As the Head of US Digital Health & Innovation Strategy at Novo Nordisk, Amy West is on a mission to leverage transformative data and technology to make quality healthcare more accessible and equitable for underserved communities. In this insightful session, Amy will share how Novo Nordisk is pioneering innovative digital health solutions to empower clinicians, emancipate marginalized patients, and eradicate systemic disparities. Listeners will come away with a roadmap for:
Amy West, Head of US Digital Transformation & Innovation, Novo Nordisk
Megan Antonelli, Chief Executive Officer, HealthIMPACT
GMT20240627-163558_Recording
[00:00:30] Megan Antonelli: Welcome to the Digital Health Talks podcast. I'm your host, Megan Antonelli, and I'm excited today to have Amy West, the head of U. S. Digital Health and Innovation Strategy at Nova Nordisk. Amy is here to discuss how data and technology can improve healthcare access for underserved communities and drive patient centered transformation through innovative digital health solutions.
We'll explore how digital health technologies can bridge gaps in care, access, and quality, and how data driven strategies can elevate the patient voice and experience. Amy will also share her insights and championing ethical and inclusive approaches to digital health transformation. Amy's been working for decades to harness the power of data to address these disparities, and we're thrilled to have her share her experience and insights with us today.
Welcome to the show, Amy. It's an honor to have you here.
[00:01:19] Amy: Thank you so much. I'm thrilled to be talking with you today.
[00:01:22] Megan Antonelli: Yeah, it's been, you know, a while since we've, I think the first time we met was at the digital medicine conference back in New York, but I'm always excited to hear about the work that you're doing, you know, at, at Novo Nordisk.
Tell me a little bit, you know, I know you started your career in consumer marketing. I think we met through Jay Erickson, who is one of our, you know, sort of UX design gurus. I know you've done work with him too. You've always taken, that patient focused design thinking approach to healthcare innovation.
Tell us a bit about your journey and how, you know, as the head of U S digital health. Uh, an innovation at Novo Nordisk, you found yourself looking at kind of the access for underserved communities.
[00:02:06] Amy: Sure. So thanks for the intro. And, you know, it's really, you know, my, my heart and passion has always been in the patient customer space when we think about healthcare.
There are really two key aspects to how I found myself focused on innovation in healthcare that can support overall improved outcomes as well as enable better support to underserved communities. One of those is very personal and one is really more evidence or fact based. From the personal side, I'm very passionate about this because I am a patient and many of my family members are patients.
We're all family, you know, we're all patients at some point in our lives. And so I know what that's like, and we all have to engage in this ecosystem. And I understand the benefits, but I also experienced the frustrations. And I strongly believe that getting access to pharmacotherapies and traditional health interventions, it's critical, but medication alone isn't enough.
And sometimes it can be hard to get that timely coordinated care. That convenience, democratize access is a real challenge. And this is where I believe, we have so much potential when we think about healthcare innovation through things like digital and technology and those enhancements.
These are areas of innovation that can enable the ability to go beyond that proverbial pill and deliver experiences and patient understanding, behavior engagement, and decision making in a more personalized and relevant way and start to close some of those gaps that we have when we see the health disparities in underserved communities.
So there's so much potential and, digital innovation just gives us so much opportunity to understand. patients as people first when we think about the data that we can capture and how we can use it better, and deliver that more personalized experience in support and along with the medication and the pharmacotherapies and hopefully achieving better health outcomes overall and improved experiences.
One thing I would note there, when we think about. digital, because that's, all the rage these days, healthcare is shifting to increasingly rely on digital tools, for, supporting patient care and, that's great. But digital inclusion, it's becoming critical to promote healthcare equity.
You're delivering that equitable care to underserved patients requires an inclusive system. And as we know, there are digital deserts that exist in order for this to really be balanced and equitable and democratized. We have to ensure that there's access to affordable broadband. There are internet enabled devices.
There's digital literacy. When you think about health disparities with race or, economic reasons. There's also age, and that impacts a lot of people from a digital standpoint. So we have to have appropriately designed platforms to support that.
The other aspect is really kind of from an evidentiary standpoint, the fact that there's evidence out there to show that, we can really move the needle on outcomes if we do things, in a way that are going to, deliver better outcomes.
You know, greater benefit and to a broader group of people, and there are many validated data points out there around, the health disparities that exist. There was a recent, paper that was published by, the W. K. Kellogg Foundation, which this foundation was actually founded back in, 1930.
And the goal was to really administer funds for the promotion of health. welfare, comfort, health, education for children, but over time, the program has continued to evolve and is much more broad focus to support, innovative interventions and responses, to ever changing needs of broader society, not just children, but They published this paper talking about, you know, health, you know, health is fundamental to quality of life, which is, which is obvious, and it's an important measure of overall societal well being.
And despite the fact that in the US we spend more money on health care than any other country, we rank well below other advanced countries in our health and life expectancy. And we have a lot of wide disparities in health by race, ethnicity, income, age, and these health disparities that start at birth and continue into adulthood affect the lives of so many people of color as well as others.
They also carry an economic burden that according to this, paper is estimated at 93 billion in excess medical care costs each year and 42 billion in untapped. Productivity as a result of not addressing these health disparities. So the greater health equity, giving, all groups the same opportunity for good health will be an important component of building a healthier country beyond just the individual.
It's a really a societal issue that we all need to be paying attention to. If we look at the costs and the negative impact. This isn't just an individual problem. It's really a societal problem overall.
[00:07:18] Megan Antonelli: Yeah, of course. I think it became so apparent, during the pandemic and, that lens of health equity has been something that we've been talking about a lot.
Seeing good programs, come into play. I'm curious though, in thinking about traditional pharma's role within the healthcare space and, the focus on, science and, molecule specific, this seems to me like a rather broad lens.
You know, Pharma's role with respect to this, it sounds like a little bit of, because of that digital tools and the access to data, there's a shift, but I'd love to hear more how, Novo Nordisk is looking at that and how, your work really touches that.
[00:07:54] Amy: Sure. And I think, that's a big focus for me. And I think we're seeing a lot of this. in the industry as a whole, that we think about the pharma industry, the science has always been our foundation. We have to get that chemistry right, in order to ensure the safety and efficacy of our medications.
And that is never going to change, nor should it. And now we're seeing the support advancement and acceleration that we have through the technologies, the AI, the different digital, aspects that can help us in the discovery space or getting product to patients, faster than we have in the past, which is great.
But I think the one piece that has been a bit missing is the integration of the human centric component. And the fact that We're not, we're not just solving for patients. We're solving for human beings and we need to understand their everyday behaviors, in order to be able to better serve their needs.
Cause you know, obviously we're all different. We're individuals. We don't, as people, we don't identify as being patients though. We're, podcasters, we're moms and dads and, You know, we're service workers. You know, we're balancing our work and raising families and living our lives day to day.
And health care is really important, but, we all want to be healthy, but it's so inconvenient. When you talk about the experience of health care overall, whether it's, getting to your doctor or getting access to medication, it can be a real pain sometimes. And so, as we are advancing the science and leveraging the technology, we need to make sure that we're applying those things and solving for the human problem as a core, as the first component of that.
That's a lot of the work that I've done in my time at Nova Nordisk, and through our incubator lab environment, where we did a lot of work to really understand what is the root cause problem for the patient. Obviously price, cost of drug is always going to be a challenge in any category for the most part.
I could argue that that's a symptom of a deeper problem, because if you can't get to your doctor's appointment to get a diagnosis, to get a prescription to treat that, then cost doesn't even come into the equation. So, so what, what's behind all of that? And where root cause issue could be, like I mentioned before, that the inconvenience of healthcare is a real challenge.
And if, I've got my doctor's appointment that I scheduled six months ago that I now have to cancel because my car broke down and now I'm going to have to try to reschedule it for six months out, you know, as soon as I can get it. But we know that's going to take time. It's just a real hassle. So how do we better understand?
What the experience of the human being is so that as these things happen, we have ways to engage that are going to enable them to, if there's some hiccup, they can still get what they need without having to, you know, completely rearrange your schedule or kind of go back to the drawing board. And I think that's where we have opportunities to better understand how can we leverage technological innovation, digital innovation to, um, sort of manage these everyday sort of things that happen in between the traditional points of care.
And one way to think about doing that is really understanding the social determinants of health. There's an institute for clinical systems that they've got some stats talking about that for the average person managing chronic health conditions, only 20 percent of what influences the health of a person is related to their access and quality, meaning getting to the doctor, getting a prescription.
The other 80% of influencers, the overwhelming majority of influencers are found in the behaviors, the socioeconomics, the environments, that make up day-to-day living in our pharma space. We haven't really looked at that. We've always looked at the clinical areas. This is the area that we can play and this is what we can impact and affect.
And so I've been very involved in how do we understand the social determinants of health attributes. Can we bring those data points and those data sets into the organization? And what can we learn from that? Can we combine them with the clinical data that we have?
Do we know something different? Are there opportunities to predict these types of combinations of social determinants of health plus clinical determinants? Is indicative of something that we can predict. What can we learn? And what we found is that, yeah, in some scenarios, there are ways that we can leverage this combination of holistic social determinants of health and clinical data sets to new insights that's helping us Develop ways of positioning our products, ways of reaching our customers and supporting them in a way that's going to be more individualized and more in tune with how they live their lives versus us forcing them into sort of this, Clinic type of, paradigm,
[00:12:54] Megan Antonelli: right?
I mean, with that, because that's not sort of the traditional path. And so you're also using non traditional data sets to gather insights. What are, you know, are there internal or external barriers to that? Has there been some resistance? When I think about health care, and the sensitivities and often skepticism around it, Access to data.
And of course, I'm sure all of us stay identified and that kind of thing. But in terms of, you know, sort of balancing that need for privacy and sensitivity, to real utility. What are some of the challenges and how have you overcome those?
[00:13:30] Amy: Sure. Yes. So from a data standpoint, you know, we are a HIPAA compliant company.
We adhere to all the, you know, GDPR and HIPAA and, you know, all of those things 100%. That's the most important thing when it comes to data. But there, you know, everything has, you know, is de identified and there are ways that you can protect your data.
So you have data existing through things like clinical data through clinical trials, you can buy data. And traditionally, that's always really been focused on the clinical data points, you know, BMI, blood sugar levels, weight, you know, things like that. They're just data points that don't really, and they're also very historic in nature, they're not really They're not necessarily their point in time in the past.
And so we're, making decisions based on our best ability on this sort of historic data. If you start to then pull in these social determinants of health attributes again, you can purchase these data sets from different, entities. You can capture some things. There could be general user information, people coming to your websites.
If they're giving you information as they're registering, you can capture some data there. And then, there are ways that you can combine, some of these data sets to see are we, by bringing together These more holistic attributes with the clinical data. What are we learning?
What are we seeing? There are models that you can run just to test many of these different combinations while also ensuring and maintaining the privacy and the security of the data.
[00:15:06] Megan Antonelli: And when it comes to access, I mean, I know, you know, pharma has done a lot around patient assistance programs and coupons and, and stuff.
I mean, is that an area where this is coming? I know that, you know, access and behavior and certainly programs like food is medicine and other interventions, even transportation, you know, helping with that. But I'm curious just in terms of like the specifics of where pharma is, you know, really utilizing this data to.
drive improvements within the, you know, the patient experience?
[00:15:38] Amy: I think, it's a number of different things. For example, about five, six years ago now, as a part of our patient support platform, it was called, Cornerstones for care at the time. It's, it's now evolved to a new brand, which isn't called Novo care.
But this is where we offered a virtual concierge. In simple terms, it was a virtual. Chat bot, but it that's really underserving it because she exists. Her name is Sophia and she has a persona and she's powered by AI machine learning.
It's not just a Bobson. It's an intelligent learning virtual concierge and people that would come to the website if they were looking for specific information, they could type it into Sophia's sort of open field area and as people are providing information, they're typing it In their natural language, the way they speak, the way they do things.
And as we are capturing that information, we are able to learn, okay, for example, when we talk about, as you said, copay cards to help offset the cost of a drug, um, we call them copay cards and we make them available. But, you know, that's a, that's a marketing term. Um, People, patients, you know, we're looking, they're using terms like, um, a coupon.
I need financial assistance. I need a coupon. I need a discount. And when we see that type of input coming in, that informs us around how the natural language that people are using and how can we, you know, Use that insight to adjust our communications, make it more relatable, more understandable based on the message that we're trying to convey and really using the language of our customers as opposed to marketing speak.
So that's a good example of how we're capturing, you know, real world information, language data from the user and able to learn in a way that we can better communicate and connect and relate with our customers.
[00:17:31] Megan Antonelli: That's great. I imagine, a lot of that is happening virtually, but then as we look at kind of the impact of telehealth and where you're sort of meeting patients where they are.
It sounds like using natural language processing to speak to them and hear from them how they, you know, the language that they're using and what they're really looking for. Tell me, I mean, in the years that you've been working in this space with the advent of telehealth and direct to consumer, I imagine that that has changed how you can approach this quite a bit as well.
So tell me a little bit more about that.
[00:18:01] Amy: Yeah. And I mean, I think we can actually, I think some good examples actually sit outside of Novo Nordisk here. When we look at like Lilly Direct, I think, you know, where they have this telehealth platform that anybody can call, for the most part.
I don't want, I'm not a spokesperson for Lilly, obviously. So I don't know all the ins and outs, but you can, Call Lily direct and say, Hey, I'm looking for, weight loss drug or migraine medication or diabetes medication. They will connect you with a health care professional that will have a telehealth consult with you.
And if you meet the requirements or, you know, whatever your problem is, is aligned to what their product is indicated for. You can get a prescription for it and they will fill and they will send it to your house. And you can also get additional. support. There's a level of support around that as well. And that's really breakthrough.
I mean, that is listening to customers saying the patient customer who's saying this healthcare ecosystem is so challenging. It's so difficult. It's inconvenient. The control is in the hands of the clinic. I just need an easy button. And I think this doesn't solve all those problems, but it certainly makes it easy for the person whose car just broke down, who is going to go to the doctor's office, doesn't have to do that anymore.
And they can now get their prescription, through this telehealth, engagement and then have it delivered to their house. Now, I might be oversimplifying that. Again, I haven't used it myself, but they're making strides in this space to really take a direct to consumer approach when it comes to accessing health care and medication and the delivery component of it.
And now we're seeing Pfizer get into the space with the with the COVID vaccine. And I, I don't know, I mean, this is early days, so we'll see how this evolves, but I think it's not going to go away. Um, I think we're going to continue to see that because it's again, it's, you know, we as health care consumers, we've.
We want the experiences that we've had through other industries like retail, travel and leisure, banking and financial services. It's all at our fingertips. We call the shots. We, we can decide what we're going to do. We can, we can shop at, you know, 2 a. m. in the morning if, if we want to. And, um, you know, healthcare just isn't there.
And, and there are reasons for that. I mean, we're a heavily regulated industry. But the example of Lilly Direct and what Pfizer is doing and even looking at Roe and you know, the, the, the, what they're doing, this is a shift. It's a big shift that is really going to be disrupt disrupting a lot of the traditional players in the overall healthcare ecosystem, but it's driven by consumer demand.
[00:20:30] Megan Antonelli: Yeah, no, absolutely. And it is, I mean, it's all, I think, we talked a little bit about, the incentives and putting the power in the hand of the patients, but then also reducing the friction and reducing the middlemen, right? I mean, you're basically putting that in there with the,
[00:20:46] Amy: And if you do that, because we all complain about The poor adherence and compliance and outcomes, but if you make it easy, I think you're going to see a spike or a positive change in the length of stay on on product, you know, the compliance adherence rates, it's just not easy, and that's a big, it's never going to be the perfect solution, but if we can eliminate the inconvenience factor to some degree, I think we're going to see some improvements.
[00:21:14] Megan Antonelli: Yeah. I mean, especially in the also in the conversation around equity, we've had so much where, you know, we'll talk about sort of the how the digital divide creates an equity. But in fact, a lot of the inequity comes from the fact that people don't have the time to navigate the healthcare system. I mean, when people have, you know, lots of multiple jobs and multiple obligations, that's the biggest piece, you know, barrier.
[00:21:39] Amy: I agree. All you have to do is turn on the news to see what's going on in the world today. A lot of people are just trying to get through the day, not to mention make a doctor's appointment and get there. Heaven forbid, they have a real serious chronic thing going on, because that's, you know, Makes it even harder.
[00:21:54] Megan Antonelli: Well, and a lot of these tools, I mean, I know myself, I've done it, you know, Oh, look, I can book an appointment. Well, it's not really booking an appointment. It's a request for an appointment and no one really gets back to you, you know? So there's a lot of even digital time wasters that are in there that aren't great that the providers have put in, but I'd love to hear a little bit also about, cause we've, talked about Novo's connection to the patient and that direct consumer access.
Okay. Where are you working with health systems and providers and physicians to help, reduce some of this friction as well?
[00:22:25] Amy: The example that I'll give is, in that space, I don't know if it's, it's, You know, direct bullseye there. But one of the things that we're doing is a few years ago, we opened up, a bio innovation hub up in Boston.
It is an R and D research and development unit. It's designed to bring life sciences, innovation to the forefront through collaborative partnerships with biotechs, academia, and potentially health systems or other stakeholders in the healthcare ecosystem. It's all really driven by the fact that, we are a heavy science company.
We're a pharma company, but we recognize that there's a lot of technology. There are areas that we need to collaborate on. We can't do it alone anymore and nobody can. So how can we create synergy by these strategic partnerships? And so through this Boston, bio innovation hub, We're looking to develop next generation technologies that are gonna enable and enhance treatments that will support research as well as the development and production of therapeutics.
So the, you know, our organization there is really interested in co-creating solutions in, in sort of three key areas. One is in the novel biomarker space. So how can we, leverage technology or ways to better identify, specific patient um, disease prediction, progression through the identification of these biomarkers that are going to tell us something that we didn't know before that can help intervene for could be rare disease or it could be a broader disease state.
Another area is in data and digital science. We're looking at chemical, molecular, preclinical and different patient models that can reduce the time and the number of iterations that are needed to develop a new therapeutic so that we can accelerate time to market potentially. And then the third area is in devices and delivery solutions.
So I would say the, the patient centric area. Like, how can we make improvements to convenience and affordability and sustainability and adherence to treatments? Um, really making it easier for the person to access, use and get the benefit of the medication through different devices and delivery solutions.
And so again, these are areas that we're opening up, you know, opening up the aperture to see who wants to work with us in this space. And, um, we're actively looking for partnerships in those areas.
[00:24:48] Megan Antonelli: That's great. It sounds like, it's really, from that sort of bench to bedside, right to the patients and you guys have got it all kind of covered in that regard.
Now, obviously, the GLP ones have, been in the news a lot and they're making a huge impact. I work with the American Heart Association. So it's amazing to see the broad scope of impact it's had, but it's also bringing to light, key areas of demand and efficacy and value.
Right. And I mean, to me, it's almost like one of these things where we're really going to see, how the healthcare system works to kind of drive, a medicine that's truly impactful. And then through the system, because you're seeing such patient demand for it. I'd love to hear, your thoughts on, you know, how that is going to shape the health care delivery system through, you know, through the next 5 to 10 years.
[00:25:40] Amy: I think we're already seeing it again with LilyDirect. This is really driving, it's really looking at, we've talked about the rise of consumerism in healthcare.
There's been a demand, but we really haven't been solving for it. We know it's there, we're trying to do something, but we just really haven't seen the big steps yet. This is the first time, that I've seen something that I think is going to disrupt the future of everything when it comes to, medication access and delivery.
Starting with this GLP one space again, like you, you've got really direct, who's really looking at how do we make this as easy as possible for you to, get a consult for and a potential prescription if you qualify for it and we're going to get it to you as easily as possible. And as we see these platforms evolve Pfizer now has one for COVID as we see how these things roll out and start to scale, I think we're going to see these start to roll out into other therapeutic areas as well.
And Again, addressing this shift to more control by the consumer in the healthcare space than by the system itself. So that's one of, I think one of the biggest impacts we've seen with GLP ones when you step outside of just, getting the medication, it's the how of it. And it's the really embracing and addressing the direct to consumer opportunity that we have.
[00:27:08] Megan Antonelli: Right. I mean, you can really see how it might play out, in all different scenarios. I mean, this one, it's been more, prevalent in that it's a, sort of highly visible, highly publicized, and, effective. So, it's created a lot of buzz around it, but certainly, I mean, it makes me think, even with TV advertising, I've lots of friends that work in that space and you hear does it really work, when you have that demand coming from the patient side, you know, and I think it can and does, it's just sort of how and where those levers are.
[00:27:38] Amy: Yeah. And I mean, I think we're seeing very, very positive compliance and adherence numbers when it comes to, the weight loss category, more so than almost any other therapeutic areas, and when it comes to weight loss, people are committed to this.
And because they're having results that they're looking for. And, that's really encouraging to see.
[00:28:00] Megan Antonelli: Yeah, I mean, and the implications for it, I think, you know, even around, you know, what, what does impact behavioral change and that type of adherence? You know, there's so much to learn and a lot of insights that will come from it.
So, yeah, it's exciting.
[00:28:14] Amy: Yeah,
[00:28:14] Megan Antonelli: yeah. It's truly an exciting time. With that, we have just a couple minutes left, you know, what are you most excited about, in this kind of digital intersection of, pharma and their role in healthcare?
[00:28:27] Amy: Sure. I mean, as a side note, I've another sort of passion area, which is in women's health and women's health tech.
I mean, I am a woman, and I've got a lot of women in my life and my family and I feel like we've been a bit underserved as a cohort, even though we're like 54 percent of the population. I'm really excited to see a lot more focus in women's health, even, beyond fertility.
Like we know that fertility has been a very, very strong and important and popular area, but there's so many other things that we need to understand when we think about women and men, our chromosomes are different, our genetics are different, and a lot of the clinical trials that have been conducted have been on men, including male rats through like the nineties.
We know that, cardiovascular disease and metabolic diseases impact women differently because we have different genetics. And so we're starting to see a real focus on what the potential is there. The Biden administration has, committed, millions of dollars out there that, people can apply for grants to get access to that, to support their work.
And so that's an area that is a personal passion of mine. And I'm excited to get to network with a lot of people in the space. I'm actually. now chairing the Women's Health Tech Initiative through the HITLAB organization. It's the healthcare innovation technology lab out of Columbia University.
And, it's supporting a lot of amazing, People that are focusing on this space, a lot of women leaders, but also, there are plenty of men in the women's health tech space too. And so I'm really excited about continuing to support that area of unmet need.
[00:30:05] Megan Antonelli: Yeah, that's fantastic.
Well, we, we love hit lab. We've partnered with them a bunch, as well as known Stan for a long time, from my Columbia days, actually. So, but that's great there. I really do love their women's health initiative and And that's, and we talk about that quite a bit here.
And I think it is, it's a really exciting thing to see, you know, the focus shifting, you know, I remember being actually at the American heart association and, you know, realizing how all of these innovations that were there, I mean, so many of them are so clearly designed for men. You know, and it's a very, it went from the cardio, you know, monitors and all of that.
So there's so much new innovation happening. I'm really excited.
[00:30:44] Amy: We need to talk about that next time.
[00:30:46] Megan Antonelli: Yes. That could be our next topic for sure. Well, thank you so much. It is, so exciting to see what Novo is up to and what you're doing in terms of that, innovation and that intersection with social determinants of health and data and really getting close to the patient.
Thanks again for joining us I look forward to having our next talk about women's health and the work. Thank you so much, Megan.
[00:31:10] Amy: Have a great day.
[00:31:11] Megan Antonelli: Absolutely. Thank you. Until next time, stay curious, stay innovative and keep striving to make healthcare more equitable and accessible for all.
Thank you for listening.