DIGITAL LEADERSHIP SERIES 2020 - Cristina Duran, Chief Digital Health Officer in R&D for AstraZeneca

Coulter Partners: Please share with us some insights on your role, Cristina and how it fits into AstraZeneca’s overall strategy?

Cristina Duran: Aligned with AstraZeneca’s accelerating innovative science strategic priority, which includes harnessing AI, data science and digital technology, my role is Chief Digital Health Officer in R&D. My team covers Digital Health in R&D for the company’s three therapeutic areas – Oncology; Cardiovascular, Renal and Metabolism; and Respiratory & Immunology – and our approach is from a scientific, evidence-based perspective.

We have three main objectives: The first is to transform how we work in R&D to help accelerate the delivery of new medicines to patients. The pharmaceutical industry has been trailing behind other industries in digital transformation, but we are now significantly accelerating our portfolio. We have made some exciting advances in the past couple of years, enabling teams to design studies more quickly and cost effectively and reducing manual effort by 50% in several areas.

A second priority is to re-define clinical trials to be more patient centric. Virtual visits and collecting data remotely from patients’ homes for instance, make it easier for them to participate in a clinical trial. We were already working to scale this across the entire portfolio before COVID-19, but we have now been able to accelerate the programme and believe that the majority of data will soon be collected remotely, from home or wherever the patient is.

We are also working across all our three therapeutic areas on how to deliver digital health in a more holistic way – not only making incremental improvements in running a clinical study or in treating patients with a drug, but also in continuously supporting and monitoring the patient and their symptoms digitally. By stepping back and looking at their entire journey our aim is to drive improvements across the spectrum – predict, prevent, manage and treat – and achieve better overall health outcomes for patients. For example, monitoring cancer patients at home and not just in hospital means an oncologist can be quickly alerted of any progression or symptoms that may require intervention. Similarly, for asthma or heart disease, alerts can be provided to predict and prevent exacerbation of the condition.

Our third goal is to look beyond the medicine to work with strategic partners in many countries and transform the entire patient journey. Working with healthcare systems like the NHS in the UK on how to treat oncology patients differently and find new ways to diagnose the disease earlier, for example. This will mean we can connect the prediction, prevention, management and treatment of patients into tangible initiatives more quickly, positively disrupting current practice and treatment paths.

CP: What do you see as the differences between a technology company and a life sciences company? Why does this matter?

Cristina: Technology brings a much more consumer-led approach. But consumer developed technology has not been developed with the intent to provide rigorous, evidence-based data and engagement. Physicians and regulators require clinical evidence that a solution can make a difference before it can be approved and then combined into treatment plans. What I’d like to see is a blend between tech and pharma, creating a different model of “Prescription Digital Therapeutics”. This would apply scientific rigour to a clinical study and demonstrate to physicians and regulators the evidence that a software-based solution has the potential to improve a patient’s health. It would be quite different from a digital consumer solution that anyone can download on their smartphone and which are akin to homeopathy, with no scientific evidence.

CP: Are you hiring from other industries such as tech and how do new hires adapt to the culture?

Cristina: We are building cross-functional teams of individuals with backgrounds spanning tech and pharma – small agile teams with a diverse mix of capabilities and skills. Designers that we hire from tech bring both strong design skills and excellent understanding of consumers and behavioural science. They are complemented on the team by people with scientific, pharma and regulatory expertise and work closely with physicians in a therapeutic area. Each cross-functional team focuses on solving a specific problem within a disease and across the team is a magic recipe of competencies, enabling them to work well together.

We recently hired several data scientists from NASA, who had never worked in pharma before and were more used to getting a robot to move on Mars! They soon transferred their data skills and adapted to the cross-functional model. What has worked well, is where each team has a clear aim and problem/ solution focus to collaborate on.

CP: What role does digital play in the patient treatment path? How does this thinking help drive innovation?

Cristina: In other industries such as banking or retail, a focus on customers has always been key to the success of digital transformation. For pharmaceuticals it is the same. We focus on the patient and listen to what they want or need. We put the patient at the centre, listening to feedback on their experience of a clinical trial, for instance – the good and the bad. We are working together with patients and physicians in all our disease areas of focus to clarify the potential health outcomes of different treatment pathways. Listening is critical to finding the right solutions

CP: How new is this thinking?

Cristina: The whole industry is moving in this direction. We started on the path five years ago and following a period of extensive piloting, we are now in a position to scale at pace.

CP: What are the kinds of data that matter most to your business? And what are the most common misconceptions around data in this industry?

Cristina: We start with focusing on identifying the problems we want to solve, and then work out which data and analytics would be required in order to make progress in that area most quickly. We have also made sure we have the future architecture we need to capture the data and are moving into cloud-based systems to achieve very fast turn-around.

The pharma industry has traditionally collected data through clinical studies, but these are relatively small pools of data. Newer continuous data studies are quite different; we have one asthma study conducted over six months, for instance, that has generated ten times more data than all the other clinical trial data at AstraZeneca! What is becoming more important, however, is connecting to federated longitudinal healthcare data. Connectivity of healthcare data around treatments and comorbidities over an extensive period can be much more revealing about the patient journey in a disease.

CP: If you could change one thing in relation to data, that would make a transformational difference for this industry, what would it be?

Cristina: Linking longitudinal healthcare data globally would be the ideal and make the biggest impact. Healthcare data are still very compartmentalised worldwide, genetic profiles differ widely across continents and the lack of electronic records is still a huge problem. Yet a small country like Finland has been able to put together electronic healthcare records that reach back to the 1960s!

We are now seeing pockets of innovation and progress in some countries towards connectivity. As they demonstrate significant improvements in their healthcare systems, their success will generate a wave of others wanting to scale globally. Research from IBM in 2017 concluded that 90% of all the world’s historical data had been collected in the past 2 years! Connecting it all would be fantastic.

CP: What are the most in demand talent profiles in your organisation right now? How are you finding this talent when perhaps the talent pools don’t exist right now?

Cristina: In Digital Health R&D, I guess we are looking for a unicorn! We need unique talent with digital therapeutic experience, together with scientific rigour to generate evidence to achieve regulatory approval. It isn’t easy to find candidates who have had this end-to-end experience in pharma and candidates from tech may have little understanding of regulation. But this is changing as the range of disciplines we use to become more patient centric expand into things like product design and customer/patient engagement.

CP: What are the key softer skills that you prize and how do you assess for these?

Cristina: I look for highly competent people who are also very strong team players. For me, it’s less about their personal achievements than about how well they will work in cross-functional teams, where everyone brings an important component. How will they contribute to the team’s collective passion for problem solving and working at pace? When interviewing candidates, I look for the passion they show in having delivered solutions collectively. In examples of their most proud moments, I want to understand how they have contributed to team success.

CP: Have you seen any benefits from diversity in your cross-functional teams?

Cristina: There is plenty of evidence in all industries that diverse teams perform better. We have a very diverse global team not only in experience, gender, ethnicity and so on but also in our working styles. I have seen the benefits and am passionate about developing teams with a diversity of styles.

CP: How has your recruitment programme progressed in these difficult days of remote hiring and onboarding?

Cristina: We are continuing full speed ahead, within the confines of the new normal. We have continued to recruit and onboard remotely across the globe using the latest digital technologies and feedback from new hires has been very positive.

CP: What are the biggest changes you see happening in healthcare over the next 5-10 years?

Cristina: Over the next few years what I believe will make the biggest impact in healthcare will be advances in the continuous monitoring of patients. The continuous monitoring of symptoms and changes in conditions such as heart disease has the potential to improve efficiencies in disease management. For example, if we can detect people going into acute events like myocardial infarctions earlier and to get alerted of signs earlier, we can intervene sooner, ideally before the damage is irreversible or the risk of secondary events is too great.

For more information please read AstraZeneca’s latest blog via this link: Digital Health R&D

Cristina Duran