A cross-functional EY team studied each step and connectivity along the value chain, asking what issues could arise. What are the required changes to existing supply chains and infrastructure to address them? How could EY leverage its strengths to create an effective solution that would enable delivery of these therapies at scale?  To develop our appropriate approach, the team reached into EY’s diverse multi-disciplinary capabilities and geographies to find the right experience and bring the best of the organization to solve this complex problem.

Overcoming representative challenges at every step

• Genetic sampling and sequencing: Core to an individualized treatment may be the collection of a patient’s blood and tumor biopsy, analyzing their genetic makeups, identifying genetic mutations in the tumor, and then developing a therapy that targets specific genetic mutations. However, there is no industry standard that exists today to do genetic sequencing at the required level of specificity and commercial scale to serve a global market, so the key question was how do you create an environment where that could exist?

• Transportation logistics: Moving not just patient samples but very large amounts of patient data safely and securely is a central challenge to implementing individualized therapies. For instance, crossing national borders means crossing different jurisdictions, which may have different regulations pertaining to the movement of data, tissue and therapeutic products. Approaches had to be found that allowed end-to-end operations to exist within different legal and regulatory guidelines. 

• Administration of the therapies: Today, most cancer drugs are administered to thousands of people, so how would health systems and oncologists deal with the issue of receiving, storing and administering a therapy that is intended only for a single individual patient? The EY team conducted market research of more than 150 specialists (practicing oncologists, oncology thought leaders, health care providers, payers and other stakeholders) across multiple geographies (US, France, Germany, Spain), to compile this data and understand the current paradigm and needed behavioral and process change from a commercial standpoint.  

• Care management: As life expectancy after cancer diagnosis and treatment continues to improve, there is growing recognition of the need to address patients’ health, wellness, emotional and psychosocial needs from the time of diagnosis through treatment and survivorship. The key question was how to leverage the large body of data accumulated on the patient to improve the patients’ overall health and quality of life by suggesting appropriate treatments to manage comorbidities, avoiding unnecessary treatment or suggesting appropriate lifestyle modifications.

Furthermore, new tools that engage patients in their own care, such as web programs for symptom monitoring, psychological support and overall health management are needed. These new therapies offer a unique opportunity to directly engage patients and empower them to take better control of their treatment and overall health and the question was how to make that possible in an end-to-end care management system.

“By providing tissue samples and genetic and clinical data, patients are providing invaluable information and contributing to innovation that offers the promise of better treatments for themselves and other patients. We must devise approaches that offer patients greater control over their health data, and help them to make more informed decisions regarding their treatment and overall health,” says Spence.

Building a fully-connected infrastructure of data, capabilities and services with Microsoft

Working with Microsoft, a multi-disciplinary EY team from across multiple geographies and industries has developed a private, secure information exchange and related end-to-end services to enables the reliable delivery of individualized therapies for cancer and other chronic diseases.   This is a fully-connected data infrastructure, with associated capabilities and services, that we call Pointellis^TM.

Pointellis^TM introduces new industry data capabilities focused on enabling six core functional areas of the digital ecosphere:

• Biometric chain of identity and custody, to track and trace biopsy tissue and blood samples from point of care when the patient first enters the system, all the way through medicine administration.

• Supply chain, to allow for enrollment, scheduling, demand and capacity planning as well as coordination of logistics and delivery.

• Patient engagement, to share appropriate information and keep the patient engaged through the waiting process as well as provide disease management information.

• Care management, to provide oncologists and health care providers who treat and support these critically-ill patients with up-to-date information and decision support based on the wealth of data captured through the platform.

• Health outcomes, to measure more accurately and allow providers, health systems, payers and manufacturers to adapt treatment and maximize clinical benefit.

• Funds allotment, to manage the complexities of paying all who are involved with the successful treatment of a patient.

By enabling each of these core functional areas, Pointellis^TM aims to build an end-to-end solution to help each client manage its own ecosphere to deliver the individualized cell and gene therapies of the future. 

“The partnership with Microsoft provides EY engineering team with access to the latest Azure services and approaches. With these Azure services, EY teams are able to rapidly build, test and deploy the platform and features which bring the exchange of information to key oncology stakeholders in the digital ecosphere”, says Frank Traina, Managing Director, Digital & Emerging Technologies, Data and Analytics, Ernst & Young LLP.  The EY team provides clients with support on the decision to buy, partner or build the capabilities to deliver this ecosphere. Joint ventures, alliance management and other partnership structures will be critical to building and connecting the various capabilities and systems needed. New incentives structures and performance metrics are also needed to keep the ecosphere operationally and economically viable for all the stakeholders.

“Combining EY and Microsoft’s experience was fundamental to developing Pointellis^TM, which connects the many stakeholders involved in providing individualized treatments,” says Adlai Goldberg, EY Global Digital, Social and Commercial Innovation Life Sciences Leader. “Pointellis^TM enables a supply chain as bespoke as the treatment itself, one for each patient. It safeguards the chain of custody and identity; validating every handoff from patient through to manufacturer and back again, ensuring patients are treated safely and securely.”

By enabling this digital ecosphere, EY and Microsoft are laying the foundation that will bring the potential of individualized treatments to a global market.

And this won’t be the end of the road. To implement individualized care properly there needs to be transformation across the industry and the health care ecosystem.

The different stakeholders involved in providing care need to rethink their operating model and develop an entirely new value chain. One that requires timely, error-free coordination, communication and hand-offs between often-disconnected health care stakeholders; the secure sharing of unprecedented amounts of medical and genetic data; and the efficient transportation of sensitive, patient-specific blood samples, biopsy tissue and the resulting individualized therapies.

“We’re approaching a major inflection point in driving the transformation of oncology care to dramatically improve outcomes, extend and improve the quality of lives and greatly reduce human suffering,” says Roberts. “What a remarkable way to help build a better working world.”The fight against cancer has made huge strides over the past 30 years. Survival rates have doubled and people are living longer with cancer than ever before. Novel treatments are helping patients delay the worsening of their disease or lower the chance of recurrence, while improving their overall quality of life.

Individualized therapies can dramatically improve patient outcomes and help alleviate the burden of cancer and other chronic diseases. EY and Microsoft are laying the foundation to enable these revolutionary therapies reach patients in need and transform oncology care and other chronic conditions worldwide. Please visit Pointellis^TM  to learn more.