Innovation's Role in the Global Pandemic

The world has seen the pace of healthcare innovation accelerate at a tremendous rate. If you ever wanted to get a  "behind the scenes" view of this pandemic, stay tuned! Mike J. Walker speaks to Tierney Morgan, Health and Life Sciences Industry Advocate with  Microsoft about the the vaccine landscape, the hurdles that needed to be overcome, and practical wisdom on how to effectively innovate in this industry.


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Transcript

Hello everybody and welcome back to another episode of The Next. I am your host Mike Walker. And today we have the pleasure of talking with Tierney Morgan. She is an industry advocate for the worldwide Healthcare team at Microsoft. And you might be wondering what the heck is industry Advocate will essentially an industry Advocate is someone we bring from the industry and expert in these specific business aspects in this case health and Life Sciences in to Microsoft to help that are connected Technology Innovation with actual customer concerns. So its going to be a super cool episode and super timeline like with all episodes all the show notes links all that great stuff. Youll find on v-necks pod.com. Thats a v-neck. Com. Alright guys, lets get into it. Gary welcome to the podcast my pleasure. So Im super excited to have you on for many reasons one, you know, we work together and you are really cool gal. But to youre doing some really awesome stuff in the health and life science space and I want to have you on and talk about all the cool things that youre doing. Are you gay Oh absolutely. Myself will talk about what a lot of us. Do you know as well as I do so itd be good to understand a little bit about you, you know your role at Microsoft and maybe a little bit about how you got here. So my role at Microsoft currently is something that is called an industry advocate. So its specific to Microsofts motion to really get close to each industry and understand it from the inside out. So prior to joining Microsoft. Ive only been here for a couple years. I spent over a decade in the pharmaceutical industry and I did work there of course in sales sales leadership some operations and tiny bit of supply chain with some projects before I left but how I got here really was more traditional Microsoft hired at a business school. I had friends in Microsoft and married a Californian. So its always wonderful to be in technology when you love California and California is in general, but my work most of the time was in what part of the country you move a lot with Pharmaceuticals really to come to understand a different parts of industry, but I was Tri-State in Manhattan so I can Microsoft brought me back to California with my family is so grateful for and tell me we were really quickly back into health and help us for two nights a week right now all of us our whole team. Theres a theres a group of us that have been built over the last eighteen months or so and health and we really operate as an advocate or really like most for the customer in the Microsoft Microsoft understand what helps with dealing with life sciences in dealing with also to help a customer understand and different kinds of different digital twins, which is a huge win for our luck. You know, lets not groom people within the Technology field, but lets actually go and get people that have lived and breathed this particular industry. Yeah. Yeah, we joke around a lot that were translators for for both sides right understand what what the customers dealing with and vice-versa understand how this has been a year where everybodys ready to talk. Its its its its a good yet the Catalyst, you know, I will get into more of a specifically some of the things that youre working on. But in general when we talked about this rapid acceleration of adoption of digital, what do you think were some of the key Catalyst for that rapid adoption? You working from home with was one of the few things. How does he care and to protect everyone at the same time? So doctors needed protection, right? Especially doctors that were largely clinicians right-to-work hospitalist to protect Frontline workers right to minimize their exposures, but in that they found found all sorts of efficiencies. So for example, one of our major Partners, hes out of here on the West Coast of major health system. They went from a for Telehealth like within a clinic to doing over 400,000 a day really is not 20% more V forty 50% of their work can be done in perpetuity. Right that doesnt have to end with covid. Theyve been able to do multiple calls a day and interesting even though its more work. Write an actual productivity for these physician. Its less strain on the position because some of these positions when you think about Southern California, they were commuting in an hour right from the Inland Empire to come an hour out but they were having a scene 15-minute conversations with patients. And so now theyre really being able to figure out what appointments need to be in person what appointments dont need to be in person and you can continue on with those two clinical routes regardless, and so, you know these doctors in some situations are asking for two days work from home a week like the rest of us, right and theres no reason to not do it because as of right now and theyre me and my daughter having a thought about it, you know, I cant wait for the waiting room to be on the endangered species list because you know, I dont ever want to go back to You know a real life Purgatory again, you know, its not a fun place to be and youre right. Its just so inefficient and you know much more convenient think the quality of healthcare would go up even more. Especially as we you would mention IRT and digital twins things along those lines and makes you think about, you know, having you know these Technologies, you know, within our own, you know, Ive got, you know, one of these, you know, Ive got, you know all sorts of different Diagnostics hear that my doctor could see in real-time there could be alerting so I dont have to have an appointment necessarily there could be. Oh, well, Im noticing theres these weird patterns on Mike. Its in between our 6 month or yearly visits. Maybe we should seem like for these things cuz its Hearts doing something weird or blood pressure is weird or whatever. It may be. Yeah, absolutely that the kind of work that youre talking about a remote monitoring a patient, right? Especially when you thinking about you thinking of patients at night be recovering it ideally but the doctor needs to do some kind of stuck in you is difficult to put that on a caretaker. Its difficult to put that on the patients themselves when they are recovering to do that kind of reporting but especially if a patient like think about depressed you dont want to have that be sent exposed to write to people in the waiting room like oftentimes hospitals are generally, you know, how dense areas, right? So the more that you can let a patient recover in there in a friendly comfortable environment the better so you point out when were thinking about efficiencies in healthcare the doctors and the people that work with a healthcare want it just as much as a patient at greatest thing that Ive seen Microsoft do over the last couple years has helped these doctors really understand that technology right now for then feels like a like a barrier between them and efficient and clinicians often are speaking about not because they now because they love disease but because they let humans right and they are looking for ways that technology can become a support system for the right. And so that is really the true Brass Ring that that everyone is going for like ambient intelligence. You know, your pasta is monitoring and the things that youre talking about OB fantastic writing to be able to read a patients needs while theyre happening real-time to be able to suggest things that are indicative of that patient patient Focus that is similar to a customer so, you know consumer but but themselves and and the can I write that is in need of a need to support and so we always When were said you know, its hard not to be as I see I hear most husbands are but its like, you know, just give me a you know, a tank full of Nyquil knock knock knocking my butt out get me a doctors appointment and you lets get this going. Yeah. Yeah. I I am not a good person either and I will speak for my husband sides, but dont worry youre not alone and Ive been really excited about this over the past couple years as this has become more popular that the reactive Healthcare so, you know, the greatest example that you know, we can can a joke around about is like a Life Alert, you know the fallen and I cant get up button right but now, you know, you got Technologies wearable technologies that detect if youve fallen over, And you dont have to press a button and you dont have to call 911 if it doesnt on your behalf, and so thats whats really exciting is not the reactive form or another form of the medical technology. But the proactive one that is, you know, acting either on our behalf. If theres an emergency being one extreme case, but also on the other side, you know doing that monitoring is you and giving you interesting analytics. So you as you know yourself not just your doctor but yourself can make really well-informed decisions on a previous episode you do I talk to someone in retail and we talked about a story about how you know, if he would see kind of the sustainability metrics on his groceries when hes at the grocery store that that would significantly change his his purchasing habits as a result and I think you know, thats an ugly. So so with all this stuff going on and youre an advocate so I may be less double-click on a little bit about what that means. Theres because because this is a big space right if you focus on all the health and Life Sciences you folks on specific areas, you know what your area that is your focus focus on her background background specifically is in biopharmaceuticals do in vaccines and its quite a year to have that kind of expertise. So I do get it. I get it pulled in for a lot of acting conversations, whether it be around manufacturing efficiency. Will there be around Rd and Drug development or most recently and so are all of those you know, when you think about this last year theres been this is the conversation I had with with everybody from my doctors like people. How you do that and theres been three major hurdle right with vaccines and weve cleared two of them this year. We cleared the first steam. Can you make a vaccine that quickly write each other pride in my former firm in end of folks there if they work with that they did what they did this year. Its at the true Testament to their capabilities directly here to UPS. Thank you for joining the cold chain supply people you have made a big difference this year. We wouldnt have been able to get and we will not be able to continue to distribute the way that we do and then this last bit, of course, this is the actual human process, you know, the operations of how do you get it from the refrigerators to the arms efficiently. How do we get to people in line? How do they know where they stand in line? How do we get enough people are standing light at that is that at the final hurdle? Youre in that is always like the long tail problem. And so spending most of my time. And Im doing that whether its directly with the customer right in and what what Microsoft will have us do is theyll actually take somebody like me into a sinus to one or two ferns with him and they want to do these kind of car did Prince write for I have a background in health but also in strategy and so Ill sit down with their leaders and dig in really deep and go what is 10 years from now. What do you want us to look like 5 years from now? What do you want to look? Like? Lets lets lets dream together. Lets build out a few ideas. And then well all will take that. You know, all of the notes from one of the strategist will sit down with us somebody like on April 13th that we worked with you and I and they will actually knocked out right? Ill Im listening and Im facilitating and pulling pulling his ideas out. Theyll knock it out. Ill help slotted into a strategy for there is something the executives on Hillside Wonder stand right terminology. Thats what we often. Do. I create a two-sided plan together right is so what? How do with the customer is Ill go with them to their leaders and go. Okay. So heres what they want to do for you. Helping able really to Microsoft doesnt do that for anybody. Right? They do it themselves. And and you know, we are there to support so thats awesome what were doing and we dont really successful the last the last year but some sort of her stuff for our longer-term. Like this is the one that this was decided. I was telling you about this before but Ill tell you again this week and theres big goals of immunizing, you know, I believe the numbers are like a lot of the government entities going to be Health Systems and saying can you scale up can your electronic health records record and immunize this many patients in this number of days will most Instances meaning the electronic health records can only handle so many people touching the same record or touching the system at any given time because most of them are still in ASL servers on premises in data centers that are owned by the health system in Coastal Health System will cloud computing allows for that Hardware to really be taken off the table and a sense of the scaling issue. And so there was a major health system that reached out to us and they were dealing with one of these problems and said we got to try to go from maybe doing a couple hundred instances per day with this with this Legacy electronic health record system that they had we need to a hundred thousand in it in a second and they can maybe do a couple hundred at the moment. Well, they had gotten estimates internally In from from her other friends that I want to take you 3 years to take this Legacy system and turn it into something and the problems now we did what we do in the customer said we want to do this on the crown. Are AR-15s architect home and came in and said absolutely you can do it put myself in a few other people on a team together and we executed in 3 weeks what they thought would take four years and they can do so this is the kind of thing that when youre sitting in line is a pecan doesnt sound like but when youre sitting there waiting in line to get me nice and you think its going to be terrible because the News tells you its going to be terrible and then you go and you just breathe through in your life. Hey, man. Thats an example of Technology enabling you to actually have a good patient experience. Right? So theres no glory in it. Because you know, its its like when it works really well, its Unforgettable experience and I think people sometimes I think were all guilty of this, you know, we kind of take for granted a bit that we dont see a lot of what goes on in the background. Its a bit of a black box, you know before you pull up to your doctors office a pharmacy or you know, what have you you dont know everything that those first two steps that you talked about. Most people dont think about that and you know, Im not an expert in this field, but you know, some of the things that I would tell friends and relatives that would Express frustration is, you know, I would just have to say to them, you know luck, you know, you have to think through that, you know, youve got someone making something for the first time. Youre not getting one shot two shot. So think of everythings been doubled and its not just the shot if the needles its the the wipes to the sanitize. Its its the dissonant that its all the things that go around. It has been talking about the fact that that might be the new mask shortage, right? So theres so much to think about it if it works. Well, this is when it doesnt work is going on right now. I think about an average flu year, right and if you get a flu shot, if you dont you dont thats fine. But but most most of the time thats one of the biggest in the hospital system makes something we talked about every year right so that year typical year. Theres about seventy million doses that would go out of us three months from September to November globally. They would Indian eyes or excuse all this talking to 3% of the US population well to get to herd immunity, which is what were aiming for right now. You need 85% of the population to be nice if theres no QR code for that right? You can say I got it. So so we really have to immunize people. Thats the only way we can Billy track them. Well, thats three acts of what we got to do. In one year right that we normally will. Do you know Bible it voluntarily and its still challenge. Its like we never had a perfect supply chain year with flu because its always happening during winter season Ramos if it was manufactured in the Northeast which is prone to large winter storm like the one were dealing with this week. So thats what this means is that operationally there was really not a lot of ways to prepare for this week been on board for a panda. Preparedness in my old industry multiple times and you can prepare prepare prepare, but then you dont realize that your EHR system can handle that many instances at once youre in the moment. This is tested every supply chain out there regardless of health or for a while and couldnt get flour baking bread. We have thats what global scale means and were learning from it. Were letting from it and people that are doing the things like this looks that we were working with this past week those changes will those changes will persist if not something that I think Lee will go away. Its not like youre going to spend up. Turn the cloud and take it back down and lose all that sad about getting the vaccine to be able to track now. I was wondering if you were working with Bill Gates to put those nasty little tractors in people as they were getting vaccinated. Im just kidding. I can throw the conspiracy theories are real quick at you and the nurses were like, hahaha. Getting your daughter and so darn it will have to do it ourselves. But that that you are coating Wrightwood more. So beyond Terry be allowable for our theres no reason theories work thats being done more. So from the government perspective as well as the private sector should you be able to say hey when we want to start opening up a site for Im more workers with opening up a site from people visiting from other firms. What is a sustainable Universal way that we could say that this person is immune right and have to be a verifiable for once you get your vaccination. And so thats something he talks about. How did Lee and that is across multiple. Your Microsoft is not meeting that but we are actually participating or not and you know, ideally the best way that it could be done right? Cuz if Vaccine industry pharmaceutical industry distribution industry. Everybody needs to be able to travel right they all need to be able to say can we safely go back to that then? How can we do that forces, you know some of the flying and things are happening our people getting tested ahead of time but being able to have it be verifiable repeatable. Its challenging right? You have to get a lot of people talking to each other but never really talked to each other before we write for someone you like me like like my body is not a stranger to vaccinations. I mean you you probably are a global traveler just as I am and having your handy-dandy trustee yellow card with you at all times with your passport. Do you think that you know, these kind of help passports are going to be something thats going to be required in society going forward because obviously this isnt necessarily going away. We see variance to this and who knows what Thatll mean I mean, Im not you dont have a crystal ball. I dont think anybody does but we know that at least with this case of you know, the covid-19 bit. We got lucky and a lot of regard that it wasnt as bad as lethal excetera. But do you think that this is going to be behaviors changing and that as a society were going to have to be more conscious of vaccinations then weve been in the past. Great question will come from infection naturally, right or from immunization. So, you know which which would be which would be an artificial or whatever youd like to refer to it. That will happen regardless. So you do this kind of global pandemic happens every hundred years. If you think back to your 1918 is the politics are really similar to the politics be dealt with with this time. But since then very effective since then we still dont have a culture at least in the US where knocking during flu season is standard Behavior, right? So I will always repeat for you what Ive often repeat for a lot of my friends and family is that the most successful mitigation to take Autumn Breeze apathy meaning we probably will go back to status quo of some sort of people dont like to wear masks. Theyll probably go back to not wearing masks when theyre able to do so, but effectively covid-19 you take the flu has mutated and 35,000 people die from the flu every single year last year. Im over 50,000 people. It will continue to be a risk for as long as it is a risk because it is its own organism that wants to live and breed and propagate right? Thats why its so the good news is that we have vaccines navigation tactics that can address that at the very least. I hope that people will just dont go to work sick anymore. You think Im trying to get healthy and then you come there and you can people deny a flu vaccine. Im always surprised because its like getting the flu even though it doesnt kill you. You feel like you got hit by a Mack truck. Really remember getting the flu and I was ever going to my doctor shivering with like a hundred and five degree fever and shes obviously Im pro-vaccine but people will make her own choices and theyre allowed to do that. Like everyone has the right to risk their lives. We dont have the right important to risk other people will probably if itll be really people saying what what is that mean? What does that rest meaning of a good conversation for us to have probably but I do anticipate that theyll be some well-earned apathy in probably a decade or so and the younger generation will remember that we are because theyll understand the treatments. Nathan Bill an alternative Yeah makes make makes a ton of sense. And I think that were all human beings and were creatures of habit. Also. Another thing thats going against us is were social animals, right? You know, and so its actually and the majority of our communication is nonverbal. And so you dont all these cues. I mean if Im covering up half my face, I mean you dont know if Im smiling am I happy or am I give you my angry face? So, you know, whats whats going on here. So I think you know what youre writing a lot of ways. Theyre outside of the behavioral side in the societal side. If youre okay with that she would mention three key pillars you youd mentioned the vaccine peace in the development and R&D you had mentioned. Okay. Well how to hack the Wii Distributors around the world in the leg? Supply chain and what that looks like in the third piece you talk about the Last Mile and actually putting needles in arms. So with the first piece, Im curious, you know, you know, this is the first time weve been able to develop a vaccine this quickly what Innovations did it require for us to do this? Thats a great question and it you know not having been deep within it like like prior. I cant speak to the specifics but just as orchestration, but they did we have created before anyone seen that was developed when they are 15 years ago. If you were still think they can develop vaccines relatively quickly. The challenge of course sometimes is isolating are the strain and then of course the testing of it but often times for example with flu vaccine, theyll often times using the same growth become hummus and protein compound right in there in the WHL identify a strain by their epidemiologist make recommendations for those trains every year. Actually using the same protein has been tested to the safe and effective and then they just have to ensure that that that Viral compound writer that attenuated virus RNA can actually understand this is what we talked about a lot. So so that data is that is really common and so knowing that these firms have that kind of background available to them and that is what strength of human trait that is what made this happen is that humans team together and they said that typically do not collaborate together together and said my old firm on sanofi Pasteur. I love you. Is he collaborated with one of her biggest competitors? Bright globally, we need that kind of collaboration and so weak. Nobody can do this alone. And that is thats what really had to happen from the get-go and you know, the scientist really had to say, lets prioritize this one area, right so they had to take manufacturing lines and pull it over. But when some of the things that they did that was really exemplary to develop the kind of logistics that they did for this and this is something that you know to me is the Is that you take a keystone to what the manufacturing firms can continue to do if they start to look at look at digital twin right side efficiency maximized development or manufacturing of the vaccine. So for example, like sometimes when you know, theyre doing a specific R&D to keep these trials going see what actually have to use the same line to manufacture the dead vaccine that they were doing physical tile for commercial use you got protein, they have to do we pay or take all sorts of things. It is truly math. Tuna, sounding level that humans cant do from an operational perspective, but when you can build a virtual Manufacturing facility and you can run different kind of operational instant isnt identify where your bottlenecks will be ahead of time. It changes everything. Right and we have lived through year after year after year of supply chain challenges because sometimes its like how do you update and keep the commercial demand because Biologicals are on a similar product and it has a limited shelf-life, right? So you only want to manufacture they cant just sit around right? So so this is some of the things that we know the major firms dead, but the biggest thing they did is collaborate and they started to ask what are we not looking at, you know what and and the cats to their They talk to their guns about the fact that science comes first, right? It wasnt about it wasnt just about seed. It wasnt just about safety with Chino safety is critical right arm somebody to protect them but they really did look at how can we help each other and how can we think through the problem faster and Route when when we were in Industry, I remember one of my leaders talking about distribution challenging distribution was and they were thinking like about the bottleneck that was literally created at the loading. How do you get that many vaccines from the direct manufacturer? And and how do you track it from the dock to the truck pulled they solved that problem this year by scaling but they also did it by actually asking the people who work in logistics front of shipping firms to come onto the dock because guess who understand Logistics better than anybody What their dispatch Transporters write-ups they did they did and thats one of the things that we heard Im directly about and then you know, one of these firms actually ended up manufacturing write this is going to be cold. Were going to build facilities ahead of time and they collaborated directly and operation buddy talking to each other but leaning on people for their real competencies right not just on this vertical integration kudos to everybody out there that does braids at the wonderful cost-effective model, but it doesnt allow for really sharing of ideas and like compounded with the ideas and thats what happened this year. Its its a its its just coming back to people caring for each other around the development of vaccine. You would mention some some some key. Essence was collaboration. And you know talking breaking down those barriers that were there before right wrong or indifferent units and leveraging Technology like iot to create simulations, you know with digital twin technology simulations and modeling of environments doing what if scenarios all that great stuff to come to understand the unknown a bit more scenario plan. Im sure that your pepper in a bit of artificial intelligence in there to do some some yo probabilistic analysis, but also, you know some of the more French Technologies, you know Technologies like Quantum Computing is talked about quite a bit in this particular field. Did you hear or experiment with Quantum Computing in the space at all? Not yet. Not personally, right, but of course, its a its a consistent discussion. So some of the stuff that you brought up around. Predictive Analytics right on predictive maintenance like those are you feeling charitable now and those are the kinds of things that theyre doing an addition to Digital Trends to figure out not only how can we maximize capacity on a line or on a site? How can we actually figure out when somethings going to go wrong and get ahead of right plan for that late. Downtime? And so things are still achievable right now and it would really prevent some of the pipeline issues that weve seen your task speaking from experience. Multiple Flagship product go down for create create actually some of these diseases research it, you know, especially in Pediatrics. So those are preventable now and achievable and and the great news is that the industry knows it and so they are they want to understand. Why do that now Quantum Computing near-term, right? But with these huge of mathematical problems thinking along the levels of Talk a little bit about using using mobile device to monitor patient. What if you could go to the next level and actually have clinical decision support for the physician themselves meaning you understand all these metrics about a patient. You understand to societally these these metrics typically would you do quantum computers could identify Trends within a certification population and they could identify with in a patients chart? What would that would that make it with any kind of likelihood? See you looking at the what is a doctor can look at you and you you with all good intensive purposes. Well talk to your doctor about what youre feeling and thinking at the time but weve all gone on WebMD in your life that you give him your five things and it says, you know, theres five things are in one was always cancer right thinking like, you know, is this is this Adam Oller this cancer working with a doctor, of course, theres the clinician and are there to diagnose and we need a human being there to make those those Judgement call Sandpoint lay hands on people and really seeing and feeling disgust but there are things that are always omitting and and no human whether its the human recording the patient or the human that diagnosing can read every single thing in a chart and synthesize it quickly enough in a 15-minute turn around and clinical decision support or Worse deciding when you were talking about social determinants of Health, right and could you for example raise up within a community knowing theres certain communities that are going to have environmental exposures are certain communities. Are there certain communities that are more affected for tracking all of that and have social intervention support along with your charts. The Doctor Who do you live in this neighborhood is neighborhoods been affected by radon in the ground and youre silly sentence. Maybe its not maybe its not an upset stomach. Maybe you actually have Freon poisoning. You know, thats something were all kind of computational effort, especially with a well-trained algorithm and a machine-learning overlay. Its achievable Health Systems, but also with pharmaceutical firms to think through as theyre doing their own research. Could they be identifying these things looking at Coast marketing research right as theyre sharing any kind of Adverse Events and identify these things ahead of time and figure out o will this avoid Adverse Events in these present population through Predictive Analytics. What I thought you were going to say was youre going to go all Elon Musk on me and start talking about putting chips in people, but we wont go there but I do. Is a fascinating place and just the amount of Technology thats been developed over the past five years, you know, weve been talking about this stuff for 20 years, but over the past 5 years, its just exploded and you know crazy sci-fi stuff like brain computer interface and those sorts of things as you know, just crazy sci-fi stuff, but thats for another day. But for today see I get distracted to see if you had you notice if a DeLorean showed up in your driveway special package by Doc Brown and you could go back in time. So, you know to the beginning of the whole pandemic and ask people were doing the R&D around the vaccine and trying to figure out how to deal with it. What do you think based on your experience based on which you know from a word from a technology prefer? Youre right, and were not judging anyone company on what they did right a wrong. But essentially what would have been extremely valuable to look at from a Technology Innovation perspective. If you could go back in time some of those kind of lessons learned that makes sense utilized yet is getting a cold. Seen out. They did prioritize it correctly and you know critical they they be tall as miss all timelines that anybody put out there right including their own. However, what date was strong what suffering from that is all the other clinical trials right for two reasons why you were so critical Trousdale long gated and which is the most expensive thing about a drug development actually is is the clinical trials themselves right as managing this medical trials and then I got a long day did some of them work were dismissed and the patient interactions. They couldnt figure out how to do some of the basic modern workplace interactions for these clinical trials. Im going to heat up get them started to recruit patience to keep patients coming to follow up with patient. All of that is available through basic Telehealth tools and basic basic. Collaboration for today all these firms need to do in pharmaceutical boys and talking to you is if you really just need to take advantage of the same model replace wheel that youve been using all through this year and a client to the clinical workspace these platforms exist. Now where you can get all of the documents that you need red identify ahead of time and once you start putting these documents together, right and using perhaps some simply developed architecture to create forms that these the user interface can be simple. It can be Universal it can be repeatable and then you can actually start tracking these protocols to find out which ones are best. So theres no reason, you know, we didnt notice of course at the time because people do just as learning her when it came to racial to old when it came to work place to travel coming here because theyre old friends. Were not doing this, right. But Pharma absolutely research and development can actually benefit from everything that theyre theyre benefiting in from their personal life right now. It just dont really know that it actually already all works together because theyre dealing dealing with it in little pieces little bits and pieces but this all you got to do is really just take one of your platform lady it all together and then boom you have a virtual clinical trial space. This is this is a bit of a flag that it is and theres so many other drugs, especially when you look at things like rare diseases that their patients will answer all these kinds of things truly suffer if theyre not able to do these drugs quickly. So, you know that makes total sense itself from other diseases that have been deferred so Yeah, we can keep that going with the things youd like this year with the vaccines and then you got the supply chain. And whats interesting about the supply chain that I am fascinated about is understanding that there was actually a ton of Regulation that was you know, just was created before the whole pandemic arrived that centered around the ability to track and Trace drugs through the supply chain. Now one of the major benefits that they were focusing on was fraud and and you know, all the different things that can happen because that whole supply chain is ripe with Bad actors and counterfeit Pharmaceuticals and its from some estimates. Its up to 200 billion raise your pinky up when you say that 200 billion in revenue for the bad guys in Obviously the good guys dont like that too and the customer certainly dont like getting counterfeit drugs. So its unfortunate. You know, it kind of going full circle here that that we didnt come to those regulations sooner, you know, I feel outside or interacting with whats going on. It feels like that would have solved a lot of problems not all of them, but it would have solved a lot of the problem would at least had some durability to our supply chains, but I dont know I guess for that second leg and in the supply chain, what do you think were some of the key Innovations there in the supply chain? What weve made mentioned some of this scale Brighton in a little bit with scale, but but that the log of a log Jam themselves to the transportation firms right there and waiting we can see that your shipment left the dock right? I could call the doctor because we work for him. Is it just this time and then waiting for it to show up in the transportation firms logs while that was all oatmeals connected through API, you know when its coming from North East PA and going to Brooklyn thats thats 2 hours. Right? So if it takes 2 hours to show up and then blew me find out its going to the wrong location that happened over and over and over again. Frequently but often enough where when youre weeding and you think about every single one of those vials represents a life right in this life that is waiting and that is nervous and it has economic impacts associated with it. Right both for it for better good and bad in the sense that if we have to do precious we have to treat them that way and what Innovations really happened to your is unipart what we talked about with the human factor. Im bringing these logistic expert into the dark with you right in trusting them and creating a contract there but thinking through all aspects of it not just the package and the coding and the API, but what about the dry ice what about the boxes? What about the actual deep down to the raw Goods that are associated with that the people that have succeeded here and if this is a success stories if I did all of that underneath it in addition to the track now what we can do is so much. Then what has already been done? Because you know, were not well that I see has been developed and there are some doses out there. Theres less than 10% of what actually needed right? So theres a lot of work to do and a scale of and if we want to do it faster you have to find more efficiencies. So how could you do that? Right you identify and track and Trace having not built into but having that built across API one of the things that weve talked you were on these calls, I believe with us when we talked a lot about vaccine management as a platform right actually touch the vaccine management process. Will you do you what do you think about from a patients arm and go all the way back to where it started. Theres theres at least six or seven different entities that need to touch it in addition to the people that need to track it right government entities local state federal and none of those firms has assistant that speak to another but For a hot Health Systems actually get more vaccine. They need to verify what if they get it right and how can I get more and where is it once it gets there? So we for example had all of these firms operating on a platform where they spoke to one another and not reporting system was and you know thankfully our chief medical officer David through this really early on hes part of the robot health Team witches and we all were talking about this real time now he was innovator of it because he was able to get state and local government speaking to help your speaking to transportation and talking ultimately to write so this this this is the kind of this is the missing link and when we lived through the epidemic of H1 N1 us to deal with it Scene It took some extra time and we had a protocols to distribute it, but it never worked right? We got the people give me nice but probably Well, possibly Steven and so we were able to catch him on the next year really, but thats those stand-alone vaccines. They require all sorts of integration and even as early as 2017 Health Systems and government entities. They werent talking to each other. This is the first time that theyve actually got the opportunity to do it because of computing and because of platforms that have been built to with open API to integrate them and so they dont need to piece it together themselves anymore. Right? We just actually need to sit down as a group and go we all are touching this its important to all of us. Lets figure out the cigarette a process and we can for example with any of these pharmaceutical firms help them build in the API connectors that would get them connected to this platform so that they can see what the state of New Jersey is doing with the state of Delaware is doing what you do sticky internationally what Singapore is doing and what this the Victoria Australia is doing this. See management specifically is something that is But like going all the way back to the beginning of our conversation youre talking about here to stay and I and I reminded these folks been talking to now or not always the head of infectious disease. Sometimes the head of Public Health nursing right and end. This is this is not a platform that you is one and done right? I think Im going to remember last year this time last year when we were we were figuring out how to redistribute PPE because we were literally fighting over a single box the masks in some situations and we thought we said to ourselves because going to be done by may know what the future holds but the good news is that these platforms can be used and scales in any situation where the best Lou where there that covid-19. Come here to stay and everybody gets their shots every year who knows or the next big thing. I verbally but technologically is going to be the expectation by not just not just the pinus I dreaming and I think thats important perspective for folks to have is that yeah. Were talking about covid-19. And you know, so this isnt new like you said and I think its just people need to understand and not rest on their Laurels this next time around because you know, if you listen to people like like Bill Gates as an example, Im not saying that because were Microsoft but you know, hes been doing tons of really great stuff out there and you know, hes just like guys, do you know why Ive been talking about this for years and kind of raising my hand, you know, this is going to happen again and its not going to be a hundred years. It might be 10 years. They might be 5 years because the Dynamics of this particular virus is very different than the Dynamics of other viruses out there. Meaning that most viruses. They dont want to kill you because they want to live up to you know, the way that this is transmitted is very different than many other types of viruses at least doing it in this type of fashion this quickly and the mutations are happening much quicker, so You know, I think that you know why weve got to hopefully a handle on things. Im not a doctor so dont take my word for it. But you know, weve at least got some really really good Solutions and I hope people take it. Seriously. I hope people you know, just do the right thing not get sick. Just you know, just get a small little prick in the arm and and just do it man. You know what? Theres going to be substantially more demand than there is going to be supply for a very long time. So people like we said had every right to risk their life they really do and and it is a personal choice and you know, but its good to know that for sure but a lot of folks a lot of folks have differing opinions on it. And is that is that is their god-given right? And it also, you know, I want to make sure specially, you know, of course these are just our personal opinions and doesnt represent the opinions of our players and also, you know, these are much bigger conversations as well. So, you know, lets definitely you know, if youre up for it and another time lets definitely talk about the kind of the behavioral societal things cuz I do think that this is also something different that with all the asymptomatic things that go on is that you actually do impact other peoples lives and you know, what does that mean for me? Sitel perspective in how does that really affect your rights or does it and so I dont have a great answer for that. But obviously as you know, Ive got plenty of opinions about it if you had a fantastic Childrens Hospital of Philadelphia, one of the major blinking on his name right now, but one of the key developers of the rotavirus vaccine significant around around this topic as he be great person to research, Ill have to continue his name when I remembered. Im sorry, youre wonderful contributor to hell and and so yeah, I living in California, you know, its been its been if its working in the industry that I did for so long. It was always, you know, its a personal choice and in no parent has the right to tell another parent which was make So that is that is just where were going to I am happy to leave that I was saying my my personal opinions and clinical decision-making, you know, not a clinician but its evident and and you have to make a strength in yourself. You really do it will continue with the theme Here of cheesy 80s references if you had a magic telephone booth and you could go back in time and propose any new way of thinking or lesson learned for supply chain segment of this, you know, what would you tell a year ago you to say? Hey you really need to look at this aspect. This was something that I didnt think of that I should have thought of But I didnt think Id or did the Cubs win today. from an industry perspective Ill be frank there. Is there a very there are very few Forum still thinking my digital twin right? Like I there theres maybe one or two that but there are calculate the rest of them are thinking about thinking about it. But how many have actually taken action on it? They know it exists. Do they know what it could do? So how how many consulting firms are you talking to right now about solving this problem for you? And how many actual technological friends have you talked about? What could they do? Because thinking back to the solution where was taken 3 years to get up and running and it really took three weeks when they finally said, please just how would you do this, you know engineer would you do that and then ideas are free. These firms will be willing to give you ideas what you really youre going to be for wish you would pay for regardless is the operational expense of taking me Capital pieces that you have and putting them in Topix. Thats it. Thats it. And its that simple and it needs it easily and easily but it doesnt need to be a leap of faith is actual like verifiable technological choice. And so if anything I would want to talk directly to all of the brilliant people that I worked with any of the first to say these challenges that youre running into Supply with manufacturing with development can be easily thought through by just putting a digital twin of your manufacturing facility of your operational processing shoot. You can look at it. Like how people move around your campus and figure out what would be where is the best place for us to actually put our money? And so Ive heard any firm pharmaceutical are not actually look at that real time now because the folks that are thinking about doing and if theyre actually doing it thats the difference between who is eating right now and who may not think about, you know, Technologies like blockchain, you know, theres a lot of hype around that theres And actually some some really good work as far as tracking and tracing assets across Supply chains using this technology. Whats your opinion on on the usage of blockchain technology in in this type of use case? This one is where I actually call you Mike and Ike tell me about this. This is not this is not an area that I had to deal yet. But thats the best part about working with folks like you is that is that theyre desperate everywhere coolest smartest people Ive ever worked with her at Microsoft. Yeah, I mean, you know, the the really interesting thing about that technology is a lot of things that we talked about his problems with the supply chain the technology just as part of that technology it accounts for that. And so it reduces the amount of you know, you mentioned a lot about apis right instead of deliberately univ crane apis to forcibly connect things together. This is a peer-to-peer system. So you dont think of like, you know back in the you know, the old days when people used to steal music on Napster, you know that you know the whole bit torrenting thing, right? No one ever said that, so, you know, its a lot like that. Its everyone connected with in that particular ecosystem. Right? And so thats whats great about that technology. Not only that but I also its leveraging old school things that were invented in the Middle Ages like the double Ledger roll meaning, you know, if Everyone else has the same thing and youre the only one that doesnt have the same exact transaction list something funny here right in so kind of having that built in verification, but also transparency youre making sure that everything at least most things are transparent so that if there are Bad actors while you cant stop because bad people do bad things, but if there is is audited and we all can see it and so that is a natural kind of psychological social engineering type of a mechanism that prevents things like fraud even accidental fraud cuz you know, I often times some of this isnt even malicious. Its you know, something that happens due to accidents, you know, we see this a lot in a is an example of bias thats built-in. So, you know, Im not going to go on a blockchain ramp at those are those are some of the things that I think are really interesting about this particular area. Is that full of mutability, you know that transaction Written in stone. You cant change it it is what it is. Its visible. Its all algorithmically encrypted. So, you know, its got the you know, you know people say is tamper-proof, but I like those tamper-resistant because I still believe anything could be hacked given smart people enough time and access to machines. But but yeah, theyre thinking about change management right? Because a lot of the leadership in these in these industries are there hundreds of years old, right and not that that the people running Mr. Hundreds of years old the most of the time the retention of talent because of wonderful places to work right? I remember if you stayed past two years you were like it like 90% chance that you were finished your career. Theyre just wonderful and so they offend you that you know what, you know a very very well these these ideas sometimes sound. Like, you know like sci-fi to them, but youre right. Its so bringing it. What Nikki get real to these firms and talking about what that would mean to them at something that that wouldnt you know a lot more about what that would really how that could really function and think about the idea is there because its not a common topic right now like the Johnson & Johnson will have what some of the biggest Supply chains in the world right that they could think I was really easily. So last Lady talking about the Last Mile and the the innovations that are happening there. I mean obviously ton of logistics and planning required but youre from up from a Technology Innovation perspective. You know, what it what did you see is kind of, you know major innovations that occurred there that kind of help make this possible as well. Then it was a big thing about vaccine. They were just talking more. So like with health in the last year for the pain to health a little bit. Youre just in general kind of over the past year kind of how is this changed is it feels like it we hit a bit of a digital Tipping Point here this past year have experienced certain deficiencies that they may never want to go back to the other one has been to be with your family everyday. Youre like, I dont want to go back to not see my family every day was that wears the happy medium that thats going to be the deciding .44 Health Care as well the last mile Health Care the last night. I would really truly be from from the health provider to the patient. Right? Weve already delivered at the patient. Has it the other the healthcare system has that means there to give it to the patient. Wheres the patient how do you get it to the patient the communication and the concept of omnipresent right is really valuable. And that is where people that are starting to think through ahead of time what the patient experience is. Then thats where the most success has happened has done through to become a CRM system for one another so not dissimilar from what we talked about with, you know, the capabilities That Couldnt exist with medical decision support in the overlay of machine learning on top of this is where they looking at. The piss pigeon is a consumer of everything that they touch within the healthcare system and ensuring that that patient understands the billing understand where they are the plan to help plan understand where they are reporting by that help plan to the immunization process that you know, the accountable care thats associated with that with that immunization all of those systems talking to each other. Theyre actually thinking about it and its been fun coming from the east coast to the West Coast and dealing with two really fantastic Healthcare Systems as a patient on both of those dealing with it and got to say the one out there just dealing with it so well and so they sending me updates every week. This is where you are within this protocol. This is where you live. This is a likely her. These are the immunization places that are closest to you are all just doing it based off my patient chart my address right click through I can schedule an appointment. I could I can enter in my insurance I can get it paid they get paid they can report back to the New York and Innovation registry where where those are and everybody everybody the cycle starts all over again right now. Captain different Ray that somebody else is taking that is a real serious approach and in the patient feels cared for even when theyre not there, right? And so and then of course the benefits that that creates to the entire health system which right now we need to understand is inclusive of transportation is inclusive of government reporting is inclusive of Public Health and all of that needs to happen together at the people that are doing it are the people that are helping everyone. So Ive got a little bit of experience in this area very very very little but you know, Ive got a patent out there with actually one of our companies that we work with quite a bit GE Healthcare, you know, its kind of help a sporting and getting people back to work in the transportation system not like Airlines and trains and all that great stuff getting that up and moving and so we worked really hard on. Christian essentially that passport that digital help passport in this was more focused on the workers less about the broader citizens. I could let the different problem with a different set of regulations excetera before the workers. There is Frontline workers that are helping keeping, you know, all those Logistics pets that we talked about that second pillar going. Yeah, we had to make sure that they can be safe and you know an effective at work but I think some of the things in these arent necessarily Innovations, but I think some of the things as a result of this that that are really good kind of Lessons Learned is one we understood kind of where all the holes are and there were a lot of holes and while weve been dated and we fix some of those I think its really bubble to the surface around kind of the the diversity Factor right and you know some of the poor communities, you know dont have the same access based on you know, how far the farmer? He is away from them. Right and there is no public transportation or what it would have you I think thats been obviously thats thats terrible that thats occurring or has occurred based on where things are at. But at least now we know and we can make action we can change it. So I think thats incredibly valuable. I think the Innovation I mean there was a young girl. I think she was like a teenager. She actually built an app for what state was it was a Pennsylvania was in New York one of those days where Mom just built like an easier you I actually have that user interface to talk to the patient portal that they had to register a cheese. Thats the one that she distributed everybody was open until Yeah, I need to like those cut aloe code no coat or citizen developers of you know, what that is something that actually is going to be the real listen and Healthcare Systems in the people that are you know, everybody loves my team. We were Microsoft wheel of it is that said theyre not often the users are you know, and so having a product owner in I see you suffer from the actual user when you can develop a platform like like power apps that slow code or no code and you can build you can spin up an app for your user base that is like meeting the team thats a deal and thats the kind of stuff that has been done over and over again and he felt the stones and everywhere for retail, but I can take a lot from other Industries right to learn from a lot of other Industries right now because theyre having to do things that scale that did they typically dont and so, you know, its its not going to be over in a month or either. Holly for right this is something thatll itll take time and and as the world gets healthier and you get smarter we can work smarter and so thatll be fun to to do together. Theres no money in there. So many little the innovations that is a great news is that everybody is is is open yours right? Nobody. Is it in and going lets do it like we use right because thats broken. So theyre just hungry for not only how can I do this? But how can I help it? When will get sick you get busy? Right and you and you do it with your do it with the with an open heart. So weve been going along here another cheesy reference pop culture reference. So if you had a hot tub time machine you could go back a few months and there was An innovation that you could bring to the table that would just help kind of where were at, right, you know right now, you know some of your suggestions based on what you know, now what would you propose? I would go back to approximately the September timeframe when we knew that there were vaccines were coming and it would have a much larger conversation with folks that were contributing operation warp speed which was itself an innovation where everybody was talking about the fact do we have technology in place right now that track this whole Loop, right? What is happening today is that theres probably 10 players 20 players maybe even right if you caught some of the smaller firms people are building things homegrown. The challenges is that when youre doing Mass immunizations to get to the level of immunization. We need to be to open up Disneyland and parking lots and Walmart and just let everybody in and you may not be needy from different Health Systems sense of self dont have the volume to get peaches in and out the way that they need to sew the concept that thats what I would have done that. Google right now but getting that ramp up and down into having it done in a holistic way you need leadership from the federal level and if we didnt have that at the time, right so that would have been really screaming into the wind a little bit. But if I if I had a crystal ball and omnipotent I would do that. The common theme is guys got to talk more collaboration and you know, thats kind of a foundational thing here. And so thats been a common theme of all the recommendations is maybe talking more more effectively openly excetera. Can you share that kind of information on a common platform and not had and have it be secure have it be hipaa-compliant have it the thoi bao. You are and non-transferable. Can you protect Trade Secrets of that? Of course you and I know through security without a doubt and that exists and that is built in ladies and Gentlemen. Please dont hesitate if youre thinking about this and thinking about doing something new for your patience doing something new for your system to make your work more efficient and your reporting processing more efficient. Its also possible right now here and the challenges of course is how do we get everybody to agree on which one it is? Thats what it comes in and get them talking to at least two, you know, where the same reporting process like for example, the federal government or your state and local government that will solve a lot of the issues by Nature. So Yeah, I used to have a lot of these conversations when I was at Gartner with with companies and you know, there was a lot of the aspects that you talked about and there was a lot of the business and legal aspects, you know things, you know, you touched upon a little bit with Trade Secrets. Ill go even further and say intellectual property and the monetization model around that in maximizing, you know, theyre exclusivity to that formula and you know before things go generic Etc. And so I think I think there needs to be a coming together not only the company but also the government as well and how these this is regulated so that everyone is in sent it to do the right thing cuz of the day human beings like corporations incentive Drive behavior. And so just being super honest with ourselves and getting in front of that issue probably would not hurt. Yeah, it wouldnt and end free is never free like when someone says oh you will give you the system. Itll be for free for example in the state of California 9th know if these two are correlated but in the state of California, I had to register on a tool that was not microsoft-based to get in line for my vaccine and within an hour. I was given a California thing. You just signed up for something I did with my work email to you were just signed up for something that says that you know, they werent we were cracking your information and then the state of California. We have to let you know when your information will be sold in this information is the potential of being sold and I was like Well that is not expensive that is not something that it is. So wonderful about working at Microsoft is that we know that that doesnt happen. Play you can sit in front of every customer and say were not in the healthcare business. We are in the storage business and you your storage is your your content you your container for your containers. Your data like is your data like it doesnt mess with others and when data is an anonymous right ensure to the platform. Its not traceable back, right? So so we can all work together on one platform and benefit from it and still running suture assistant. So thats something that Im probably not coming I think about the cloud they think about this Wild open space. Like I was think about Willy Wonka the kid was sucked into the television and they had all these like Blitz and bloops about him going to reach up and grab some data. Its no my parents. So we covered a lot of ground and you know, I definitely want to be respectful of your time. But you know, Ive got two last questions for you. The first one is if people want to get ahold of you. Whats the best way to get ahold of you? Is it like LinkedIn email something that Im as a platform is Super Active on that David wrote we working is full of experts know. The last question for you is you know, its a personal one. So if there was something that your best known for Professionally or not your choice that someone might not know so as an example, Ill give you an example of army people might not know that Id like to skydive people would never probably know that because youve been around me you would see that Im afraid of heights. So why the hell would I jump out of a plane? But Im crazy and I like doing it. So for you, will it be something that people wouldnt know about you that would be interesting to share. Its a pretty benign thing, but people are always surprised to find out that. What has two two loves besides my children and my husband who are my passion but I love to bake and I love to do Fitness CrossFit and kind of free hardcore Anacortes to Bluetooth. But the bacon is the is the thing that people are always surprised about when theres when I am at my most height of stress and theres just nothing better than like butter and sugar and like a warm oven and so I really got into that show a British baking show the Great British baking show man. And and so you can just making all sorts of things like scones and muffins and theres always something baking at our house and we all have to we all work out because I bake a ton. The requested well at the things that I think it was turned in the most fun if I didnt realize the art of baking a cake so cold it is actually allowed for this even though I love to bake. I never took the time to vacate. I didnt I never enjoyed until I realized how delicious homemade cakes are. So now we are at our house birthday people. Look forward to any surgeon half birthdays to the right and they get to request whatever cake they want and feel like whatever style color and I will spend you know a good it is a good three or four days to make a cat like bacon and decorate it. And that is it. Ill have to show you some of my argument started to like like work on calligraphy so that I can do the letters because we got time man. If you ever if Im not on camera for a work video in like tuning Mighty like baking something right now cuz I got the muffins just to perk up my mood. You cant do that anymore. So this is been a super super fascinating conversation. I really appreciate you coming on and talk and everybody about what you do and all your insights and hopefully  you' will come back and share even more again sometime.