September 15, 2015 (Vol. 35, No. 16)
Stephen K. Klasko M.D., MBA
Time for a Radical Change in Collaborative Approaches to Healthcare Research
It’s time to break the mold. We need new models for collaboration between the health research industry and academia.
In the face of unprecedented generation of knowledge, we need to rethink how we speed discovery to patients. But we have an equally great mandate—to rethink how we select, train, and grow the next generation of health professionals and researchers who will create meaning from all this data.
When we hosted BIO2015 in Philadelphia this summer, it became even clearer to me that we need transformation of not just American healthcare delivery, but also of fundamental relationships between scientists and educators as they work to improve health.
First, the explosion of knowledge calls out for new models for research collaboration between industry and academia. At the conference this summer, BIO unveiled a new report on models for industry scientists to work with university research faculty: “Advancing Translation Research for Biomedical Innovation”.
The report showed that between 2004 and 2014, industry patents using university publications doubled. It also suggested that the time is ripe for expanded collaboration under novel ways to organize basic research, entrepreneurship, and competition.
But rather than congratulate ourselves for a “mission accomplished,” it is time to “double down” on moving from a vendor-vendee relationship to a solutions partnership relationship (with appropriate conflict of interest discussions). The only way that will happen is if we can reduce some of the local competition and fragmentation and create super-centers of innovation for:
- regional consortia for clinical research,
- experimental therapeutics centers,
- advanced biomanufacturing centers,
- centralized repositories for patient data.
Better Ways of Working Together
This is where new organizational models make sense. We need ways to work together that manage potential conflicts of interest and competitive secrecy while still accelerating the revolution of knowledge to advancing health. Some of these models may be “precompetitive,” where basic research can be supported and sped up by collaboration. Others may involve multi-university consortia that collect big data but contract it out as collaborators pursue product development. Some models may be entrepreneurial based on a risk-reward equation.
At my institution, Thomas Jefferson University and Jefferson Health, we’re seeing these models. We recently co-funded an entrepreneurship initiative with a major insurance company, Independence Blue Cross. Expect to see more science collaborations between providers and insurers.
A second fascinating example close to home was the deal struck between Theranos and Capital Blue Cross to provide super-fast, cost-effective blood testing in the insurers’ patient centers. As retail chains build America’s largest primary care networks, we’ll see more of this.
At a recent conference in which I was a speaker, the most interesting discussions regarding data and innovation were between academic medical centers and pharmacies (not pharma), understanding how Walgreens, CVS, Walmart, and others plan to use their own “big data” to disrupt and improve consumer healthcare delivery.
Lastly, universities need to figure out entrepreneurship. We have been averse to risk and suspicious of profit, sometimes with good reason. But I believe innovation is now a mission for higher education, and innovation means flexibility, speed, and the ability to take risk. We need tenure and promotion criteria not only to include entrepreneurship and innovation, but also to move toward an entrepreneurship and innovation “track” with a very different peer review group. And we need structures for faculty to share in return from risk, while providing a clear picture of potential conflicts of interest.
My second insight in watching these trends is that those of us who teach must ensure we’re preparing the workforce of the future. The healthcare industry already is desperately unable to find skilled professionals who can combine big data and user experience. We need engineers who understand the predictive analytics of genomics, population health, and user design.
We also need professionals who can help patients make meaning from knowledge. We know there’s a revolution waiting to happen if we can empower patients. But our current tools to help patients take control of their health are clumsy—we’re relying on exercise trackers when we need life changers.
Pharmaceutical companies are struggling to offer more than pills. They want to use their knowledge to guide behavior as well as provide medication. But Big Pharma often finds it doesn’t have the workforce to take that big step—to enhance health, not just provide the Rx. That’s a challenge for all of us as scientists and teachers.
Emerging Health Professions
At universities, our mandate must be to energize the emerging health professions that take this rush of scientific discovery and translate it into lifestyle and population health. We need to ensure our brightest students and young scientists are trained to lead the revolution, not to become frustrated by their training.
A recent editorial by Alan Leshner, the former CEO of the American Association for the Advancement of Science, hits the nail on the head. Leshner starts by observing that in the United States, more than 60% of new PhD’s in science “will not have careers in academic research, yet graduate training in science has followed the same basic format for almost 100 years, heavily focused on producing academic researchers.” He concludes that “the system is failing to meet the needs of the majority of its students”.
We need to balance our educational opportunities for these bright students. As always, we need to guide students who will become the next generation of bench laboratory researchers—those who will lead the science of the future. At the same time, we need to mobilize scientists who will figure out how to bring those breakthroughs from the laboratory bench not just to the hospital bedside, but also to the home, where people struggle with their illnesses and try to build up their health.
That’s why at Thomas Jefferson University we’re building an Institute for Emerging Health Professions, from forensics to habit change to “trusted health advisors.” I predict Emerging Health Professions will soon be a major college and a driver of the health science universities of the future.
The bottom line is this: the future of health belongs to patients “owning” their own health, at home, in their neighborhoods, and in their communities. We need a generation of bright young scientists to help us make that happen. It’s a huge task, but a tremendously exciting one.
The fact is that academics and healthcare are under siege with decreases in NIH funding, clinical reviews, and the recognition that we cannot solve this math problem on the backs of students through tuition. So innovation, academic-industry partnerships, and entrepreneurial education are no longer luxuries but rather prerequisites for survival and prosperity.
While some may view this as a threat, count me as one president that is very optimistic about this academic and healthcare transformation.