S3.E1. 新時代的來臨 Time for something new

數位化正在改變整個醫療保健行業。新的商業模式正在孕育，以前未知的元素也湧入市場，導致整個商業流程完全被顛覆。百靈佳殷格翰長期以創新者的角度來經營，我們也正在幫助塑造這種數位化改變。研究人員正使用人工智慧來發展分子化合物。隨著智慧化生產起步，我們正在以數位化來改進人和動物的健康。此外，相同重要的事是，製藥工作的性質本身也正在改變，變得更加敏捷和富有創造力。

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​總部在德國的百靈佳殷格翰，如何與美國合作進行臨床研究？藥物研究很快就能通過PC電腦和智慧型手機運作，研究對象可以使用NORA應用程式與醫生進行直接對話，醫生們透過網路向他們解釋如何服用藥物或在發生副作用時該怎麼應對。沒有人需要在研究中心面對面的跟大家分享自己經驗，一切都是通過遠端醫療系統來實現，此方法快速又簡單。NORA是美國一家新成立公司，是Science37與百靈佳殷格翰於2019年初合作的數位平台，這只是眾多數位化合作的其中一個例子，其展示了數位化在醫療保健系統上的改變。像百靈佳殷格翰這樣的製藥公司，正在改變他們的運作方式和產品，使其變得越來越數位化。從另一角度來看，數位軟體公司也積極地朝醫療保健領域發展。舉例來說，Google參與了遠端醫療服務「Doctor on demand」的計畫，該計畫讓美國患者使用智慧型手機應用程式與醫生線上諮詢。另外，通過Verily，搜索引擎營運商在尋找能早期識別和治療疾病的新方法，此計畫使用大量數據來分析，當然，運用大量數據是這公司最高的原則之一。

Google和其他矽谷公司，也因此正式進軍醫療技術產業和尋求與像百靈佳殷格翰這類製藥公司的合作機會。在此潮流中，百靈佳殷格翰不僅僅是觀察新技術如何顛覆既定的商業模式，還積極參與技術創新，「我們的目標是在研發領域上找尋利用新技術的機會，特別是在臨床開發方面，以及在治療期間為患者提供支持。」百靈佳殷格翰董事會主席Hubertus V. Baumbach說道。 

現代醫學與製藥也是一種數據處理。內科醫生檢查患者除了有系統的檢查身體功能並將結果與基準比較之外，還做了什麼？當放射線技師在看X光片時會怎麼做？他們都在試著辨識分析研究模式。那數據處理對於百靈佳殷格翰這樣的製藥公司來說代表著什麼呢？百靈佳殷格翰與研究人員合作，測試數千種分子變化，並確實記錄每種效果來尋找新的活性成分。如果沒有醫學藥物研究，就沒有實驗室中測試和臨床試驗中產生無數的研究結果，公司也無法充分利用這些累積的數據做為製藥的基礎，這都實實在在的證實藥物開發是基於數據。

Matthias Schönermark解釋說，數位化技術現在的目的是減輕讓人分析和處理數據的負擔。Matthias Schönermark醫生是德國SKC Beratungsgesellschaft的負責人，該公司專門為製藥公司、醫療保險公司和醫療技術公司提供諮詢服務。Hubertus v.Baumbach補充說道：「由於數位化正在提供全新的數據，我們將來能夠提供患者更明確的治療方法，該數據的調查結果將決定未來新藥的概況。」

Hubertus v.Baumbach說明，公司正在推動十分重要的改革：「對我們來說，數位化是未來一個重要話題」。並非巧合的是， BI Venture Fund代表百靈佳殷格翰集團投資的組織，也不斷尋求數位化上的創新機會。憑藉其數位化實驗室BI X，百靈佳殷格翰集團擁有自己創新的能力。數位化的趨勢已影響了整個公司。

該集團的數位專家目前正致力於數位化的「聽診協助」，其能幫助醫生診斷罕見的肺部疾病，以及識別豬咳的計劃。最近擔任柏林電子衛生保健研究所主管的Sylvia Thun博士認為，醫療保健行業集體智慧時代即將來臨。 「人工智能幫助醫生做出診斷」， Thun解釋。 「醫生相互建立更近一步的關係，並藉鑑全球同事的知識，這將是數據驅使下的醫學。」

↳ 請見「S3.E3. 成為經典」、「S3.E4. 時間的問題」、「S3.E5. 豬圈聲音偵測器」、「S3.E6. 解讀隱藏的訊息」。

數位化在藥物開發中也扮演著關鍵的角色。NTC Studio軟體能評估患者數據，臨床試驗和研究的工作，並為開發人員提供新的想法，他們的同事通過「智能助手」ADAM來使用人工智慧構建分子的立體結構。他們可以在螢幕上修改這些結構並測試其屬性。

↳ 請見「S3.E7. 更好，更快，更進一步」

與其他行業一樣，數位化也影響了生產。工業4.0和「智慧工廠」 正在尋找進入製藥產業的途徑。在德國殷格翰的新工廠，預計將於2020年開始運營，智慧機器人系統將很快能填充少量的藥物。為此，技術人員佩戴虛擬數據眼鏡，幫助他們與包裝機同步。

↳ 請見「S3.E8. 未來的設施」、「S3.E9. 像噴射機一樣複雜」

最後，數位化正在改變百靈佳殷格翰員工的團隊合作方式，位於法國里昂的動物保健工廠展示了未來數位辦公室的樣子。最近在殷格翰開設的BI CUBE，員工正在接受培訓，成為「agile facilitators」，並且為公司帶來現代的設計與思維。

↳ 請見「S3.E10. 每個人都在一個平台上」

百靈佳殷格翰多次參與其自身產業的提升。Hubertus v.Baumbach說，創新一直是公司最高的指導原則。當創始人Albert Boehringer在1885年購買酒石工廠(tartar factory)後，公司開始生產酒石酸。然而之後，他的興趣迅速轉移到檸檬酸生產，而後並開發了一種以細菌來培養製造丙交酯的工藝 ，這對當時來說，是一個很冒險且高風險的決定，但這項決定最終獲得成功。在20世紀70年代早期百靈佳殷格翰再次展現了勇敢和創新的理念，他脫離了乳酸產業，並且在1986年建立了當時歐洲最大的生物製藥工廠。Hubertus v.Baumbach說明，現在，數位化在這個行業中佔據了一席之地，對以創新和進步為公司DNA的 百靈佳殷格翰來說，所做的一切不僅僅是為數位醫療保健行業做準備。 「我們是期待著這個未來。」

Digitalisation is changing the healthcare sector. Completely new business models arebeing created, previously unknown actors are entering the market and processes are being turned upside down. Boehringer Ingelheim is helping to shape this change and has long been an innovator itself. Researchers are developing molecules on their screens using artificial intelligence. Smart production is taking hold, we are improving the health of people and animals with digital assistants. Last but not least, work itself is changing – becoming more agile and creative.

Boehringer Ingelheim clinical studies in the USA? Running soon over PC and smartphone. Study participants sign up with the NORA app and dialogue live with physicians. The physicians explain to them online how they have to take medications or what to do in the event of side effects. Nobody has to present themselves at the study center, everything works virtually, through telemedicine: fast and simple. NORA is part of the digital platform of the US start-up Science37 with which Boehringer Ingelheim joined forces at the beginning of 2019.

It is just one of many examples that shows how fundamentally digitalisation is changing the healthcare system. Pharmaceutical companies like Boehringer Ingelheim are transforming their processes and products and are becoming increasingly digital. Digital companies, on the other hand, are turning to healthcare. For example, Google is involved in the telemedicine project “Doctor on demand” which

Allows US patients to obtain a consultation from a doctor using a smartphone app. Via the company Verily, the search engine operator looks for new ways to identify and treat illnesses at an early stage – using large volumes of data, of course, which is the company’s supreme discipline.

Google – and other Silicon Valley companies as well – are thereby venturing into the field of medical technology and pharmaceutical companies like Boehringer Ingelheim. And, instead of simply observing how disruptive technologies are changing established business models, Boehringer Ingelheim is playing an active role in the innovation process.

“Our goal is to use the opportunities of new technologies in the field of research and development – particularly in clinical development –, but also when supporting patients during treatment,” says Hubertus v. Baumbach, Chairman of the Board of Managing Directors of Boehringer Ingelheim. “We believe that we can thus develop even more precise diagnosis and treatment.”

This works because modern medicine is also data processing. What does the internist examining a patient do other than systematically investigate bodily functions and compare them to the norms? What do radiographers do when they look at an X-ray? They try to identify patterns. And a pharmaceutical company like Boehringer Ingelheim? It looks for new active ingredients, with researchers testing thousands of molecule variations and recording every effect in exact detail. Without pharmaceutical research, countless findings from laboratory testing and clinical trials would never have been made, even if companies come nowhere near taking full advantage of the foundations provided by this accumulated data. It is clear: medicine derives from data.

Digital technology is now set to relieve people to an ever-increasing degree of the burden of identifying patterns and processing data, explains Matthias Schönermark. The physician is owner of SKC Beratungsgesellschaft, a consultancy firm in Hanover, Germany, that specialises in strategy consultation for pharmaceutical companies, health insurers and medical technology companies. Hubertus v. Baumbach adds: “Because digitalisation is making completely new data available, we will be able to provide much more targeted treatments in the future. The findings from this data treasure will determine the profile of new medicines in the future.”

The company, says v. Baumbach, is therefore driving forward fundamental change: “For us, digitalization is an important topic of the future”. It is no coincidence that the BI Venture Fund, set up to invest in promising enterprises on behalf of the Group, is constantly seeking digital innovations. With its digital laboratory BI X, the Group has its own incubator for new ideas. Digitalisation has spread throughout the company.

Digital experts in the Group are currently working on a digital “Auscultation Aid” that helps physicians to diagnose rare pulmonary diseases, and on a program to identify pig cough. IT expert and physician Prof. Dr Sylvia Thun, who recently became director of eHealth and interoperability at the Berlin Institute of Health, believes that the age of collective intelligence in the healthcare sector is approaching. “Artificial

intelligence assists doctors with diagnosis,”says Thun. “Physicians are becoming interconnected and drawing on the knowledge of their colleagues worldwide. This is data-driven medicine.”

↳ READ MORE I N ”S3.E3. Upgrade for a classic”,”S3.E4. A question of time”,”S3.E5. Eavesdropping in the pig pen”,”S3.E6. Deciphering hidden signs”

Digitalisation also plays a key role in the development of medicines. Here, the software NTC Studio evaluates patient data, clinical trials and research work and provides the developers with new ideas. Their colleagues build three-dimensional molecule models using artificial intelligence through the “smart assistant” ADAM. They can then modify these models on their screens and test their properties.

↳ READ MORE I N ”S3.E7. Better, faster, further”

As in other industries, digitalisation has also impacted production. Industry 4.0 and “smart factory” are finding their way into the manufacture of medicines. At the new Launch Facility in Ingelheim, Germany, which is expected to commence operations in 2020, intelligent robotics systems will soon be filling medicines in minute batch sizes. For this, technicians wear virtual reality data glasses to help them align the packaging machines.

↳ READ MORE I N ”S3.E8. Facility of the future”,”S3.E9. As complex as a jumbo jet”

Last but not least, digitalisation is changing how people at Boehringer Ingelheim work together. The Animal Health facility in Lyon, France, shows what the digital office of the future can look like. At the recently opened BI CUBE in Ingelheim, employees are training to become “agile facilitators” and bringing modern methods of design thinking to the organisation.

↳ READ MORE I N ”S3.E10. Everyone at one desk”

Boehringer Ingelheim is thus participating once again in the renewal of its own industry. Innovation, says Hubertus v. Baumbach, has long been a guiding principle for the company. By buying a tartar factory in 1885, the founder Albert Boehringer started to produce tartar and tartaric acid. However, his interest rapidly shifted to the production of citric acid and a little later to the development of a bacterial procedure to set up the production of lactid acid – a venturesome and high-risk decision back then, but one that payed off. The company once again proved to be brave and innovative when it moved away from lactic acid in the early 1970s and again in 1986 when it built a production facility for biopharmaceuticals, the biggest in Europe at the time. Now digitalization is taking hold in the industry, and Boehringer Ingelheim, where change and progress are deeply embedded in the company’s DNA, is not simply gearing up for the new, digital healthcare sector, says Hubertus v. Baumbach. “We are looking forward to this future.”