Best practices for university-healthcare partnerships: Lessons from Oxford – transcript

Conversations in Healthcare

Mike Ward:  Hello, everyone. I’m Mike Ward, welcome to Conversations in Healthcare broadcast series brought to you by Clarivate. In these broadcasts, we reach out to key opinion leaders across the whole of the healthcare ecosystem and talk about the challenges they face and the solutions that they are developing.

A key component of that ecosystem is the fundamental research that’s conducted within academia. Indeed, many of the technologies and products that shape modern society, even outside the healthcare system, were probably first conceived within a university.

The process of translating such insights into new products and services that provide benefit to wider society is one of the missions of many university knowledge exchange and tech transfer offices.

So to get some insight into how that process actually works, I’m delighted to be joined by Dr. Phil Clare, who is the deputy director, research services, knowledge exchange and engagement at the University of Oxford, one of the world’s leading universities. So Phil, thanks very much for joining me.

Phil Clare:   Absolutely, Mike.

Mike Ward:  As I mentioned in the introduction, the role of tech and knowledge transfer activities is to translate university research into products and services that have the potential to provide societal benefits. So I thought it might be helpful if you could first describe the University of Oxford’s vision and mission for knowledge transfer and exchange and give us some insight into this with the breadth of opportunities that you are dealing with.

Phil Clare:   Sure. Oxford, like all universities in the UK, is a charity, and we’re focused on public benefit through our research and through our education and teaching them through our knowledge exchange. So I guess if I sum up what we do, it’s to work through all of the ways in which the university can make a difference to the world. Make a difference, culturally, socially, economically. And some of the mechanisms that we use are very commercial, creating new businesses, licensing technologies.

Some of them are much more about engagement with different public audiences, with the policymakers. Some things are broadcast widely. Some things are protected under intellectual property. Some things are managed through collaborations with other organizations where we co-create knowledge as part of a research program and then share that directly with the person we’re working with. So there are many, many mechanisms that we use, but all of them are aimed at maximizing the impact of our research.

Mike Ward:  And with such a wealth of research that is generated within the university and obviously almost on a continuous basis, how do you go about prioritizing which programs, or projects, or assets that actually are going to sort of grab your attention or get your attention?

Phil Clare:  The real answer is you just can’t. I mean, there’s so much that comes up. What we try to do within the various aspects of our work is develop processes and develop support mechanisms of education that will allow academics to achieve their individual goals. So if what they really want to do is reach a wide public audience, a public engagement with research activities is designed to give them the tools, to help them evaluate what they do, to help them find ways to reach out to larger audiences for their research.

Equally, if somebody has a commercial opportunity, they’ll talk to Oxford University Innovation, our wholly owned subsidiary that does the technology transfer and they will look at the market. They will look at the possibilities for patenting and they will reach a decision with the academic on what the commercial possibilities might be and what routes to market they might take.

And there’s a whole other range of opportunities in between that we try and facilitate through networks, through training and through engaging with other partners. So prioritization, really difficult. In the end, sometimes with prioritization, the endorsement comes from external partners. If you’ve got something that’s available for licensing, people want to license it and then the markets have spoken. It’s the same way with spin-out companies. If something is suitable for a spin-out company and investors express an interest, then you take it forward. So the colleagues should look into the commercial end, the very experienced and understanding those market opportunities and then they use that to prioritize. In the end what we don’t want to ever do is deny a piece of groundbreaking research the opportunity to have that impact.

So actually what we’re doing is investing in different channels, in different mechanisms. So let me give you one example. At the moment, we’re looking to increase the number of social enterprises that come from the university. So historically, technology transfer 20 years ago was all about financial return, but actually the university in a review seven years ago, explicitly said that financial return is always secondary to maximizing impact. And what that’s led to is growth in businesses being founded, who are aiming at social outcomes.

I think we created 10 in the last 18 months. These require access to a different sort of investor. Investors who are looking for a societal as well as an economic return. And therefore we’re working with 11 other universities in the UK to raise a fund collectively to invest in those sorts of businesses. And this is an area of growth, and there are many people who are not very interested in making money, but are very interested in making a difference. So we want to facilitate all of these opportunities.

Mike Ward:  So could you give us an example of a societal enterprise, how the whole concept was sort of created and then delivered?

Phil Clare:  Small hand pumps. So it turns out that with the application of sophisticated AI, you can improve the ability of communities that rely on pumped water from the ground in very rural communities in developing countries, you can improve the health care through improving your ability to manage these mechanical devices. So you go to the dry parts of rural Africa, where the ground water is not fit to drink, and the only way to get healthy water is pumped from deep wells.

So the trouble there is if that hand pump breaks, which an entire community relies upon, it can take a month to fix that pump, by which time everybody has been forced to go to polluted water sources and there are bad healthcare outcomes for the community. So it turns out if you put a sensor on the handle of one of these pumps which is tuned using AI techniques to understand what vibrations in the mechanism are predictive of an imminent failure, it means you can call somebody out to fix the pump before it breaks. That means that you can reduce the amount of time it takes you to fix that pump to a time which will allow people not to be forced to use dirty water for drinking.

With a little modification, you can also send a signal to the company in the city that’s responsible for sending the engineers out to fix the pump so that they know it’s going to break even before the people using it. So in experiments, that cut down the fixing time from 30 days to 24 hours, which is a tremendous outcome. And this was a collaboration between Oxford computer scientists and Oxford engineers. And that was turned into a social enterprise. It was funded through crowdfunding, the university has OxReach, its own crowdfunding platform, in order to set this up as a social business.

As an aside, I was told, I was talking to somebody about this, that they also discovered that they could tell the difference from the signals between whether men, women, or children were the ones operating the pump. So this turned into a new research project to understand what the sociological uses of those hand pumps were, and which sections of the community were the ones that ended up going out to pump the water. So that’s one example of something that was crowdfunded from a very broad community to set up a social business based on some quite sophisticated technology emerging from the university.

Mike Ward:  How proactive are you in seeking those sorts of collaborations? Or are they initiated by potential partners? So in that case, was this an idea that you thought, oh, we can think of an application, or was it that somebody came with a problem and then you realized that there was something that you had access to that might help?

Phil Clare:   The idea and the application of the idea was driven by the academic groups who recognized a problem and set about solving it. And a lot of research in those areas is directed towards a particular solution. So how do we build those collaborations? I mean, we have many collaborations with industry. Oxford has the largest volume of industry collaboration for funding of any UK university. And some of those are very long standing collaborations that have been going on for decades.

Where do they come from? Sometimes a company with a problem will approach the university or, even better, a company with a longstanding interest in their research will approach the university and from that a collaboration will develop. Sometimes somebody can bump into an academic, it’s a conference from a company and discover they have a mutual interest. Sometimes someone will read a paper and phone up. Sometimes we will target particular areas of expertise where we’re looking to build activities and we’ll go and speak to companies who might be interested. So especially as colleagues in the university act as that interface between the academic community and external businesses. And I think our aspiration is very much moving towards not just research contracts but long-term partnerships.

So we’ve got long-term partnerships with companies like Rolls-Royce, or SCG, or Novo Nordisk, who just moved into a laboratory on our campus, and we see that as the future. Companies who want to invest, and not just money, but time and people and building a collaboration. Those are the things which seem to be the most productive in producing mutual benefits. And I think the transfer of knowledge through interaction with people is far more effective than exchange of money and writing things down. So I think our aspiration is for deep, long-term strategic partnerships with our corporate partners. And often of course, that’s the channel for commercialization.

So if you have a long standing partnership and ideas which are capable of being commercialized or emerging from that partnership, then the obvious channel for taking some stock to the market is through the partner. What we don’t ever do is sort of leave things on the shelf, if you like. Our job is to create knowledge that’s used or made available not hidden or locked away. So I think a cornerstone of everything that we do is that things are published or made available for the world for use or just for sharing. So obviously academics’ careers are built on their publications. So even within our kind of corporate relationships, we always include the mechanisms that will allow academics to publish, even if our corporate partners are patenting or we’re patenting things in order to more easily attract investment, the outcomes will still be published and made available.

Mike Ward:  Right. And actually, I mean, that’s interesting. You mentioned  publication because historically, that’s how university researchers, their efforts have been recognized. Are there any instruments where, for example, being involved in one of these societal enterprises or helping create that, that it might not necessarily deliver a publication, but there is still some sort of recognition of the value that it provides to the university?

Phil Clare:  Yeah. I think so. I mean, many of our enterprises come as a consequence of, or as part of the delivery of research. So as an institution, excellence in our research and excellence in our teaching is at the heart of what we do. So most of what we do is driven by that excellent research that sits behind it. That’s not to say, I suppose the caricature of technology transfer is we do some great research and something fascinating randomly appears, and we think, oh gosh, what could we do with that? I think it’s a lot more thoughtful than that. And so research projects will have the impact pathway designed in from the beginning.

And so most academics when they start doing a piece of research will also consider what the application, the center of that research, is. And we’ll start to engage with partners who are going to be part of that application from day one. So this idea of this sort of linear notion of idea to market, it’s always a lot more complicated than that. That’s really what my academic colleagues will continue to push.

Mike Ward:  So when you’re creating these collaborations, what are the challenges or the issues, or the most common hurdles that you have to overcome when you’re constructing a collaboration?

Phil Clare:  Yeah. So I think there’s often a couple of hurdles. I mean, companies and universities are very different, particularly when you’re dealing with corporate partners, but external organizations and universities are different and have different drivers. So we are a charity and so public benefits are at the heart of what we do and the ability to speak freely and the ability to publish are the heart of the academic mission. So sometimes the desire to publish or the desire to manage intellectual property in a particular way is something that is not such a bone of contention, but a point of discussion that always needs to be properly managed between universities and companies.

And I think for a long time in the UK, we’ve had the Lambert agreements, which many companies and universities use to enable research contracts to be established. And even if people don’t like the agreements themselves, what is useful about them is that they established some of the principles. And they, if you like, highlight some of the core challenges they do need to overcome. So any contract with a company is going to see the mechanism for managing intellectual property, a mechanism for publication, a mechanism for commercialization, a mechanism for managing the project. All of those sorts of things tend to be built in. A lot depends on the project.

If it’s a piece of research which is essentially one in which a company is bringing us some of their ideas and some of their intellectual property and asking us to contribute some of our work to their ongoing program, then whatever we design is going to be bias towards delivery of a program, which is going to be part of their work. If on the other hand, we’re doing some fundamental research and have a long standing research program, a company comes to participate in that, then we would expect that to be them contributing to part of the university’s long-term activity or what they gain might be knowledge, it might be access, but will not be control or ownership.

And there’s a whole bunch of nuances there and you build them on a case by case basis. In the end, it comes down to understanding what everybody wants out of a relationship, not assuming for a university that you know what an industry goals are without asking and vice versa, not assuming that all universities are the same. Universities are different, they have different characters, they care about different things. So for a company talking to a university, I would make sure that I asked questions and listened to what the key priorities are. And for any university talking to a company, I would say the same thing, because not all companies are the same either.

So those are the sort of issues that often come up in contractual discussions. Actually sometimes not included, but very, very important to what does the ongoing project management look like? How do we make sure that we are comparing notes on a regular basis? What’s the sort of the structure of the management committee of a project or program, depending on how big it is? And who’s on it and are they committed to success?

Those are the sorts of things which also need to be part of any project proposal. And those are the sorts of things which support long-term partnerships. Well, if you have a long-term partnership, we then talk to each of those not going to last. If you’ve got a long-term partnership with a good structure where people regularly discuss the direction and strategy of a project, then you’re far more likely to succeed.

Mike Ward:  And the people representing the university, would that be people associated with your department or would it be the academics themselves?

Phil Clare:  So, it varies. I mean, we work in partnership with academics. They’re the ones with the vision and the research. But we aim to lighten all their administrative burdens and provide professional support services where we can, not just in my department. So research services provide a lot of that professional support for contracting and for partnership building, but there are other colleagues distributed through the university and research facilitation teams or industrial partnership teams or in the tech transfer teams who actively support the academics in these endeavors. So academics are obviously the key focus and what we will do is build teams or support networks around the individuals to help deliver the outcomes that we want.

Mike Ward:  When we see companies getting together to build collaborations, I hear that sometimes it can take 18 months from the idea being first proposed to the deal actually getting prime time. So in the relationships that you have with your external partners, what is the timeline we are looking at from creating the original idea to actually coming up with something tangible?

Phil Clare:  Well, that’s a very good question. I mean, as is always the case, how long is a piece of string? And it depends. Sometimes relationship building can be a long-term trust building exercise. So actually small projects to see how things go, to build trust and lead to larger projects can be the way to get these things going. And doing the deal and writing the contract, again, the first time you interact with somebody it’s going to take longer because you’re seeking to understand each other’s needs and hopefully you’re doing some listening. And that may take longer. When you’ve got a long standing collaboration or somebody who you deal with a lot, you understand what the issues are, you understand what the feelings are on both sides, so things can be turned around extremely quickly.

I think also circumstances play a huge role. The best way to speed things up, it turns out, is to have a massive global pandemic. And that was a flippant remark, but I’ve been amazed in the last year, how quickly the scientific and industrial community has moved to work together to deliver things that everybody knows are really urgent. So in the early days, the work that everybody did on constructing ventilators and bringing together research groups from universities and companies who are able to develop production processes in a matter of days was a remarkable feat of collaboration.

So I think the answer is you can do it very quickly when it’s very urgent or you can take time if that’s what circumstances require you to do in order to build trust and have a great long-term relationship. So again, I didn’t give you a timeline. I think realistically, busy and large organizations could often take quite a long time to turn these things around because people in companies and people in universities may be dealing with 50 contracts at once. That’s just the reality of people with busy lives. It always takes longer than you want it to take. But equally, I think I’ve rarely come across insurmountable challenges that can be overcome by having a deep understanding of each other’s needs in putting these contracts together.

Mike Ward:  And in your experience, are there some tips or best practices that potential partners could engage with that would ensure that such negotiations are conducted as rapidly as possible?

Phil Clare:  Personal contact is always important and I’ve never been a fan of doing everything by email. I think understanding what it is that you want to achieve before you start writing a contract is always key. And communicating the principles of what everybody gets out of it, there’s nothing worse than getting halfway through the process and realizing you misunderstood the intentions of the person you were talking to. So open dialogue, all this dialogue about what’s wanted, about what limitations are, about what timescales are possible, about what budgets are possible is always a sensible place to start.

And I think then just investing personal time in the process is something that I would always want a partner to do. That’s probably not very helpful in terms of tips, but I once heard somebody, a leading industrialist, talk about his philosophy for engaging with universities and said, you’ve just got to put boots in the ground. If you don’t want people in the equation you might as well burn your money in the car park, which was an image that has stuck with me. And I think the same is true of universities. We need to make sure that there’s a proper relationship going on, or there’s a proper connection between people in the company and people in the university, and their academic needs.

Mike Ward:  So as a final question, I want to sort of flip back to what you mentioned about the desire to ensure that there is a societal benefit from the research that is conducted. When one is developing an industrial relationship where it might involve a new medicine, or it might be new diagnostics or a new ventilator, one can see success in terms of revenue generated, which could flow back to the university. On the societal benefits, how do you measure the impact? What would be a good result?

Phil Clare:  These things are often very hard to measure. And the trouble is the metrics that are used tend to be financial proxies for real outcomes. So it is very hard. I mean, in some areas of our activity, the public engagement activities, measuring the outcomes requires built in evaluation processes from the beginning. And this is good practice in that community that I’d like to wonder if we could broaden out in other areas. If the collaboration works then everybody will want to do it again. And that’s one measure of success, that everybody feels that they got out of it what they wanted.

In health care, clearly you want an intervention that saves lives. What you want are things that improve people’s quality of life. What we want right now is as many vaccines in as many arms around the world, and as many countries as possible, as quickly as possible. So those are the outcomes that we want. One hopes that history will find good ways of measuring success. Look at what political or public opinion struggles with from time to time. I think, yes, in the end, those sorts of outcomes are best delivered through large partnerships.

We’ve talked a lot about the relationship between universities and businesses, but what we’ve not really talked about is engagement with the whole health care system and patients and all of those things. And I think it is important when we’re considering the really big healthcare challenges that we’re facing. The problem of aging and aging diseases, and multi-morbidity is not something that we’re going to tackle with a one-off research project.

These are the sorts of things that require significant rethinking, significant collaborative programs. Just one such program that we’re engaged in at the moment is the UK SPINE. It’s a CCF that’s collecting community funding program funded by Research England. And that involves the universities of Oxford, Birmingham and Dundee, the Medicines Discovery Catapult, Crick Institute, and a growing number of partners in the UK, looking at tackling some of the challenges around aging diseases. New therapeutics, new regulation. In order to improve our solutions to these challenges, we need to take a systemic approach. And no one institution, however big, could possibly hope to tackle on their own.

So working with industry partners, different universities, different intermediaries, and different groups to pull together broad collaborative programs to try and deliver solutions, I think is something that we’re going to have to do more and more. Climate change is not a single project issue. Pandemics are not a single project issue. These are things that’s going to require concerted efforts over the decades. And I think that kind of also plays into the way that we need to view our universities.

As a nation, we’re tremendously good at research and development in the UK and our universities are collectively by every measure, very good at it. We don’t know what the next crisis is going to be. We don’t know when we’re going to need all of the knowledge that is generated in those universities. I think what’s really important though, is that we in the UK and people like me in the universities develop effective mechanisms so that when it’s needed, either in terms of a partner who wants to draw upon that knowledge or because there’s a national need or a global need, then we’ve got a mechanism for making sure that that knowledge can be translated out of the institution to partners, to the world at large, to the public with appropriate mechanisms. And yes, measuring that success.

So you talked about measurements. Research England just published the knowledge exchange framework across the UK, which looks at all of the many different dimensions of how universities are tackling this problem of, how do we make a difference? And within that, there were several perspectives, of which one is IP in commercialization, one is research partnerships, one is public and community engagement, one is regional development.

These are all the different ways in which we make a difference. And what is fascinating about that knowledge exchange framework exercise, which can be found when researching the website, is that of the 150 universities in the UK, you can look at those outcomes and see the strengths of all of those universities. And all those universities that are engaged in it. And they’re all strong in some areas, and you wouldn’t expect everybody to be good at everything. But what you would expect is everybody to be thinking about how they make a difference.

And that exercise has demonstrated that we all do think about it, and we all do measurements. And as I said before, unfortunately there are no good metrics for outcomes. So there are always just inadequate proxies, but it is heartening to see how much effort and how much is achieved by universities looking to fill that public sense of mission in this way.

Mike Ward:  I just wanted to add an additional question and it’s a follow-up on something you just said in your last answer which was, when we’re dealing with the healthcare system, we are looking into the challenges, and I just just wonder, in your engagement, how much do you try and listen to the voice of the patient? How patient-centric are some of your activities?

Phil Clare:  That’s a really good question. So I’m not a healthcare specialist. So it’s not something that I’ve personally engaged in much until very recently, I’ve been talking to colleagues in the medical sciences division who’ve been talking about the increasing and many layered ways in which we engage with patients. And I think certainly in the UK SPINE program, that’s our recent conference. One of the things that we wanted to do when we were discussing the problems of aging was to make sure that we included patient groups and patients themselves, and patient support groups, because in the end, when you’re tackling a problem, you have to include the people that it is affecting in order to make sure that you’ve looked at all of the perspectives. And this is something which is an increasing focus in what we do. I’m no expert, but I know there are colleagues who are passionate about making sure this is a much stronger focus. Yes, so I think it continues to be important.

Mike Ward:  Phil, thanks very much for taking the time to speak to us today. I think some of the insights that you’ve shared, the processes and the way that the University of Oxford is thinking about that exchange of knowledge is going to be fascinating to the audience. Thanks very much. And also I’d like to thank the audience for listening in, and if you would like to hear other editions Conversations in Healthcare, be sure to follow our LinkedIn page because that’s where we’ll be posting alerts to future episode releases. So until next time, stay safe and healthy. I’m Mike Ward, and I’ll see you in the next episode.