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On November 26, 2017, Monika commented on Supplier Scorecards: Walmart’s Push for a Cleaner Supply Chain :

As you pointed out, Walmart is one of the largest retailer worldwide with substantial bargaining power over its suppliers. Currently, Walmart if focusing on providing incentives to its suppliers to implement climate- friendly practices.

As a next step, Walmart could take similar approach to working with suppliers as Toyota with JIT implementation. Walmart could work closely with its suppliers and work with them closely to develop best-in-class practices regarding climate protection processes. Given Walmart’s experience and cooperation with multiple suppliers, it can now act as a coach for sustainability practices. Walmart would need to establish long-term relationship with supplier to encourage them to invest in sustainability. According to PwC, with long-term relationships in place, suppliers will be willing to implement practices and process that support environment [1].

[1] PwC. “Retail & Consumer Insights: Megatrends in the retail & consumer products industry”. (June 2015). Available online:

On November 26, 2017, Monika commented on Unilever’s climate-proofing strategy :

Unilever has recognized that the long-term viability of the business depends substantially on managing climate change. However, many companies still struggle to take the long-term approach and sacrifice short-term gains.

I believe that in order for companies to implement climate-proofing strategies, sustainability performance metrics should be included as part of the compensation. This would provide incentive for leadership to think not only about short-term results, but about the future of the business [1]. Additionally, the cooperation between companies and their suppliers would be the key driver to encourage smaller players to think about climate. Large companies, such as Unilever, have strong bargaining power and can influence their supplier to implement practices that protect the climate. Unilever, could work with its competitors e.g., P&G or Mars, to define industry standards for climate change practices.

[1] PwC. “Retail & Consumer Insights: Megatrends in the retail & consumer products industry”. (June 2015). Available online:

On November 26, 2017, Monika commented on Ford: Fusion Across Borders :

Ford and other car producers are facing a risk of very high tariffs for importing cars to the USA. If the US administration implements such laws, the risk for Ford is very high, potentially even becoming bankrupt. Therefore, moving at least part of the production to the US could be a risk-mitigation strategy.

Despite the fact that Ford should lobby against high tariffs and retrain the US workforce to value-added services, it still needs to implement some strategies against potential risk of tariffs. Completely disregarding the current trend of isolationism and Trump’s push to move jobs to the USA, would be irresponsible on Ford’s side.

I personally do not believe that governments will impose strict restrictions on drugs manufacturing. The reason is that access to healthcare is a sensitive and political topic. If companies start bringing up cases of drug shortages or high drug prices due to import restrictions, there might be substantial response among the society. Even though I can see the government encouraging to produce APIs locally, the economies of scale in API manufacturing, particularly in small molecules, are an important driver. Thus, splitting the production to multiple locations might be a challenge.

On the other hand, when it comes to large molecules such as biologics, there might be justification to produce locally as operational excellence is more important rather than economies of scale [1]. Thus, innovative companies that master the complex production process of large molecules and reduce the operational costs will have significant advantage over low-cost producers.

[1] Peter Pollak, Andrew Badrot and Rolf Dach. “API Manufacturing: facts and fiction”. Available online:

On November 26, 2017, Monika commented on Telemedicine as a Partner in Care Delivery :

Implementing change in how healthcare is delivered could be challenging due to resistance among multiple stakeholder [1]. While working in a digital healthcare start-up (eConsult) that was focused on implementing patient contact with their own general practitioner, we identified a set of barriers. It is worth pointing out that in the UK there were relatively limited legal barriers e.g., licensing or reimbursement as compared to the US. Thus, the main barriers were related to patients’ and doctors’ acceptance of the solution:
1. Physicians have been thought how to treat patient in a face to face environment. Thus, they might be feeling resistance to treat patients remotely as they can not examine the patient directly.
2. Patients are used to seeing doctors face to face. As a result, they might feel uncomfortable getting treated remotely, without the doctor being able to examine the patient. Also, some patients, particularly elderly enjoy going to the physician and treat it as a social activity. Also, patients value being able to choose with which doctor to connect.
3. People are often unaware about the possibility to contact doctors remotely. Educating them on the options and process, increased the implementation rate of eConsult. Thus, I expect that such approach could support usage of the digital solutions at hospitals such as Partners.

In summary, I believe that educating patients and physicians on the options of digital healthcare delivery solutions such as telemedicine, could increase the usage. Making the solutions clear, easy to use and accessible, could strengthen the acceptance among both patients and healthcare providers. The admin and clinical team should be well-informed about the solutions and how they fit with the overall patient journey. Once they are aware, they can educate patients and thus reduce the resistance towards new solutions. Potentially, educating medicine students on how to work with patients remotely could increase the popularity of the solution.

[1] Clemens Scott Kruse, Priyanka Karem, Kelli Shifflett, Lokesh Vegi, Karuna Ravi, Matthew Brooks. “Evaluating barriers to adopting Telemedicine worldwide: A systematic review”. Journal of Telemedicine and Telecare. October 16, 2016. Available online:

As you pointed out, patient data are considered very sensitive and there are legal guardrails on how the data should be protected. In my view, digitization of patient data poses a risk of the data being hacked and hence, compromised. However, I believe that by providing legal barriers on how the data should be managed and also, posing consequences for data being compromised, the healthcare delivery companies will be encouraged to implement top data security systems. The banking industry also holds sensitive data, but this did not stop digitization of banking. In my opinion, the risk of data privacy in healthcare should also not be a limitation for implementing digital solutions. However, processes and standards should be set to manage the risk.

As far as I am concerned, in the short- and mid-term, full automation of patient diagnosis would not occur, due to patients and doctors being used to the judgment happening by a real person. The question of who would be responsible for a potentially deadly mistake by AI solutions, would be a significant barrier. However, I would expect that doctors judgment could be supported by AI e.g., AI could provide preliminary results that would need to be approved by a licensed physician.

On November 26, 2017, Monika commented on The Best Supply Chain in The World :

J&J ambitious plans to have the best supply chain in the world pose in my opinion significant risks in the privacy area. Having multiple elements interconnected, with automatic triggers and different information being stored together could lead to data being compromised. As a result, J&J should, in my view, invest not only in fully digitizing the supply chain, but also having the best data protection system in the world. However, data being protected from hackers is only one step. Another aspect is that the legal systems around the world put additional requirements on companies regarding how, when and to what extend they can use certain data. Being in line with multiple regulation system could be a challenge, as potentially they could sometimes contradict one another.
I believe that in the retail space having a digitized supply chain should be easier from the data privacy standpoint than in healthcare. In healthcare there are additional security concerns as patients’ data are sensitive. In my view, J&J should move only as fast as the privacy concerns could be addressed.