The A-Team

It’s no secret that healthcare systems across the world are under huge pressure resulting in “a stagnation of health progress on key health indicators in recent years”, according to the World Health Organization (WHO).

Take one of the pressure points, chronic disease. On the current trajectory, exacerbated by ageing populations and climate change, cardiovascular diseases, cancer, diabetes and respiratory illnesses etc will account for 90 million deaths each year (86% of total annual deaths).

That’s a 90% increase in absolute numbers since 2019. Stefan Woxström, SVP Europe and Canada, AstraZeneca, puts it bluntly: “We cannot build more hospitals to deal with that.” He sees that the only way forward is to focus more on disease prevention, which gets just 3% of healthcare spending currently, and partnerships.

As an industry, healthcare is sold on the power of collaboration, but given the enormity of the challenge, it’s got to go further. The WHO has gone so far as to say that “strengthening multi-sector partnerships is a prerequisite for improving the healthcare system”.

Meanwhile, public-sector bodies like universities are traditionally strong healthcare collaborators. When it comes to the private sector though, partnerships like joint working have been much more quid pro quo.

Pharma company x offers training to healthcare provider y, which helps the company’s brand and relationships, and hopefully sales, for example.

That’s changing, however, and an increasing number of companies that share Woxström’s attitude are entering partnerships for disease prevention, developing solutions ‘beyond-the-pill’, with a much wider variety of partners.

Roche, with its 250+ partnerships, is one such company while AstraZeneca’s A.Catalyst Network is another particularly interesting example.

The A.Catalyst Network (A.CN) was set up by AstraZeneca in 2021. Today it is a collection of 26 hubs spread across the globe, which in their own words, exist to accelerate and scale solutions that will improve equitable access to healthcare and help make healthcare ecosystems more resilient in the face of change.

Big organisations have big partnerships. Boehringer Ingelheim has teamed up with Google to apply quantum computing expertise in R&D, while Kyowa Kirin, the Japanese pharma company, is working with Harvard University – and the UK National Health Service has teamed up with Microsoft and other large suppliers for its net-zero target.

These strategic partnerships will move the industry forward in the long term. If you are a doctor, however, working hard and struggling to keep up with treating symptoms, let alone addressing the root causes or the backlog of referrals, the big partnerships can’t help you right now; you need something that is locally useful today.

This is one of A.CN’s strengths. The A.CN hubs are spread around the globe from Mexico to Malaysia. They are also disconnected from AstraZeneca products, so they can focus on local healthcare challenges where AstraZeneca has expertise, free from the pressure of short-term sales targets.

Healthcare startups are a significant source of disruptive innovation that develops and uses emerging technologies to invent a new product or reinvent the existing one with high efficiency.

As a startup though, you often lack resources or experience in areas like conducting clinical trials or how to integrate with hospital systems to make your innovation have practical value etc. You can try and figure all this out for yourself. Or you can ask someone that has experience, like a successful pharma company.

Only you can’t, because giant organisations don’t take cold calls from startups, but A.CN does. Through its global presence of experts in local healthcare systems, A.CN can connect established organisations and startups alike with related projects across the network, expertise within AstraZeneca, or relevant third parties.

All this focus on local relationships and local solutions might suggest that AZ has limited ambition, whereas it’s quite the opposite. The local approach enables a test and learn agile approach, rarely feasible on a global scale.

It’s this agility that the CEO of medtech company Tucuvi, María González Manso, appreciates so much with A.CN. Tucuvi is a small, nimble organisation and pharma companies are often big and time-consuming, typically involving many experts in decision-making.

The A.CN hubs on the other hand, share much more of the scale-up mentality with the bonus of knowing how to navigate to the right resources in AstraZeneca.

Another benefit of starting locally is that local actors are often deeply passionate about solving their local issues. Madeleine Thun is one of the handful of people that works centrally in A.CN, enabling the local innovation hubs.

What she sees in the network is that people who are in love with the problem rather than their own career or research paper, seek understanding and stick with things through thick and thin. Once the local problem-lovers have proven the concept, it’s time to scale up the outcomes.

David Lowe is an emergency physician in Glasgow and Clinical Director for Health Innovation at The Chief Scientist Office in Scottish Government. He is involved in another heart disease project with AstraZeneca and uses a climbing analogy for outcome scaling.

The lead climber is the first up when setting a new route. The lead takes the big risk and the likelihood of falling is pretty high. The lead climber also de-risks the route for other climbers by figuring out the way up or setting bolts for other climbers to clip their rope into.

The lead also shows others how to set new routes. Scaling can also be inviting others to follow your path, like Lowe and his colleagues are doing. Following their successful project in Glasgow, it’s being shared with health boards across Scotland and they have also got their sights on the 40 Trusts in England.

Further afield, A.CN has connected the project with interested parties in Spain and France as well as putting the tech provider Tucuvi in contact with teams in other countries, to expediate their solution getting to patients faster, whether that’s in partnership with AstraZeneca or not.

Another route for scaling outcomes is the application of the same solution to new problem areas. As González González, the Operational Manager of Innovation in Madrid says: “ECGs are cheap. We could absolutely screen for other things in the future.”

Then there is scaling through application of the method of innovation and collaboration, which has seen AstraZeneca in UK sign agreements with NHS and academic partners in both Scotland and Wales to co-create all manner of projects solving for challenges in the provision of effective, evidence-based healthcare at scale.

The model is to pilot projects, show evidence of clinical and cost-effectiveness and then to scale them not only in UK but in other geographies via A.CN. One relatively small heart disease project in Glasgow can have global implications thanks to A.CN’s multifaceted approach to outcome scaling.

Jacob Andersson, GP, researcher, and deputy head at a university primary care centre in greater Stockholm, provides a frontline physician’s perspective on adopting the innovation offered during the scale up of the ECG AI analysis project.

He had two primary questions: 1. Is there potential for significantly improved patient outcomes and 2. Can the solution be fully integrated into existing systems and care pathways; no new logins or manual data transfers for instance.

This exemplifies another essential component to scaling, or even getting the solution to be valuable in the first place: making sure the system is ready to receive it, otherwise, just like with organ transplants, the system will reject it.

This is where the cross-functional, cross-industry participation in A.CN projects really shines. Only providing a technical solution, AI analysis of ECG/ECHO, is like thinking that new customer relationship management software is going to improve your customer experience automatically.

The technology is one part of a multifaceted, often complex, change process and the healthcare system must be ready to for an expansive cultural shift.

Healthcare is built on scientific innovation. When it comes to trying new things beyond the pill, the story can be different. Tom Keith-Roach, General Manager at AstraZeneca UK, reflected: “When I first approached the NHS to talk about the heart disease collaboration in Glasgow, I didn’t know whether I would be laughed at or kicked out of the room.

“Thankfully the focus on real health system problems spoke to them and led to a constructive discussion and ultimately a successful collaboration”.

Going up against established priorities and ways of working can be hard. Just as colleagues in traditional roles like Sales Managers or HR Business Partners have their professional networks, healthcare system innovators need a safe haven too.

The A.Catalyst Network provides a peer group for these change agents, within AZ and beyond. There is the benefit of knowledge exchange of course but also the interpersonal support you need.

When Vanessa Simpson, Customer Engagement Lead at AstraZeneca UK was approached about getting involved in London Tech Week, she could turn to network colleagues to get advice on how to make the most out of the opportunity. These network benefits extend to pretty much anyone.

During the Slush start-up and tech event in Helsinki, AstraZeneca staff and A.Catalyst Network partners stood side by side wearing matching hoodies to welcome the stream of interested startups and direct them to useful contacts across the A.CN ecosystem.  That’s pretty far from the traditional relationship with big pharma.

On the one hand, it’s not immediately obvious to an outsider what the A.Catalyst Network team does, and that’s probably because they are more interested in making a difference than claiming credit for it.

On the other hand, it is staring you right in the face – they catalyse and, with the scale of challenges among healthcare systems around the world, making things go quicker is precisely what is needed.