Adam Pearson’s life experiences and a recent diagnosis of a rare disease give him a unique perspective to guide the pharma company’s strategy

Adam Pearson, chief strategy officer at Astellas Pharma, has been working in pharma for 20 years, almost all at the Tokyo-based company.

Coming from a consulting background, he says he was eager to work inside the industry for which he had been consulting because he was intrigued by the challenges of a commercial business that is highly scientific and highly regulated.

"It struck me as a fascinating combination of different factors and piqued my interest in learning how to make that business successful," Pearson says.

Pearson began on the operational side of pharma, but recently moved to the global chief strategy position. About four years ago, Pearson had taken the role of head of corporate strategy and in April 2023 took the reins as chief strategy officer.

"I had built my career on the operational side, owning the P&L for different geographies," he says. "But I couldn't turn down this opportunity. I am glad to return [to strategy] to be able to steer the bigger questions and the bigger picture of the whole organization."

Dealing with a rare disease

In the past couple of years Pearson has faced several challenges, including being diagnosed with AL amyloidosis as he took on his new leadership role at Astellas. He says the diagnosis, which he calls one of the most impactful experiences of his life, has transformed both his personal and professional perspective.

Adam Pearson, chief strategy officer at Astellas Pharma. Photo courtesy Astellas Pharma.

Pearson says his illness was discovered early, and with continual treatments it is currently under control.

"I'm still under treatment," he says. "But that process, that experience, has helped me to reflect and understand much better what it means to be a patient."

Pearson has brought his new perspective to his leadership role at Astellas and to his team. He says he is much more aware of how pharmaceutical companies can support patients and incorporate an understanding of their perspectives.

"It's certainly changed my point of view," he says. "My unique experience as a patient has informed my leadership perspective. This has allowed me to relate to patients on a more personal level and reflect on how the actions we take in support of our drugs are perceived by patients.”

“I understand the gratitude patients feel from receiving treatment, as well as the challenges they face while trying to find the best treatment options, coping with side effects, and facing the uncertainties of the disease," he adds.

With a new R&D focus comes new challenges and a reorganization

About the same time he was managing his health issues, Astellas shifted its business model and created a new leadership team to manage the transition. He was promoted to chief strategy officer, at the same time that Naoki Okamura became the CEO and other executives took over new roles.  

"There has been lots of change and it's been very interesting," Pearson says. "Working with a  new leadership team has been an important time of reflection on how Astellas is doing and what comes next. We made a large acquisition last year with Iveric Bio and that's also been a major part of what I've been involved in."

Astellas' R&D strategy, called the Focus Area Approach, consists of three components: Biologies with high disease relevance, versatile modalities/technologies, and diseases with high unmet medical needs.

"We're trying to evolve our R&D operating model," Pearson says. "We are met with having to make difficult choices around how to allocate our resources and there are tough decisions to make. We are facing new unknown challenges in development that we never faced before with small molecules or antibodies."

One of those challenges has been determining how to maintain a high level of investment in R&D while working on other promising areas.

"One of the challenges that's certainly at the heart of it is: how can we make the best [of] these investments?” he says. “How do we get our R&D engine working better and better?"

The leadership team has reorganized R&D in one way by giving more empowerment to teams and allowing more agile decision-making at the team level. This creates a more fast-paced environment.

Another priority was to ensure that the new leadership team works together to create a clear focus for the organization. As a result, Astellas established three enterprise priorities for the company.

"Broadly speaking, the priorities are maximizing the potential of our products to reach as many patients as possible,” Pearson says. “It's around raising our sights and improving our capabilities in R&D, really driving products faster through the pipeline, and third, it's around responsible management of our margins and costs and transforming the business so that we become more sustainable in the long term.”

"It is very exciting,” he adds. “It gives us all the fuel to take on the challenges for products that show that they can make a difference to patients. For example, we've had some dramatic results from PadCev, a treatment for bladder cancer, which in combination with Keytruda has shown to double the lifespan compared to the standard of care for patients with bladder cancer."

Leadership skills needed for leading a global transition

Leading through a company-wide transition takes an accurate and realistic assessment of the situation and a deep understanding of one’s team members, all while creating a new model for the organization. Pearson believes this requires trust in one’s employees, a deep understanding across cultures, and clear communication.

"I think my role as chief strategy officer requires me to be able to articulate as clearly as possible where we are trying to go as a business," he says. "We need to articulate clearly what the challenges are and the choices that we need to make to get us to our goal."

Pearson says he is all too happy to empower his teams to work autonomously and is not interested in micromanaging. His first step to building a solid team is to hire the right people for the job, and then give them the freedom to do it.

"I put trust in them and provide them with a combination of support and coaching and challenges, but I also allow them to get on with their job," he says. "I love watching this growth  happening in my team, when team members feel confident and empowered to own their responsibilities and make their own choices around them. My job is to be a sounding board mostly, and sometimes to challenge them a bit, and certainly to try to make sure that they understand how they operate in the full organizational context.”

“The ideal situation is when they're owning the plan,” he adds. “They all know their job well and do it better than I can and I'm there to empower and support them in that."

While it is difficult coordinating with people across so many countries and cultures, Pearson has had plenty of practice. Astellas' center of gravity is in Japan, but it has a large presence in the US, Europe, and other parts of the world. Pearson says this makes arranging meetings quite a challenge from a time zone perspective.

"It's difficult getting everybody on the same call," he says.

But more important than meeting times is the many cultural differences that must be accounted for and understood. The cultural differences across Astellas might be a bit broader than in a typical global company.

"Leaders need to invest more time to understand what is behind the way someone is acting and behaving because what is going on in their heads may not be what your instinct tells you,” he says. "It might be something quite different in fact."

Pearson has the experience to manage a global company, having lived in nine countries. He was born in Australia and spent much of his childhood in the UK.

"We moved around a lot and sometimes we lived abroad, sometimes we lived in the states," he says. "I lived in Greece when I was at university. I worked a bit in France, and I studied in the US. While at Astellas I have been based in five different countries; at one of my positions, I had responsibility over 10 countries. And I now live in Japan."

Pearson and his wife are settling into Japan and enjoying the many aspects of its culture, including learning the language.

"We are doing a lot of exploring and hiking and just trying to get to know the country and stay active," he says.

While it would be easy to visit other parts of Asia, Pearson says there is more than enough to explore just in Japan.

"It's really a fascinating country, and it's a privilege to live somewhere internationally," he says.

The cyberattack is the latest event to force leaders to alter their approach.

Hospital and health systems have been going through the wringer for a few years now. The last thing CEOs needed on their plate was a cyberattack at the scale and magnitude of the one Change Healthcare suffered.

And yet, what is being called “the most significant cyberattack on the U.S. healthcare system in American history” is now the latest event in a series of twists and turns to send a shiver down hospital leaders’ spines and have them rethinking their strategies.

“Cybersecurity issues are just added icing on the cake,” Matt Heywood, CEO of Aspirus Health, told HealthLeaders.

The financial implications have been massive.

Change Healthcare processes 15 billion transactions annually and the lost payments from the attack are draining hospitals by the day. According to a survey by the American Hospital Association that collected responses from nearly 1,000 hospitals, 94% of operators are reporting financial impact, with more than half reporting “significant or serious” impact. Of the 82% of hospitals reporting impacts on their cash flow, nearly 60% report that the impacts to revenue is $1 million per day or greater.

It's never a good time for hospitals to be losing money, but the cyberattack has exacerbated the multiple financial challenges many operators have already been fighting. It’s creating somewhat of a perfect storm, Heywood stated.

“I coined that 2024 is going to be ‘the year of chaos.’ What I mean by that is you're going to have organizations that have had two to three years of financial issues really start struggle,” he said.

“You're going to have some of these issues with the for profits and hedge funds because the easy money is going away. And as that easy money goes away, the structures of some of those deals are not viable anymore. So you're seeing a lot of clean up and a lot of turmoil in 2024 and you're going to see it carry on in probably 2025, if not a little further out.”

The future is now

If there were any CEOs on the fence about investing in technology, especially on the cybersecurity and IT side, the Change Healthcare situation should have plenty reconsidering their stance.

When something is affecting the bottom line so drastically, hospital decision-makers have no choice but to re-strategize with the aim of both preventing future attacks and steadying the ship when it inevitably does occur.

“Hopefully it gets a lot of CEOs’ attention because they need to cross their T's and dot their I’s, close loopholes in their systems, and upgrade systems,” Ben Wobker, founder and CEO of Lake Washington Physical Therapy, told HealthLeaders. “It sounds like that's going to be the case here according to the headlines, but then again, you have to have that allocation of security spend and technology spend and make that a bigger budget line item.”

The AHA survey found that most hospitals are implementing workarounds to deal with the cyberattack, but those solutions are labor intensive and costly. Healthcare, as an industry, is known to be slow in implementing new technology, but with the rate tech is growing at, hospitals may not have much of a choice anymore for slow playing it.

Investment, of course, requires money and resources. That’s why Heywood believes it’s as important as ever to ensure you have some financial wiggle room to not only spend on technology, but to potentially throw capital at whatever is around the corner.

“You have to have a strong balance sheet,” he said. “You have to have cash on hand to be able to weather some of these storms that are coming. You're going to need to be in in this tight environment. You're going to need to be willing to spend money on cybersecurity and your IT. If you're already financially challenged, you do not want to be cutting your IT, your security, because that only further puts you in a bind.”

When it comes to dealing with the fallout of a cyberattack, however, technology is only one part of the equation.

You’re only as good as the systems you have in place and those systems aren’t immune to failure, Wobker noted. Updating and refreshing hardware and software should be the first step, but there also needs to be contingency plans in place to go offline.

Straying too far from traditional methods isn’t the answer either, according to Heywood.

“Now if you ask people to go back to paper, it's like, ‘Oh my gosh, I'm back in the stone age,’ he said. “So you have to have preparations to go back to paper in order to be able to get through a down time and you have to have backup systems so you could shut something down and turn it back on.”

There are few positives in the Change Healthcare attack, but the one silver lining may be the lessons that CEOs are forced to take away from it.

Whether it’s another cyberattack, pandemic, or anything else, those lessons should have hospitals better prepared for whatever is next.

The Match IT Act of 2024, now before Congress, would create a federal definition for 'patient match rate' that providers would address as they would a clinical quality measurement

A new bill before Congress aims to jump-start the unique patient identifier conversation by creating a healthcare industry standard definition for “patient match rate” and improving provider efforts to match patients with their health records.

The Patient Matching and Transparency in Certified Health IT (Match IT) Act of 2024, introduced in February by US Reps. Mike Kelly (R-PA) and Bill Foster (D-IL), would, if passed into law, set the bar for providers in matching patients to their records. It would establish the patient match rate as a clinical quality measurement, creating standards by which providers identify patients with their services and information.

The legislation addresses a key pain point in the interoperability arena, where supporters have long argued for the establishment of a unique patient identifier (UPI), or individual code similar to a social security number that would be used by providers to identify and match patient data. While that debate has bogged down (with some critics blaming the heated political environment), this bill would move away from that issue and give health systems something to work with.

“We have this major issue in the industry that’s costing lives, costing money, costing time [and] causing a lot of frustration,” says Aaron Miri, MBA, FCHIME, CHCIO, senior vice president and chief information and digital health officer at Baptist Health Jacksonville. “This gives us [an opportunity] to create a measurement of success, a benchmark.”

Clay Ritchey, CEO of digital identity management company Verato, said the bill comes as the industry is making a “mad dash” toward digital transformation and interoperability. Healthcare executives are struggling, he says, to manage and use vast amounts of data, including unstructured data coming in from outside the EHR, and trying to avoid data silos as they move toward value-based care.

“We often don’t know who’s who across each of these touch points,” he says. “That’s why we need meaningful standards in place.”

In a press release introducing the bill, Kelly said 35% percent of all denied claims result from inaccurate patient identification, costing the average hospital $2.5 million and the industry more than $6.7 billion annually. In addition, the cost of repeated or unnecessary care due to inaccurate medical data costs $1,950 per patient inpatient stay and more than $1,700 per ED visit.

And that’s not counting the patients who suffer harm from an unnecessary medial procedure (such as surgery on the wrong site or incorrectly prescribed medications).

"This legislation would promote interoperability of patient matching systems, which would protect patients and decrease burdens on healthcare providers,” added Foster.

The bill has drawn support from a number of healthcare organizations, including HIMSS, CHIME, and AHIMA, all part of the Patient ID NOW coalition. Another member of that coalition is Intermountain Health, whose chief digital and information officer, Craig Richardville, MBA, CHCIO, also backs the bill.

“[T]his legislation will address our nation’s current inability to consistently and accurately identify patients to their health records. Improved standardization of patient demographic data will lead to more accurate patient matching, which in turn will produce advances in patient safety, more complete information for clinical care, and cost savings from reducing the need for repeated medical care, among other benefits,” Richardville said in a Patient ID NOW press release on the legislation.

Aside from reducing patient harm and unnecessary medical expenses, Miri said the bill would gives hospital and health system executives an important tool in managing patient data—including that of their own doctors and nurses. And with Baptist Health Jacksonville managing some 35 million unique patients now and seeing roughly 100 people a day moving into northern Florida, the health system needs to keep track of who it’s treating and hire more clinicians to handle the growth.

It would also fit well with the industry’s emphasis on patient-centered care and patient engagement initiatives.

 “We have a consumer demand that’s insatiable for their own data,” he points out.

So while the UPI argument seems stalled, advocates for the Match IT Act of 2024 are hoping that bipartisan support will propel the bill at a time when Congress is struggling to agree on anything.

The health system is working with a Norwegian digital health company to develop an app that would allow parents to test their babies at home

Intermountain Health is developing a digital health app for smartphones that will help parents identify jaundice in their babies at home.

The Salt Lake City-based health system is partnering with Norwegian digital health company Picterus AS to create the app, which would use a smartphone camera and a laminated card to measure bilirubin levels in newborns without the need for a return trip to the hospital or clinic and a blood draw.

“Bilirubin and jaundice management has long been based in the hospital and the clinic,” Tim Bahr, MD, an neonatologist who is leading the study, said in a press release. “Taking a newborn to the clinic or laboratory for frequent blood tests in the first days of life can be a huge inconvenience and burden on families. We hope to simplify this care and move more of it into the home. This is a win for families and for our healthcare system.”

The app addresses a care management pain point for hospitals. According to the March of Dimes, three of every five babies born in the US develop jaundice within days after birth. Many recover quickly with little medical intervention, but jaundice can lead to serious health concerns, including Hyperbilirubinemia, brain damage, or hearing loss, if untreated.

Intermountain, which greets and tests 33,000 newborns a year, aims to turn the smartphone into a diagnostic tool that would enable parents to quickly check their baby’s health at home after discharge from the hospital, and to contact their care providers if jaundice is evident. Parents would use their phone to snap roughly six photos of the laminated calibration card placed on the chest of their baby, and the app would translate those photos into a diagnosis.

“We do know that parents are pretty good at taking pictures of their babies,” Bahr noted in the press release. 

“This technology is exciting to us because it makes it possible to measure the bilirubin in a baby without taking blood,” he added. “Right now, the only way to measure bilirubin levels in babies is to take them to a laboratory and draw blood.  By having this technology available on a smartphone, we will eventually empower parents to make these measurements without having to leave their homes with an easily accessible and affordable tool.”

The health system is testing the digital health tool on about 300 term babies born at Intermountain Utah Valley Hospital in Provo, Intermountain McKay-Dee Hospital in Ogden, and Intermountain Medical Center in Murray, as well as on about 100 pre-term babies. They’ll test the app against the traditional method of drawing blood.

If proven reliable and introduced to clinical care, the app could not only save new parents the hassle of return trips and treatment, but help providers identify and treat jaundice earlier and more effectively, improving clinical outcomes and reducing costs.

As healthcare costs rise, CNOs must brainstorm ways to lower them. 

Cost containment is an issue throughout all of healthcare, and because of the nursing shortage, keeping costs down has become an even more difficult task. To combat this, CNOs need to focus on nurse retention and creating the right work environment where nurses will want to spend their entire careers.

Here's what you need to know about cost containment, according to Gail Vozzella, senior vice president and chief nurse executive at Houston Methodist. 

Click here to read the accompanying article. 

CNOs must strategize to keep tenured nurses in the workforce longer.

On this week’s episode of HL Shorts, we hear from Gail Vozzella, Senior Vice President and Chief Nurse Executive at Houston Methodist, about how CNOs can bridge the gap between tenured nurses leaving and new nurses entering the workforce. Tune in to hear her insights.

As the industry assesses the financial damage of the cyberattack, healthcare execs will also be looking at how their technology strategies can be improved

The workaround is a popular healthcare technology term right now.

As healthcare organizations across the country assess the damage caused by the Change Healthcare outage, executives are not only looking at the financial fallout but also the technological repercussions. In short, what will health systems need to do to make sure this doesn’t happen again—or if it does happen, that they have the resources in place to minimize damage?

According to the results of an American Hospital Association survey of roughly 1,000 hospitals released on Friday, some 81% of hospitals found that workarounds enacted to keep operations going during the outage were only “somewhat successful,” while 11% found that workarounds didn’t work at all. And two-thirds of those responding to the survey said it difficult or very difficult to deploy workarounds, particularly in switching clearinghouses.

As has been well-reported, the financial implications are even more alarming. According to the survey, 94% reported being affected financially, with more than half sustaining “significant or serious” damage. About one-third reported impacted to at least half of their revenue and about 60% saw that impact to be more than $1 million a day. Some 44% expect the negatives to continue for another two to four months, and more than 20% have no idea when the tide will turn.

The takeaway is that healthcare executives will need to think long and hard about what they need to do to improve their technology infrastructure, on both the financial and clinical sides.

“These survey findings are another irrefutable reminder that the impact of this cyberattack is far reaching and far from over,” AHA President and CEO Rick Pollack said in a press release accompanying the survey. “When nearly every hospital says they are experiencing a financial loss and half of those say it’s ‘significant or serious,’ with no immediate end in sight, then the debate about whether we need to help them should be over.”

The AHA is one of several organizations calling on federal authorities to take action, and an investigation has reportedly been launched to see whether UnitedHealth Group did anything wrong that led to the attack or caused it to be so damaging.

“We continue to call on Congress and the Administration to take additional actions now to support providers as they deal with significant fallout from this historic attack,” Pollack said. “We also need UnitedHealth Group and commercial payers to step up and support patients and providers on the front lines by waiving prior authorization and timely filing requirements, as well as advancing payments that will allow providers to continue providing 24/7 care to communities.”

Beyond that, healthcare organizations need to take stock of how an incident like this affects clinical care. According to the AHA survey, almost three of every four hospitals reported a negative effect to patient care, and nearly 40% said patients had difficulties accessing care, most often because of disruptions to the health plan authorization process.

With rising costs in healthcare, CNOs need to brainstorm how to keep expenses down.

Cost containment is an issue throughout all of healthcare, and because of the nursing shortage, keeping costs down has become an even more difficult task.

According to Gail Vozzella, senior vice president and chief nurse executive at Houston Methodist, the nursing shortage drives up labor costs and turnover costs in nursing. Labor costs have gone down marginally with the consolidation of travel nursing, but many organizations are still requiring the use of agency nurses, which drives up costs.

“Every time we spend time training a nurse, it costs money,” Vozzella said, “[but once a nurse] feels that it’s not a good work environment… [they turn] around within those first three years and leave that organization or unit, [and] it is a significant cost.”

To combat this, CNOs need to focus on nurse retention and creating the right work environment where nurses will want to spend their entire careers.

Redesigning care

One cost containment strategy that CNOs should consider is using technological solutions to change the day-to-day workflows of nurses so that they have more time to care for patients.

At Houston Methodist, Vozzella said they meet with the deans of the surrounding nursing schools, and the number one reason why nurses go to nursing school is still to help people. Nurses want to be at the bedside, not typing into an electronic medical record, hunting supplies, or finding equipment.

“The nurse’s time is precious, and a good thing that’s come out of having a shortage is the focus on nurses doing things that only a nurse can do,” Vozzella said, “or what technology can pick up other tasks that are non-value added.”

Vozzella also recommends using ancillary support staff, such as phlebotomists, to do lab draws instead of the nurse. At Houston Methodist, Vozzella said they also partner with Rice University to help develop robotics that can screen trays to make sure the right tools are present before a tray goes into an operating room, so that the responsibility of checking the trays no longer falls on the nurse.

“[When] nurses have such a high value…and some ancillary support, we can redesign the work of that nurse in order to give that support,” Vozzella said, “so that it offloads that work and [nurses] are able to focus on caring for the patient.”

CNOs should be careful about the designation of work as well, and make sure that they support staff with communication efforts to make sure nurses understand the why of what they are doing.

“We tend to be a little controlling sometimes, or there’s factors like a very tenured ancillary person and a new graduation nurse,” Vozzella said. “It’s sometimes a challenge for that nurse to tell somebody else what to do.”

Care coordination

Additionally, efficient patient care management can help keep costs down by creating a better work environment. There are care milestones that patients must meet before they can go home, and those milestones are met with the help of care management, leadership, physicians, nurses, and advanced nurse practitioners.

According to Vozzella, improved care coordination is beneficial to both the patient and the nurse, as it improves the work environment and provides the patient with some insight into why certain processes are happening.

“It certainly helps patients with a shorter length of stay feeling like they’re a part of their care journey,” Vozzella said, “but it’s definitely helpful for the nurse too, because they feel [like a] part of something bigger than themselves and part of a team.”

Preventative care

Preventative care can also keep costs down. When primary care physicians can help patients manage diabetes or hypertension successfully, they are less likely to have an inpatient admission, Vozzella explained. Technology can help with this, so that patients can have more support at home without having to go into a doctor’s office or to the hospital.

Patient education is important to preventative care, because patients need to know about how different health factors affect their overall health, and nurses are a huge part of that.

“It is an exciting time for nurses to be part of that,” Vozzella said, “because it does offer nurses [the opportunity] to do more preventative care, but also to potentially do that virtually.”

CNOs should look at why patients are coming to the hospital in the first place and strategize ways to create support for them at home as well as in the hospital. Vozzella recommends having a case manager or social worker who can check in with patients and make sure they have transportation, food, and psychological support so that they attend their appointments and prioritize their health needs.

Leveraging technology

Over the past 15 years, according to Vozzella, health systems have moved toward rebuilding facilities to have better environments with natural light and private rooms, but it has just increased the amount of walking nurses have to do daily to see their patients.

“When [nurses] are in a room, they’re typically the only person,” Vozzella said, “and it’s so very isolating for, in particular, nurses that are newer in their career.”

However, bedside nurses are no longer alone with the addition of virtual nursing. Through virtual care, nurses can log in and come on the television screen in a patient room and act as a second set of eyes for the bedside nurse.

“I think virtual [nurses] can be a huge support, but it has to be implemented in partnership with bedside nurses,” Vozzella said. “We have to really work hard to understand where nurses tend to need support and make sure that’s our highest priority.”