Integrating patient centricity culturally and operationally, with Dr. Anthony Yanni, Sr. VP and Head of Patient Centricity at Astellas

November 21, 2023 00:27:40
Integrating patient centricity culturally and operationally, with Dr. Anthony Yanni, Sr. VP and Head of Patient Centricity at Astellas
Power to the Patients
Integrating patient centricity culturally and operationally, with Dr. Anthony Yanni, Sr. VP and Head of Patient Centricity at Astellas

Nov 21 2023 | 00:27:40

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Show Notes

In this episode we delve into the topic of patient centricity in clinical trials with Dr. Anthony Yanni, Senior Vice President and Global Head of Patient-Centricity at Astellas Pharma Inc. Dr. Yanni shares what patient-centricity means for him and how it is integrated both operationally and culturally at Astellas.

We explore how specialized teams work collaboratively to transform patient information into practical solutions, and the conscious patient-awareness that is a fundamental part of every role at Astellas. You'll also discover some innovative programs that bring patient-centricity to life.

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Dr. Anthony Yanni

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Episode Transcript

[00:00:03] Speaker A: Welcome to Power to the Patients, a LinkedIn live and podcast series hosted by Power, where clinical research leaders across sponsors, sites, CROs and patient advocacy groups discuss patient centricity in clinical trials. We explore the bottlenecks in today's system, challenge the status quo, and talk about future opportunities for innovation. Let's dive in. [00:00:31] Speaker B: We are joined today by Dr Yanni, who is the senior vice President of. [00:00:36] Speaker C: Patient Centricity over at Estellus. [00:00:39] Speaker B: Dr. Yanni is going to be talking. [00:00:40] Speaker C: To us about patient centricity and how he thinks about it today. [00:00:42] Speaker B: But I'd actually maybe just love to turn it over to you to give. [00:00:46] Speaker C: Us a little bit of an introduction, maybe a thumbnail sketch of your career. [00:00:48] Speaker B: And how you ended up in this. [00:00:50] Speaker C: World of patient centricity and how you think about it. [00:00:52] Speaker D: Yeah, it's great. Thanks, Brandon. Great to be here. Thanks for inviting me. As you said, I am Senior Vice President of Patient Centricity at Estellus. I joined Estellus in 2019. Prior to that, I was at a very large pharma company for about twelve years, 13 years, trying to develop this idea of what patient centricity should look like, what it could look like, how do we integrate the patient into the. [00:01:17] Speaker B: New into new solution development. [00:01:19] Speaker D: But prior to my time in pharma, I'm an MD by training, and I practiced clinical medicine for 13 years inpatient outpatient critical care. I was an internal medicine specialist. So I've had a lot of experience and a real privilege of being in the exam room with patients, seeing what their needs are, how they address their concerns, and doing the best we could, one patient at a time to treat their problems as best we could. After clinical practice, I was Chief medical officer of a hospital system for a short time before coming into pharma. So that's been my journey to this point. I've been very fortunate being patient facing. [00:01:58] Speaker B: Nearly my entire career. Absolutely. [00:02:00] Speaker C: So we'd love to maybe just start at the highest level then. [00:02:03] Speaker B: It sounds like your path has been. [00:02:06] Speaker C: One increasingly trending towards this idea of patient centricity. [00:02:09] Speaker B: Can you tell us a little bit more about what that means to you? I know it's rather open ended. Yeah. [00:02:14] Speaker D: So, patient centricity, when I started at Estellus, I realized that the words are being used by so many different people in different ways. I sort of defined it in two ways inside of Estellas when I started. One was operationally. It's the execution, the integration of the patient in all decisions regarding new solutions. So that from the beginning, from research and development all the way through delivery, we have processes and teams that help us integrate the patient perspective into how we make decisions moving forward. But then there's also a cultural definition that's very important, and that is a conscious awareness of the patient in every role, every day, in every geography. So that when folks come to work, they are fully aware that they're contributing to the patient solution. So together, operationally and culturally, if we can bring those things to life, I think we have a whole new way. A pharma organization can deliver solutions with patients, not just for patients. [00:03:13] Speaker B: Wow. [00:03:13] Speaker C: So this is much broader than just kind of like at the R D stage. [00:03:18] Speaker B: You're thinking about it across the cycle. [00:03:21] Speaker C: Of the organization, but then also culturally at Estellus. [00:03:24] Speaker B: That's right. [00:03:25] Speaker D: And I think the two components creating specialized teams to not only capture patient information, but to integrate it into analyses. [00:03:34] Speaker B: That are useful for researchers, that are. [00:03:37] Speaker D: Useful for development teams and that are useful for teams that are delivering solutions in the real world setting is critically. [00:03:43] Speaker B: Important, but none of it is sustainable. [00:03:46] Speaker D: In my view, if you don't have a culture that is actively reminded and the culture is the people are actively participating in activities that remind them every. [00:03:58] Speaker B: Single day of the importance of their work. I'm just so curious to learn more. [00:04:02] Speaker C: About this culture piece because I think that we hear a lot of organizations talk about patient centricity as a core value. [00:04:08] Speaker B: How do you think about bringing it. [00:04:09] Speaker C: To life culturally at Estellus? [00:04:11] Speaker D: So early on, I realized that you. [00:04:13] Speaker B: Can have a narrative about culture, and. [00:04:17] Speaker D: That'S important to have a narrative and remind folks with your words that culture. [00:04:21] Speaker B: Is important and taking a step back. [00:04:24] Speaker D: In Pharma, we're very fortunate that we have a selection bias. Folks join Pharma because they want to make a difference. Think about it. [00:04:31] Speaker B: You can be an accountant in any. [00:04:33] Speaker D: Company in the world. Why would you want to join Pharma? Well, you join Pharma because you say, I want to make a difference. [00:04:38] Speaker B: I want to do something for people every day. [00:04:41] Speaker D: The problem occurs six months later when it's a number in a box because we're not consciously working with them to remind them of their choice. So what we've done is created active programs so that employees everywhere, in every role, every day can participate actively in learning more about why the patient piece is important, how they can integrate the patient into their work. So, for instance, we have a solveathon where teams form spontaneously all over the world to develop a solution for a gap that they see in the interaction with patients or patient solutions. We have a program called Stars in the sky where everyone has an opportunity to give a testimonial on five questions that range from why did I choose to work in Pharma all the way through the fifth area, which is, how do I tell my family what I do? And the idea behind this is to create a library of inspiration not only for the company, but for the people themselves, so they can share with their families the great work that they're doing every day. [00:05:45] Speaker B: And lastly, this year we launched what's. [00:05:47] Speaker D: Called Patient Centricity University. It's a curriculum based learning opportunity inside the company with four certification levels, and each certification level has certain criteria. Anyone can join. Anyone can participate. But through Patient Centricity University, we've created a learning opportunity with certification for everyone to join and become more patient centric in their work. [00:06:13] Speaker B: Wow. [00:06:13] Speaker C: I love the thought and attention that you've kind of brought into this and. [00:06:16] Speaker B: The multi layered, almost journey that team members can kind of go on. [00:06:21] Speaker C: I think the bulk of the audience for this podcast is really on the R and D side. [00:06:25] Speaker B: So I'd love to hear a little bit of how have you thought about. [00:06:28] Speaker C: Bringing patient centricity into the R and. [00:06:30] Speaker B: D side of the world in clinical operations? [00:06:32] Speaker D: Actually, Brandon, that's where this all started for me when I 14 years ago or longer now thought about how to integrate the patient into new solution development. The first thing that came to mind is, how do we influence researchers? Because that's where the most critical decisions are made regarding portfolio investment. That's where we decide, how impactful can we be if this molecule becomes a medicine? So we've created in the research space a highly specialized team that consists of medical doctors that have practiced clinical medicine, PhDs, PharmDs, and business people. And we create a full analysis that includes some of the metrics and some of the data that they're used to using researchers. What is the entry points in the treatment continuum? What is the current standard of care? But we also do a great deal of work with understanding the gaps in care. We interview patients. We interview physicians. We interview caregivers. We bring all of this together in an analysis that has information they're used to seeing and information that's new, and we have seen changes in decisions. Because of this, researchers are now much more aware of what are the opportunities in this disease space, but what are the risks? What are we developing? That may not be what patients are asking for. So the understanding of need and value linking to science is much more apparent with the analysis that is given to them. [00:08:03] Speaker C: Can you help me visualize this a little bit more? What are some of the metrics, the data points that you bring to the. [00:08:09] Speaker B: Table that might be unexpected? And then what are some of the decisions that have kind of gone a. [00:08:14] Speaker C: Different direction as a result? [00:08:16] Speaker D: So you can imagine. So, really, Patient Centricity is more about change management with new ideas than anything else. So the traditional developmental process and research has been, does the science make sense? Does the molecule do what we think it does? And does it look safe in a laboratory before we go into clinical development? [00:08:36] Speaker B: Right. So what we're doing now is taking. [00:08:40] Speaker D: The information of the science from the scientists, and now we're saying, here's a better understanding of this disease, because the scientists don't always understand the depth of the patient journey. They don't understand the impact of standard of care. And with standard of care. What are the gaps that patients are saying I need help here? Sometimes they're very associated with the disease, sometimes they're not associated with the disease but it has to do with fatigue and insomnia and anxiety and all the things that go along with chronic illness. [00:09:10] Speaker B: So what we do is bring in. [00:09:12] Speaker D: This extra piece of information so they see here's what the science is doing. We share with them what's necessary, what are the characteristics that would be necessary in the molecule for successful impact on patients. And then we have a broad discussion of whether or not they believe the science will achieve that goal. And if the science doesn't achieve that goal, then real discussions have to take place inside of pharma companies across portfolios to decide maybe this isn't the best approach or maybe this isn't the right disease or patient population for this molecule. And so what we've seen is scientists looking at it and saying well, maybe we need to look at a different. [00:09:52] Speaker B: Indication or maybe we need to look. [00:09:54] Speaker D: At a different point in the treatment in the disease progression or maybe we just need to think about a different molecule altogether. So really good discussions and my teams are not decisional. We don't try to make the decision. We try to just inform research teams so they can make better decisions. And we've seen it because the researchers are very open to this concept because all our goals are aligned. [00:10:21] Speaker B: We want to help patients so they. [00:10:23] Speaker D: Don'T want to waste time and resources if it's not going to be something. [00:10:26] Speaker B: That would be impactful. I imagine that this data is not. [00:10:30] Speaker C: Sitting in a structured database somewhere where. [00:10:32] Speaker D: You can just kind of query it. [00:10:34] Speaker C: So how do you go out and gather these insights? [00:10:37] Speaker D: Well, everything we do for the most part is created internally and delivered internally so we don't try. I think the important thing for people out there who are trying to develop processes for patient centricity is that you don't have to be everything all at once at one time and understand that the process is a journey as well. [00:10:59] Speaker B: So what I did when I sat. [00:11:01] Speaker D: Down and tried to try to create this concept was what information would researchers consider to be actionable? Doesn't have to be everything. It doesn't have to be every piece of information on the patient journey. It doesn't have to be the opinion of thousands of patients. It's got to be enough information so they can understand the link between the science and the disease. So what we do is we go out and we do both literature based searches and real world interviews and understanding, talking to physicians that are treating these patients, talking to patients who are being treated, and try to integrate that in real ways that are very understandable to research teams so they can better link the clients, which they're the expert with. [00:11:48] Speaker B: What we've presented to them. Yeah. [00:11:50] Speaker C: So I'm a new person on your. [00:11:51] Speaker B: Team, and I'm doing this analysis for. [00:11:54] Speaker C: The very first time. [00:11:55] Speaker B: How do you want me to present. [00:11:56] Speaker C: This to the research team? [00:11:58] Speaker B: What's the right kind of output for me to kind of go over? Yeah. [00:12:02] Speaker D: So that's a great question because the. [00:12:04] Speaker B: Teams were designed so that each area. [00:12:07] Speaker D: Of expertise clinical practice, physicians, PharmDs and PhDs. [00:12:11] Speaker B: Right. [00:12:12] Speaker D: A little bit of idea of the science, an understanding of the pharmaceutical standard of care in medicines, and an understanding of treating patients in the exam room that the teams were designed so they had to sit around a table and have discussions and arguments about the analysis. So that's the first step. There is a lot of disruption when they're presenting an analysis because everyone's opinion is slightly from a different perspective. [00:12:37] Speaker B: Right. That's what I want. [00:12:38] Speaker D: I want those teams to really work through almost like the pregame work that football teams do before a Sunday game. [00:12:47] Speaker B: Right. [00:12:48] Speaker D: They're all talking about different aspects. Then when we present it to the project teams, we acknowledge the science that they've given to us. We don't create that. And then we walk them through in a stepwise fashion the same approach we would have if I was in the exam room with a patient. So we talk to them about we bring that exam room into the research lab and we say to them, here's the journey, here's what they're facing, here's what physicians have to deal with, here's what the standard of care is. And if you can imagine, that story brings the researchers through the diagnosis, the interaction, the choices, the results, the gaps in care. And then we talk about the competitive landscape. Researchers need to understand, and they do fully what's available, what's in the research pipeline. And then we talk about what the ideal situation could be and the challenges of entering the treatment continuum. So this isn't a lecture to the research teams. It's a conversation with the research teams. Because without science, you don't have any medicine. [00:13:50] Speaker B: And with science alone, you don't have any medicine. [00:13:53] Speaker D: Because patients don't buy science. [00:13:55] Speaker B: They buy medicine. Right. [00:13:56] Speaker D: They buy treatments. So we need to make sure that marriage occurs in that discussion for them to contemplate the opportunity. [00:14:04] Speaker B: Yeah, absolutely. [00:14:05] Speaker C: So I imagine that at some point, this mapping of the patient journey and this idea of, okay, what is the patient going through? This ends up informing how you think about recruitment. [00:14:16] Speaker B: Right. [00:14:16] Speaker C: Everyone's talking about how recruitment is constantly delayed and if we are more patient centric in recruitment, then maybe that it would be easier for patients to participate. How do you think about translating some of these insights into the clinical operations world then, in the kind of recruitment. [00:14:31] Speaker B: Space I think companies have done, there's. [00:14:33] Speaker D: Been a lot of progress made in the recruitment space. [00:14:36] Speaker B: As far as patient engagement goes, I. [00:14:39] Speaker D: Think it's different and it's part of patient centricity but it's not in and of itself a full patient centricity sort of activity or a complete beginning to end patient centric work stream, right. The recruitment and retention. It's such a critical part of it. [00:14:56] Speaker B: But it's one part. [00:14:57] Speaker D: And I think we've seen in Pharma now the importance of understanding the patient's perspective of the protocol, the patient's perspective and understanding of their role in the clinical trial, the sites and their importance of understanding the patient's perspective and making sure that they stay engaged throughout the clinical trial and understanding whether we're creating protocols that are just unreasonably burdensome. So I think companies have done a. [00:15:25] Speaker B: Really nice job with that piece and. [00:15:26] Speaker D: I think it's a very important piece. I think patient centricity has to start in discovery before you even get to that recruitment phase and it has to. [00:15:34] Speaker B: Continue through delivery because we have a. [00:15:37] Speaker D: Behavioral science team and I'm happy to talk about that. But we also understand that in the real world setting behavior has a big impact on treatment success. [00:15:46] Speaker B: And so if we can include the. [00:15:49] Speaker D: Patient from discovery but also not forget the patient in the real world setting at delivery, I think then we have a comprehensive best case scenario for delivering solutions. [00:15:59] Speaker B: I do want to talk a little. [00:16:00] Speaker C: Bit about the behavioral science, right? Because classically there's a bifurcation between the state of preferences and the revealed preferences. And it's kind of hard, I imagine to get to revealed preferences upfront while. [00:16:11] Speaker B: You'Re doing the kind of like initial research. How do you think about that? [00:16:15] Speaker D: So what we do, I'll give you an overview of the behavioral science piece. So what I was interested in doing and what we've created here is a group of behaviorists with all different backgrounds and specializations behavioral economists, behavioral psychologists. [00:16:30] Speaker B: And our idea here is we fully. [00:16:34] Speaker D: Accept that the patient in the real world setting is different than the patient in a clinical trial setting. We fully accept that geography matters, socioeconomics matter, that patients in a city with lots of access and perhaps financial means are different than a patient in a rural setting without financial means and without access. We fully understand that a patient in the Middle East is different than a. [00:16:56] Speaker B: Patient in Middle America. [00:16:58] Speaker D: And so having a full understanding of the barriers patients face, the behaviors, the fears, the diagnostic barriers is so important because you could have the best treatment available. [00:17:10] Speaker B: But if patients can't get it for. [00:17:13] Speaker D: Whatever reason, if it's a behavior of the physicians not asking the right questions or a behavior of the patient afraid to ask the right questions, we need to understand that and we need to break down those barriers so we can optimize the treatment patients receive. [00:17:26] Speaker B: And I think that is part of. [00:17:27] Speaker D: What pharma should be working on. I don't think it's just a delivery problem and we should hand it over to the hospital systems, the pharmacies or the physicians alone. I think we, as we develop these solutions, should be thinking about it years in advance. [00:17:40] Speaker B: Yeah, absolutely. I mean, this reminds me of the. [00:17:42] Speaker C: Conversation I had with our mutual friend Vicki where all of these decisions need to be made upfront. [00:17:48] Speaker B: Right. [00:17:48] Speaker C: It kind of goes back to even what are the endpoints that we're defining. [00:17:51] Speaker B: That we're kind of going after? And how do we think about that. [00:17:54] Speaker C: In the broader context of somebody's real life? [00:17:56] Speaker B: Exactly. [00:17:57] Speaker D: Context of the so many there are so many pieces to understanding the complexities that patients face, both emotionally, physically, geographically, and socioeconomically, that we need to do better with that. [00:18:14] Speaker B: Yeah. [00:18:14] Speaker C: What do people get wrong today? [00:18:17] Speaker B: What do you mean by people? [00:18:18] Speaker D: Pharma or patients or caregivers or physicians? Because we all get things wrong. [00:18:25] Speaker B: That's fair. What do you think pharma industry side. [00:18:30] Speaker C: Gets wrong with respect to thinking about patient centricity today? [00:18:34] Speaker B: So a couple of things. [00:18:35] Speaker D: It's a great question. I don't think I've ever been asked that question. I've been asked just about every think. I don't know if it's wrong, but if they got it wrong. But I think pharma has not yet fully accepted the impact of patient centricity. [00:18:52] Speaker B: On not just the impact on patients. [00:18:55] Speaker D: But the impact on the business. Patient centricity has a significant and real measurable impact on the work that pharma does. And we're starting to show that with metrics both qualitative and quantitatively inside of estella. Once you develop this infrastructure, specialized teams that are working along the developmental continuum, then you have to start saying, okay, well, how can we show that the support is making a difference both qualitatively in the way we make decisions and quantitatively in ways such as timelines and maybe even financial impact? Because we're redirecting programs that would have been perhaps more challenged than the new programs with the patient input. [00:19:37] Speaker B: So that is one area where pharma. [00:19:40] Speaker D: Has accepted the idea that patient centricity is important. But I'm not sure, and this is my goal in the next year or two, is to create a real understanding. [00:19:51] Speaker B: That patient centricity is the new disruptor. [00:19:54] Speaker D: It will change the way we develop medicines for the better. It will be measurable and governments payers, regulators will require this as part of the developmental process. [00:20:05] Speaker B: So that's the first thing. And the other thing that I think. [00:20:09] Speaker D: We can do better as a pharma. [00:20:11] Speaker B: Industry is that we need to be. [00:20:13] Speaker D: More clear about the language we use. We can't use patient engagement so freely. [00:20:18] Speaker B: That it could mean an advertising agency. [00:20:21] Speaker D: Talking to patients, a market access team parking and talking to patients, and patient centricity talking to patients. All of those interactions are really important. [00:20:28] Speaker B: But they're not the same. [00:20:29] Speaker D: And we tend to use the phrasing and the terminology as a checkbox to say, oh yeah, we're patient centric. [00:20:38] Speaker B: Right. [00:20:39] Speaker D: And it becomes vanilla and it becomes not meaningful. [00:20:43] Speaker B: We should be asked to show what. [00:20:45] Speaker D: Does that mean to your company? [00:20:47] Speaker B: We want to see it. [00:20:48] Speaker D: We want to see how you're patient centric. And I think more of that will benefit all of industry and patients. [00:20:54] Speaker C: Yeah, I'm so curious to kind of learn a little bit more about this. You kind of cracked the lid, but I want to see inside. How have you quantified the impact of patient centricity? [00:21:06] Speaker B: How do you think about that? [00:21:07] Speaker D: So there's two things that I've looked at and I think it's really an interesting we could spend an entire half. [00:21:15] Speaker B: An hour on this alone because I. [00:21:17] Speaker D: Think it's so interesting when we talk about quantification and value of a process. Right. So patient centricity is a support function. It will be a support function forever. It will be a function that helps teams in discovery and research and clinical development and post launch make better decisions because we understand our customer better. Every industry in the world talks to their customers before they produce something. Every industry pharma was probably the last one to, hmm, I wonder what the patient thinks before we build it. [00:21:51] Speaker B: Right. [00:21:52] Speaker D: So, because we're in a very scientific and rigorous industry, as we should be, we rely too heavily on quantitative and discard qualitative information. [00:22:02] Speaker B: And I don't buy that at all. [00:22:04] Speaker D: I think it has paralyzed patient centricity functions because what's the return on investment? Can you show us what impact you've had? Well, first of all, we do qualitative measurements all the time. We send surveys out anonymous. We talk to our internal customers and we just simply want to know, was your decision tree more informed because we gave you information? Have you ever had this information before and would you like to proceed without it? Universally, 100%, the answer is yes, you've had an impact. No, we don't want to go without this information. [00:22:37] Speaker B: Yes, we need more of it. [00:22:38] Speaker D: So we know there's a qualitative benefit along the entire continuum to give this information to teams to make better decisions quantitative is a little challenging because the game is long. [00:22:49] Speaker B: Right. [00:22:50] Speaker D: So we know that we might have. [00:22:52] Speaker B: An impact, but it might not be. [00:22:54] Speaker D: For seven years or five years until we see the result. The other thing we know is that as a support function, we are not solely, nor should we be the only ones influencing decisions. So when we look at things like. [00:23:06] Speaker B: Regulatory or Is or some of the. [00:23:11] Speaker D: Other pharmacovigilance, all of them are very, very important, but none of them can singularly say in most instances, oh, we did that. No, we've contributed to that. So we are measuring these sort of things now to say, well, how have we influenced portfolio decisions? [00:23:26] Speaker B: Have there been any decisions that we've. [00:23:29] Speaker D: Recommended that have been followed? And how does that play out over. [00:23:32] Speaker B: The next few years? So there are ways to do that. [00:23:35] Speaker D: We are doing it, but it's a. [00:23:36] Speaker B: Bit slower and it's going to take. [00:23:38] Speaker D: Some time, but I tell the team all the time because I don't want anyone to be discouraged. And that is, if you walk into. [00:23:45] Speaker B: A room in your house and you turn the light on, you don't call. [00:23:49] Speaker D: The power company and say, hey, thanks. [00:23:50] Speaker B: The light went on. [00:23:51] Speaker D: The only time you call is when there's a problem. [00:23:53] Speaker B: And so what you have to become. [00:23:56] Speaker D: Accustomed to as a support function is team saying, we just need more of. [00:24:00] Speaker B: This, we need more. [00:24:01] Speaker D: And they're not calling up every day saying, boy, this is the best thing I've ever seen. [00:24:05] Speaker B: But when there's a problem, they're going to let us know. [00:24:08] Speaker D: And so all of these things need to be tracked in real time. One area where we can track very quantitatively is in the culture piece. [00:24:15] Speaker B: So we know exactly where a question. [00:24:20] Speaker D: Such as do you feel in your role you're contributing to patients directly? We knew what the number was before. [00:24:27] Speaker B: We started our program, and we know what the number is now after we launched all of our programs. And the results have been remarkable, really. [00:24:36] Speaker D: Very high percentages of people in the organization worldwide, across all roles, including HR. [00:24:44] Speaker B: Finance roles that don't typically engage patients. [00:24:48] Speaker D: Very high penetration of, yes, I know I'm contributing to patient solutions. [00:24:52] Speaker B: That must make it far more inspiring. [00:24:54] Speaker C: To come to work every day. [00:24:55] Speaker D: Exactly. [00:24:57] Speaker B: I want to close with maybe a slightly different question here. [00:25:02] Speaker C: Let's imagine you're taking a new role and you're being tasked with taking a new company through the exact same journey. [00:25:10] Speaker B: That you've just been on from the ground up. What are the first three things that you do? The first three things are one, assess. [00:25:17] Speaker D: Where the company is right now with the engagement activities that they have. Two, accept that this is change management. It's not going to be universally loved and accepted that you will have early adopters, you will have late or no adopters. But remember, the 95% in the middle just want their work to be better, their life to be better, and they want to deliver solutions. [00:25:39] Speaker B: So concentrate on those activities. [00:25:42] Speaker D: And three, never accept anything less than what will be impactful. Do not compromise because existence your existential threat. There's an existential threat to your activities. So those three things are critical when you launch this because given the opportunity, given time, and given successful construct of this, I guarantee there will be value seen. You just have to get through that rough path, put your armor on and just go to work every day building something that's going to matter for people. Because at the end of the day. [00:26:15] Speaker B: It'S about the patient. [00:26:16] Speaker D: It's not about structure, it's not about the division, it's not about me. It's really about how are we contributing to patient solutions. And if you keep focused on that, you'll be successful. [00:26:26] Speaker B: Yeah, I love that. [00:26:27] Speaker C: Well, I hope that if there's anybody who's starting the journey down patient centricity. [00:26:33] Speaker B: That this conversation was a helpful starting point for them. [00:26:38] Speaker C: Dr yanni if there's anybody who wants to learn more, hear about some of these thoughts that you've had, the thinking, the journey. [00:26:45] Speaker B: Where can they find you? [00:26:46] Speaker C: Where can they learn more about the. [00:26:47] Speaker B: Way that you've approached this? [00:26:48] Speaker D: Reach out directly to me. Anthony [email protected]. It's very easy. I love talking about this. I welcome everyone's email and more of this is better. This is a pre competitive space. We should all be doing this. [00:27:03] Speaker B: Perfect. I love the inclination towards collaboration here. [00:27:07] Speaker C: Well, hey, I want to thank you for spending the time with us today. It seems like we could go on. [00:27:12] Speaker B: Another half hour and probably do a. [00:27:14] Speaker C: Part two and a part three of this as we get into increasing levels of detail and I'd love to do that at some point down the road. But thank you for taking the time. [00:27:20] Speaker B: Today to have this conversation. Dr thank you brandon really enjoyed it. [00:27:26] Speaker A: Thank you for tuning in. If you haven't already, please follow power on LinkedIn, sign up for our live events and engage with us in the conversation. We hope to have you join us next time on power to the patients. [00:27:39] Speaker B: Take care.

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