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Designing the Data-Driven Medical Affairs Team of the Future


About this Webinar:

The pandemic has presented a myriad of challenges to our health system. But these challenges have also fostered significant innovations. In medical affairs, agile teams have pivoted to more data-driven engagement strategies and adopted technologies that will provide lasting value for the MA teams of the future.

In this webinar, you will learn:

  • Why insights from dynamic data is key to effective digital engagement
  • Why stagnant lists are inadequate for tracking and responding to fluid care patterns
  • How you can take advantage of the technology trends that have taken hold amid the pandemic, many of which are here to stay

Webinar Transcript:

00:00 Neil Patel: Alright, we are going to get started today. Thank you so much for joining today's webinar, "Designing the Data-Driven Medical Affairs Team of the Future." We're super excited to have a moderated panel discussion today, and I will hand the floor over to today's moderator, Dave Bitner. Dave?

00:19 Dave Bitner: Alright, thank you. Thanks, Neil, I appreciate it. So for today's conversation, we're going to be having a sort of a fireside chat. We'll start out with some introductions across myself and my two guests, Joe and Jason. We're gonna look at some current trends and sort of the market point of views coming as a result of COVID, and then we'll have a moderated discussion around how we think that COVID has impacted medical affairs, how data is going to drive decision making and potentially changes, and how customers are engaged. And then, we'll go with some audience Q and A, and then finally to conclude with some key takeaways.

01:09 NP: And just a reminder for the audience as well, the Q and A box is at the bottom right-hand corner of the screen. As the moderated panel is going on, please feel free to submit questions and the panel will get to those.

01:28 DB: Super. So just considering that we're going left to right here, Jason, if you wouldn't mind, go ahead and do a brief introduction on yourself.

01:35 Jason Olin: Sure. Hey everybody, Jason Olin here. It's nice to participate in this. I'm Vice President of Medical Affairs at Akebia. And as you might expect, I'm not here speaking on behalf of Akebia. I'm just telling you what I'm thinking based on my previous experiences. I've been in pharma since 2003 which to some of you might sound like the good old days, but when I started it was really... It's supposed to be the '90s that were the good old days. So I'm really happy to talk to you about my experiences going through this very interesting time in med affairs. Thanks.

02:11 DB: Super. Thank you so much, Jason. And I'm Dave Bitner. I joined Komodo about a year ago. I'd had come over from over 20 years on the pharmaceutical manufacturer side, having worked for about six different manufacturers. I was always on the commercial side, so I'm grateful to have colleagues like Jason and Joe here who can represent the medical affairs side. I think in some cases, the needs of the organization are similar. Perhaps the deployment is a bit different, and some of the regulatory... There's some regulatory differences in how we can engage our customers, but all in all, we are ultimately all trying to drive impact to... Or not impact, but to drive conversations with the physician community to make sure that appropriate patients are ultimately served down the road. I, again, come from a number of different pharmaceutical manufacturers. Most recently, I was at Intercept Pharmaceuticals for about a year. I came to Komodo as a client. I had an enormously complex project to do, and I was so enamored with the Komodo team and the vision and the Healthcare Map that they had assembled that I joined about a year ago. So Joe, please, if you don't mind.

03:45 Joe Imperato: Absolutely. I also wanna thank you and the Komodo team for having me here. I'm thrilled to be a part of this. By way of introduction, I'm a Senior Medical Director in the medical affairs group for Oncology at Regeneron Pharmaceuticals. Like Jason, my opinions are those... Or what I discuss today really reflect the opinions of myself and not of Regeneron Pharmaceuticals specifically. But in terms of my background, I've also had approximately 10 years of experience in the manufacturing side, working predominantly in medical affairs across biosimilars, cardiovascular and most recently, oncology with a break in there where I was actually doing some work on regulatory policy and also in the clinical development, both late-stage and early-stage, which has given me a nice broad vision of the drug development life cycle, including working to and through the launch. So I'm really looking forward to today's discussion.

05:01 DB: Super, super. So again, as mentioned earlier, our goal here is to significantly reduce... Both of our founders, our goal and their goal is to significantly reduce the burden of disease, and over time, they have assembled a best-in-class Healthcare Map, which is a combination of data aggregator data, claims data... In some cases, some EMR data, as well as complete payer data sets, which we feel gives us more depth and breadth across the entire healthcare system in the United States than just about anybody out there. So one of the things that we think we can do is just this, we can help our customers think about how they can leverage that data now in ways that will help them basically enhance their capabilities and move past ways of doing things that were commonplace five and 10 years ago, and really to bring cutting edge technologies and platforms to do this. So the way I'd like to set this up is, a lot of the ways that we engaged healthcare professionals in the past, be it commercial, be it medical affairs, in this case, we're gonna discuss medical affairs, was to deliver the right message hopefully at the right time. But this was all reliant upon things that put the patient... That didn't rather put the patient at the center.

06:54 DB: So a lot of that was just engagement with thought leaders and HCPs that were potentially dealing with high volumes of patients and then trying to communicate a medical conversation about a product or an MOA to them, but not necessarily in an entirely patient-centric way. So if going back to trying to reduce that overall burden of disease, we need to think about patient centricity here first and foremost, and then think about ways that we can help utilize data and technology to assist med affairs teams to look at clinical data because clinical data is an indicator of patient opportunity. And so hopefully we can move away from some of these antiquated approaches and drive more efficient, effective, conversations with physicians who will have these populations. And so hopefully thereby, even further increasing the likelihood that the appropriate patients will be at least considered for these therapies, especially given that there has been an opportunity for a medical conversation to ensue between the med affairs teams and the providers.

08:33 DB: And a lot of that in the past was sort of a serendipitous or a sort of hopeful interaction with an HCP and an MSL, or someone else in medical affairs who could convey that. And so the notion would be that through some of these software as a service applications and platforms and through a much stronger tighter healthcare map, we can do that much more effectively than we did in the past. Okay. So with that, what we're hoping to do here is we're hoping to create an environment where we can get a hopefully a better understanding of how that data is being used in the marketplace right now, and whether or not trends in the past are sort of moving towards this now, and even more of a... Even more of a sort of a breakneck speed because of the introduction of a global pandemic I.e, COVID-19. So I guess, Joe and Jason I mean, so how have you probably seen over the last few years these macro trends develop over time? And then how do you think about how COVID-19 is accelerating changes in the marketplace that might have taken longer to draw out, but are certainly probably drawing out sooner?

10:19 JO: Which one of us you do wanna go first?

10:21 DB: Okay. You can go first.

10:22 JO: All right, very good. I'll start. Thanks. Thanks. So I think the first thing I want to say before we start is just to remind all of us, we're all [chuckle] in this together, right? This is really an amazing time, and it's me and Joe up here sharing our opinions about this, but it could be any of you, frankly, because this is new to every one of us. So just to start answering that question, I think that it has a lot to do with access to information and the traditional ways you might get information. So one of the first things I've noticed is how hard it is just to get information because we have to schedule times to meet. So the in-office experiences where you can just run down and grab somebody, and we all know this is gone. And the side effect is scheduled meetings and then scheduled meetings that take longer and eat up more of our time. And I guess the last part I'll toss in there is that there aren't really great boundaries between the work time that you have and the home time, like when does your day really end?

11:30 JO: And I know for some of us, there's dependencies you have around you that call it to end whether you want it to or not. But even so, the computer can be on for as long as you want it to be. It's easily accessible if you have Teams or Slack or whatever, you can always be shown as being right there, whether you are or you aren't. So I just think just to kick it off, that's just... That's just there's just plenty to just think about, just the in-office home experience. Joe?

12:02 JI: Yeah, I want to echo that as well as somebody who's just recently returned to a company that they had worked for for six years. I am the beneficiary of having a pre-existing relationships in my current department in medical affairs, but one thing that I find very challenging, getting ramped up in this particular group, under the auspices of COVID where we are basically doing everything remotely. I couldn't agree more about the challenges in getting information from team members as you're trying to sort of piece together where we are in terms of strategic direction, et cetera. And I think that is... One of the things that I like most about medical affairs myself is that it is a very collaborative discipline within the pharmaceutical different types of job functions. Having been in clinical development, which is its own unique culture, in medical affairs I think we really do rely a lot more on face-to-face interaction, not just externally, which obviously is very important. But even internally with various stakeholders, since we sort of straddle lots of different worlds.

13:17 JI: To try and do that effectively remotely, it really poses a lot of different adjustments that we need to make, and really the effective use of technology like we're doing right now becomes paramount to be able to make best use of that. And I think we're still sort of collectively as an industry, sort of figuring that out but in real time. Whereas these changes might have been already in the works and would likely happen slowly over time as people gravitate anyway naturally towards more work from home and the like just because I think in our industry, there's a finite amount of specialized talent out there. And so in order for companies to compete, they are a little bit more flexible with those things. Now I think we're gonna see a major acceleration in that because we've had to adapt to this. And so I think it's gonna be interesting to see how that persists once the pandemic is over.

14:20 JO: Yeah, I wanna toss something else into this too which is, in med affairs... We're talking about med affairs and so much of what we manage are the optics of things, the perception of what we do versus what we really do, and that often takes precedence in what we communicate via email. And again, our... So much of what we have to do, we have to say to each other because we're managing optics, and it's so much harder to do that today.

14:47 DB: Yeah, I'm sure it is. So I guess the question for me is, just how far different really is your job today than it was in February?

15:06 JI: I'm happy to start with that. I mean, I obviously have a little bit of a unique situation, but regardless, I think, unquestionably trying to manage group discussions, particularly those where we have to drive towards decision-making, it's more challenging. And there's a funny meme or video, I think, that was circulating a couple of years ago where it's people live in a conference room simulating what it's like to be on a teleconference. [chuckle] And people are hanging up and leaving the room and all this other stuff. Well, it is funny, but now everything is like that, and so we don't have the benefit of being live together.

15:58 JI: And so one thing I've seen that's actually quite interesting, I'd like to see if Jason's noticed the same thing, is in a lot of the platforms that we've been using, there's been a very judicious use of the chat feature, which I think different platforms have different functions that... The one that we tend to use is Skype, and so they have a really nice chat feature where sidebar conversations can occur in real time as presentations are happening amongst the group, and it's actually kinda nice in a way, it has added a different layer of efficiency, I think, to the way that the meetings are run in sort of a surprising way that you wouldn't necessarily get in live meetings. Obviously, there's a give-take, but I think that's one of the benefits that I've seen, and certainly a change since February for me.

16:52 JO: Yeah, say for... Sorry, you were gonna...

16:54 DB: No, no, no, go ahead.

16:57 JO: Yeah, yeah, yeah. Yeah. So yeah, the chat feature for us, it depends on the meeting and the group, there's some... It isn't homogenized across the company, right? So and externally as well so some people are just more that way than others. We were talking about this before about the use of video in communications, and some companies everybody has their cameras on and others they don't. And so when you get together, it's very noticeable when this occurs, and we haven't really set up norms to navigate how to manage that either. So it's not like we all have a tool kit for when you're in a situation, what's the right way to talk about this? Or do you not talk about it? So this is all the kind of thing we're sort of dealing with.

17:39 DB: Sure. Sure, and I know it's probably early on, but are you experiencing that there are specific... There are archetypes of physicians that are... Or HCPs that are engaging in very different ways? Are some just withdrawing all together or are some really embracing this change? What are you seeing out there?

18:06 JO: Well, one thing is, we're past the beginning phase of this disruption, right? So people have shifted to the point where they realize to communicate, you can communicate virtually, and just about... It seems like everyone's had some exposure to a platform like this one. So it's not the very, very first time, which helps. So that helps a lot, but nevertheless, there are people who are more tech savvy and tech comfortable and you can have an easier time relating to them. Just to be ridiculous for a second, I'm sure we've all had this sort of meeting where you're talking... The person's talking to you like this because this is where they see you, right? [chuckle] And it's kind of hard to navigate that. You know what I mean? 'Cause you don't... You can't really tell sometimes what their expressions are non verbally even 'cause they're turned virtually in some other direction. Yeah.

19:03 JI: Yeah, it is, you know the whole unspoken body language piece of it becomes much more challenging, much more different in this environment than an in-person encounter. And I think that to kinda build on what you're saying in terms of how physicians have sort of taken to this, I think that the first month or two, I think it was a little bit more challenging, not only because I think physicians were in various stages of comfort level and adapting to this new normal, but also on our side, trying to figure out our best way to kind of incorporate this. Because, obviously everybody's used to sort of dealing with things the old way, which was especially let's just take the field for instances, flying out to somebody's institution and setting up a meeting and meeting with them face-to-face. So all of a sudden, you're sort of challenged with doing these types of things and trying to engage with people this way.

20:06 JI: And one of the things that you probably don't think about, but I've heard and seen is that there are compatibility issues sometimes if somebody has a certain platform or is used to using that, but we're not using that and vice versa. And these are things that you would not necessarily think about pre-COVID necessarily. But they are now a very real concern and I think that some of those things... Again, as the overall population is getting more comfortable with these, I think that's becoming less of an issue, but it certainly was there at the beginning.

20:42 JO: Yeah. Oh yeah, it's a good point, Joe. Because, the situation where we have faced these challenges, and I'm sure we all have is sharing your content when it's not the platform you usually share your content on. [chuckle]

20:56 JI: Yeah.

20:56 JO: Yeah.

20:57 DB: We're not going into that. [chuckle]

21:00 JI: Well, and furthermore, with all of the... I think that at the beginning here, Zoom just experienced a complete explosion in usage, and then it was quickly noted that sometimes there was a bit of a security issue with the platform and that has also raised additional issues, I think more from a legal and IP perspective. And maybe even a regulatory perspective to kind of consider those things when determining which platforms we use and don't use.

21:35 DB: So the next question I have for you guys is being that you're medical affairs professionals. How important is data and technology and not so foreign technology in terms of whether it's WebEx or Zoom or... But how important is data and technology or how much more important? How much less important? Is it equal? Is data an identification of who you should be talking to and technology services to help you whittle down who you should talk to? How is that playing... Are you seeing that as becoming an increasingly important thing, or are you not seeing that a lot yet? Jason, if you wanna go...

22:25 JO: Yes, sure. I'd say right now, it's of greater importance and it's because it's a bit harder than it used to be to gather information, right? So when there's something we don't know and we have to gather it, it's just not as easy as it used to be. For all the reasons we've been talking about, yeah. And so as a result, any place where there's a resource that has that information readily available, it's just from a practical point of view, it saves us a lot of time. Now, inevitably, we all know there's lots of gaps in our knowledge that come from insights that we can only gather by talking to certain experts or certain people that we can't get from a database. So that's always going to continue, but there are parts... There's vast amounts of information that's already been gathered basically that when we can access it just saves us a lot of time.

23:15 JI: Yeah. And I think sometimes it's a bit overwhelming because the channels of information and the types of information that exist out there for us to dive into seem almost limitless, and as we try and leverage these things... This again, I think is gonna... Speaks to an acceleration of something that was probably inevitable anyway, even without the pandemic. Data is obviously become a key feature of all industries. And the aggregation, gathering and organization of said data and acquisition of data is very important. Clearly that is the stock and trade that our industry deals in, because essentially data is everything for our molecules, for understanding patient practice patterns, etcetera, etcetera, even internal performance metrics, for instance. So I think that hopefully what this is doing is allowing us to become a little bit more focused on how efficiently we can gather that information and finding resources that help us do that to make our lives easier as we try to adapt to a world where we're not able to readily go and get first person information to insights, etcetera, from experts as easily as we used to.

24:44 DB: Yeah. So I would imagine, and I would imagine in a post-COVID world that there are probably... And you can correct me if I'm wrong in this assumption, because this is not a data driven assumption, but logic would suggest that there are less people that you can reach now than you could potentially have reached even when you were able to go out and have more face to-face interaction, right? So, it's probably like, this pool used to be this big and now it's this big because for a variety of different reasons. You've got no seas... And you have no seas because people are obviously worried about contracting the disease itself, all these kinds of things, right? So, specifically, what pieces of data or information are most important for you in order to determine who you're going to try to see so that you can be as effective with your time and efforts as possible? Are there any thoughts?

25:51 JI: I think it's gonna... I think it'll depend on the question that you need answered. I think a thorough profiling of the experts within your therapeutic area, understanding sort of what their research interests and their affiliations and so forth are to help you triangulate how best to efficiently get information in a targeted fashion once you've decided what questions you need answered is going to be critical. Now, we already do that through a lot of other means, and it's been a part of the industry for years, but those types of profiling exercises are getting more and more sophisticated as platforms are able, again, to aggregate data more efficiently and more meaningfully. So I think that it might be just a function of creating a better mousetrap in terms of providing us, as medical affairs professionals, with richer information to help us be more targeted in getting that information.

26:58 JO: Yep, I agree completely with what Joe's saying, and I think the other part of it too is the skill-building around how to get connected to those people when you know who they are, and that's the other part of this that's new for us too, because it takes an additional skill sometimes to make those meetings happen when your opportunities to meet are more limited. So the folks who you traditionally could get a meeting with by seeing them at a live congress and catch them at the end of their speech, that's gone. So if that was the way they were used to engaging and setting up meetings, and they don't even know of a way to do it, you see what I'm saying, right? Those kind of skills are really valuable. So we may know who we wanna see, but if they don't have their own way of figuring it out, we have to figure it out for them, and that takes skill.

27:50 DB: Are you seeing that sort of innovation in some of these virtual congresses? Are they trying to come up with mechanisms for you to mimic that sort of interaction?

28:08 JI: Sorry, Jason, I haven't seen it. I feel like the virtual platform is good in some ways, because I think it allows you to more easily deal with seeing important, relevant data presentations in a more efficient way, but as far as expert engagement, my experience has been that we've had to operate outside of that and essentially engage separately, because it's no longer the place where everyone's gathering physically, so you're not doing that. Jason, I'd like to hear your experience as well.

28:47 JO: I'd say more than anywhere else, this is kind of the frontiers, and so we all are reaching out to folks who've gone through virtual congresses to see what's working and what's not working, so the kind of thing that you imagine might be obvious is not. So let's create a virtual booth that has someone who's always there on a video that you can always see, doesn't seem to be necessary based on feedback we hear from people at other congresses. ASCO was the last big one, so there's a lot of ASCO feedback coming out. But this continues to evolve, right? I think the key learning is, for these virtual congresses, the reality is, no one's actually at the congress, right? No one's there, and so it's not like the person's thinking mentally that they're at the congress, because they actually aren't at the congress, you see. Where they attend sessions, it's different. So even the question of whether we should be planning to engage with experts during a congress's time frame may or may not be necessary or realistic or add value.

29:49 JI: Yeah. Instead, we might find that it just gets spread throughout the year and a lot of those engagements are not necessarily opportunistic, tied to a congress, but instead are happening as we find that we have specific questions or certain internal datas being released and we need to better understand it and get feedback on it, so it's more tied to those types of milestones than it is the congress's.

30:16 DB: Yeah, and as you both know, a lot of the conversations are in between things or during a particular session that you didn't necessarily and then you run into a colleague or it's sitting around a coffee or it's over lunch, so a lot of that stuff is gonna be very difficult to replicate, so...

30:37 JO: Yep, it is difficult, it is, and even though we're all now really used to having these planned video meetings, which aren't necessarily formal, it's hard to let that slide away, because you do now have to schedule and plan everything. There's no more spontaneity that you can... That's gone for a period of time.

30:58 DB: And so I guess the last question I have before we jump over into something else, how much do you just subjectively, how much of an impact do you think that this has in pulling back the way scientific information is communicated overall? Do you think we're gonna see that this is gonna actually inhibit standard of care, treatment, information flowing through overall, or... And the reason I ask this, 'cause it's a bit of a segue, probably, into the next conversation.

31:33 JO: I'm an optimist about this. So I'm not... I actually am not so concerned that information won't be exchanged or transferred, or that knowledge won't be able to get there. There're so many channels that have been around before COVID-19 that exist that people have already been familiar with, so I feel like... I think that there's certain ways that we've been traditionally communicating that have been disrupted, but just generally speaking in terms of knowledge transfer, I think it will happen.

32:03 JI: Yeah, I tend to agree. I think a lot of what we, the ways in which we get information is already through some of these sources and going to websites after the fact, after a given congress. It really comes down to the engagement directly with HCPs, which as we said earlier, has changed a little bit, but I think we're adapting.

32:27 DB: Okay, great. So just recognizing that we've got roughly about 20 more minutes, and I wanna make sure that we leave some time, I thought we would segue now into what I would consider a fun blue sky sort of exercise, which is really spending more time just talking about what you think is going to stay, what best practices we might get out of this, whether or not in your opinion, without leading you guys, but in your opinion, do you think that it will revert once this pandemic is over, in a lot of ways, and just general thoughts about how you think that, are we gonna bounce back? Is it gonna be a hybrid? Is it gonna be a complete shift? I mean, I think these are all the questions people are understanding. And a lot of it, you know, it's not just tied to how we're going to be able to do this, but whether or not there's a future in med affairs for people, you know, I think there's a lot of different ways to think about this, right? So I'd love to hear your thoughts.

33:36 JI: Yeah, I'll go ahead and start off on this one. I mean, I think you know, taking this in two different parts. You know, for instance, I think the big elephant in the room is, and the thing that changed the most is how we engage live at congress, at scientific congresses and things like that. And I do think that while those are probably going to be some of the last things that go back online once we are "back to normal", given the type of the activities that they are, and the risk for transmission of viruses, et cetera, I think there's a lot of pent up demand for that. I mean, I do think that even though in-person attendance at these, by kind of garden variety practicing physicians has gone down over the years, and that's more of a macro trend for a variety of reasons, including, challenges in the office in terms of finding time, et cetera.

34:29 JI: Among the types of experts that we engage with who are primarily clinician-researchers and the like, this is still their opportunity to engage directly in the dissemination of science that they're involved with, and they value that person-to-person networking very much. And so I think that those will likely come online, but do so slowly, probably as people get more comfortable after we have a vaccine et cetera. You know, what kinds of changes will that leave us as med affairs professionals down the road? Well, again, we've had a forced crash course in the adoption of various different types of technology here. I think what you're gonna probably find is a little bit more of a mix in the future of in-person meetings that have to happen at congresses with some of these virtual platforms, and maybe that will allow more flexibility based on need, and a certain level of comfort in engaging that way, on both sides of the relationship, both on the industry side, as well as with our stakeholders and the physician community.

35:52 JO: I'll say this, the med affairs has been around for a pretty long time and has gone through its share of disruptive events. So there was a time where you could create any manuscript you wanted and present data as many times as you wanted. And there was no such thing as a needs assessment document. This all came about because of CIAs right? So there was a period where if anything happened, it was fine. We didn't really have to justify how many times we'd met with people, you know, pharmaceutical companies went through that transformative change as well. So there have been these kind of events that change how med affairs functions. This is another one of those. I mean, you can look at it that way too, right? This is just sort of like just a disruptive event, but not a... It's a worldwide disruptive event. But in terms of what it's doing to medical affairs, there's a lot that still remains the same.

36:47 JO: What Joe said about meeting with advisors or getting expert feedback, I think now there's much more comfort and expectation and an understanding of doing virtual meetings, virtual advisory boards. So I think that's gonna continue because they can work, right? There's a lot of learnings that come from conducting those and being effective at those that everybody has to go through. But I think that's going to continue. At the same time, when it's safe again to have face-to-face meetings, we'll strive to do it. Now is a hard time to do it, talking with some of my colleagues, we weigh what is it like to go see somebody who you don't really know that you're building a relationship with, to sit in a room at least six feet away from them, and all of you are wearing masks, right? They can't tell... They can... Maybe they can tell if you're smiling, but they may not be able to tell if you're smiling.

37:48 JO: While on the other hand, you could have a meeting like this where you see each other but you're not in the same room. Right? So this kind of calculus about relationship building has changed a bit. But I think that it's not impossible to build relationships and good relationships with people you've never met before and only do it virtually. But there is the added value of those actual face-to-face encounters.

38:11 JO: We haven't spoken yet about kind of the other audience that we all think about too, which is where the medical outcomes folks go and talking to business-oriented scientists. That's a place where there's also this disruption and I think traditionally, where that face-to-face navigation has meant a lot. So, I think if there's any place where there's probably more desire pressure to really have people in the same room with masks off, that's a place where we would love to see that happen.

38:49 DB: Okay. Is there anything I haven't covered that you guys would like to talk about as well?

38:58 JO: Ah, let's see. I'll say this 'cause we've been... I wanna share a few learnings about doing virtual advisory boards, the kind of things that you only realize as you're doing them. So, one thing is getting to know folks the usual way, you have your meeting and you sit around. Your usual way is you have some dinner on the night before and you get to know each other, and then you still have your time at the beginning of a meeting, and you'd speak to each other and get to know each other. In the virtual setting, that takes a lot more time than you might expect. And we've been trying to figure out how to make that be more easy to do, maybe require like a happy hour the night before, to take pressure off of the meeting to have the get-to-know-you part occur. The other part is making sure you have those channels open to communicate with each other on your team, which are actually really easy to implement, but you must realize you need to do it. So, it helps when your moderator can be reached by anybody to have them feed in a question if necessary. And the other part to think about is if you are working with other stakeholders, other partners, other partner companies, to make sure they're part of that communication chain as well. So, those are the kind of things that help make those meetings go even more effectively.

40:27 JI: Yeah, and one thing to add to that, I think that was really, really good and I'm glad you brought up the ad board piece, Jason. I think that in addition to that, I think the facilitation is very different online than it is in the room. And if facilitation even in the room, for anybody who's done several ad boards, you know that sometimes it's very challenging and it obviously is very important sometimes to choose the right type of chairperson to help with that moderation. You just need to be a little bit more cognizant of the challenges of technology and really trying to engage people because I think, it can be very easy to... For people not to get as involved in the conversation, if you're not careful.

41:12 JO: Yeah, it's true. And the people who are... What I've realized too, is when the person who's speaking, or the person who's moderating is doing that, they're very focused on things to conduct the meeting that take them away from kind of the feel of the meeting often. It's a very hard thing to do. And so, oftentimes, it's the people who aren't speaking, who are part of the company, who pick up on the vibe of the meeting and that's kind of what you're trying to transmit so that people are aware. Like someone's been talking a long time, or you feel like it's going in the wrong direction, whatever, "wrong", in quotes of course, but you're trying to get good feedback from your attendees, those kind of challenges. So, that's where this kind of back-channel communications could be invaluable.

41:53 JI: Yep.

41:54 JO: We've got a couple of questions that have come in, I'm noticing through the Q and A thing.

42:02 DB: Neil, were you gonna address one of these?

42:04 NP: Yeah, let's... I would hope the panel would address these. So, there's a great question in the chat here for Jason, Joe, around, how are you thinking about the objectives, models, and size of field medical teams going forward given the potential long-lasting changes that we're discussing here? If you were building a team now, how would you think about it versus supposedly, how you thought about it before? So, perhaps Joe, you can start and Jason can add.

42:34 JI: Yeah, sure. I think a lot would depend on the therapeutic area. Obviously, if you're dealing in an area where, say, a more targeted disease, for instance, like kind of an orphan drug or a high-end med need, but it's small population in say, oncology or something like that, I think, you're going to be sizing your team appropriately. And I think that initially, and if the team is being built in the middle of this environment, clearly, I think the expectation should be for a certain level of technical proficiency and ease with those types of tools. I still think though, as I said earlier, I think that the relationships and the relationship building is not going away. It's just... We're just going about it a different way and so I do think that the same kind of skill set and the experience the different field personnel bring to the table will still be of value to the organization and still a very important function. I don't think that just because of this and a shift to leveraging technology is going to diminish the importance of field medical. I just came from a world where I was doing early clinical development and we were very... Relied very heavily on our field personnel there, even in a small company, to help us with site engagement, which is critical for a small company's success. And obviously, in a larger company there's even a larger need for them, so.

44:25 JO: Yeah, I agree. Again, this is an area where I'm optimistic, but also a bit realistic. And so there are more challenges now to engage for field medical folks than there were before because you have to get that engagement through a virtual means, and setting up appointments can be more challenging, just getting the time in front of somebody. And then the other part is what's being shared and what information are you trying to gather, and having that skill set to do this all virtually, which is, again, not exactly the same thing if you're used to seeing people in a room and sitting beside them or right across from them. So, there're dependencies in making sure that the field teams are skilled in working this particular way, and realistically, not everybody is, and that's kind of one of the gaps that we have to solve for because if you have those skills in place then you can get the meeting and you can work with the content that you have and get the information and insights that you wanna share. I've said content a couple of times because I think this is also a time where money is well spent by companies to really up their game in terms of the materials that are being used. Not all materials have been designed to be presented on screens or looked at on someone's phone or iPad, and this is not trivial in the least.

45:45 JO: Thinking about how much information you can share with people this way, is also something that needs to be really fully considered. So the 40-minute live presentation may only work as a 20-minute virtual presentation. And then because things are being looked at visually, you're not in the room, it's harder to engage people as quite as directly, the content sometimes needs to be revamped to be even more engaging. So, I think those tools are also a dependency so it's not just literally like the MSL or an MSL skill set. They need good pieces to work with. If you're just throwing out the same material and expecting you're gonna get the same result, I think that's gonna be where it becomes hard.

46:31 NP: Great. Thank you, Jason, that's super insightful. We have a lot of questions coming in on the line. We'll try to get to one or two more, particularly on metrics. So, interesting question around what types of field medical metrics are being requested by senior leadership during the time of COVID-19? Are you counting email correspondence? What do these metrics look like during this time? So, perhaps, Jason, we'll turn it to you and then Joe for some final commentary on that.

47:01 JO: Yeah. Folks, generally speaking, in the field are never super fans of metrics because it reduces what you do down to numbers. It's kind of an unfair thing. And we all know the example of the national medical expert who you text and a couple of texts are all you need to get your work done and so how do you capture that versus... That's not a 40-minute live meeting sharing a deck. So, this is actually kind of an interesting time, I think, to start gathering baseline metrics on how things are working to kind of solve for it. I'll say this, we're open to looking at anything as a metric, so whether it's email, or whether a presentation has been delivered or not. That's something we wanna capture right now because we're trying to understand how work is getting done, but in terms of making judgments on performance based on that, that's a bit more complicated. And I don't think... We haven't kind of figured that out exactly right now.

48:02 JI: Yeah, and my experience is similar. In places that I've worked, there's been less of a reliance specifically on hard metrics, for the reasons that Jason outlined. I think that, at least the way that I view field medical, I think that we exist in a kind of a professional engagement type of environment where a lot comes down to things that are hard to put a metric around, such as the strength of relationship, the ability to be able to reach out to somebody quickly when we need an answer on something critical to the brand, to the business. A lot of times, it really comes down to the quality of the interaction, not so much the quantity and so I like to look at the type of feedback we're getting and sort of look at it kind of holistically over time. And then as we feel like we need to sort of leverage our field team a little bit more, we engage in a targeted way. Obviously, the field team is organized geographically, so sometimes, if we feel like we're a little bit too heavy in one area, we can kind of... Based on where we're getting the feedback from, utilize that. It's not really a metric, it's really not used for performance, but really, I think is more... Fits a purpose for what we, as scientific professionals, are really trying to achieve.

49:33 NP: Right, and I think that's a great place to sort of conclude today's webinars. I know we have a lot of questions coming in, which we've not been able to get to, but we promise the audience we will get to those via email. Wanted to thank Jason, and Joe, and Dave today for their time and sort of, this thoughtful discussion, and Komodo Health, again, for helping put this on. Again, follow us on komodohealth.com, where we'll continue to share insights as we learn more. Continue to reach out to us in marketing at komodohealth.com, if there's anything we can do to support your business during this time. And follow us on Twitter @KomodoHealth and LinkedIn, to keep up with the latest news, insights, and future webinars. Again, thank you so much to all of you today for joining us, and to our distinguished panel, and we will conclude today's webinar. Thank you.

50:32 DB: Thank you. Thanks, Joe and Jason.

50:34 JI: Thank you.

50:34 JO: Thank you.

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