Ginger Graham: The Changing Landscape in Healthcare Innovation

14^th Annual Thomas Fogarty Lecture: Focus on Innovation (Nov 9th, 2012)

Ginger Graham delivered the 14^th Annual Thomas Fogarty lecture this year, focusing on changing landscape in healthcare innovation. Ms. Graham is the current President and CEO of Two Trees Consulting, the former President and CEO of Amylin Pharmaceuticals and the past Group Chairman of Guidant Corporation. She also serves on several boards such as Proteus Digital Health, Genomic Health and Walgreens. With her extensive experience in both the pharmaceutical and medical device industries, Ms. Graham gave a thought-provoking talk that challenged conventional views on healthcare innovation.

Shifting Paradigms in Healthcare

Ms. Graham has spent the last two years gathering information about changes afoot in the healthcare industry from various sources, ranging from traditional healthcare providers and think tanks to entities with emerging healthcare interests, such as large retail operations. She collated insights from her research to highlight five major paradigm shifts that are transforming healthcare in the US and abroad, with implications for innovation in healthcare.

First, she spoke about the revolution in gene sequencing and the possibilities of a personalized approach to healthcare. The cost of sequencing the entire human genome has contracted at Moore’s Law rates, opening up opportunities to understand the genetic origins of disease. This in turn will enable the accurate prediction of disease incidence, its prognosis and its recurrence, revolutionizing the effectiveness of managing and treating stubborn diseases like cancer, autoimmune and viral disorders.

Next, she turned her attention to the changes in how patients access healthcare. She talked about the retailization of healthcare, wherein care will increasingly be delivered outside the conventional hospitals and clinics. Healthcare delivery is migrating to pharmacy counters, retail clinics and even to the internet. The growth of companies like Walgreens, CVS’ MinuteClinic and eye/dental counters at your neighborhood Costco are all part of the movement towards retail. According to Ms. Graham, the rigidity of the current healthcare system will have to give way to a more flexible, patient oriented system that rewards outcomes. She challenged the audience to imagine a healthcare system that received payment only for patients cured, rather than patients treated.

The third transformation is the digital explosion, with massive increases in the amount of information generated, manipulated and stored today. Ms. Graham talked about the need to manage increased computational capacity and to leverage it in healthcare. Medical products are becoming generators of big data and need to be thought of as not just products but as information systems. She also emphasized the mobile revolution, which is enabling telemedicine, particularly in resource-constrained parts of the world.

These emerging regions of the world also hold the key to the next big change in healthcare. In the next decade, the global middle class will expand to over 2 billion people, exponentially increasing the demand for quality healthcare across the world. These healthcare markets will undoubtedly leapfrog many of the technologies found in Western healthcare systems today, and Ms. Graham noted the importance of healthcare innovators keeping an open mind to learning from other contexts.

The final paradigm shift that Ms. Graham discussed was related to healthcare policy changes in the United States and their implications to the healthcare system. She talked about healthcare exchanges mandated under the Obamacare laws, which will radically change healthcare delivery in this country and afford a great opportunity for disruptive innovation in healthcare.

Lessons Learned Along the Way

In addition to delivering her stimulating lecture, Ms. Graham also took the time to meet with the Biodesign Alumni Women’s group. During the free-form discussion, she spoke candidly about building her career and the lessons she has learned along the way. She stressed the importance of knowing one’s own likes, dislikes and style of working in order to be most successful in a job: “if you’ve had a good day at work, go home and write down what you liked about it”. She said that approach had helped her seek out openings where her passions were aligned with her skills. She also talked about continuously gathering information about interesting opportunities, so as to be prepared to seize them when they become available.

In response to follow-up questions from her lecture, she expanded on ideas for disruptive innovation in healthcare. The aspiring healthcare innovator needs to take the larger perspective on the issues facing the patient, rather than focusing on clinical outcomes alone. For example, behavioral patterns of patients need to be taken into account when prescribing long-term medication as non-compliance is the largest risk to a successful treatment.

She mentioned seeking out a seat on Walgreens’ board, a non-traditional healthcare company by most measures but one that is rapidly transforming how Americans access healthcare, in order to understand the shifting paradigms better. The healthcare market does the patient disservice by being inflexible, and she talked about how patients are increasingly moving to healthcare providers that are flexible, easy to access, cost-effective and most importantly, effective at solving their healthcare problems.

We thank Ms. Graham for an extraordinary lecture and an engaging discussion.

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Ritu Kamal is a former Stanford India Biodesign fellow and currently works for Roche Diagnostics in research and development.