Introduction by Tom Rhoads, CEO Spencer Health Solutions (00:03):
This past January, I had the pleasure to speak at the open innovation and health event at the JP Morgan healthcare conference. The event was sponsored by Mount Sinai Innovation, Ogilvy Consulting, and Humble Ventures. Our panel discussed the consumerization of healthcare delivery, which was led by Ritesh Patel, Chief Digital Officer of Health at Ogilvy Consulting. Ritesh is an amazing thought leader in the digital health space and has been kind enough to accept our invitation, to be a guest on our podcast. And frankly provide is timely healthcare insights who could have known than the dramatic changes we’ve experienced over the last six months in healthcare. Simply remarkable. I hope you enjoy this conversation between Ritesh Patel and our senior digital brand manager, Janet Kennedy on the “People Always, Patients Sometimes” podcast.
Janet Kennedy (00:52):
Welcome to people, always patient, sometimes a podcast production of Spencer Health Solutions. Healthcare has come to a crossroads and it’s time to start listening to new ideas. That challenge are always done it that way, thinking we hope you enjoy our conversations with the disruptors, the innovators, and the transformers in clinical trials in healthcare. My name is Janet Kennedy and with me today is Ritesh Patel. He’s the chief digital officer for health at Ogilvy Consulting. Welcome to the podcast, Ritesh.
Ritesh Patel (01:22):
Thank you, Janet. Thanks for having me. I hope you’re having a good morning.
Janet Kennedy (01:26):
Everything is going great here a little bit rainy, but uh, I’m very happy to have that.
Ritesh Patel (01:31):
Janet Kennedy (01:33):
We’ve had a chance to run into each other. A number of times in social also engaging in the digital medicine society, which I find the Slack channel to be very, very engaging, and very full of exciting people wanting to do new things.
Ritesh Patel (01:49):
Yeah. You know, I was funny when, when I first became a member and got invited to be a member of it, I thought, Hmm, that’s an interesting way of engaging with your membership using Slack, but I’ll tell you what you’re absolutely right. It’s a fantastic tool. And a lot of other members or societies should really look at that because the engagement level is fantastic. There’s so many ideas being exchanged, people, helping each other announcements being made. I think it’s a really smart move by the Dime Society to do that. So I’m very impressed.
Janet Kennedy (02:23):
I have used Slack for a couple of other organizations and companies that I’ve been in. And I constantly am surprised when people are like, Oh, just text me. You know, it’s a conversation that just gets lost. It’s very hard to have a group text with anybody and not drive folks crazy. And you are pushed by text, whereas Slack, you can engage with at your own pace and at your own level. So I don’t know why they would prefer that, but I love the way Slack has enabled me for instance, to meet and engage with folks. And in our case to reengage after podcast interview over four years ago.
Ritesh Patel (03:02):
I know. We use Slack as a collaboration tool for Ogilvy Consulting for many years now. With the youngsters that we have coming in from universities, they’re used to that. They’re not used to us old fogies using email and mainly email. So it was interesting for me, and eye-opening society would use it the way that are using it. It’s very well done.
Janet Kennedy (03:26):
Well, I think the other interesting thing about the Digital Medicine Society is you don’t join as your brand or company. You join as a person and everybody in essence is equal because it’s only $50 to join. And it’s an individual membership and you may or may not be speaking on behalf of your company. If you want to innovate, you can come in there and be part of the conversation.
Ritesh Patel (03:47):
Yeah, exactly. Exactly. I love it.
Janet Kennedy (03:50):
Well, let me ask a little bit about Ogilvy Consulting for the folks who don’t mind for the folks who don’t know. Do you mind giving folks a little elevator pitch on what Ogilvy Consulting is?
Ritesh Patel (04:01):
Certainly. About seven years ago, we noticed that the big consulting companies like Accenture and Deloitte are getting into the creative agency space and buying up agencies. I think Accenture Interactive is huge now because they’ve acquired so many interactive digital agencies. And so we, as Ogilvy, with our deep 75-year heritage of advertising decided to get into the consulting world. We wanted to make sure we could claim an area because of the brand Ogilvy to help our clients with. And it’s really around brand customer experience and positioning in this new digital world that you’re living in. So three years ago, it was all about digital transformation. And what we would do is say, well, that’s all good. You’re transforming your business, but how does your brand fit into that? How are customers experiencing your brand or your products or your service in that digital world, you may be transforming internally, but there is an impact that it has on the revenue that’s being generated.
Ritesh Patel (05:02):
So that’s what we focus on. We have a, quite a large group of folks around the world 400 or so that do that for big brands, as well as healthcare where I sort of read on the digital health practice is what can we do from that perspective if you’re a pharma company or a health system or a payer or a medical device company, we’re doing a lot of work in that area that way.
Janet Kennedy (05:26):
And I understand that the work you do is also very collaborative. It isn’t Ogilvy coming in to do strategy and we’ll do all these other pieces for you. What you’re actually doing is basically “cat herding”.
Ritesh Patel (05:39):
You know, a lot of the times one client we’re working with a global pharma company where we’re creating a digital business framework, et cetera. We then work with, you know, I think they have you name it. They have McKinsey in there, Cognizant in there, Wipro in there, Accenture in there 80 in there. And then on the agency side, they have 13 different agencies they work with. And we’re the Switzerland in the middle of that basically works with the business units to create all these things. And then we educate the agencies and the partners to say, this is how we need to operationalize this. So we’re very much focused on what is that you’re trying to achieve, how will it get achieved? And then who are the players we can help you get there. And that’s not necessarily Ogilvy on the sign.
Janet Kennedy (06:25):
I’m curious about brand with a pharma company because some people may know a drug name better than they know the pharma company when drugs are being designed. And they’re going through the naming process and the logo design process. Do they take a lead from the corporate branding or did they view each of these drugs as independent brands?
Ritesh Patel (06:47):
Well, I don’t know if you know, it’s a little secret here in the US that there’s only two companies that have the market for naming drugs, that they split between them 50/50, and it’s all around the product. It’s never around the parents. It’s never around, it’s Pfizer products or Novartis products or a Merck product. It’s all around the molecule and the medicine. And there’s some taxonomy that’s been created as a gentleman’s agreement between the two organizations that they adhere to and the scientists adhere to. But, you know, I think Inventive owned one of those companies back when I used to work for Inventive that did that naming and they actually, they were based in Raleigh. Actually, if I’m not mistaken, I have to look them up. Now my brain is as melted around all that, but I think most cases, they look at it from the product, never the parents.
Janet Kennedy (07:38):
That is absolutely fascinating. And I learned my something new today. So I definitely want to find out more about that. That’s awesome. Well, I know one of the things Ogilvy Consulting has been doing is some big thought leadership programs from an in-person program at the JP Morgan pre event, where my CEO, Tom Rhodes, was able to participate to a whole series of webinars that you’ve been doing. Tell me a little bit about how you go about selecting what you’re going to be talking about and what are you getting out of these webinars,
Ritesh Patel (08:12):
I’ll take those industries. So the first one is sort of how do we select based on what’s happening. There’s not a sort of a global annual content calendar we create. It really is around what is the interest in? And do we have enough thought leader capability or partners or people we know we can reach out to, to pull that together? And so recently you’ve seen an uptake on the webinar simply because we’re seeing a huge amount of interest from our clients on the topics that we’ve covered so far. The first one we did was around the open data walls. You know, CMS announced the open data rules and interoperability rules that people like Epic were fighting for a bit and the President signed them into law not too long ago. So there was a huge amount of interest from a lot of our clients. What does that do for me? And what’s the impact on my business? We thought it’d be good to bring some people together who knew about that stuff so they can get into the nitty-gritty of it a little bit. So that was then, and similarly, the next one was around virtual trials, huge amounts of interest in virtual decentralized trials because clinical trials have come to a bit of a grinding halt since the pandemic. And so what can we do? I was getting frustrated because I was attending a number of these, whether it was all about the technologies, it really wasn’t about how do you do this and what are the pitfalls like, really, if you’re going to go do this, it’s not just a matter of putting some remote patient monitoring tools in the patient’s hands and digitizing the investigator. There’s a huge amount of change that has to occur. So we brought some people together who are doing that at the cliff face, like Moe, from Boehringer and Craig Lipset from Pfizer, or formally from Pfizer to impart their knowledge about what you need to think about. If you’re going to go down this route. And the same thing, patient centricity, we’ve been hearing the worst patient centricity from our healthcare pharma clients for 10 years. Now, everybody says the words, but what really does it mean? And how are you going to actually make it happen? And with the pandemic, everybody’s even amplified the patient-centricity verbiage, but nobody’s really doing anything about it by things like, including patients in the trial design or including patients and figuring out how you can engage in a trial or how you discover a trial, or what do you do if you want to enroll in one or whatever. The rare disease community has figured it out a little bit, but in general, they haven’t.
Ritesh Patel (10:41):
So we said, you know what? Let’s bring some people together around that. So that’s how we sort of have been putting them together this year. And then on the, on the popup side, it really is around innovation. We wanted to, one of the biggest issues I have is when I call people to see how, if I can help the word Ogilvy qualitate in their mind an ad agency, we really needed to reposition Ogilvy Consulting in the marketplace, particularly within the healthcare environment, as the consulting organization that can help you think through these hard problems from a digital perspective. So that’s how we started doing those innovation popups. And it’s really around positioning, Ogilvy Consulting as the guys to come to. If you’re really thinking about some of these challenging things, we can certainly help you there.
Janet Kennedy (11:25):
Well, I definitely think that Coronavirus has accelerated a lot of conversations regarding decentralized trials. And I’m curious to know in hosting all of these webinars and having a chance to listen to all of these thought leaders, do you think digital health and innovation are really going to change clinical trials?
Ritesh Patel (11:47):
Yes. With a caveat, the caveat is how do you get the IRB on board? Because they are a gatekeeper and increasingly the ones that say no to most of these things. Number one, number two is how are you convincing the sponsors who are led primarily by the CRO to do this as well because the CROs have a view and a difference of opinion on how things need to be done because there’s revenue involved there, right? You always have to look at the money, follow the money. Here’s why I think it’ll change. The pandemic has forced a fundamental change in the way we consume healthcare anyway. In a recent study from cancer, 70% of the doctors that they interviewed, I think it was about three, 400 of them in the US see 30 to 50% of their practice being completely telehealth after the pandemic is over.
Ritesh Patel (12:43):
So what has been adopted as a way of working in the interim is becoming normal going forward. And if that’s the case, then I’m going to start looking at other ways that I can apply this technology and these ways of working into what I do. And so a lot of these doctors are also primary investigators. So they’re going to start asking, well, hell if I can see a patient using telehealth, why can’t I see a patient on a clinical trial using the same technologies. And I’m already starting to hear some of those rumblings from a few investigators that we’re working with. So I think this force digital for the pandemic is going to change and create new norms that a percentage of the population will expect. And therefore that will drive the innovation within clinical trials.
Janet Kennedy (13:32):
I think that’s an interesting point because you were talking about innovation at the convenience of the investigator. And I think one of the things that the patients have been saying all along, but with Coronavirus, they can finally say, ‘no, I’m not leaving my house. You have to figure out how to get to me if you want me to participate’. So I think we’ve seen a sea change in that patients were requesting asking demanding, but they were just a smaller part of the equation. And now we have clinical trials with no patients because people won’t come here. I’ve got to figure out how to accommodate them.
Ritesh Patel (14:10):
And the sponsors have to, right. We are talking about billions of dollars at stake here. So if an investigator, if she uses to do it, it’s incumbent on the CRO or the sponsor, or whoever’s running that tries to figure out a way to either change the investigation or figure out a way to give the investigator the tools and the capabilities to do all of these technologies that we’re talking about now have been around for five years. The pandemic has forced the use of them. And I think that’s the biggest thing here. That’s the mindset change and it personalizes the box suffocation of our lives. You know, there are taboo subjects that never were spoken about. I remember working on Cialis in 2012, I think. And you know, it was the, what they call the doorknob conversation that the man had with the call with the doctor. Oh, by the way, I’ve got a little problem as they’re leaving the office along comes hymns and Romans, and now it’s perfectly acceptable to go to a website, talk to a doctor via video, get a prescription. And it arrives in a box every three weeks. So these new norms, and now that we’ve gone through pandemic and we’re used to having Instacart deliver our food to us Uber deliver our takeout to Doordash and GrubHub doing the same thing, Amazon doing the same thing, Hey, this stuff actually works. I press a button and things are over at my door. So why can’t I apply it to healthcare?
Janet Kennedy (15:37):
That makes so much sense. Well, I’m curious where you think if you wanted to make impact and get your innovation into a clinical trial, would you be talking to pharma people or would you be really working the CRO route?
Ritesh Patel (15:53):
It’s an ecosystem, I think. The sponsors have a responsibility to make sure that the trial is successful, obviously because there’s revenue at the end of it or bring you a new product to market, right? A lot of us struggling because their business model is not conducive to the new world that we’re living in the business model was an army of people managing this thing for you, making sure the CRS were trained, making sure the investigators were set up when the site was done. Even the feasibility study work, right? There’s enough data out there today that you can create a dashboard around, say, you’re doing a trial for a new diabetes thing. You can take the care set data, which is five years or eight years up to date have Medicare or Medicaid data overlay with IQVIA data and some other data. And you can find the referral patterns between hospitals and the investigators within those areas.
Ritesh Patel (16:46):
And also the patient population within a two-mile radius of that facility. You don’t need an army of people going around doing that. Feasibility has to change as well. So there are processes that are embedded in the CRO, particularly the bigger ones, that need to change as well. And then the third area is around the investigators and the IRB. The IRB is particularly the one. Those independent review boards. It depends on the digital acumen of the person reviewing. We all proposal as to whether you’re going to get it done or not. So really need to educate those people and engage with them and show them that the EKG that’s handheld, that the patient is using that’s FDA approved device is as good as the patient going into the office and having a nurse do the EKG.
Janet Kennedy (17:36):
Now, the other thing too is the ability to get the information much more frequently. If your patients are having to come in every week, well, that’s a huge burden for the patient. If you were only seeing the patient once a month, that’s a long time between datasets. If you’re not gathering information digitally.
Ritesh Patel (17:52):
I believe there are certain trials where you can do this completely remotely today, where you have the ability for a patient to use a device in their home to be able to report data. And it’s not the eCOA, forget the eCOA is actually real data, right? So the EKG, for example, the cardio mobile product from AliveCor is a six and a 12 lead as good as any EKG you will find in any academic center. So I think the lower end product is on sale for $89, right in Walmart. So you can get an $89 product as a sponsor, give it to a patient and you can collect the data on a daily basis. You can do it on an hourly basis if you wanted, and then have the patient come in once a month, you can do the same thing with a bunch of other toolsets.
Ritesh Patel (18:40):
Now, Propeller just got approved for the AstraZeneca. I think it’s AstraZeneca is an inhaler product, where they are now going to collect the data for every squeeze of that inhaler for the patient. So why can’t we apply that to a COPD trial? Right? So I think there are some places where we have to sit through and things that journey through and say, where’s the application of data collection or connectivity with the patient. And then instead of saying, I’ll get you an Uber because you don’t have a car or we’ll figure out a way to pay for your journey on public transport. Well, his $89 kit go do it yourself and we’ll collect it every morning and every evening as you use it.
Janet Kennedy (19:22):
Just a really relatively easy solution that pays for itself in a minimal amount of time. When you just add up the Uber trips or the however else, things are being funded.
Ritesh Patel (19:33):
It’s not that hard to find the money for something like this. I mean, look, what is the cost of a trial these days? Do you have any idea, roughly? Do you take a product like a COPD product, right? The trials gotta be at least a couple of hundred million dollars by the time you’re done. Right? So if you’re going to get 10,000 patients times, 200 bucks, not that much money for the trial to be successful, the problem is the collectors of the endpoint data. It’s like researchers in an agency, the researchers in an ad agency, I used to using four tools. If you come across and say, here’s a new digital tool that can give you 600 mums at scale on an app that can tell you instantly within 10 minutes, what they think of your product, they’re looking at you like you’re from Mars. It’s not possible. It’s not research. It’s not statistically viable. Who’s going to do the tabulations, how aren’t going to know, which is… All of the questions come up with the traditional way of doing things. And we have the same issue with the people who manage the endpoints of the data collection. A lot of them say, well, you know, the investigator nurse didn’t actually check it. How do we know it was not them, really, could they give it to their child in the house? All of those things come up.
Janet Kennedy (20:50):
Absolutely. Well, I think we’re going to have a conversation that’s going to happen multiple times over the coming months and years regarding digital health innovation and clinical trials because it is, I hope as exciting for those folks in pharma, as it is for those of us working with pharma, there are so many opportunities to do a better and more efficient and more cost-efficient job in clinical trials. By engaging with digital health.
Ritesh Patel (21:20):
I’m even more optimistic because I’ve seen how R&D has embraced AI already for discovery. And I think that step has been taken and the culture within the sponsors to use AI and AI capabilities for drug discovery will bleed over into trials fairly quickly I think.
Janet Kennedy (21:40):
Awesome. Well, Ritesh, I cannot thank you enough for being a guest on People Always, Patients Sometimes it is always a pleasure to talk to you. And I think this is a conversation we should have on a regular basis because the innovation that’s going on in pharma and in healthcare is one that’s literally changing every day.