Revisionist History
The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau
Thu, 06 Feb 2025
How is technology transforming the healthcare space? Malcolm sits down with Diogo Rau, the Chief Information and Digital Officer at Eli Lilly and Company, to discuss the ways his company is innovating to deliver care to customers who need it. Rau also previews some new products Eli Lilly is especially excited about.See omnystudio.com/listener for privacy information.
Chapter 1: What challenges does Diogo Rau see in healthcare technology?
Pushkin
Hello, hello, Revisionist History listeners. Happy New Year. 2025 is going to be a great year for this podcast, and I want to give you a little preview of what to expect. The main event of the year is going to be a multi-part series from Alabama, true crime, but with a very Revisionist History twist. So keep that in mind. Then before we drop that, we're going to do two other smaller things.
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I had a chance to sit down with a guy named Diogo Rao, who worked for years at Apple, way up high, and then left to become the chief information and digital officer at Eli Lilly and Company, one of the biggest drug makers in the world. Diogo, as you will learn, is irreverent and fascinating and sees a good 10 years ahead of the rest of us.
At the end of our conversation, Diogo said to me, you know, we never got to AI, which is true. Can you imagine a conversation about technology so interesting that you never get to the subject of artificial intelligence? That's what you're about to hear. We're going to talk about a whole number of things, but I wanted you to start because you're a very unusual figure.
You work for Eli Lilly, but you are a very unusual figure at Eli Lilly. Is that a fair statement?
I think I have that reputation of being unusual. At least I like to try to do things a little bit differently.
No, no, I was talking about your background.
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Chapter 2: How does the healthcare industry differ from tech in terms of timelines?
So there is certainty that this product will be approved, but just the... You can be 10 years away and be certain it'll be approved, but know that you still have 10 years worth of work to do?
Yes. You can't be certain, of course, that anything is going to be approved. And so we apply a probability of technical success. This phrase I'd never heard of before I got here, but every step of the way has probability of technical success. And so you factor it in and you take all that into account. But you know when you have a good medicine and you know what it's going to take.
But it just takes 10 years to bring a medicine to life. And I don't think that was one of the things that I realized before I came into this, just how long it takes and how much money it takes. So it is possible that you will work on things that you will never see come to fruition? In fact, most of our scientists that work here will never see their medicines that they're working on come to life.
which is kind of crazy to think of. How does that affect the culture of an organization? It gives it a really long-term perspective, like a crazy long-term perspective.
When we're talking about things, making decisions, we're really not thinking, you know, like in an executive committee level, there are some things that we're doing on a this-year basis, but there are a lot of things that we're doing that we're really talking about like the 2030s, like just... just a much different time scale from anything else.
And so we're not going to do anything stupid, I think is one of the good things. We're not going to trade off some of the long term to get a little bit of benefit in the short term. So I think it makes us much more rational that way. I guess I would say we play the long game.
But I want to go back to, so you come to Lilly, and I'm curious, so what did they want from you?
My boss, our CEO, gave me a mandate to really change, to bring in technology into everything that we did. So it was not a caretaker role sort of a mandate. We want you to just keep running the things. We want you to really figure out what can you do to shake things up. And so that was really the goal. And I think a big part of it was bringing a consumer orientation as well.
And I think this is an industry that has largely worked the same since the 1950s. I mean, if you look at it, the way you get medicines today as a patient is basically unchanged. You go to your doctor, they write a form. Maybe now they submit your prescription electronically. You still have to make sure you can pay for it. You still have to go to a retail pharmacy in most cases.
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Chapter 3: What is the significance of customer experience in healthcare?
And the way you'd always do things at Apple was different. You would always start by like, what's the customer, the consumer experience that you want to create? and then work backwards and then figure out, can you make it a financial case around it? Well, maybe you can't. Okay, so maybe we can see how we can change things back and forth. But everything was centered on the customer experience.
It wasn't like a pillar of one thing of five. It was like the thing that was guiding everything. And I think that's, we're not there yet, but that's the kind of thing we need to do every single time. We need to go back and see what's the customer experience like. We need to actually focus on making a customer experience better. Yeah, yeah.
You have a whole table full of goodies over there. I want you to pick a goody and let's use this as a specific, walk me through the kind of thinking behind the product, the specific challenges, how it represents this process that you've been talking about. You pick.
Okay. Great.
Just so people know, about a couple of feet from Diego is there. There's about, it looks like, eight to ten mysterious boxes that are... So I have to...
share with everybody that, like, Malcolm and I had a little prep call before, you know, a couple weeks ago, and it was only about 10 minutes because he just said, okay, you know, if you've got any toys, any goodies, like, bring them along. And so, like, my team gave me a box of goodies here, which is all splayed out on the table. And then I think he said, okay, I don't want to talk too much more.
Let's not do any more prep. Let's just get going.
Well, the thing is, if you have small children as I do, you think exclusively in terms of shiny little gifts. I almost said, can you bring snacks?
That would be the only thing that was top of mind. Awesome. All right. So let me grab a box. All right. I'm going to show you something that is... No, let me grab that one. Yep. And I'm going to hide it here for just a second and tell you what the problem is that we're going after. One of the big challenges in the world right now is medicine and medicine safety.
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Chapter 4: How is Eli Lilly innovating against counterfeit medicines?
don't have anything like that for statins or anything else, right? And that's, again, like why people drop off. Just imagine if you could just see, oh, hey, actually, you know, or I'm taking cholesterol medication and you know what? Hey, my cholesterol went down versus yesterday, not versus three months ago.
Yeah. Who controls this data? So interesting, you began this conversation in talking about the multitude of steps that exist between the manufacturer of some of these medicines and the user. That's right. Now you're talking about a system where presumably the manufacturer can speak directly to the patient.
Correct.
Does this mean that you cut out some of the middlemen?
That's my hope. But the data, ultimately, the first part of your question, the data really should be with the patient. And I think there's a tendency to say, even still today in this industry, that the data is really for the healthcare provider. And I think that's a mistake.
I think ultimately the data is for the patient, and the patient can choose to share it with the healthcare provider, and the healthcare provider can look at it. But it really is, it's really the patient's data.
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Chapter 5: What new technologies is Eli Lilly developing for medicine safety?
My mom... is in a nursing home has arthritis yeah which acts up on and so she moves around a lot this is a perfect tool for her so somebody is so does she is the model here that she checks her movement scores and that's a way of and she can choose she can see oh this is time to share that my data with a practitioner isn't it more efficient for her to have someone who is
or AI or something that's continuously monitoring her?
I think the continuous measurement part is, you're absolutely correct about it. But I think it needs to be, I think she always needs to be able to see the data herself. Yes, you can see that.
And by the way, that's one of those things that sounds obvious if you're coming from outside the industry to inside, but inside the industry, it's like, wait, why would you share the data with the patient themselves? That's something that the healthcare provider should see first. I mean, What happens if your mom misinterprets the data without the advice of a healthcare provider?
That's kind of the big caution that would keep the industry from saying your mom should be able to see that data itself. But I take a very different view on that.
But we're moving. What's interesting, a lot of these things, the implication of what you're talking about is we are moving the primary point of contact from the hospital or the doctor's office to the home. Correct.
right? This is... That's, if you don't mind me going on a tangent on that too, that's one of the reasons why I'm really, really excited about like how we can change things too. Because if you look at it today, it's, there are so many barriers to getting medicine. You know, like first you have to get a doctor's appointment, which we've all suffered through. Like it can take months to get one.
Then even after you have one, then you also have to be able to get it actually get access to the medicine, which is a big problem because I don't know if you've heard the stats before, but 45 million Americans live in pharmacy deserts. 46% of counties in the country are in pharmacy deserts where there's no pharmacy within 15 minutes of your house. And so I
I think, and so if you add all of that together, it can take months from like the moment you say, you know what, I'm not feeling well, or there's something I want to change in my life to like the day that you get the medicine. I want to bring that like down to like the same day.
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