July 19, 2019
Sometimes, our desire for urgency cannot be matched by our knowledge about disease pathway or origin.
In the Cold War era, the threat of mutually assured destruction was real as the United States and Soviet Union stared each other down, each with a finger on the red button that might launch their atomic arsenals. Though our frequent “survive the fallout” trips to the hallway, sitting facing the walls with little hands over our heads, felt protective, we soon realized we were being naïve.
Years ago, the red button was replaced with a red hotline between Washington and the Kremlin, making communication easier. The move from an adversarial to a cooperative, albeit cool, relationship wasn’t far behind.
Today, healthcare innovators need to move from where they are to a red hotline in order to connect the leaders of our fractured ecosystem before we implode. We are feeling more frustrated. We recognize that the care we can provide is out of reach to those challenged by access obstacles. We all know that costs within therapeutic categories and procedures are mysterious and sometimes, when the bill arrives, eye-popping. But, these problems pale next to our inability to create medicines of significance at the speed needed. That’s reflective of a globally fragmented innovation engine. Simply, we are not communicating or collaborating at the speed necessary to keep disease at bay, costs down and people healthier longer.
Moonshots of all sorts are needed; some are being launched. We have desire to heal, and people are desperate to be healed, whether they face cancer, diabetes, heart disease, or genetic conditions. Dr. Eric Topol, author of the bestseller, “The Patient Will See You Now,” is right. Technology is more than information at our fingertips; it created the “now” expectation. “I want a car to appear at my doorstep, now!” “I want a book delivered, now!” “I want to see a doctor, now!” “I need a cure for my illness, now!”
Why can’t it be now? Sometimes, our desire for urgency cannot be matched by our knowledge about disease pathway or origin. Take Alzheimer’s. For decades, we studied the disease and pursued cures. We have spent billions on research in the lab and by the bedside. Yet, our progress in this category is still defined by what doesn’t work. Science is an arduous process at times, but these failures give us more and more insight and direction.
Yet, there is a bigger challenge we must confront beyond absence of knowledge or clinical paths pursued for naught; the threat of self-directed destruction from illnesses that we could overcome but fail to. We need to get our act together, working collaboratively across labs, companies, and geographies. To overcome some diseases, we need more cooperation and less competition.
Artificial intelligence (AI) or machine learning is enabling academic research centers, health insurance companies, and physician groups to amass and study patient types and data. It’s the magic of our brains operating at a faster pace, with purpose and ability, that can match data to physician and patient needs with precision medicine. It can help us anticipate what person with a specific tumor type might benefit from immunotherapy, or, if the person with frequent polyps requires more frequent colonoscopies to avoid preventable, but deadly colon cancer. Can you imagine the greatest research teams and medical centers of our planet sharing their data for combined synthesis and analysis? What might be the output of that collaboration? It’s beginning, but is it fast enough? It’s not about science that's beyond our reach. It’s about collaborative opportunity unrealized.
Just as the web enabled patients to mobilize into advocacy groups and share information, pushing the system to move faster, AI will eventually push us to overcome another obstacle. Our academic medical centers compete too often and guard their data to ensure credit for the next big idea and path to discovery. It’s the stuff that leads to the Nobel and Lasker Prizes, among others. Big private and public grants head toward the frontrunners’ labs. That leads to fragmentation of insight and delay in sharing big – moonshot like – insights. Can we break down those barriers?
The developed world does not lack resources, ideas, brilliance, or even data. But it’s also rife with structures and processes that impede rapid collaboration. We are rooted to older research models with placebo-controlled groups, reluctant to employ AI models that can replicate with synthetic control arm data to speed drug trials to their outcomes. We have companies and academic research teams sharing information at the endpoint of the discovery or trial effort instead of finding ways to learn from each other earlier and accelerate progress. It’s happening – but not fast enough.
Collaboration should not be confused with agreement. It is an untapped skill that Jon Katzenbach, author of the business bestseller, The Wisdom of Teams, cited as the effective path to exploit data and improve performance. However, collaboration – with wings spread wide – is necessary if we are going to optimize all our scientific achievements to develop cures.
Just as we work to protect people’s survival from external dangers, we must act with confidence and collaborate to overcome disease. We must harness data, talent and resources to work much faster across artificial lines we create through governments, corporations and academic centers – finding incentives to better serve the people we seek to heal. How do we begin?
We begin as global leaders did, staring each other down, each with a finger on the button, recognizing that it was never a solution for success. Innovation – brought forward faster and faster to the marketplace with costs pushed down, determined who would dominate. We now need to move quickly to communicate; it is the foundation of care for healers, and those seeking to be healed. The red button is now unchallenged disease. The solution is humanity realizing its survival is essential. Collaboration is the fuel that sustains moon missions.
[Looking to accelerate the pace of biomedical and life science innovation? Then go to the CNS Summit in October 2019 cnssummit.org]
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