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"To create the future of health, we need to come together as an ecosystem"

27.10.2021

The future of health has already begun – but where does it lead us to? Patricia Gee is director of the future of health initiative at Deloitte Switzerland. We have talked to her about the drivers and barriers of the healthcare of the future. In our podcast episode, you will also learn how highly she thinks of Basel – and about her home team, the Chicago Bulls.

Patricia Gee, Deloitte

Patricia Gee leads the future of health initiative at Deloitte Switzerland. She sees a change in the perspective on healthcare that slowly drifts away from sick care towards health and wellbeing. With COVID-19, prevention gained awareness, with simple things like washing hands and wearing masks.

“The concept of health has gone far beyond the brick and mortar health system and has foot in the pockets with individuals,” says Patricia GeeBut it takes more than the individual to take responsibility for him- or herself. The whole complex health system needs to change. 

Data is the underlying piece for the future of health

To make that shift happen, however, a couple of things need to happen: “Science and technology are not holding us back. The bigger challenge often tends to be human behavior and that tends to be a difficult thing to change.” 

Patricia Gee doesn’t rely on an individual change agent in driving the future of health but sees this as a task for the whole ecosystem. But the underlying piece of that is data. “It’s crucial that we have data, and that we have the ability to connect it, read it, understand it and apply it.” While the data load is growing every second, interconnectivity of data is still an issue. “Imagine the power of connecting that data,” says Patricia Gee. The power of data doesn’t only lie in recognizing illness in a state when it can still be reversed and in better individual health but mainly in helping create better policies and in building trust.

“Basel will diminish the rest of the world”

Patricia Gee is convinced that the Basel Area is ideal to push the future of health for new startups and entrepreneurs who dare to think big. “Given the environment with universities, technology schools, academic hospitals, you have the perfect melting pot of expertise and access.”

DayOne, the healthcare initiative led by Basel Area Business & Innovation, is critical to push the future of health further, according to Patricia Gee. “These kinds of organizations are critical. It’s critical to come together as an ecosystem to solve issues, to find solutions. If you bring companies like us as advisers, companies like Novartis and Roche, patient organizations and people from hospitals and institutions in the area as well as startups together, that’s where the magic happens. When you bring a billion of people into a room to solve a problem together.”

About the Basel Area, Patricia Gee says: “I cannot imagine the significance that the Basel Area will bring not only to Switzerland. But also the rest of the world will diminish. The institutions and the talent create the perfect environment for continued opportunity.”

Podcast transcript – Patricia Gee: “To create the future of health, we need to come together as an ecosystem”

I’d say before we take a look into the future, let’s reflect on patients and their present behavior. I can speak for myself: I go to the doctor when I’m sick and only if it’s really necessary. What about you? 

I tend to be very much the same. I think it’s also by nature of the way, the environment in which I grew up and that we grew up in an environment where healthcare is generally considered sick care, right. So, what triggers you to go to a doctor? It’s when you’re not feeling well and I think ultimately what we’ve seen, especially recently as we put health instruments in the hands of patients, that’s what’s creating an initiative for them to look at health in a different way versus looking at the system as sick care.  

And the COVID pandemic, I mean, that brought a huge change. Did you see a change in patients’ behavior during that period? 

Well, certainly we saw lots of evidence for lots of reasons of patients not going in. Not going in for their wellness visits, also not going in for sick visits. So there is a huge decline actually in the care and I think there will be a huge impact on the backside of COVID and catching up on some of that.  

So imagine all of the cancer patients with delayed diagnosis, people who needed operative surgery, where those surgeries were delayed. Additionally, I think there’s a massive impact on mental health that continues to be an issue as we go through COVID. But I think the impact as we come out of the pandemic will be much bigger than what many people anticipated. 

But also prevention played a key role in this. You were talking about all the damage that we see in the health and sick treatment but what about prevention? Did the mindset change during the pandemic?  

I do think individual and population awareness of what can be done to help prevent diseases has grown through the pandemic. Simple things like washing hands and wearing masks in public. With that being said, I think it’s not just about the individuals, but about the policies that were put in place over time and you can see the variable policies in the US and Europe. Even within Switzerland, canton by canton had a huge impact on the overall responsiveness of the people and responsiveness of the health systems.  

Prevention plays a key role in the future of health. Can you tell me what you imagine health care to look like in the future? 

The concept of health care in the past has very much been sick care. I think when we talk about health care in the future we’re talking about a fundamental change towards the focus on health and well-being. It is about how can we advance the early diagnosis, how can we do things to catch conditions at a state where they can be reversed, at a state where you can find the underlying issues and correct those issues. I also think prevention plays a big role in the sense of wellness. I think there is an ongoing trend. I hope that trend stays of individuals, of consumers taking responsibility for their health. Whether it’s through things like 23 and me, and a lot of people going out and getting genetic testing on their own dime, or where it’s things like health and wellness programs. Apps that they use on their phone, like Nike training. The concept of health has gone far beyond the brick-and-mortar health system. 

I also read in one of Deloitte’s papers that diabetes and cancer could join polio as defeated diseases and I thought: well, that sounds too good to be true. How do we get there?  

I think it’s an interesting statement in the sense that I don’t think it’s science that’s holding us back. I think the scientific advancements that we’ve seen particularly over the last few decades since identifying the genome and being able to decode DNA have been tremendous. From a science perspective, I see that that is possible and potentially even within our lifetimes in some areas. But I think the bigger challenge often tends to be human behavior and that is a very difficult thing to change.  

You talk to a patient who is in their 60s or 70s, they’re still smoking and they want to enjoy their life and that enjoyment of life outweighs maybe the decision to live a more healthy future. It’s not as much a science issue and the potential of bringing innovations to market but much more how do you deliver policies and nudges to get people to make the right choices about their health.  

Are we ready for that shift? 

I think it’s difficult because we’re talking about population versus individuals. COVID is a perfect example in many cases. It affected a huge population and people weren’t only considerate it in most places of what their individual health was but of the impact of that society. I think there are definitely points in time, like COVID, that allow us to see a glimpse into that future. The rapid development of the COVID certificates and – whether it’s based on policy or individual behavior – people’s willingness to go through that to be able to live in a society in which we are trying to protect all in the public, not just the individual. I do think though it’s a challenge, for sure. People’s behavior shifts over time and sometimes we have to deal with the incremental nature of how we get to that change. 

Who is driving the change, from where does it come? Consumers, health care providers, the industry – where do you see that coming from? 

Health care is a complex ecosystem. It touches everything. It touches individuals as patients. When people talk about health care they think about the health care system of doctors of hospitals, but it goes well beyond that. You’re talking about government policy, you’re talking about financing health and wealth. It’s an important topic to think about as we get older and health care expenses start getting more. How do we balance that? What is the obligation of individual businesses to protect the health of their employees?  

I don’t think there is an individual change agent in driving the future of health. It’s really our ability to work as an ecosystem towards that future. If we look at a recent COVID example out of the US: getting a product through the US approval process and getting into the market is quite complex. And they recognize this and the only ability that they had to deliver it on time was to put in operation warp speed which forced agencies and companies in the entire ecosystem to work together to get to a vaccine. On the other hand, they had the downfall of the diagnostics piece where they just couldn’t get connectivity fast enough. They couldn’t get manufacturers to onboard early enough to scale the diagnostics products. So there was a huge delay in being able to predict where the virus was moving and how it was moving. To me, it’s an ecosystem that has to come together to work, and the underlying piece of that that’s so critical to the future of health is data and the ability to connect that data, read it, understand it, and most importantly apply it.  

Collaboration, data – where do you see the biggest barriers right now? 

Certainly, the interconnectivity of data is very difficult. There’s just so much out there and it’s just multiplying on an exponential basis with all of the personal applications. You have the underlying insurance data, systems data, hospital data. Just imagine the power of being able to connect all of that and accurately predict which patients will benefit from any surgery, at what point will they benefit from heart surgery. I do think not only in the infrastructure but also in the politics – and there’s a lot of concerns around privacy and data on a personal level – makes it hard to realize. Every country, every institution is somewhat tackling it in different ways. And we do see areas where it is more progress, where that is interconnected almost by nature of the way that the system was set up, in the Nordics for example. 

Can you give me an example from there? 

Sure. In many of those markets, the infrastructure of their hospital systems, of their payer systems was already highly integrated as these new data tools and systems came online. It enabled them to be much more predictive and proactive in their ability to use that data, because it already had the connectivity between payer systems, between hospital systems. They could collectively work together to help improve loss in the system, where things where the value of the medicine delivered or intervention delivered wasn’t producing the outcomes that were expected. So I do you think that there are markets that are inherently structured through history and through the development of healthcare to be in a better position to move to that future. 

You are advising companies about their progress, about digital health strategy, so exactly how do we get there. You also get an idea of the status quo. What is lacking? 

Before we jump into what the issues are I think digital health is one of those everything and nothing types of words. When I think of digital health it’s ultimately technology with people that are creating positive outcomes and interventions that show value through technology. So I think it is a very broad definition of how digital health works. Where do I see barriers? I mean, I certainly think the data interconnectivity point, because fundamentally that’s the backbone of being able to really make all of this work. I think that tends to be a big barrier. I also think how we handle data and that people have confidence and trust in the institutions that are doing this work. So how many people trust their insurance company to have full access to all of these things and potentially not punish them down the road? How do you trust a pharmaceutical company that you know is a profit-making entity with opening up all of your data? I think we do have a long way to go as institutions and industries to build that trust and to build that credibility. Then there’s policy and I do think policy can act as an enabler and it can also act as a brake to progress.  

In Switzerland, 1.6 million people have downloaded the Swiss COVID app and the vaccination rate is around 63% right now. Traditionally people trust the institutions in Switzerland and still we see that lack. What do you make of that? 

I think this also comes back to what makes policies, what makes interventions, what makes digital health successful to some extent. You have to understand what is the barrier and it’s not one answer. I think with vaccines one part of it is it was approved rapidly, it is a new product, it is a new technology. Never before have we seen people so interested in the underlying mechanism of how a product works. People do have a natural fear and I do think with doctors, with other health practitioners, with people who are trusted in their communities and their lives you could nudge those people towards feeling comfortable, towards making the next step in taking a vaccine or improving their own health outcomes. So I can understand why there are different points of view. I think less here in Switzerland but certainly in the US the vaccine has become politicized, so it’s almost a statement: well, if I don’t get vaccinated I’m stating my freedom – that one I understand a little bit less. I think that will dissipate over time and I am hopeful that some of those barriers will get reduced. You look at some places where there’s high trust and around 75, 80% of the population are vaccinated. So there’s hope. 

What can you make for example about the trust issue when you advise companies when that comes to the table? 

I think important with trust is transparency. I think that is something that the pharma industry – not as a whole, but every time one company makes a mistake, it has a huge impact on the entire industry. So I do think importance of transparency. Transparency of data, of results of their studies, of the kinds of activities that they’re delivering in marketplaces, for example how they interact with doctors, what that sales – and that’s almost a bad word in the pharmaceutical industry. I think it really has to be done on the point of creating more transparency which again comes back to data and the fact that you’re able to translate that data into things that are meaningful to individuals, right. So that’s the other thing: I think we in the industry have quite a complex language and quite heavily scientific ways of expressing things which doesn’t resonate with individual people. So, I would say it’s a twofold step.  

And there is one more thing when you talk about huge amounts of data and connectivity: is the staff there to tackle that? Do they have the talent? 

Absolutely. I mean, one thing is technology and then the other thing is talent. Science and technology I don’t think are our barriers. I think the applicability of many of the solutions that exist today can enable that future. Are the people ready? I think we’re seeing massive transformations in the industry on exactly that point because we need new skill sets, we need a new way of working. The whole concept of the future of work from a day-to-day basis will look very different. How a doctor will be a doctor in the future will be very different with the enablement of virtual surgeries and robotics and nanotechnology. I do think there is a huge upscaling of our capabilities and individuals, whether that be in the hospital system or health care companies, or pharmaceutical manufacturers.  

And where do you see the biggest potential? We have talked a little bit about barriers now but let’s turn this into something positive. 

This is where I think the potential is limitless. There are so many areas, especially if we talk about digital health and the implications of that. I mean, you have telemedicine and virtual care which enables access to treatment, access to advice, maybe in areas or in populations where it wasn’t so easy. You have advances and as I said robotics and let’s say the machine side of engineering, that is giving tools that are more precise. And putting those in the hands of practitioners halfway around the world to create those operations. Again I think, with the underlying data there is so much being done around AI. And I think the use cases are immense. The challenge with AI comes back to data and scalability, because every infrastructure, every institution, every country, region – the way in which data is coded, the way in which data is collected, is very different. I think scalability can be a challenge across some of these things, but yeah, certainly AI is an important future of how we’re going to be more predictive and preventative and drive a better wellness infrastructure. Patient support: I think there is an increasing amount of patient support coming through from all different directions whether it’s your tech giants like Google and Apple and things like that heading into the industry, or smaller startups in terms of really focusing on a niche area or a particular difficult-to-treat-disease, for example in rare diseases. Where you are really giving tools to the individual caregivers and patients that will allow them to better treat their own condition and better predict when they’re going to go through difficult times. 

You are usually advising bigger life science companies. Let’s give a bit of advice also to the smaller startups. Imagine a startup in the Basel Area that wants to be successful in digital health. What should they think about?  

I think a lot of the startups that I speak with have great solutions. Where sometimes I think enough work hasn’t been done necessarily is: who is the audience and what is the actual unmet need that you’re fulfilling and where do people value that? What you want it to be about ultimately, the end result of the patient, and that is ultimately serving that individual or person in their needs. But there are so many other stakeholders and players along the way and really understanding what value is to them. What’s incentivizing them to be a partner of yours, to work with you in producing more data, and to delivering your pilots? I think that’s an important point to understand what are the incentives and triggers, not only of what a patient need is and that there’s a desirability in the marketplace of the patient, but also who are all of the other stakeholders along the way? That’s really going to buy into the value proposition that you’re offering. So that would be one point I would say. And then the second point is: I think sometimes in Switzerland we don’t think big enough. How can you early on think about what the bigger ambition could be, what scale could look like as you progress from an early startup to a huge startup? I think these are two important things I would point out in the conversations. Focus on who cares about your value proposition and what problem you’re solving in the end, and then ensure that you have big ambitions and that you have a plan for how you’re going to scale that. 

And big money is not the problem? 

I think in Switzerland there are lots of funding agents. Clearly, we don’t have the same access to the funding pools as the US or the China market. Again, with big ambitions comes the ability to tell the narrative that can draw funding from other centers of biotech in early-stage health startup funding. I don’t think fundamentally funding is the primary barrier. 

Are there any interesting, exciting developments that you have seen recently in Switzerland that you can tell us about? 

I don’t work with a lot of local Swiss companies, but what I will say: given the environment that exists here, the universities, the technology schools, the hospitals, the academic hospitals you have the perfect melting pot of expertise and access to bring those things to market. The companies that I’ve mostly spoken with are looking very much at how can we bring AI solutions and data solutions to market and how can we put more solutions into the hands of individuals? They are looking at applications. Most of the startups that I speak with could just think so much bigger.  

There is also the DayOne Conference that you are part of. What do you make of initiatives like this that deal with bringing people together from different fields? 

Critical. I mean these kinds of institutions, organizations are absolutely critical. As I said I think one of the most important things is how do we come together as an ecosystem to collaborate and solve issues together. And I think by being able to bring together companies like us as advisors, like Deloitte, companies like Novartis and Roche, and bring together patient organizations and people who are from hospital institutions in the area as well as startups, and I think that’s where the magic happens when you bring brilliant people into a room to solve a problem together. 

What do you think the future holds for the Basel Area as a leading hub for digital health? What are you doing about this? 

I wouldn’t have come to Basel if I didn’t think it had a hugely bright future ahead of it. And it has already created massive global and world impact on healthcare throughout history. So I can’t imagine the significance. The impact that the Basel Area can bring not only to Switzerland but to the rest of the world will diminish. So I have high hopes for the Basel Area. I do think, as I said, the institutions that exist here, the talent that continues to come in here creates the perfect environment for continued growth, for continued opportunity. 

You’re from Chicago, so I need to ask you this: Chicago Bulls with Michael Jordan or FC Basel? 

Chicago Bulls. I’m sorry. I mean I grew up with Michael Jordan. I was a kid going to the basketball game,  I got to go to watch the World Championships, I have a basketball signed by Michael Jordan, Scottie Pippen, and B.J. Armstrong.  

What do you miss about your home country, Patricia? 

I think what I miss most, certainly my grandma’s home cooking. It’s mostly family and friends connections. I don’t necessarily miss the US per se, because I’ve loved being able to integrate here into Switzerland. 

Why did you move here in the first place?  

Both personally and professionally it was the best place. I work in life sciences. Switzerland is probably the second-largest hub in the world for producing innovations and real impact and personally, it’s just a wonderful place to live. I can go 15 minutes and be in the mountains or on a lake. I mean that you can find almost nowhere else in the world where you have those two things together in one place. And I think, in particular, Basel Area is quite international. It sits at the border between three countries, Switzerland, Germany, and France.  

And in addition, I think it’s welcoming to expats in Switzerland. We have Novartis and Roche, so two large international companies sitting here. There is a wealth of knowledge and expertise coming out of the universities and hospitals in the area. I just think it creates such an amazing well-rounded place to have a career and to grow your personal life. 

Do you wear a smartwatch or a mechanical wristwatch? 

I don’t wear a watch. This is maybe one thing that was difficult for me coming to Switzerland: everyone here is very punctual and I am always very late. So maybe a watch would be a good thing to add to my armament. 

You have a dog. Is walking the dog your best effort in prevention or do you have any other healthy habits? 

Oh no, I do have healthy habits. Definitely in terms of eating and the way in which I set my diet. I tend to be a faster, so I have a fasting diet which I think tends to work really well for me. I also go running, I try to do at least three, four days of exercise a week to get out but mostly it’s with my dog. 

I have one more question: which book can you full-heartedly recommend? 

Nudge. 

Alright. Thank you, Patricia. 

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