The Future of Healthcare Technology with Eli Lilly and Company's Diogo Rau

Episode Summary

Executive Summary: Malcolm Gladwell interviews Diogo Rao, a former Apple executive now leading technology at Eli Lilly, about how pharma differs from tech: longer timelines, more certainty, and a patient-centered future. They discuss using NFC/RFID-like tags to verify medicines, wearables and home-based monitoring, direct patient data access, and how faster feedback could improve adherence and outcomes.

Main Topics: From Apple to Eli Lilly (Priority: 5/5): Rao explains his unusual move from tech into life sciences and what surprised him most: the culture, the people, and the radically different pace of work. Long-term planning in pharma (Priority: 5/5): Unlike tech’s short planning horizons, Lilly works on 9- to 15-year timelines, with product launches and revenue forecasts stretching far into the future. Patient-centered product design (Priority: 5/5): Rao argues pharma should adopt Apple-like thinking: start with the consumer experience, then work backward to the business case and operational model. Medicine authentication and anti-counterfeiting (Priority: 4/5): They discuss an NFC-tagged packaging system that lets patients verify medicines with a phone tap, addressing counterfeit drugs and safety risks. Wearables and continuous monitoring (Priority: 4/5): Rao describes how wearables can support adherence and clinical trials, and imagines a future where patients use a small number of devices to track health at home. Data ownership and home-based care (Priority: 5/5): The conversation emphasizes that health data should belong to patients, who can choose to share it, helping shift care from hospitals to the home. Speed, feedback, and adherence (Priority: 5/5): Gladwell connects swiftness in deterrence to medicine adherence; Rao agrees that faster feedback on treatment effects could improve persistence and outcomes.

Key Arguments: Pharma operates on much longer and more predictable timelines than tech, which changes decision-making and encourages long-term thinking. Lilly’s mandate for Rao was not maintenance but transformation: bring technology into everything and modernize the consumer experience. The current medicine-delivery system still resembles the 1950s, so there is major room to improve access, convenience, and patient engagement. Patients should be able to verify medicines instantly using cryptographically secure NFC tags that cannot be copied like QR codes. Wearables can improve adherence by giving patients immediate feedback on progress, especially for chronic conditions like weight management. Health data should primarily belong to patients, not providers, because patient access and choice are essential to better care. Reducing friction in access to medicine—appointments, pharmacy access, delivery—could make same-day treatment initiation possible. Faster feedback loops in medicine, like faster mitigation in tech risk management, may improve adherence and treatment success.

Data Points: Years before revenue forecast: 2030 forecast discussed in 2021 (9 years out) - Rao’s first executive committee meeting at Lilly Product launch horizon: 2036 - A product launch discussed in December, illustrating pharma’s long timelines Years to bring a medicine to life: About 10 years - Rao explains the development cycle for a medicine Apple-to-life-sciences executives: About five - Rao estimates how many people have made the same move Wearables in 10 years: 2 to 3 - Rao’s estimate of how many devices a person might reasonably wear Americans in pharmacy deserts: 45 million - Gladwell cites access barriers to medication U.S. counties in pharmacy deserts: 46% - Gladwell notes the share of counties without a pharmacy within 15 minutes Prep call length: 10 minutes - Gladwell mentions a brief pre-interview prep with Rao Age: 50 - Gladwell asks Rao his age near the end of the interview

Pivotal Quotes: "This is not the future we were promised." — BBC promo voice: Opening tagline for The Interface, framing the broader tech theme "We never got to AI." — Diogo Rao: Rao’s remark at the end, highlighting that the conversation covered many tech topics without centering AI "The data really should be with the patient." — Diogo Rao: Rao argues for patient ownership and control of health data

Implications: The episode suggests pharma’s next leap is not just better drugs but better systems: faster access, patient-owned data, anti-counterfeit verification, and home-based monitoring. If adopted, these changes could improve adherence, safety, and outcomes at scale.