Emergent Collaboration

Mike Jacobs from Chess Media Group presented at AIIM’s conference in 2012. I discovered it on YouTube last night (click here to view it).

In his talk on Emergent Collaboration, he described a social business framework. This consists of 5 main areas:

  • Process
  • Organizational Culture
  • Governance
  • Goals and Objectives
  • Technology 

These 5 areas were further broken down into various sub-areas, You can click on the image below to see more on this.

This really got me thinking…you need to cover all five areas to make sure the adoption of a collaboration strategy is sucessful. Just having one is not really enough.

For example… having the technology is important, but this by itself is not enough…

  • AIIM Provides Useful Social Business Roadmap
  • New AIIM Task Force Research Shows That Enterprise Social Technology Gets Work Done
  • The Five-Step Maturity Model for Building a Collaborative Organization
  • The 12 habits of highly collaborative organizations
  • The collaborative economy emerges
  • How to Select Enterprise Collaboration Vendors
  • The Role of HR in Enterprise Collaboration
  • Collaboration: Changing the World for the Better
  • Collaborative Advantage

Summary of The Pharma Summit 2012 – by someone who was there

The following is an excellent overview that Carolyn Buck Luce has written on her blog of The Pharma Summit 2012, recently held in London . (Everything below is hers. The highlighting, however, is mine, and I have added my own comments.)

Clearly some very interesting topics have been discussed. And from Carolyn’s excellent notes, it’s readily apparent that there is a huge move in this industry.

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Insights from Economist Pharma Summit – Finding New Directions

Here are some insights that are “sign posts” of Pharma 3.0 where the patient is in the middle, not the product and the focus is on delivering health outcomes to individuals at an economic benefit for health systems and society.

  • GSK CFO, Simon Dingeman, observed that in emerging markets most medicines are paid for “out of pocket” by individuals. This reality has spurred a different business model by more closely integrating the Consumer, Pharmaceutical and Vaccines businesses to focus on ultimate customer.
  • Bruno Strigini, Merck President of Europe/Canada — reflected on the demise and bankruptcy of Kodak and observed that in hindsight the trends were visible to all but changing a business model is exceedingly hard. This is quite analogous to the pharma industry where it has to move to delivering outcomes. For Merck this includes increasing innovative partnerships with non traditional players like food and IT companies and building solutions and services.
  • Managing Director of GAVI, Nina Schwalbe, discussed that every two minutes a woman dies of cervical cancer but now, based on the system working together, there is a vaccine for this.
  • Stephen Whitehead, CEO ABPI, and Bruno Strigini, Merck President Europe/Canada
    — Fascinating conversation about value and outcomes. Everyone agrees that today there is not a common definition of what is the optimal health outcome with payors, patients, doctors and pharma having different perspectives. All stake holders have a role in the measures to assess value. And this can include a range of interventions to innovations. For example, if a pill can be taken once a day instead of 4 times a day could increase patient adherence and is therefore a valuable intervention.
  • Patrick Flochel, EY, observed that we are in the health business not the sick business. The HC system needs to put the patient in the middle. And the HC system will be shifting to health care everywhere – beyond the two pillars of the doctors office and hospital to the “the third place(s)” —wherever the patient/health care consumer is.
  • Theresa Heggle, Shire: A shift from provider to payor with the patient at the center has helped Shire shift their focus to the needs and value to the patient. Working with rare and orphan diseases, Shire works closely with patient organizations and families, possibly a model for the future of “personalized” medicines. There are already 300-350 drugs for orphan diseases and over 7000 such diseases.
  • John Pottage, ViiV: HIV is a good example of patient at the center model where patients literally took an activist part to become equal partners in innovation and regulatory process. Relationships, incentives, roles and responsibilities, data transparency etc were redefined.
    Now, ViiV is an example of a business model where the focused resources of two large companies contributed to a new company that is focused on just one disease with extensive partnerships and collaborations, from medicine to delivery with the patient at the center.
  • Wendy White, Siren Interactive. Patients and caregivers with rare disorders are now frequently the primary drivers of diagnosis and treatments given their active use of internet and mobile technology to get educated. Their activity can be predictors for future innovations as innovation happens at the margins.
  • Fascinating conversation about the value of transparency and data.
    For example everyone publishes what IS working in clinical trials but there is a wealth of insights in the data of what didn’t work but those data are not published in an easily accessible way.
    On Social media —notwithstanding the regulatory constraints of using social media in interactions with doctors and patients, pharma companies are beginning to dip their toe in by listening. However, there are challenges —in part due to the quick response expectations that don’t leave time for appropriate reflection and educated deliberations. Building trust is key to the industry so missteps in social media would be a real setback for the industry.
    (This is an excellent point. Listening, however, is an excellent start. There is a continual stream of incredibly useful feedback that the patients are giving. – Mark)
  • Discussion around the role of behavioral change in improving health http://ow.ly/8Y0z8
  • Sir Andrew Dillon, Chair of NICE — the trend of value-based pricing will continue. This is a growing trend that will touch both developed and developing markets.
    Sir Andrew encourages pharma companies to not “run away” from the developed markets to find countries without this approach as there will eventually be a NICE-like agency in China and India etc. The future will have funders, providers, innovators and users working more closely together earlier and earlier in the process to come up with good decisions. There will always be tensions but they can be creative tensions that produce value for health systems and better outcomes for patients.
  • Anders Ekbloom AZ – it was interesting to hear his perspective on what the innovators need from the payers:
    • reward value that medicines contribute to the overall cost of health
    • create trust by considering all the relevant data and being transparent in rules for decision making
    • insure rigor in how decisions are made to insure they reflect the needs of the population
    • justify decisions with clarity and give innovators opportunity to reflect and react
    • go faster as sometimes it takes payers up to a year after approval to agree on price but the IP clock is ticking

In the end, innovators have a long lead time and are making big investments. The more harmonized, clear and transparent rules and decision making across boundaries are with respect to reimbursement, the greater the win for all.

  • Reflections upon listening to Brian Griffin, CEO Medco International on Patient Data and how it will transform the Pharma Industry:
    Many of the health systems strategies around bending the cost curve through cutting prices has not been effective and the focus is turning to increased adherence which will be driven in part by better data —integrated, actionable and accessible to stakeholders, including investors.Facts in Europe. — 50% of patients don’t take medicines. This is made up of 1/3 don’t fill their prescriptions; 1 in 10 stop taking their pills; 1/2 forget to finish regimen and 1/4 of all patients don’t take recommended dose. This costs pharma companies in Europe $125B and causes 200,000 premature deaths per year.Focusing on real of use patient data and offering an integrated medication support package with a suite of adherence services can make a real difference and provide the base line improvements that support demonstration of value. These real use data will also provide key insights on patient behavior that will help build incentives and interventions to improve adherence and safety.
  • Freda Lewis-Hall, Chief Medical Officer Pfizer and HBA 2011 Woman of the Year, spoke on The Future of Medicines – The Disruptive Innovators.
    As usual, Freda had compelling perspectives of the future from the patient perspective and the need to approach this with a sense of urgency. She made the point that disruptive innovation is only disruptive in hindsight.
    Pharma can’t lower performance or be all things to all people – ie better, faster, cheaper – given the imperative to move to targeted precision therapies. More important that we start asking disruptive questions like 1) how to best characterize diseases, and 2) how do we streamline the matching of therapies to disease to increase precision and 3) how do we create 21st century science by upgrading 1950’s funding.
  • The conference ended on a high note with a keynote from Tachi Yamada, former President of the Global Health program at the Bill and Melinda Gates Foundation and now EVP, Chief Medical Officer of Takeda, speaking on changing the game in global health.
    Tachi spoke eloquently about the importance of the emerging markets to the industry and the “moral tragedy” of the current state — 8 million children dying unnecessarily life expectancy less than 50 years; with examples like TB which kills millions of people every year and is being fought with a vaccine that is 80 years old and medicine that is 40 years old.
    His answer is to revolutionize innovation, turn things upside down and get to work with the following prescription: 1) Challenge accepted dogma and promote those that challenge 2) Be willing to fail and fail often and take big risks 3) Forget peer reviews because innovators HAVE NO peers and don’t let the experts kill ideas 4) Decide fast while the excitement and enthusiasm is there 5) Create a sense of urgency so that desperate ideas are welcome.(The comment “Forget peer reviews because innovators HAVE NO peers and don’t let the experts kill ideas” is brilliant and worth repeating – Mark)

Forget peer reviews because innovators HAVE NO peers and don’t let the experts kill ideas

Carolyn’s original post can be read here. Also check out her other great posts.

  • Pharma 3.0 (markjowen.com)
  • A Commentary: Pharma’s Ongoing PR Problem (biojobblog.com)
  • The future of healthcare is visible but requires new ways of thinking (worldofdtcmarketing.com)
  • CBR Pharma Insights’ Latest Report, The Perception of the Pharmaceutical Industry – Health Care Reform, Drug Safety, and Drug Costs (prweb.com)
  • 2 Risky, 2 Safe Pharma Plays (dailyfinance.com)
  • Big Pharma and the Prisoner’s Dilemma (markjowen.com)
  • Bad journalism paints unfair picture of pharma industry (worldofdtcmarketing.com)
  • Medicine Makeovers – Thomas Pogge Disects the Pharma Industry’s Shortcomings & Proposes a Solution (TrendHunter.com) (trendhunter.com)

Comments on “The Problem with Shared Network Folders”

Adrian McGrath recently wrote a post calledThe Problems with Shared Network Folders“.

It’s a great post, and Adrian is someone that I have a lot of respect for. He’s a smart guy, and I learn a lot from him. In the post (read it here ), Adrian discusses the disadvantages and limitations of using Shared Network folders.

These include:

  • Duplication of documents and confusion as to what the latest version is
  • Complex file and folder naming conventions 
  • Lack of consistent folder structures 
  • Redundant documents 
  • Ineffective search
  • Inaccessibility of information
  • Lack of subscription and notification
  • Limited ability to synchronise documents offline
  • Inability to cross reference and relate documents
  • Lack of document governance and control
  • Compliance, Risk & Legal Admissibility 
  • Impeded collaboration
  • Storage and maintenance costs

In essence Adrian is correct. Using Shared Network drives does have limitations, but in the spirit of debate, I’d like to make a few comments on what he says.

Duplication of documents and confusion as to what the latest version is.
Complex file and folder naming conventions
Lack of consistent folder structures
Redundant documents

These are all indeed real problems. Are they inherent to Shared Folders? Not really – these can also happen with Document Management Systems.

Governance plays a large part in ensuring that these sort of things do not happen. Information Architecture is critical in ensuring that a suitable structure exists, defined by folder, and metadata, so that every document has a correct location.

However, this does require enforcement. Without enforcing such a system, even EMC systems can end up overly complex and with duplicated (and therefore redundant) documents. A lot of these systems, however have de-duplication functionality built-in (Documentum), and, if not (SharePoint), there is often a third-party tool that will do this.

Ineffective Search

Can’t argue with this. Unless some sort of indexing application is implemented, searching will be very inefficient.

There are many applications that allow Shared Network folders to be indexed. These include applications such as Google Desktop, Windows Search, X1, etc. SharePoint, also, has the ability to index information in file shares, as well as making the search results a little bit more meaningful.  

Inaccessibility of information

Adrian is definitely right here. Most (if not all) companies are quite strict with their network security. Users are not able to make ad-hoc changes.

However this can also occur in an ECM system depending on how much “freedom” a user has. I have seen some situations where, because the security policies in the ECM system were so strict, that users have resorted to exporting a document to a file share, so that it can be shared with others, or worse, e-mailed to an external party.

A good governance model helps to reduce this, as does training. If the users are aware of why something is enforced then there is, often, a better chance of compliance.

Lack of subscription and notification
Limited ability to synchronise documents offline
Inability to cross reference and relate documents

No arguments here

Lack of document governance and control
Compliance, Risk & Legal Admissibility 
Impeded collaboration

I’ve mentioned governance in my comments above. A good plan is required to ensure that documents are not haphazardly placed in seemingly random locations. And, as Adrian mentioned, Most ECM systems provide an audit trail keeping a record of the “actions” upon a document (when a document changes status, etc).

However, this is only effective for versions of the documents that are within the document management system. Once it is outside of the system (a user exports, or e-mails, a document) there is no audit trail. (Often this is done to collaborate with someone who does not have access to the ECM system.) This can create compliance issue. Again – good training, and governance, helps to reduce this risk.

Storage and maintenance costs

As Adrian mentioned, the amount of storage space required in a file share can be quite high, as users store more, and more content. And he is correct that because of the scattered nature of such content, this leads to inefficiencies.

ECM systems tend to handle the storage of content in one of two ways:

  • Content is stored in a file system on a hard drive. Usually the content will have some meaningless name, and might also be encrypted. Metadata about the content (including it’s location) is stored in a  database. Access to the content is via the CMS (native interface, or API).
  • Content, and metadata, are stored in databases. The content is usually stored as a BLOB.

If the ECM system is configured to keep create a version every time a document is checked out, and then checked back in again, the number of “duplicate” versions can increase quite quickly, thereby requiring extra space. Of course, setting a lower limit for the number of version kept can help reduce this. Configuring the system to purge all minor versions of a document (e.g. 0.1, 3.2, etc) when a major version (e.g. 1.0, 3.0) is created also ensures that disk space is kept to a minimum.

Keeping documents in the database as a BLOB also presents extra maintenance. As with a file system, the databases can grow exponentially. Often extra work is required to ensure that the database still performs efficiently.

Conclusion

I am convinced that to be able to keep content in a system that allows adding meaningful metadata, auditing, security, document life cycles, and workflows, is critical if a business needs to track, control or route content. Often these activities will exist to match the requirements of a business process, and to make it more efficient.

However there are a few situations where using a file share is still of value.

In my next a later post I will go into this more…

  • Is unauthorised use of file sharing solutions putting organisations on a slippery slope?
  • What Enterprise Content Management Technologies Do Manufacturing Companies Use?
  • Enterprise Content Management (ECM) 101
  • Using a network file share – a case study