Providing the Best Care | Dr. Veronique Michaud

Throughout her career in academia and industry, Dr. Michaud’s work has centered around developing knowledge on multi-drug interactions, pharmacogenomics, and the impact of diseases on intersubject variability in drug response. “Drug safety to improve patient health outcomes has been and will always be the pillar of my research, and now, as co-founder and President of GalenusRx, I oversee our product development and the science behind it and know that our work will save lives,” says Dr. Michaud.

Working for the Patients

For Dr. Michaud, the stern belief that patients need better health care transformed her ideology. As a pharmacist, she considers the best options when using medications as a treatment strategy. Co-morbidities in the aging population pose challenges like complex drug regimen, inappropriate polypharmacy, side effects, multi-drug interactions, drug-disease interactions, and drug-food interactions. There is a need to optimize health care for these individuals, as these conditions can contribute to a prescribing cascade—the unnecessary addition of drugs—which worsens the situation.

Throughout her career, Dr. Michaud has emphasized the importance of individualized patient-centered care, consideration of drug safety, and preventing premature death. GalenusRx develops proprietary products and solutions that support medication safety. Their innovative solutions, with health technology development and clinical practice guideline implementation, can lead to significant health improvements. Nevertheless, despite improved technology in the health care setting, medication-related problems and adverse drug events (ADEs) continue to rise. Although polypharmacy may be beneficial and improve health status for some, inappropriate use of multiple drugs is associated with problematic clinical situations and carries a considerable risk of harmful ADEs. The increase in inappropriate polypharmacy is alarming! Polypharmacy and ADEs represent a serious public health problem and pose a threat to patient safety. Numerous statistics have shown that ~50% of ADEs are considered preventable.

According to Dr. Michaud, even if no ADEs have occurred, it is essential to proactively identify medication safety risks that could harm the patient. It is also important to identify the underlying reasons of an ADE when one is observed to avoid a prescription cascade to circumvent the observed side-effect. “I believe that medication safety initiatives can be cost effective if a proactive approach is used instead of the observational “reporting” method which is very costly as it awaits patients’ harm before acting. Highly qualified pharmacists, as medication experts, can be the quarterback breaking these silos. We can play a central role in ensuring medication safety across the continuum of care,” she states.

Healthcare is directly connected to everyone in many ways: physically, mentally, emotionally, and financially. So, new digital technologies in healthcare require a health professional attention. The traction for artificial intelligence (AI) in healthcare is a concern rather than a challenge. Generative AI tools in healthcare may substantially improve efficiency of systems, diagnoses, and the patient’s experience. However, a lack of data for women and vulnerable populations can create gender, race, and ethnicity biases in healthcare systems. Clinically informed AI-based systems may help in pharmacovigilance to develop models that identify patients with complex drug regimens at risk of ADEs.

However, AI-based algorithms in the field of ADEs or multi-drug interactions encounter data limitations such as the lack of empirical data to validate systems, limited diversity, insufficient practical data, and varying quality of data and studies in the literature. The imbalanced or misrepresentative training data are crucial and may exacerbate bias. She adds, “We routinely face patients with polypharmacy taking 5-10-15-20 and 25 pills per day. These complex drug regimens are unique. We can leverage an AI-based approach in the medication safety space by using a clinically- and science-based approach combined with AI systems.”

Supporting the Next gen in Healthcare

As Dr. Michaud gained experience and knowledge, leadership roles presented themselves to her organically—she never thought about it nor sought it out. Her work, ideas, and perspectives produced positive results and inspired people to be better clinicians. “I gained confidence and was no longer shy about offering my ideas and solutions. I exemplified that hard work and attention to detail were the best ways to succeed,” explains Dr. Michaud. “But success can rarely be attributed to one person; it is most often the result of team effort. To be in a leadership position means that you have the privilege to be the first to go to “war.” It does not give you the power to ask others to do things you do not want to do.”

Dr. Michaud thinks of others first. Whether it is a patient, a colleague, or an employee, each person is considered in her decision-making and leadership. She spends time with her team members and develops strong relationships with each of them, greatly influencing company culture. Her qualities have led to high team member engagement and employee satisfaction, and she has created an environment where team members work together and feel valued.

Second, she leads by example. She gets her hands dirty and treats everyone with respect and dignity. She honors her commitments, actively generates ideas, and prioritizes tasks given to others.

As a world-renowned expert in her area of research, her team is confident in her abilities and enthusiastic about her ideas, driving passion and participation at GalenusRx. She is generous and collaborative, creating a work environment where her team feels supported and understood and defining a culture where employees feel a sense of belonging. She invests her time in her employees to ensure their values align with the overall mission, helping employees thrive independently and as a part of the team.

Her main driving force is her desire to make a difference, as each patient, each team member, and each person matters. She strongly believes, health professional teachers and practitioners, academic researchers, executive leaders, and mentors have the opportunity and the responsibility to develop a competent and effective next generation of professionals through the transfer of knowledge, hard skills, and attitude to positively influence the workplace. Mentoring is not static or one-sided; it comes from both the mentor and the mentee. It is important to build a trusting and transparent relationship and to grow and learn together. Talents, knowledge, and ideas from graduate students, residents, or employees improve mentor qualifications.

“Science and technology are constantly evolving, and I am still excited to learn. I am not afraid to admit that there are things that I do not know. Knowledge gaps are not a failure, and a leader does not have all the answers! Be aware of your limitations and use them as an opportunity of self-improvement as a mentor and as a mentee. Always maintain intellectual humility,” she rationalizes. “The idea that knowledge is power seems cliché. Early in my career, I found myself having supervisors, leaders, and mentors who continually immersed me in their knowledge. I was able to grow and establish myself as an independent scientific expert and leader.” Knowledge has power when it leads to action and influences and empowers people. In fact, with technology and available, real-time information, power is not about the fact that one has knowledge but is about how to share the knowledge they have gained, how to learn how to learn (continuing education), and how these strategies can lead to success. Sharing knowledge can create a powerful, dynamic, and trusting workplace, helping to foster creative solutions. This is a key to success.

Making Lives Better

Dr. Michaud’s desire to translate the complex science underlying the causes of adverse drug events into user-friendly, understandable, and applicable content led to the creation of products to ease the management of multi-drug interactions in polymedicated patients. In 2001, she co-partnered in creating IntermedRx, a spin-off company from Université de Montréal. While she was still a full-time professor at the Université de Montréal and researcher at the Centre de Recherche du Centre Hospitalier de l’Université de Montréal, Dr. Michaud spent nights and weekends developing IntermedRx, a paper form tool to manage multi-drug interactions, which eventually evolved into a web-based application. For ten years, the tool was used by community pharmacists in more than 100 community pharmacies in Quebec and by specialty pharmacists in 10 hospitals.

“In 2013, a license of IntermedRx was granted to CareKinesis, a subsidiary of Tabula Rasa HealthCare (TRHC) (USA). And my dream came true! In 2016, TRHC bought IntermedRx,” elucidates Dr. Michaud. “As I could not let “my baby” go, I left Montreal, moved to the U.S., and joined the company. In 2019, the company launched the Precision Pharmacotherapy Research and Development Institute (PPRDI) for which I was the COO. In three years, PPRDI published more than 100 peer-reviewed papers, focusing mostly on medication safety for older adults.” Medication problems do not only affect older adults, and there is a social need for better healthcare experiences for all people. These achievements with IntermedRx and PPRDI created a renewed sense of purpose and fueled her and her colleagues’ desire to do more impactful work that can help more people.

Dr. Michaud took this opportunity to innovate as an individual and part of a team by forging her path. “As a leader, you should be authentic, trust yourself, and take action. So, recently, I co-founded GalenusRx where we envision solutions that are more precise, more powerful, and can have a greater impact on patient’s lives,” she adds. “I want to be part of the team creating the most advanced clinical decision support system, used by all pharmacists and care providers throughout the world. I want all pharmacy and medical students to be exposed to our medication safety approach so that these notions are foundational for the next generation of health professionals. Today, drug efficacy and adherence are the driving forces of our pharmacological approach. Safety should come first.”