With the enormous changes that occurred in the healthcare industry during and following the COVID-19 pandemic, Conga's Chief Marketing Officer, Randy Littleson sat down with Conga’s Lead of Vertical Strategy for Healthcare and Life Sciences, Tom Cowen, to discuss the most impactful ways COVID-19 has and will change healthcare, life sciences, and the entire HHS (Health and Human Services) ecosystem. The following are key takeaways from the discussion.
How the right technologies improve HHS processes
During the pandemic, we saw an incredible speed at which companies ran their clinical trials and received vaccine approvals. So, what were the effects of clinical trial acceleration? In what ways are stakeholders focusing on this process, and how can the right technologies improve it?
Tom says, "We're starting to hear from some of the pharmaceutical companies we work with, that it's a renewed focus for them. [These stakeholder companies] have always been focused on clinical trials and how fast they can get those done, but they're being asked to dig down again and really look at squeezing every last ounce out of that process. Now, some of these parts of the process are very clinical in nature, very science-based in nature, and there's only so much you can do there. But some of the areas that they're starting to focus on are very mechanical—very process-oriented. And one of those, for example, is clinical trial agreements. So, they're looking at how they can speed that up through solutions that help them do that faster and ultimately drive down the time it takes to onboard a physician to participate in an individual investigation."
“One of the effects we saw to the vaccines that came to market was one of the first successful applications of mRNA technology," Randy says. "So, what will be the downstream effects of that on the industry?"
Tom explains that "mRNA is messenger RNA, which essentially is a mirror of the DNA….20, 30 years ago, the human genome was mapped and the code behind all this became available…resulting in the acceleration of how to develop cancer drugs and in this case, vaccines. Prior to this, the mumps vaccine was actually the fastest vaccine ever developed at just four years. The usual if we look back over the past century, it was about 10 to 15 years to bring a vaccine out to the public. So once again, speed is a very important part of this story."
The impact on patients, providers and insurance companies
“If we look at the insurance payer that’s going and funding that hundreds or thousands of dollars for one-time or several-time treatments for that patient. What happens when that patient or their family member moves companies six months later and is suddenly under a new insurance plan who now is benefiting from the results of that. Also, that big upfront cost is causing a lot of people to think about this—making sure they’re getting the value there,” says Tom.
Tom says, "What we're hearing from the companies we speak to is a lot of discussion around outcomes or value-based agreements coming into the forefront. It used to be every two or three months we’d hear this. We're now hearing on a weekly or biweekly basis. So, a big change there."
Telehealth and COVID-19
The explosion of telehealth has been a positive outcome of the pandemic, so where do we see this going in the future?
"I look at some of the charts today, and I'm blown away by them. I have to do a double-take on the numbers. Sometimes we're seeing 1000% growth in telehealth. Other numbers I’ve heard are 20% of doctors previously used telehealth, now it's upwards of 80%. I find 20% even hard to believe," says Tom, “I had a son who battled cancer six or seven years ago and we literally got one telehealth visit within his treatment and we certainly would have liked a lot more. There were times when it was very difficult to get him to a hospital or get him in front of a doctor for things that we needed to discuss. Certainly something very welcoming McKinsey actually estimates that 250 billion dollars of the current U.S. healthcare spend could ultimately be virtualized.”
The delivery of healthcare to foreign, remote segments is also changing. With the expansion of provider networks, there is more of a need for them to participate in contract and risk management. So, what needs to happen from a commercial standpoint to support this?
“This calls into question what needs to be done to ensure that telehealth is contractually a little different. How will doctors and hospitals manage risk when they’re not physically seeing a patient?” says Tom.
The answer: we expect continued growth around telehealth within the healthcare system, and we need to be ready to meet and support that growth.
Contracts at warp speed
You relayed experience you had at a recent healthcare general council forum about supply chain choke points. Can you relay some of what you heard?
"We heard a lot of war stories from them. Literally they were arranging contracts and then standing on a loading dock or in a supply room waiting for that supply to show up. So they got deeply embedded in the business, more than they ever had been. The need to go in very quick order establish contracts with secondary and tertiary suppliers for PPE (Personal Protection Equipment) and other critical healthcare items that needed to be there. We heard about ventilators needing to be retooled and those types of things. The ability to go in contract, establish commercials on a very quick order was important. Certainly, a lot of these agreements that were put in place had an effect on profitability. One thing we heard about was a need for contract repository. We heard from general counsels who had contract repositories and I heard from others who had paper-based contract repositories. I'm sure there’s many more out there but they needed to go in and find things like force majeure clause. Which, in the past might have been a minor clause but now has become the most important thing in the world. So could they go and find those clauses for each individual supplier, understand them and then how do they go and recraft that to lessen their exposure in the future and protect themselves?"
(A force majeure clause allocates the risk of loss if performance is hindered, delayed, or prevented because of an event that the parties could not have anticipated or controlled, i.e., COVID-19.)
Government involvement in the pandemic has been both a blessing and a curse. So, how do healthcare suppliers lessen their exposure in the future and protect themselves? What will be the lasting effects?
"I think we saw the highest level of partnership ever between healthcare and life sciences companies and government to get these great things done. We talked about a heavier involvement in the clinical trial process, the acceleration that went on there is certainly very, very favorable," says Tom. "We saw the Defense Production Act invoked several times along the way and we've just heard about baby formula. Looking at these types of partnerships and potentially having a more commonly used price transparency is something that's been ongoing from the Affordable Care Act discussions almost a decade ago.
With an increased involvement of the government, what does this mean then for companies within the healthcare industry?
It points to a greater need to generate the documents that the government needs at a local, state, and federal level. When it comes to a healthcare provider's contract and pricing, having those items at the ready and defensible is indispensable if ever called upon for an audit.
Increased transparency in the healthcare ecosystem
At Conga, we continue to analyze how to improve transparency in the healthcare arena and support your mission to accomplish groundbreaking and lifesaving work.
To learn more and get first-hand insights, watch the full video with Tom Cowen and CMO, Randy Littleson as they discuss COVID-19 and its impact on HHS.