Gemma Estrada is the Head of Digital Health & Technology, a new department created to enter and leverage digital health to build healthier and more sustainable societies.

Good morning, I am delighted to interview you as a Sponsor of our upcoming event, the Barcelona Health Hub Summit 2019. Could you briefly explain what Ferrer does and what your role is at Ferrer?
Ferrer is a global pharmaceutical company headquartered out of Barcelona with presence in over 110 countries. I am the Head of Digital Health & Technology, which is a new department created just last year as part of Ferrer’s initiative to enter and leverage digital health as a means to build healthier and more sustainable societies. Our vision is to enable a more personalized, effective and responsive care to patients through a connected ecosystem facilitated by digital technologies.

We heard that Ferrer is launching a new program called Ferrer 4 Future targeting digital health start-ups. Can you tell us more about it?
Yes, we at Ferrer believe that digital health is about putting patient’s needs first and developing digital solutions across the patient care value chain (physicians, caregivers, payers, hospitals and so on) to address those needs in a manner that enhances the patient’s human experience. By human experience I mean that the patient is treated swiftly and with empathy, respect and warmth.
The aim of Ferrer 4 Future program is to use digital technologies aligned with healthcare professionals to develop solutions that provide patients with more knowledge about their condition, more control about their treatments and higher level of care and comfort; thus, helping build a more efficient and sustainable healthcare system.
We understand that in order to generate and implement patient-driven solutions using digital technologies successfully and sustainably, we need to balance the knowledge and experience of pharma companies with the creativity and agility of start-ups. Ferrer 4 Future is all about that. It is a platform for collaboration between start-ups and Ferrer to explore digital health solutions together.
Through Ferrer 4 Future program, we will invite start-ups to respond to our challenges in health twice a year. The first set of challenges will be launched in October during the BHH Summit 2019 and published on Ferrer 4 Future website. In parallel we will also be exploring collaboration projects with start-ups and small businesses in the digital health space, which do not specifically respond to the challenges.
If the solution proposed by the start-up is a “match” with Ferrer’s interests, we will either partner with the start-up upfront or enrol the start up into our program with access to Ferrer mentors, experts and, access to our internal resources to develop the solution further. The path taken (offer to partnering directly or offer to join mentoring program first) will depend on the size of the start-up, type of solution and the stage of development. Moreover, start-ups enrolled in mentoring program will also be able to apply for partnership or investment opportunities which will be negotiated case by case.
More details will be available on our website (www.ferrer4future.com) which is being launched soon.

I see. So Ferrer wants to work with start-ups in digital health. What kind of start-ups are you looking for?
That’s a great question. Although the digital health department was created recently and is still small, our ambition is not. We are quite passionate about disrupting health and driving digital solutions that address real pain points of patients and stakeholders in the patient care value chain. So naturally, we are looking for start-ups which are equally ambitious and passionate about disrupting health and how healthcare is delivered.
At Ferrer, we have vast experience in a number of therapeutic areas such as Central Nervous System, Cardio-metabolism, Pain, Dermatology, Gynaecology, Gastro-intestinal and Oncology. So we are looking for solutions in these areas. However, we are also open to explore solutions in other therapeutic areas if we see a strong potential for synergies.
We are looking for start-ups, from all stages, that are trying to solve real and verified needs for ill patients or patients suffering from illness related disabilities/hardships. The solution can be focused on patients themselves or other stakeholders in the patient care value chain such as physicians, caregivers, payers, hospitals and so on.

There are so many large pharma companies who are also looking to work with start-ups. Why should start-ups work with you?
It is true that many pharma companies much larger than us have a program to work with start-ups as well and many start-ups would naturally gravitate towards them. This is fine. We don’t want start-ups to choose us if it is better for them to partner with someone else. What we are looking for is fit and compatibility. We want start-ups to choose us because they would like to work with a smaller pharma where they are not competing with a large number of other start-ups in the program for attention, support and resources. At Ferrer we can provide start-ups with a closer and more intimate relationship with the pharma company with access to senior management more readily available. Start-ups may leverage Ferrer’s knowledge, reach or expertise in specific therapeutic areas, geographies or business networks. And, finally, we also want start-ups to choose us because they identify with Ferrer’s values, social mission and culture.

What are the current challenges in the healthcare sector?
I believe that the universal challenge modern healthcare systems are facing is to reach a high overall level of health with an accessible, integrated, quality care model that is sustainable. I think that pharma companies are pivoting their strategies towards building solutions that support this “comprehensive care” concept, and it certainly cannot be done with drugs alone. Digital health tools are here to leverage the care we are currently providing but the economic and social paradigms need to be taken into account too. As we transition towards Value based Healthcare Environments, we need powerful IT systems that can handle all life and health information at once. The integration of clinical data with real-world data, not only regarding health but also socioeconomic aspects, allows us to build a joint system of big data that, once integrated and analyzed, creates an unprecedented opportunity to transform the patient/citizen experience. In summary, the current challenge is to evolve towards Medicine as a Service (MaaS) which puts the focus on holistic care (taking into account the medical and socioeconomic circumstances of the patient/citizen) to provide a Human Experience that delivers value.

And, specifically in digital health, what do you think are the challenges? 
Digital health is recognized to be a transformation accelerator to improve healthcare delivery and health outcomes. It has the potential of enabling a healthcare that is more empowering and accessible for patients, more efficient for providers and more cost-effective for health systems. Yet, despite this potential, most digital health solutions struggle to scale beyond the pilot phase and neither become financially viable nor integrate into national healthcare systems.
Regulations and Market Access are the main challenges. Regulations today were largely conceived in the pre-digital era. Although regulators do recognize that digital health solutions can be developed more quickly than drugs and benefit from agile development practices, for therapeutic solutions at least, the prevailing principle is to request efficacy proof and health economic value through the traditional clinical trial process.
Though this efficacy proof and health economic value is good to have – and access to healthcare market depends upon it- the lengthy and costly clinical trials process may deter start-ups from entering the development phase. Furthermore, the obligation of proving outcomes for digital health solutions immediately, may also lead to situations where some good technology solutions are never developed as the natural course of development would go through a trial and error process instead of a randomized clinical trial. Acceptable regulatory frameworks for digital health solutions will need to be finalized soon as well as the relevant economic models for reimbursement.
Another challenge is the adoption by healthcare professionals. Digital health solutions that do not fit well with the existing care pathways or require a significant amount of work upfront by the clinicians to integrate the online and the offline care are unlikely to succeed.

Which technologies do you think will shape the digital health sector?
It is very difficult to pick one technology as the real power lies in the convergence and superposition of different technologies. Think for instance of a grandmother with mild depression who uses a cognitive behavioural therapy on her smart phone, that is integrated in electronic prescribing, dispensing and medical record platform directly. Then this is paired with her wearable sensors and, all the digitized dataflows that are generated trigger engagement messages at an individual level for the grandmother while they also contribute population data for advanced analytics to generate ongoing improvements in care. This means that the grandmother’s personal health avatar would analyse her data in real time, compare it with relevant big-data lakes and suggest improvements in her therapy, and even send her the newly prescribed drugs or refills of the ones she is already using.
As you can see, there is a large number of technologies involved in the creation of the platforms and the new ways of delivering patient care. Artificial intelligence, connected devices (IoT), patient monitoring systems and, block chain to securely track the medical records and the prescriptions are very relevant but, the technologies that are opening new ways of delivering care like telemedicine, virtual reality, etc. are also relevant. And if we were in a situation where surgery was required, then 5G, robotics, and 3D printing would also be paramount.

What are you excited about regarding the BHHSummit?
We are really excited about meeting lots of interesting start-ups and entrepreneurs at the BHH Summit 2019. I along with senior members of Ferrer’s innovation team and top management will be attending the event. We have a beautiful room reserved for the whole day where we will be launching meaningful digital health challenges for start-ups, answering questions about Ferrer 4 Future program, hosting meetings to discuss opportunities for partnerships and listening to pitches. The start-ups who are interested in attending our challenge launch event and meeting with us, they can reach out at contact-f4f@ferrer.com.
We are also interested in listening to and learning more about what is happening in the digital health sector in Spain and the world and explore the beautiful setting of Hospital de la Santa Creu i Sant Pau designed by Lluís Domènech i Montaner.
I also think that the BHHSummit is a great vehicle to promote digital health solutions by supporting and fostering partnerships between start-ups and institutions in the health care value chain and moreover contribute to develop Barcelona as a leading digital health hub.

Gemma Estrada, Head of Digital Health & Technology