The future is on the way.  Leading-edge innovators, we are assured, have already moved on, and are earnestly focusing on the just the sort of problems - manufacturing, energy, transportation (and I'd add healthcare) - that urgently require imaginative solutions.

Reviewing "The Myth of The Paperless Office" for the New Yorker in 2002, Malcolm Gladwell argued that if the computer had come first, and paper didn't exist, someone would have had to invent it.  Paper, it turns out, is a lot more useful than we typically appreciate.

Patients who take a close look at medical science in search of treatments are often appalled by what they discover. On the one hand, there's academic research, a self-contained and self-absorbed universe of its own where data may be internally consistent (on a good day) and robustly reproducible, yet often has little relevance to real-world clinical conditions.

Perhaps it's the sweet California air, but the pervasive (though not universal) pessimism in biopharma these days is really bumming me out.  Consequently, I'd like to discuss three potential responses to difficult industry problems.

Successfully translating scientific discoveries requires a sense of urgency, which some disease foundations seem to have, and many big pharmas appear to need. Patients waiting expectantly for medical research to produce important new cures are finding bad news almost everywhere they turn.

Of the many factors that make improving the health system difficult, few challenges are greater than the misty-eyed recollection – often from genuinely distinguished practitioners – of how great things used to be.  Doctors were highly regarded authority figures, pure and beloved, while patients were meek and grateful in the presence of such brilliance and expertise.

Today, URL Pharma was acquired by Takeda for nearly $800M.  The story here in brief is that for hundreds of years, colchicine was used for the treatment of gout and other conditions; it was an effective drug but had to be used carefully. URL invested in the formulation development and clinical studies required for colchicine, and ultimately received FDA approval in 2009. 

Durably improving health is really, really hard. I've discussed this in the context of drug discovery, which must contend with the ever-more-apparent reality that biology is incredibly complex, and science remarkably fragile. Here, I'd like to focus on another challenge: measuring and improving the quality of patient care.