In the life sciences field, digital health is becoming a growing area. Pharmaceutical giant AstraZeneca believes that applying data-based solutions to research and development is a step toward improving patient health. Cristina Durán knows this well, having previously served as Chief Digital Officer of AstraZeneca's R&D division and now as President of Evinova, the British company's digital health business.

Last week, AstraZeneca demonstrated its commitment to digital transformation by officially launching Evinova. The company will prioritize clinical trial optimization. However, before the new company was officially announced, AstraZeneca had already been building its digital capabilities in using data to improve patient health through a multidisciplinary team led by Durán.

Durán specifically noted that technologies enabling remote healthcare, home monitoring, or pooling broad patient research data pools in clinical trials will give the industry a fuller understanding of patients before their disease progresses too far.

"The biggest, most central problem is late diagnosis," Durán said. "Among cardiovascular disease patients, more than 20% only discover they have had a problem for a long time upon their first hospital admission."

This situation also applies to other areas AstraZeneca focuses on, including respiratory diseases and cancer.

"The devices in our cars that tell us whether the car has broken down are more numerous than the devices we use to judge our own health status—we always wait until our bodies 'break down' before paying attention."

"I am passionate about data health activities that can help screen patients earlier," Durán said, "because early detection means the difference between giving patients only a limited extension of life or a full quality of life—a huge difference."

Before Evinova was established, we spoke with Durán about how she positions her role in digital R&D, her cautious approach to 'glamorous' new technologies like artificial intelligence, and how digital solutions can balance specificity with broad scalability.

This interview has been edited for length and style.

PHARMAVOICE: Before joining Evinova, what did your role as Chief Digital Officer of R&D at a company like AstraZeneca entail?

Cristina Durán:My scope covered all therapeutic areas, from cancer, respiratory, and cardiovascular to vaccines and rare diseases. So, the day-to-day work was quite diverse. The way we approach projects is to start from the problem we want to solve. In the past, these problems were often barriers to patient participation in clinical trials or operational difficulties faced by trial sites. When addressing the daily challenges of the R&D organization, we look at both immediate problems and long-term opportunities. My goal is to solve today's problems with solutions that can last for the next ten years.

We work in what we call 'sprints,' forming cross-functional teams around solutions rather than working in silos, so that projects can be transformative. Projects use agile methods. For example, we can have patients provide feedback on solutions and gather evidence proving their benefits. This is key to the long-term development of digital health teams, especially in the pharmaceutical industry, which requires scientific evidence.

You mentioned the breadth of AstraZeneca's therapeutic areas. How do you manage to address all areas simultaneously while treating them differently?

We ensure communication with each different team, but ultimately find that the needs are very similar. Although we acknowledge differentiated needs, the solutions can be platform-based and holistic. Many of the solutions we build are applied across all therapeutic areas. We may have a patient-facing clinical trial operations platform that applies to the entire company; at the same time, we may have modules for new endpoints in respiratory diseases or for remote patient monitoring in oncology. But these modules are built on the same platform, rather than developing different products for each therapeutic area.

Why is it important for a pharmaceutical company to have a dedicated unit for digital innovation?

From the patient perspective, pharmaceutical companies still have huge potential to improve efficiency and outcomes. Telemedicine can certainly help and support—in one of our published results on new endpoints supported by digital technology, we were able to complete a study with 50% fewer patients than originally required because we could collect more data points from patients' homes. Instead of asking patients to go to the hospital every few weeks to blow into a spirometer, we send them a device to use at home. Through telemedicine, we obtain more continuous data, and monitoring frequency can be higher. Also, costs are lower due to shortened timelines. This is a win-win situation, so for pharmaceutical companies, continued investment in digital centers is a huge opportunity.

How does artificial intelligence fit into your digital strategy?

The term 'artificial intelligence' is overused these days; it seems anything using algorithms is called AI, but that is not the case. However, we do use some foundational data science and machine learning algorithms, as well as natural language processing, which are often considered part of AI. For example, we have a machine learning algorithm for event adjudication. In the past, event adjudication typically involved a second physician reviewing all documents to determine whether a cardiovascular death was due to cardiovascular causes or other reasons—somewhat like conducting an investigation. Now, we can run machine learning models that analyze historical study data with event adjudication and perform the same task. This new approach to event adjudication also needs to be validated from a regulatory perspective. At the same time, I firmly believe that if simple solutions work, there is no need to complicate them.

The pharmaceutical industry is sometimes traditional and slow to change. How do you navigate this challenge with your goals and ambitions for the company?

I have worked in both the tech and pharmaceutical industries, and AstraZeneca is by no means a slow machine. But obviously, within the company, there are different teams—some are more innovative in adopting new ways of working, while others are more traditional. My belief is that you have to start somewhere. Pharmaceutical companies are very good at launching projects and conducting large-scale pilots—they often struggle with scaling and deployment, but we have been able to move quickly. I think the key is that we must change how we work, bringing together teams with different capabilities, such as people with clinical or R&D experience, along with experts from technology, behavioral science, design, and data science.

What are AstraZeneca's next steps in the digital space?

We are always committed to continuously improving patient experience and clinical outcomes, and I believe data health can play a role across the entire pharmaceutical industry. Across all therapeutic areas, there is a common challenge of identifying patients earlier in the disease course. Through earlier identification, the probability of curing these diseases can be increased, and this can be supported by remote patient monitoring and more comprehensive care. Examining the complete patient journey is crucial, ensuring patients are not overlooked along the way. They need to be supported by health technology. I find it interesting that the devices in our cars that tell us whether the car has broken down are more numerous than the devices we use to judge our own health status—we always wait until our bodies 'break down' before paying attention.

In which areas can AstraZeneca and your team fill gaps that are currently unmet?

There is a key long-term factor—the risk for digital health teams is that they can be easily attracted to glamorous ideas and neglect delivery and scaling, which require great resilience. You need to balance focusing on a few things and delivering on those priorities. Our approach is to conduct reviews across therapeutic areas to identify key needs or pain points. That is how we generate our team's backlog of priorities, such as those involving early screening or patient monitoring.