need, what are the truly human things that we need to do, which is building trust, building inclusiveness, partnership and design. That's a purely human human interaction. But then there's an incredible opportunity for the machine, for generative AI to have a lot more precision across diagnosis, therapeutics, precision, social determinants of health for that end of one. And even identifying implicit bias that we colleagues from children's National Dentist study is showing that if you are a a white child versus a black child with a injury, the black child will have a longer time across children's hospitals to receive pain meditation.

(00:43:34):

Not just saying that in each individual physician is explicitly racist, but that implicit bias shows in clinical decision making. But we know the information actually at that point in time, alter that care delivery. There's new organizations thinking about that right now, such as true light health. But how do we, there's opportunity for generative AI to actually, it affect implicit bias as well. It's a two, it's a two-sided coin, as we've seen historically around technology. And as sounds mentioned, the data you need is what are the language models for as our foundation? Who's included in it, what information's included in it, and we know there's gaps. And will it likely cause more disparities as we activate generate AI in healthcare? I think right now, probably yes, but then shouldn't be the future.

Laura Westercamp, Accenture (00:44:26):

Yeah, that's, that's really a lot to, a lot to think about Encore, especially generative ai. I wonder, just to go back, sans so many powerful statements around some of the barriers and challenges. Are there other, and Alex, you talked earlier about the trust equation wi I think you touched on a few of these pieces as well, and Ken any other reactions to, to what sans laid out? I think very well, there's, there's so many challenges within the current ecosystem, so many barriers to effective digital health. Any other reactions?

Whit Rawlinson, Merck (00:45:03):

Yeah,

Sans Thakur, Medable (00:45:03):

Probably just go ahead, please lit.

Whit Rawlinson, Merck (00:45:08):

No, I was just gonna pick up on a couple points, right? That I thought was important that she made it uncoordinated, which needs to come through. It's an idea about trust, right? And trust this idea that I think comes about in terms of a long-term commitment. You can't just show up today and, and be one-sided and take and then walk away. The community has to believe that you're there for them for the long term and not just for a one-sided transaction. And I also think transparency in terms of really trying to be clear about what it is you're trying to accomplish and, and the role that you need them to play, because that's gonna get the community engaged around the things we're trying to do. And if you don't have those things, you don't, it's not gonna work. Then the idea of partnership, I think on core mentioned is that that's hugely important, not only with the organizations that are within our community, but with the community itself. We have to partner with them to let them be a part of the solutions that we're developing. Otherwise, it, it just doesn't work.

Sans Thakur, Medable (00:46:03):

I wanted to just add on to the, the team here. I, I feel that my perspective on trust has changed. And I think that trust is more simple than we may think it is or at least at the way I used to think about it. Oh, the system. So the data, but ultimately what I've seen in patients is that they trust their phones, you know, they trust their computers. And it's, it's, it's, it's we who often put them in a system that is far too complex or doesn't meet their needs or expectations. And as Unru said, and there is, you know, a little bit more, you know excitement with this machine and human concept. But, you know, I see it every day when we talk about what is a decentralized trial. And it's not just taking everything and making it ritual the outcome.

(00:46:59):

The best outcomes are on the thoughtfulness of the design. And if we understand the patient population and we apply the right digital interventions and to the right people with the right protocols, that's when we see the best outcomes. If we blindly just apply technology to a disease or to a population, we don't see any good outcomes at all. So I akin this to this combination of do we know who the human is and do we know what machine matters? So without that, and that comes from the human, I think that still comes from the system. And we all have it in our responsibility and in our power to say it's not a one size fits all answer, but that does solve for, are we being thoughtful? Do we really just are we really changing you know, how we do, how we do our work in medicine? And I would say no. Change management is the biggest barrier I have seen really moving people to not just adopt technology but adopt the way they also behave in context of that technology is the only way you get the outcome. Technology is just an enabler. So but I do think there is more trust out there that we have yet to earn, is the way I would look at it.

Laura Westercamp, Accenture (00:48:24):

Yeah. Thank you Sanz. And you've, you've touched upon so many things. One of those which is a future pieces of Accenture research coming out around trust and digital health. More to come soon. But, and, and you also talked about a really, really critical area, which is designing for the right digital interventions. I'm just gonna put that to the side for two seconds. We will come back to it, you know, this idea of customer experience and CX and really making sure you're doing the right things at the moments that matter. So I'm gonna put that aside for just a couple minutes and before we Jeff

Sans Thakur, Medable (00:48:59):

Tease us like that Laura <laugh>,

Laura Westercamp, Accenture (00:49:01):

I know, gosh I guess moderators, right? I guess we'll take it this one time. So we'll, we'll put it to the side for just one minute or two. And before, before we get there I'd just love to hear from any of the other panelists around just impressions around mitigating bias and what are some, what are some things we can think about and do. Encore, I know you grounded us there, you brought up generative ai. Thinking about you know, analytics a little bit differently but any other impressions around mitigating bias and how we ought to think about that as we're bringing digital health capabilities to market either in r and d or in commercial? Alex, you look like you might wanna jump in off. Well,

Alex Condoleon, Sanofi (00:49:46):

I, I dunno, I'm, I'm, I'm maybe not gonna help the discussion, but, but say, you know, obviously we've talked about like several you know, barriers, right? That need to be addressed from, you know, funding to the trust equation, et cetera, et cetera. The digital divide I guess I would just call out that if we were to address all of those, I still hold a real concern in the back of my mind that the lack of representation in data and the incredible speed at which AI and all of us many forms is accelerating, is the greatest danger we will confront to a good intent to solve for equity, but in fact, which we will, will create inequity. And, and I, I dunno, I was listening your ancor to your comments. I I, I don't know how we get that better representation. I don't know where the incentives in the system are, but you know, if, if you are not where the communities are, you are seeking to serve, if you don't have the trust equation, we know in those populations that we lack, we probably have the weakest of the trust equations. We really do run that risk. And I, I think it's a key, a key topic for further, for further, further forden debate.

Sans Thakur, Medable (00:50:56):

Well, you said it earlier, I think you can't do that alone. And every data conversation, at least these days, I have, you know, people aren't willing to share their data. So ultimately when we look at both at the private and public sector, they're two different problems. We have innovation, the private sector, but there's elements of that data and that innovation that must be shared for the global health. And then in the public sector, there's no yet infrastructure to collect data on just the basics of the community globally. I mean, to this day, we do not have basic demographic data basic health data from many countries.

Dr. Ankoor Shah, Accenture (00:51:37):

And I, I'm reflecting on my time here at Accenture, I was leading the vaccine rollout for the District of Columbia. And an interesting problem came to us, which was of course getting demographic information across the nation. It was poorly done during the initial phases of the vaccine rollout as an effort to do that, creating systems that capture race and ethnicity data early in the process. And what we found was that was slowing down service delivery as well. And we worked with a lot of clients in which the over-indexing on comprehensiveness actually misses the goal of, or the intention in the first place. So I say that just to say understanding how to, or how do we get comprehensive data that's sourced directly from the individual, I suppose a third party, or using different mathematical formulas like imputation but really derived from the individual doing so quickly, having empowered and not actually missing the force for the trees sometimes because that is another a barrier dish we see happen. I don't have a similar, I'm go throw out more problems and solutions, but that is one that we should keep an eye on as well,

Ken Tubman, Takeda (00:53:03):

You know, from, as a, as a digital guy, I, I wonder, I wonder if we can use kind of open AI to develop synthetic data, you know, so maybe we don't have our hands on the data, but can we use this to, to kind of generate data that can help us? Just a thought.

Sans Thakur, Medable (00:53:21):

So I would, I would say you know, what is Medable is the platform. It's direct data capture. That's what it is, that's the value of it for clinically regulated research. But we don't own the data, right? So ultimately the sponsor owns the data. And so while we have a platform with millions and millions of direct data points from patients, it ultimately is up to the industry and the governments to make the choices about how we share it. So I do think, Ryan, that there is that opportunity and we see it every day when we de-identify and, and audit our own you know, information. But we can't actually get there without the right frameworks aligned in inside the private public sector.

Laura Westercamp, Accenture (00:54:13):

Great. Thanks. Thanks, sans. Ken, Alex, Encore with lots of thoughts here and many challenges, some great solutions. Ken, I love the point about synthetic data and how can we train models and how can we be really thoughtful about creating that right avenue for equitable, equitable information to, to make sure we're bringing health equity to bear. Soans, you touched on design earlier. I'm gonna go back to that topic and I'd like to direct this one to you, Ken. So would love to get your perspective of how you think about inclusive design that element of customer experience with which we talked a little bit about what do you think about around service design and what strides are you and your team making in this space to make sure that you're really designing for equitable outcomes?

Ken Tubman, Takeda (00:55:08):

Yeah, thank you. So you know, it, it sounds cliche, but it does start with kind of patient first. You know, you, it, you know, we all say that, but it is, it is true. That, you know, you have to bake that into your ethos. And you know, so when, when we're, we're doing this, you know, we're really trying to figure out how can we get at the unmet need, but then how do we get the patient into one place better, right? And there's a lot of great materials actually as I was preparing for, for this session. I think we can also lean on some of our big tech companies. Google has, has something called belonging. And, and their tagline is building for everyone, with everyone, right? Another great resource. Microsoft has something called Microsoft Inclusive Design.

(00:55:57):

 And if, if you haven't seen it, it's, it, it is really neat. They have a lot of materials. There's a, there's a toolkit for inclusive design. They have a methodology built around, you know, just a range of perspectives, but they have these like activity cards and, and a cognition worksheet. And, and maybe it's not built just for health, but it could be applied to health. And, and so that's something that I found that was, that was really neat. And it just gives you a different lens to, to kind of look through. And there, there are some videos that are very health centric. So, so definitely check those out. Then Apple also has some, some good resources as well. So, so take a look at those. But I mentioned this, this concept of, of one better.

(00:56:36):

 You know like in, in my company we produce, you know pharmaceuticals, right? So there's, these medications are making the lives of patients better, right? And so what we can do with digital is how do we get them just even one more better, right? And, and that's, that's, that's kind of the, the biggest goal. And, and we do have to think very inclusive to do that. And it's, it's not thinking about the technology first. It's more concentrating on the, the, the patient and, and outcomes and quality of life and accessibility and usability is extremely important. And just being just effective for everyone. You know, some of the ways that we've made some strides in this is I work on, on kind of the global scale. And what that means is, you know, you, you have to kind of lift your head up and it's not just us, right?

(00:57:26):

This is what we live, we're in the us but like, how do we look at it from a global scale? I, I've, you know, been deploying software, medical devices and, and, and even just regular straight up digital to, to over 60 countries. And so when you start to think about them at this global scale, it almost naturally injects a little bit of equity into how we think about the solutions. Cuz we have to think from a, from a localized perspective to the language, to the content, to the ages. And then the technology enables us, right? But we don't really start at the, the technology first. And the other thing in, in our particular company is everything is very decentralized out to the regions. So we do involve the community in that region, in the, in our projects.

(00:58:15):

 And this tends to create more of a universal design that lowers kind of barrier with, you know, language and health literacy and you know, just, just usability, right? Just the ease of use. And that doesn't mean that, you know, we're looking for just a one size fits all because that would go against what we're talking about today that would kill the discussion <laugh>. But you know, it, it is, it is very important to, to, to look at the aspects of, of the design and, and usability. And so it's very important to have that partnership with, with your local team especially the ones that are gonna be deployed these solutions. Bringing the, that voice into the, the voice of the local countries into the solution. And and also understanding what is the digital maturity of these countries, right? Cuz that, that plays a big factor as well. So yeah, I think that's how I'd put it out there.

Laura Westercamp, Accenture (00:59:10):

Greg, Ken Lock lots to think about, but lots of progress being made, it sounds like. And I, I really appreciate you opening up the aperture to some of the broader healthcare stakeholders and where we can get some inspiration within our industry. I'd love to hear from any of the other panelists around what we're doing in pharma to really design inclusively and to make sure we're getting that customer experience right, like Ken, Ken, set that up for us with some really thoughtful, thoughtful considerations. Wit or Alex, any reactions? What do you see happening at Sanofi and Merck to really make sure we're designing for the patient with that patient first?

Whit Rawlinson, Merck (00:59:50):

Yeah, I'll, I'll, I'll start off first. You know, to your point, you know, engaging these diverse communities and development and testing about solutions, really important, right? And a couple of areas that we've found to be important, you think about co-creation rates. So we're involving these diverse communities in the design and development of our digital solutions from the very beginning. So before we start doing anything, we sit down and we try to map out what their needs are. And I think the point that was made, understanding the human I think sands made that, and understanding that. I think the second thing, you know, we look at is these user centered design approaches, right? So this design approach ensures that the digital solution is easy to use and accessible to these populations, right? We, we, we, we get, you know, wrapped up into this because we do it every day and we forget about the people on the other end of it that may not necessarily be doing this the way we do it.

(01:00:38):

So really thinking about what do they need. And then the last thing we're doing, I would, yeah, I would just point out is community engagement, right? So really looking at the broader communities to say who should be at the table and making sure those people have a seat at the table and they're ta they're getting their views out and we're listening to that, and then we're playing it back to them. And that's the only thing I would say to you that beyond just having 'em at the table, but listening to them and playing back what we're hearing from them so that they understand that we are listening and that we understand what they're, they're saying to us versus us taking that feedback and then walking back and saying, we got it. And, and not really playing it back. So supposed to be the three things, co-creation, user center design, and then community engagement.

Laura Westercamp, Accenture (01:01:20):

Yeah. Magical three wit, I think those are, those are some really, really powerful things to do. Alex, any, anything you'd like to add?

Alex Condoleon, Sanofi (01:01:30):

So I think, I mean, I think, I think, you know, we, I think you touched on like the absolute fundamentals that we have to solve for 100%, right? And, and bringing the people we're seeking to serve in, into, into the core of what we're doing. I think the, the one other call out i, I would have is, you know, I think all of all of us are trying to think and understand what's the future go to market offer gonna look like? And if there's a future state when we stop selling just an input like a drug, but we start selling a solution, then all of a sudden, all of, all of that inside and partnering starts to change the proposition of the intervention. And, and I am, I am hopeful that, you know, firstly, I, I think it's, you know clear that, that digital is the foundation that, that lets a shift in business model happen so that we start talking about whole care solutions at which a drug is one part of a whole care solution.

(01:02:26):

But so is the engagement platform, the device and, and everything else that we wrap around it. But when, when we start doing that, we start to understand that science has a critical role to play at the molecular level of disease. And the disease often has commonality at a molecular level, but the person we're seeking to serve doesn't have that commonality. And I think that's where, that's where the adaptability and the experience of a solution, rather than an input into healthcare changes the, the value proposition. So although, although I think that a slow build to get us there and to understand, you know, the receptivity of policymakers, payers, the people that we're seeking to serve, I I think that's gonna hopefully be something that we all keep pushing the boundaries on when we, when we have that depth of connection and understanding of, of the, the, the, the diversity of populations that, that we seek to seek to, to solve for

Laura Westercamp, Accenture (01:03:19):

Y Yeah. Alex, I, I, I'd love just to throw a little bit of a, a deeper question to you for a second, and if others on the panel would like to answer as well. At Accenture, we often think about value as being really critical to everything that we do, period, right? And I know most of you're with your commercial organizations, respectively, so I'd love to just get a perspective, and I know this is a little bit outta before we move to about the 30 questions in the chat here, <laugh> from the audience I'd love to get any thoughts you have around value and if your organization has a way to think about value of digital health and health equity just yet, or if that's still something that you're working through. And Alex, I'm sorry to put you on the spot.

Alex Condoleon, Sanofi (01:04:09):

Okay. Okay. I'll begin

Laura Westercamp, Accenture (01:04:11):

Question. You know, I, and we think anyone else? Yeah, we think about human and economic value as part of our health equity research. Typically we see a lot of commercial organizations do wanna ground back to some kind of value beyond the human and economic societal good, but also making sure we're tying back to, frankly, value to the organization, which I know is a little bit of a delicate topic at times, but realistically, everyone here on this panel is part of an organization that, that needs to drive value. So just again, just curious if you have any reaction. Yeah.

Alex Condoleon, Sanofi (01:04:48):

Well, I think firstly, wherever you've got health and profit, you'll have controversy, right? So, so that's just part of what happens in healthcare. But having said that, of course, where you've got, you know, businesses that are incentivized, you are, you are, you are, you've also got the potential to, to really accelerate what's possible, right? And, and that's why, why we see that, that, you know, being in, in the industry side of health can, can have a dramatic impact on the population. And that, and that's, that's today we have like an established mechanism of reward, and it's a little bit more based on if someone gets treated, you get rewarded. And, and that's a, a model which has served a really good purpose. I think there's recognition that that model doesn't fully reward the full value that gets brought to the table and doesn't necessarily incentivize solving for, for example, that the extent of health equity as an as, as one example of what we're talking about today.

(01:05:47):

Now, let's talk about what's it gonna take to get to a future state. I, I, I think in, in a future state, there's no question that, that having reliable data that represents the impact of health interventions is key. And today, there's, there's a quandary today. It costs, when, when you talk about value-based models, it can also, it can almost cost you as much in just trying to do the analytics and be confident in the outcome as it is for what saving or upside you're gonna find, right? So, so there is going to have to be a further evolution so that we, we get to a point where we have the ability to understand the full extent of the health impact that we have. We're never gonna achieve that only by looking at clinical level data, right? So I think we're very fortunate to have the, you know, electronic health record systems that we've got today, and the lab data and the healthcare utilization data. That's all really great. But un until we can get that data combined with the data of the people we're actually solving for and their experience and how their work productivity is improved, how their satisfaction, their mental wellbeing, all of these quality of life dimensions that are unmeasurable today, when we can get to that point, I think we can redefine how to reward people for the full dare I said, whole health value that's being brought to the table.

Laura Westercamp, Accenture (01:07:08):

Yeah. Thank, thank you, Alex. So, so thoughtful. And if I were to summarize the way that we think about it, Accenture, and I think the way that you just articulated it, value is the value to the human, the patient outcomes value to the healthcare system payer and provider frankly, and there is a, there is a value to the company's providing the service be that reducing internal cost structures, or there could be a revenue component. And then there's a value to employees, which is really about inclusion and diversity, and making sure that there's that, that human element and that belonging. So thank you, Alex. That was really, really a fantastic overview of thinking about value. Anyone else from the panel want to opine on on this one before we move over to audience questions?

Sans Thakur, Medable (01:07:58):

I would here as well only because now you know, having always loved being in life sciences, you have this 10 year opportunity, right? This arm of value to be created, which makes, I think the industry much more thoughtful now, being in technology, you know, you can create value overnight. And I think what this has helped me to see is the dichotomous relationship between our, in our ecosystem. I think that there's a lot of shared value to be created there that helps us to accelerate together, but manage the the, you know, ultimate outcome for patients. And I think that's really what, when Ken was talking about patient being patient-centric, I don't think it's possible anymore to be patient-centric from one lens, just from the lens of a pharma or lens of a health system or the lens of technology. It has to be an understood, shared value to the patient. And I think that's gonna get us more in the long run with basic economics. One, one last thing I would say, I think economics matters. You know, if we prevented all disease as we should we would put a 1.3 trillion industry out of business. So ultimately, I think the solution focus that Alex had mentioned earlier, gets us closer to really thinking about what's the true outcome we're, we're seeking to achieve together.

Laura Westercamp, Accenture (01:09:26):

Thank you, Sanz. Ken, I think you had a quick point there too.

Ken Tubman, Takeda (01:09:31):

Yeah, just a real quick one. You know, how you, you were kind of asking, you know, how do you, how do we measure, right? This, this value, I, I would almost say that we could put out a call to action that maybe there's like a K P I that could be return on health equity, right? That could be like a measurable thing that goes into, you know, as we're designing products,

Sans Thakur, Medable (01:09:52):

I love that. I mean, we have a carbon credit, don't we? Why wouldn't we have a health equity credit that all of us seek to share? And this list, of course assumes we agree on what health equity means at the end of the day. Love that suggestion.

Laura Westercamp, Accenture (01:10:07):

Thanks, Ken. All right. Well heard it here first. We, I think this panel can take credit for the future of a return on health equity metric which we can all strive for to combat this, this really critical challenge. Alright, so before we move to questions, I just wanna give the panel just an opportunity if there's any final thoughts, reactions, lots of discussions so far. It's okay if there's not, there are, like I said, about 30 plus questions, <laugh>, that we can start to work through over the next 20 minutes or so together. But any other final thoughts?

Dr. Ankoor Shah, Accenture (01:10:43):

Well, one kind of relates to value. I think the evidence that there are incredibly high disparities across the United States and health outcomes and life outcomes is the argument that there is a untapped market that's not gateway needs met. So from a business case, we have an untapped market that's not getting the needs met. We need, the normal players aren't doing well. As Alex mentioned, thinking about solutions as opposed to single products. The innovation industry and innovating to meet those needs are the ones that are going to ma meet that market. And as a result, we're gonna have reduction disparities at pre pets

Whit Rawlinson, Merck (01:11:27):

And life outcomes.

Laura Westercamp, Accenture (01:11:30):

Yeah, great, great point on curve. All right, well, with that, the moment we've all been waiting for audience q and a so we've got a curated list from the 35 questions or so, which have been asked. And for all the folks on the phone who have asked questions, we will also in parallel do our best to respond to those via the chat. And of course y y you know, we'll, we'll do the best we have with the remaining time that we have together here to answer some of these questions. There's quite a few. All right. So the first one I, I'm gonna direct towards Ken and Whit because I think you've touched upon this topic through the discussion already a little bit. So maybe you could expand the question is what actionable digital initiatives are your respective organizations undertaking at the moment to address health equity and accessibility? I'll repeat that again. What actionable digital initiatives are your respective organizations undertaking at the moment to address health, equity and accessibility? All right, Ken and Whit,

Whit Rawlinson, Merck (01:12:41):

Right? So I'll, I'll take the first one and talk about it as much as I can. I think, you know, early on we talked about this idea about, you know the evolving, you know, care landscape in terms of how care is delivered. So we're looking at, you know, understanding better, you know, as care moves out of the traditional settings hospitals, you know, you know, academic centers, how do you meet those patients and support those patients who are gonna be in these new environments, whether it be at a pharmacy or whether it be in their home. You know, how do we provide the necessary tools and support that they need? You think about monitoring a patient who's at home, getting, you know, in this case, oncology care. How do you ensure that that patient's receiving the same level of care as couple with level of care at home as they would in the in a acute setting and also the access to their physician?

(01:13:31):

Something we talked about a little bit, but we really haven't done a lot of this idea around health literacy and education. So as you think about that, you know, how are we ensuring that we are delivering education literacy to those patients? They understand what we're giving them or what we're asking of them. Because if you think about some of the gaps we see in, in care, especially in, in the sub these communities, a lot of times we're giving them information that they don't necessarily understand what to do with, and so therefore you don't necessarily get the right outcomes around that one. So we invest a lot of energy in making sure that, you know, the educational content that we're providing those patients is at a level that they understand and and culturally relevant for them. So those are just a couple things we're doing, looking at the hybrid care setting in terms of, you know, care being delivered in different places, which will address some of the costs around transportation. Getting patients into a physician's office will also address geographic, you know, patients who are not necessarily close to these academic institutions, but they can still have access to them, you know in their, in the setting. So I'll stop and give candid opportunity, but those are some of the things that we're doing.

Ken Tubman, Takeda (01:14:33):

Hey, you, you covered actually a couple of the things that, that we were thinking about. So and doing education and awareness are, are top of mind. There's, there's different ways we've done it. We've done it with gamification, you know, producing really fun quick games that people can play to really wa raise the awareness of, of a certain disease in, in a, in a, in a population. And then transition to care with you also mentioned is something that is top of mind. So how do you, how do you transition someone from a hospital setting back to the home? Make sure that you're still able to kind of keep in touch with those patients as as they've transitioned. So yeah, those are, those are probably two of the main things.

Laura Westercamp, Accenture (01:15:14):

Okay, great. Unless there's anything else from the panelists, we're gonna keep moving just so we can get through as many questions as possible. So next question, and I think Sanz, I will direct this to you and Alex. And sans I would argue, I think Metabo really is one of the question, one of the companies that is ought to be highlighted this question. The question is, are there any companies strategies that you know of that seem to be at the forefront of garnering equitable digital access user engagement in their digital health company? What are the key elements of success? So, again, I'll repeat the question. Are there any company strategies that you know of that seem to be at the forefront of garnering equitable digital access, user engagement, what seem to be the key elements of their success? So Sons and Alex Sanz, maybe you can start us off.

Sans Thakur, Medable (01:16:07):

Sure. And I'll, I'll speak for myself and the company. I, I would, I would say ultimately the, the greatest point of unmet need is filling the need for treatments and medicines because of the economic burden that healthcare has, the most important lever in which to do that is clinical development. It is very well known that clinical development is about a hundred years old and isn't reaching everyone. So the strategy was simple. What is the biggest place you can move the needle the most with technology? So, in my view, if it's not simple, it's gonna be hard to execute anyway, and it's hard to execute anything in healthcare. So the three things I think are the most valuable to be a leader in this space is having an evidence generation mindset. So I think it is very clear to this team that, you know, digital companies are going to come and go, and we, it as part of the healthcare ecosystem, are responsible for creating the best evidence possible around medicines and treatment.

(01:17:28):

So that's number one. Number two, we dil designed our platform to be a consumer facing, consumer ready platform because the pivot that we understand the system needs to make is not just to be patient-centric, but to be accessible and relatable enough that we as a, as a, as a healthcare ecosystem and life sciences ecosystem will be engaging and trusting to our end users. So that's the second piece. I think the third piece is thoughtful. Being a thoughtful organization, you know, our c e o is a physician. We have people in our organization that are an amalgamation of life sciences data, and I think that's really critical to setting the right tone and creating the right product and growing sustainably so that we can continue to lead in this space.

Laura Westercamp, Accenture (01:18:33):

Great. Alex, any reflections?

Alex Condoleon, Sanofi (01:18:37):

Yeah, so maybe I'll I'll use an example. We we're we are partnered with a, a digital therapeutics company by the name of Dario of Health. And, you know, in, in selecting a partner, right, from an ecosystem perspective it, it is important to be highly attuned to like, what are the features that are going to convince you that you're gonna at least be able to serve a broader population? And, and some of these features, like if they're not thought of from the beginning, they're very hard to play the catch up game, right? So if I, if I use them as as an example, I think you know, and they're, they're, they're fundamentally a platform which is all about engagement. If I use them as an example, you know, they, you have the ability within the app to alter the font size and the dimensions.

(01:19:20):

Now, if you don't do that early on, then you're not gonna solve for those who have visual impairment equally. Their their, their ecosystem has been built such that if you don't have connectivity at a given time point, that's just fine. It is, it is still gonna collect your relevant biometric data. It's gonna allow you to sync when you're in a Starbucks or a local library. And, and again, I'm just calling out the, the, the, the attention to that detail from early design is key, right? And they're, you know, 10 years down the track. So they've started their journey and they've got a mature product, but you've gotta get there. Having a multilingual platform is, is really important. And starting to think about sort of features of how you engage with various dimensions of the healthcare system. So I, I do think for those of us who are in the, in the partnering part of, of of life sciences, we, we can make sure that those dimensions are key and then we can start to think about how do you build that evidence base, right? The, the sense you just touched on, so that as we're trying to help scale and help broaden the the availability of these sort of solutions, we make sure we're highlighting how that as an innovation can translate into an actual community benefit.

Laura Westercamp, Accenture (01:20:35):

Thanks, Alex. I love all the points around evidence-based and really working with partners that can pull through those, those key gosh, I wanna say features, but it's really values around equitable digital health design. Really, really excellent points. And San certainly appreciate yours as well. I, I would love to direct the next question from the audience, <laugh> to Ken and to Whit and Ken, maybe you could get us started on this one. I I think this topic will be very close to your heart, and the question is around what does the panel think about interoperability? So for example, apple watches, Fitbits, phone tracking credit cards how could we actually learn more about the patient and the context of their lifestyle, and how can we bring the data together? I actually think if I, if I break this question apart into two big pieces.

(01:21:29):

So one is interoperability with all the different data sources. And whenever I hear interoperability, I think with EHRs with, with our, you know, wonderful friends with an Epic and Cerner and others, but then there's also this element of interoperability with other data sources that knit together the patient lifestyle. And data has been such a big theme of this panel and getting data, right. So Ken, if I could direct it to you first, and then wit, if you have any impressions, and this is such a, a great big question, if others on the panel wanna jump into, we'll certainly give the time and space, but Ken, you could get us started.

Ken Tubman, Takeda (01:22:07):

Yeah, it's, it's overwhelming, you know, how many data sources there are and how they don't really talk to each other. But the good news is, you know, from, you know, all these EMRs that have been collecting data over time, at least now we have data, you know, before, before EMRs, we didn't have anything to really react to. Same thing with wearable data, you know, watches and, and things like that, getting activity. So, you know, I I, I'm not really sure exactly where to go with this, but basically there's number of tools that the industry has that, you know, that we, we tap into to, to be able to pull in this data in, in a reasonable in, in inexpensive way if we could and, and be able to, I guess, look at the active insights that that data can tell you. And, and connecting, you know, disparate sources together. It's, it's, it's almost like you're, you're looking at maybe weather data that could then tell you something about, you know, a a patient that is suffering from, you know, diabetes, you know, can, you can start to tie together interesting data sources to, to get some, some action insights. But over to you, Whit.

Whit Rawlinson, Merck (01:23:13):

Yeah, thanks, Ken. This is, this is a very big question. We're having discussions about this internally now, and when I hear, I think about a couple different things, right? So first off, I'll say that having access to more data is absolutely a great thing, but one of the big things we talk about internally and are sorting through is this idea about what data, right? Because we wanna make sure that we're collecting have access to the, the data that's gonna really be able to allow us to make informed decisions versus just swimming in, in a lot of data. So that's the first piece of it. Then on the other element of this, you didn't mention Laura, but it's this idea about privacy, right? So in, in order to make any of this work, this is the question around, you know privacy and being transparent to the cust the patients and customers in this case to say, here's what we're collecting.

(01:23:57):

Here's what we're doing with this, and here's, you know, how it's gonna have an impact on you. And so all, all those elements play into, you know this whole idea by interoperability. While on one hand it's great, there are a lot of, you know big, you know, things that we have to weigh in terms of what do we want and what are we gonna do with it? Are we transparent to the pe the patient's data that we're using? So they understand that and they're comfortable with that. So I don't know if that answers your question, but those are kind of the things that we're struggling with, you know, in terms of how you deal with this whole interoperability. While it's great on one hand, there are lots of things we gotta work through in terms of really making it actionable for us.

Laura Westercamp, Accenture (01:24:32):

Yeah. Hey, I, I think the answer that I've heard from both you and Ken, if you don't mind me summarizing, it's, there's a lot of potential and we're starting to crack into it and really solve for how we can bring the data story together in the future for people so that digital health is a source of, of health equity and really drives, drives that promise of health equity, which I think is, is really, really important, but still in progress, which for all of the startups who are on the phone right now and listening into this presentation, lots of opportunity. This is, this is what I'm hearing, and we're, we're still solving the, the challenge as an industry and,

Ken Tubman, Takeda (01:25:12):

And great call out wi with privacy. That that is, that is such a big concern, especially when you look across the globe and not just one country.

Dr. Ankoor Shah, Accenture (01:25:20):

And I would, you know, expand on that, that the technology and the technical aspects are actually, we're right there, especially with buyer standards. But you could envision a future in which there's not a sponsor who owns the data, but the individual who does. So privacy, ownership and consent at the individual level with what we now have with encryption and ability to connect different data sources. Centering on those three will likely be the data sharing and your availability of the future, as opposed to ownership by one institution or sponsor.

Whit Rawlinson, Merck (01:25:54):

Yes. Love it.

Laura Westercamp, Accenture (01:25:56):

All right. Well, speaking of sharing, thank you panel for sharing all of your incredible insights and expertise with us for the last hour and a half or so. We only have a few moments left. So, and thank you all for asking questions in the q and a. We'll do our best to go in and answer as many of those as possible with such credible expertise on the phone and so many incredibly important topics to talk through together. You know, I, i just really appreciate the time. Thank you, thank you. Thank you all for joining us. So I will punt it back to Gina who will talk a little bit about what's next.

Jeana Konstantakopoulos, MATTER (01:26:36):

Amazing, well, what a great discussion and I, I think we all have lots to think about and it seems like even more to do. So with that, thanks to the amazing panel today. Thank you to Laura and the Accenture team. And thank you audience for joining us today. A recording of the event will be posted on matter.health Live in the coming days. You can also find us on YouTube. And if you've enjoyed today's program, you might wanna tune in for our next program, the Momentum Final Showcase on June 7th. It will be both in person in the MATTER space and livestream, and we'd love to see you. You can find out more about upcoming events and other programs on our website at matter.health/events. And with that, thank you again. Enjoy the rest of your day and think, continue to think about how we can have a more equitable future.