Clinerion: Tell us a bit more about yourself! Who are you and what’s the problem you are trying to solve with Wefight?

J.M.: My name is Julien Moussalli, I was born in Montreal, Canada, grew up in Paris, France and studied in Singapore and India. Both my parents have been working in the pharma industry since I was born. Most of our dinner conversations were about clinical trials: “What is clinical monitoring?”, “What is an EDC?”, “What is the purpose of writing a protocol?”, “How do you recruit a patient” – not typical questions a 12-year old boy asks.

After graduating with a master’s degree in business administration, I joined IQVIA (previously Quintiles) in their department focusing on late phase research. As a business developer and account manager, my role was to expand IQVIA’s customer portfolio, focusing on real-world insight services. 

There, I had the opportunity to meet with hundreds of professionals involved in clinical trials and real-world studies. Now, if you ask anyone involved in research, they will confirm that one of the main challenges the industry is facing is patient recruitment.

In clinical trials, we tend to want to control everything to ensure statistical relevance of the results, but we also tend to forget who is at the source of the data we are generating during studies: patients. The study might be very robust from a scientific perspective, but if the targeted number of patients is not recruited into our study within the defined timelines, it doesn’t help the purpose.

In clinical studies, we often tend to “neglect” the recruitment part because we think this will work by itself. We try to be reassured by the results of a feasibility that focuses on patient recruitment potential at a site rather than focusing on better understanding the patient situation/behaviour and, accordingly, develop targeted, patient-centric strategies to support the sites in their recruitment efforts.

To solve this problem and to position the patient at the center of his treatment alternatives (participating in a clinical trial is one of these), patient engagement is crucial. In a few words, the idea is to engage patients to become a key partner/decision maker in their own treatment journey.

Informing, educating and empowering the patient is at the core of WeFight mission.  

Clinerion: What’s the current situation that you want to change – how did Wefight come up with Vik, an Instant Messenger companion?

J.M.: Today, the way we recruit patients is still archaic. We are not aligned with what patients expect from science, we keep on insisting that patients go to the investigator site, which is such a burden for them.

Today, when patients want to join a trial, most of them connect with the trial via their doctor. But only 5% of healthcare professionals take part in clinical research. Patients who want to participate in clinical research will sometimes be told that nothing is available due to a lack of knowledge or awareness on the part of their treating physician. There’s also a real lack of training, interest, and/or time on the healthcare professional’s side. They treat patients in real life, but it’s an additional burden for them to work on clinical research, so they don’t “push” for it.

If we just have a look at Institut National du Cancer’s website (a French website, the equivalent of clinicaltrials.gov in the US), the medical jargon which is used is incomprehensible to the average patient, i.e. a non-expert with no scientific background.

In joining Wefight, I wanted to create something more innovative. In one simple statement: we bring trials to patients. 

Instead of having patients looking themselves on clinicaltrials.gov or an equivalent, we want to “reverse” this.  We want to facilitate the process.

To do this, we at Wefight have developed a virtual bot called Vik, which will develop intimacy with the patient and develop a trust relationship. This comes before the clinical trial step. As we go along, we gain more and more credibility thanks to this close relationship.

First, Vik acts as the patient’s companion, understanding their needs well and providing them with information, advice and support for their disease.

In parallel, Vik collects information about the patient by asking questions to better understand their medical situation. It is then able to sort and filter the patient’s data and match the patient to protocols of existing trials.

In this way, Vik is able to inform the patient about clinical studies which are potentially relevant for them.

Vik regularly gets back to patients to follow up with them. The more information the patient shares about themselves, the more Vik will be able to give them personalized information in return. Of course, all their data remains anonymized and nothing is shared with any third parties without the patient’s consent.

Clinerion: Before patients can hear about a trial via Wefight and before they can decide to get enrolled in a given trial, they must find your tool, Vik. How do you let patients hear about the tool?

J.M.: We have a “direct to patient” enrolment strategy. We use social media – Facebook, for example – and we do targeted display via Google.

We also work with pharmaceutical laboratories who can promote Vik to the physicians and healthcare professionals they work with. Vik is definitely part of a pharma patient engagement strategy. Instead of focusing exclusively on a disease or drug, a pharma partner salesforce is now able to propose a patient support tool, not only a trial matchmaker tool. 

We also take part to a lot of events where patients and group of patients are present.  We have a Vik for several diseases: Vik asthma, Vik depression, Vik breast cancer, Vik ovary cancer, Vik lung cancer, Vik migraine etc. In the long term, we have the ambition to develop a “Vik” for every indication in oncology and for every chronic disease, and we already have many other Viks in the pipeline!

We see a real need, here. At the moment, there’s a lack of information or support once a diagnosis is given. Patients go on blogs, forums, and find information that is not necessarily correct or appropriate. We want to give them the most credible and accurate information possible. The information also has to fit the patient’s current situation. For example, if we talk about cancer: before the first operation, after the first chemo, if the cancer comes back, etc. 

The questions Vik receives from patients can be related to many things: the environment of the patient (for instance: “Can I still practice sport despite my asthma?”), administrative support (“Can I get my wig reimbursed?”) or quality of life (“My scar tends to hurt at night, any advice?”). Quality-of-life validated questionnaires are also suggested to patients in order to track the impact of their treatment.

Vik doesn’t replace doctors but is complimentary. Having patients using Vik as a virtual companion through their healthcare journey should free up time for doctors who can dedicate their time to other tasks with more added value (like changing treatment dosage), and who won’t have to repeat the same answers to the same frequently-asked questions every time, as their patients will already have received a lot of information and answers via Vik.

Clinerion: We tried your bot system here at Clinerion, and chatted for a while with Vik, the avatar / conversational interface of Wefight. How was this built and how does it work exactly, is it using the same AI technology as Alexa or Google Home for example? Can there be human intervention?

J.M.: Good question! First, for every new Vik we develop, we start by identifying and understanding patients’ needs for and expectations of a new digital solution. It sounds obvious, but many companies are launching their new solutions without looping in the patient’s voice early in the development process, which results in low acceptance from the patient community, and failure for the app.

By working closely with patient associations, our objective is to gather insights around patients’ issues and frustrations. Once we have this, we start to write the content that will be available to the user, with the help of health professionals. All our product managers have a PharmD . We also work with specialist doctors and key opinion leaders who advise us in content preparation.

Then, we build our algorithms. We identify keywords and we perform natural language processing, which lets us query our database and get the most appropriate answer, instantly.

All aspects of the technology of Vik are controlled by healthcare professionals, from the answers delivered to patients, to the training of the algorithms.

As an example, at the launch of Vik Breast, our virtual companion supporting breast cancer patients [1], we hadn’t yet identified the need for therapeutic tattoos. We only realized through requests we received later that many women wanted to cover surgery scars using tattoos, after mastectomies. We then talked with patient associations who linked us with professional tattoo artists – and we updated the bot’s answers.

We constantly update the platform according to the patient’s needs and interactions.

Clinerion: Will you still improve the chat technology and how? What’s the user response so far?

J.M.: Yes, it’s a process of continuous improvement and we have many different, new projects in the pipeline. For instance, our patient-users requested a new feature to remind them to take their medication. Vik is now able to come back to patients, proactively, and remind them. Beyond that “reminder” functionality, Vik is also able to better understand why the patient is not adhering to the treatment regimen. The data generated from those interactions help us build new strategies to improve patient observance.

Vik now has more than 100,000 users! Some people almost have a “friendship” relationship with Vik. It’s not a gadget, it’s a real, virtual companion.

Most importantly, Vik aims at supporting patients along their entire journey. Vik is not another health “gadget” app that you download and erase in less than two weeks: we are very proud to have a retention rate of 90% after twelve months.

Clinerion: How did it start? Why the name Wefight?

Our CEO Benoît Brouard was a pharmacist in hospitals in Paris. He realized that many questions coming from patients are not addressed by doctors. The reasons are multiple: doctors don’t have enough time, because it is related to patient experience and not the medical field. And many questions are not asked because patients don’t dare to ask them to their doctors.

With Wefight, Benoît wanted to give the power to patients to fight their disease using information.

This is the core value of Vik: empowering patients during their healthcare journey, to reduce complications and relapses.

Clinerion: A classic but important question: what does the future look like in terms of using digital technologies and AI in healthcare?

If I take a step back, to me, AI and everything regarding digital in healthcare will “complement” the doctor’s and the healthcare professional’s roles.

Access to the information is very important. Imagery-reading algorithms are being developed now. For every important step (diagnosis, follow up, monitoring), we’ll have more and more tools. We should not have generic tools but very specialized tools for every indication. The patient isn’t patient, he wants the info right here, right now. It’s okay for a human being to make a mistake, but not a bot. Many companies will have trouble to succeed because mistakes will not be accepted.

The patient wants information, which is reliable, relevant and right.

Another key topic will be being transparent in how the data-gathering that we do brings an added value to all our users. From the very beginning, when the user downloads Vik and also when they first chat with Vik, we explain to them how we will use their data: for research purposes, in anonymized and aggregated studies. Technical innovation can’t work without transparency.

Clinerion: If you were to put in one simple statement your ultimate goal and what you could achieve in the ideal situation, what would it be?

J.M.: Our ultimate goal is to: “Never leave patients alone with their disease again.” This means being able to get them an answer to any concern they may have.

We also want to do this in the most personalized way possible and without time and location constraints: bringing the most appropriate answer to the right patient, anytime, anywhere. Whether it is 2 a.m. in the morning, or if they are at the other side of the world, patients deserve information and answers!

[1] Watch https://www.youtube.com/watch?v=VzBt_zEVCpQ