What is the Transformation Playbook for Moving From Digital Pilot to a Truly Scaled Production Solution?

Cristina Ortega Duran, President of Evinova

Cristina Ortega Duran is the President of Evinova, a separate health-tech business which AstraZeneca recently launched to accelerate innovation across the life sciences sector and the delivery of clinical trials. Prior to this role, she was Chief Digital Health Officer, R&D at AstraZeneca, a global role covering all therapeutic areas within the organization.

She currently contributes to courses at Cambridge University. Finally, Cristina is a chartered accountant (CIMA) and has completed the MIT leading enterprise transformation program.

Q. As one Harvard Business Review article shared, two key challenges for this continued pain point are “an unspoken disagreement among top managers about goals” and “a divide between the digital capabilities supporting the pilot and the capabilities available to support scaling it.”¹ As you have worked directly for a Fortune 500 firm, as well as consulted to them during your earlier strategy consulting days, why is it so challenging for many firms to transition from pilots to full-scaled operations?

A. Duran: During my strategy consulting days, this challenge was a recurrent pain point that frequently came up. And so, I wasn’t surprised a few years ago when a Harvard Business Review article pointed to a survey of 1,500 C-suite executives across 16 industries where 84% of them knew they needed to scale AI to achieve their growth objectives, but only 16% of them actually moved beyond experimenting with AI.²

Innovative R&D is crucial to the life sciences industry and so well-intentioned pilots, often many of them having the same and or similar target outcomes, are the norm. The duplicative efforts are exacerbated when some departments ask for additional data points and then even more follow-up pilots are spun out. Such actions then unsurprisingly lead to the recurring digital pilot syndrome in pharma. What many employees don’t recognize are the potential lost benefits if there is not an intentional framework for decision making. As the authors of that Harvard Business Review article referenced, for the successful leaders, they achieved nearly three times the return on their AI investments when compared to their lower-performing counterparts.

The secret sauce for large transformation at scale, is firstly focus. Focus on the biggest problems for your business that will give you the largest benefit now in the next 10 years. Do not fall in the trap to start with technology or methods, like where to implement AI. Moreover, plan to scale; not just run pilots. Establish early expectations of the project costs to scale the initiative so that financial benefit outcomes can be realized. Secondly, having the right combination of diverse skill sets on the team are absolutely crucial and as I shared during Q4-2023, mixing teams with different capabilities like clinical R&D leaders, scientists, technologists, behavioral scientists, as well as designers and data scientists are all part of that equation.³

For us at Evinova, we have been fortunate of having cross-functional collaboration across many capabilities and that many talented individuals decided to join this scale up. For those of your readers who may not be aware, about a decade ago, AstraZeneca was having challenges and Pfizer approached to acquire us, with some investors urging the drugmaker to sell out to Pfizer. Our recently appointed (at the time) CEO Pascal Soriot presented an audacious plan to jump start revenue to $45 billion by 2023. Last year, AstraZeneca achieved that goal with sales reaching $45.8 billion.

And so, it speaks volumes that employees who had the comfort to stay with a large pharma company that successfully transformed, elected to try something new and challenging, with a growth mindset. During my career, I’ve seen the potential value of hiring people who are willing to try new things as they bring a fresh lens on pain points.

For instance, we hired data scientists from NASA, who had never worked in pharma before, and yet they helped create value by asking questions and sharing new ideas that we had not considered. However, they needed to be paired with those who have clinical pharma experience, so the ideas can be directed to follow regulatory requirements.

This is why diversity in teams are so important. Beyond capabilities, we are looking for attitude, resilience, and grit. When it comes to innovation roles, two types of individuals apply for them, the ones that want to work on new ideas and new things but jump around as soon as it gets hard. And then there are the ones who have the resilience and grit to drive it when it gets hard to secure outcomes and drive scale. These people are good at problem solving, through creativity and collaboration with cross functional teams, to find solutions. Transformation at scale is hard, so hire for resilience.

Q. Given the big bets that Fortune 500s, including biopharmas, continue to invest in such transformations, what are your top three playbook recommendations?

A. Duran: Earlier this year, I recall how Goldman Sachs economists predicted that investment in AI will approach $100 billion in the US by 2025.⁴ When you consider how J&J’s 2023 revenue of $85 billion was the largest within our vertical, that provides some context around AI investments that will begin in about four months.

First, build an intentional investment prioritization framework for transformation initiatives so that instead of 300+ pilots, you have perhaps the top five to ten, max. Many companies reward teams for the number of innovation programs, not for the numbers of scaled programs. This usually ends up in “pilotitis” and limited benefits, as it is a different focus to start many pilots versus scaling one across 50 countries with benefits. Moreover, ensure that your transformation has a good balance between long-term versus short-term returns with ideally 70% of the benefits occurring within the first 24 to 36 months; and 30% being long term. This approach will ensure sustainability of the program.

Second, remove the inevitable blockers that impede the speed of your transformation. Make it easy for your employees and their external partners, such as consultants, to collaborate by changing the ways of work. While human-centered-design thinking can generate significant value as we have seen with companies like Amazon taking a consumer-centric approach; it has taken our industry a while to tap into this opportunity for change, but we are making progress.

We focused on understanding the problem first and doing the required research and discovery on the “why this problem is happening.” For example, only 3% of eligible patients choose to enter a clinical trial resulting in years of recruitment timeline delays. Why does this happen? We asked patients in nine countries their reasons for joining or not joining. And using diverse cross functional teams, we explored the possibilities to change this by solving in an agile way now.

Third, implement change in a way that makes the experience for users easier not more complex. What do I mean by it? There was the recognition that by using digital in clinical trials, this could improve how data was collected from patients at home and also accelerate the clinical trial by moving away from manual data capture to device data capture. What happened to many pharma companies is that to solve this problem, you needed to use either multiple suppliers or companies that had grown by acquisitions and which had not integrated their solution offerings from a user perspective.

This resulted in complexity being pushed to users if not done in a different way. For example, you could end up with six apps for patients to participate in a clinical trial: one for surveys, one per device, one for supply etc., resulting in more complexity and no benefits. Subsequently, we have taken a lot of effort on building a global platform that supports a more human-centric approach to users, while following the heavy regulations required for clinical trials, and delivered benefits.⁵

Finally, invest in a communications strategy that can support not only the C-suite but the entire organization. Changing the ways of working on teams distributed in 40 countries, split into many functions, requires significant efforts on communication and change management.

The size, scale, and complexity of global biopharmas as well as the inevitable human dynamics of competition for limited resources require transparent and timely communications across functional areas and at different levels of the organization. The great news is that when teams follow this blueprint, there can be large-scale benefits as AstraZeneca has introduced digital health solutions into clinical trials at scale, across all therapy areas and 44 countries: demonstrating improved patient experience, accelerated timelines, and reduced costs.

About the Author

Michael Wong is a Part-time Lecturer for the Wharton Communication Program at the University of Pennsylvania. As an Emeritus Co-President and board member of the Harvard Business School Healthcare Alumni Association as well as a Contributing Writer for the MIT Sloan Career Development Office, Michael’s ideas have been shared in the Harvard Business Review and MIT Sloan Management Review.

References

1. Sutcliff, Mike,Narsalay, Raghav, and Sen, Aarohi, The Two Big Reasons That Digital Transformations Fail. HBR, October 18, 2019

2. Kanioura, Athina and Lucini, Fernando, A Radical Solution to Scale AI Technology, Harvard Business Review, April 13, 2020.

3. Pharmavoice:https://www.pharmavoice.com/news/astrazeneca-evinova-digital-health-cristina-duran/700770/

4. Rosen, Phil, S&P 500 companies are more obsessed than ever with AI, Business Insider, February 15, 2024

5. https://www.nature.com/articles/s41591-023-02489-z