With this presentation I wanted to highlight a number of trends in the healthcare sector and some major challenges born out of the current healthcare delivery model. I’d then like to propose an alternative model in which the combination of distributed patient and diagnostic data collection, cloud technology and AI would support better healthcare tailored to the individual at lost cost to payers. I would conclude by highlighting opportunities for AI-led innovation.

1. Copyright © 2019 Centre for Process Innovation Limited trading as CPI. All rights reserved.
Through the looking glass:
A digital future for healthcare
Alfredo Ramos Plasencia
Managing Director CPI Enterprises

2. Healthcare today

3. 3
Key healthcare market trends
SOCIETAL FACTORS
INNOVATIVE
TECHNOLOGIES
SHIFTS IN CARE AND
BUSINESS MODELS

4. 4
OSD
Biologics
ManufactureSupply
Clinical
Diagnosis
Diagnostics
Monitoring
Point of care /
Pharmacy
Clinical
Consultation
Clinical
Intervention
Therapy
Healthcare systems today – a model

5. 5
OSD
Biologics
ManufactureSupply
Clinical
Diagnosis
Diagnostics
Monitoring
Point of care /
Pharmacy
Clinical
Consultation
Clinical
Intervention
Therapy
Healthcare systems today – a model

6. 6
OSD
Biologics
ManufactureSupply
Clinical
Diagnosis
Diagnostics
Monitoring
Point of care /
Pharmacy
Clinical
Consultation
Clinical
Intervention
Therapy
Healthcare systems today – a model

7. 7
ManufactureSupply
Clinical
Diagnosis
Diagnostics
Monitoring
Point of care /
Pharmacy
Clinical
Consultation
Clinical
Intervention
OSD
Biologics
Therapy
Healthcare systems today – a model

8. The future

9. 9
ManufactureSupply
Clinical
Diagnosis
Diagnostics
Monitoring
Point of care /
Pharmacy
Clinical
Consultation
Clinical
Intervention
OSD
Biologics
Therapy
Healthcare systems today – a model

10. 10
Healthcare systems today – a model
ManufactureSupply
Clinical
Diagnosis
Diagnostics
Monitoring
Point of care /
Pharmacy
Clinical
Consultation
Clinical
Intervention
OSD
Biologics
Therapy

11. 11
Healthcare systems today – a model
ManufactureSupply
Clinical
Diagnosis
Diagnostics
Monitoring
Point of care /
Pharmacy
Clinical
Consultation
Clinical
Intervention
OSD
Biologics
Therapy

12. 12
Healthcare systems today – a model
ManufactureSupply
Clinical
Diagnosis
Diagnostics
Monitoring
Point of care /
Pharmacy
Clinical
Consultation
Clinical
Intervention
OSD
Biologics
Therapy

13. 13
Healthcare systems today – a model
ManufactureSupply
Clinical
Diagnosis
Diagnostics
Monitoring
Point of care /
Pharmacy
Clinical
Consultation
Clinical
Intervention
OSD
Biologics
Therapy

14. 14
Healthcare systems today – a model
ManufactureSupply
Clinical
Diagnosis
Diagnostics
Monitoring
Point of care /
Pharmacy
Clinical
Consultation
Clinical
Intervention
OSD
Biologics
Therapy
C&G
Therapies

15. Some of tomorrow’s opportunities
Machine-learning enables
large-scale processing of
individualised data
Advanced manufacturing
facilities supply personalised
treatments just-in-time
Machine-learning enables
assessment of effectiveness of
treatment for each patient
Enhanced quality of diagnosis
supporting earlier interventions
& individualised treatments
Enhanced quality of care
through earlier, individualised
interventions
Pharmaceutical and MedTech
companies reimbursed for
positive outcomes
Wearable diagnostic devices &
cloud computing providing
individualised medical data
Patient and treatment data
shared across the medicines/
medical device supply chain
Ubiquitous diagnostic devices
monitor patient’s response to
treatment
Data-driven,
Personalised Therapies
Smart & Connected
Diagnostics
Business & Reimbursement
Model Innovation

16. Does it all stack up?

17. 17
Healthcare systems today – a model
ManufactureSupply
Clinical
Diagnosis
Diagnostics
Monitoring
Point of care /
Pharmacy
Clinical
Consultation
Clinical
Intervention
OSD
Biologics
Therapy
C&G
Therapies

18. 18
Smart pharmaceutical packaging:
Condition Monitoring in the Supply of Medicines
• Condition monitoring using multiple sensors
• High volume, low cost solution using existing hardware
• High “resolution” (item-level tracking)

19. 19
Smart blister packs – improving adherence
Information Mediary Corp.
med-IC
https://informationmediary.com/med-ic//
Schreiner-Medipharm / ECCT
https://www.schreiner-group.com/en/press/detail/schreiner-
medipharm-develops-smart-blister-pack-for-clinical-
trial.html
Jones Packaging Inc
Presented at AIPIA Congress and
Expo, Amsterdam. November 2018

20. 20
Making personalised therapies a reality…
Current Art of
Drug Product
Manufacture
Digital Predictive
Design of Flexible,
Agile Manufacturing
from Mechanistic and
Data-driven Models
Digital Operation using
Predictive Models and
Autonomous Learning
• Manufacturability
• Operational efficiency
• Flexibility of operations
Digitally integrated
pharmaceutical supply
chain supporting Just-
In-Time manufacture &
Real-Time Release of
Clinical Material
Smart, demand-led
commercial supply
chain supporting
Stratified Medicines,
Regulatory and Pricing
Innovation
Medicines Manufacturing Innovation Centre

21. 21
Data-driven, Personalised Therapies
Medicines Manufacturing Innovation Centre
Just-in-Time Clinical Pharmacy

22. 22
Stranger things…
Healthcare Newsfeed

23. 23
OMAR ISHRAK
CEO, Medtronic
VALUE-BASED HEALTHCARE”
“…part of a broader shift to
ADJUST PRICES based on
“…[signing supply contracts] that
how well the product works”
1,000 CONTRACTS”
“…Medtronic has signed nearly
Business & Reimbursement Innovation

24. Summary

25. 25
Summary
▪ Innovative materials, novel manufacturing of electronics and digital
technologies are opening up significant opportunities to improve healthcare
delivery
▪ Uncertainties in business (e.g. establishing of digital ecosystems,
intermediation, new entrants) and reimbursement models, coupled with
regulatory and cultural hurdles will slow adoption
▪ Collaboration across the healthcare value and supply chains with joint
standards, strong cybersecurity protocols and clear data ownership models is
needed to exploit the benefits these technologies are poised to deliver

26. 26
Barriers to adoption
▪ Regulatory hurdle to certify novel diagnostics & therapies
▪ Sophisticated supply chain requirements beyond current practice
• Managing patient data through the supply chain
• Challenging system infrastructure, process execution, quality assurance
• Traceability (right product → right patient for multiple products & multiple patients)
▪ Data ownership and data sharing model, particularly regarding patient data
• Who owns the data? Who decides how data is used? Who can see what in the healthcare
value chain? Individual’s privacy and business competitive advantage concerns
• Cybersecurity
▪ Emergence digital platforms & ecosystems (which ones will dominate?)

27. 27
Some thoughts on addressing today’s and future
challenges (I)
▪ Pre-competitive collaboration through consortia built across the value chain
• Definition of standards, communication protocols, programming interfaces, etc.
• In the UK, the Medicines Manufacturing Innovation Centre (MMIC) will provide the
environment to test manufacturing technology innovation within a GMP environment, at
scale
▪ Allow exploration beyond regulatory framework, similar to other industries,
to de-risk technology and business model innovation
• In the financial sector, the UK’s Financial Conduct Authority (FCA) has set up a “regulatory
sandbox” to allow businesses to test products and services in a controlled environment
with real consumers (https://www.fca.org.uk/firms/regulatory-sandbox)

28. 28
Some thoughts on addressing today’s and future
challenges (II)
▪ Solving the data ownership puzzle will require dialog and the
implementation of policy instruments to regulate the space
(rules of engagement)
▪ Regulated segments of the healthcare sector (pharma,
medtech) need to embrace digital technology
• Recruitment of new or cross-industry talent, retraining and further
development are essential
• Partnerships with technology companies may accelerate the process

29. Alfredo Ramos Plasencia
Managing Director CPI Enterprises
alfredo.ramos@uk-cpi.com