MIT Sloan Health Systems Initiative
The 2021 Sloan Healthcare and Bio-innovations Conference
Is Faster Better? It Depends, of Course.
Three student co-leads marshalled a peer staff of 35 to design and execute the annual Sloan Healthcare and Bio-innovations Conference in February 2021. This year’s theme was, “Is Faster Better? Exploring the Trade-offs Between Speed and Medical Innovation and Quality of Care”. Members of the student-run Sloan Healthcare Club are always responsible for this conference, but this year, the 19th, presented new complications since the event was held entirely online.
Conference attendees couldn’t be placated with cookies and coffee; the team had to think very thoughtfully about maintaining engagement throughout the event, mitigating participants’ screen fatigue and supplementing an off-the-shelf package to host the event on a reliably stable technology platform. In all, the conference team did a fantastic job of using the best of in-person and on-line aspects to deliver an exciting, thought-provoking conference featuring three keynotes and six panels. A sampling from the day’s events follows.
Four Levers Affect Drug Discovery R&D
Most sessions explored various balancing acts required to optimize complex healthcare systems. And many featured highlights of how the COVID-19 pandemic forced companies to make decisions in a rapidly changing environment.
The opening keynote speaker, Kathy Fernando, Head of Worldwide Research Development and Medical Operations for Pfizer succinctly summed up the trade-offs in drug development. Speed is not the only factor, nor is it the one to prioritize at the expense of others. It depends. Rather there are four interconnected levers in research and development:
Quality (degree of innovation)
Volume of programs
Speed of execution
The objective is to optimize the system within a culture of objectivity, free of or at least cognizant of recognized biases embedded in decision making. Sophisticated and thoughtful integration of levers is the goal, not deciding which one is best. Integration was a recurring theme throughout the rest of the conference.
Five Factors to Balance for Successful AI Drug Discovery
One of the morning panels, “Using AI to Accelerate Discovery”, outlined five factors that need to align for successful drug discovery. One of these is management of expectations around data. While the phrase “Big Data” might suggest a plethora of data for any sort of application, the data needed for drug discovery is patchy, and there are areas where data are scarce. So, first infrastructure and data are needed. Along with patchy data, there is also a disconnect between the people who create the data and those making the tools to address the problems. A collaboration between those making decisions about data generation and those seeking to derive value from it would ameliorate this rift. So, the second factor for success is a talent pool of cross-trained individuals.
The remaining three factors follow a similar theme. With standardization, data can be more useful. With thoughtful connections to those who will use what is developed, the downstream will be ready to use what is produced. Wrapped around all of this is management support, the fifth and final factor.
A final requirement is for these five factors to thrive in an enlightened scientific environment. Observation, long the most used scientific method, does not work in using AI for drug discovery. Instead, development and prediction happen in a sort of black box that requires different methods of validation than observation. This change is not fast, but it is necessary.
Another panelist addressed a common concern that AI will replace people. He clarified that AI/Machine Learning will not supplant workers in the healthcare industry, although one day workers who apply AI/Machine Learning tools may supplant workers who don’t.
Balancing Speed and Integration to Address COVID-19 Vaccine Challenges
The afternoon keynote, “The Value of Downstream Innovation - Improving Patient Access to Groundbreaking Therapies” featured Bill Sibold, Head of Sanofi Genzyme. He emphasized the central role of patients in drug discovery successes. “Patient care, safety and efficacy have to be front and center. Not something that is managed…Developing the COVID-19 vaccine in such a short time without sacrificing patient safety and efficacy is a success that can be replicated, if we keep the patient in the center and innovate around that”.
Another afternoon panel, “Accelerated Refocusing and Repurposing in Times of COVID”, similarly put the patient in the center of the solution. But in this case, the focus was global – all patients. “If you don’t work to help everyone, the virus pool keeps adapting and then affects all of us again…it is a local problem that requires a global solution”.
The conference explored trade-offs among innovation, speed and quality of care at a variety of levels from AI in drug discovery to vaccine distribution to patients. Ultimately the problem isn’t about trade-offs among just these three. As the conference discussions made clear, there are additional factors in this system and the complex calculation is to optimize all these competing factors for the best possible patient outcomes.