The What-If Blueprintby Nikhil Kasturi

Life Sciences

How therapies, devices and diagnostics move from the lab bench through trials, regulators, manufacturing and into patients' hands.

17 categories
51 processes
0 redesigns published
Pharmaceuticals — full pipeline, discovery through commercialization6 processes

Drug Discovery

4-step flow

Identifying biological targets and screening candidate compounds against them. Narrows thousands of candidates down to a handful worth developing further.

Where it breaksScreening and validating thousands of compounds manually/semi-manually is slow and resource-intensive.

Open process page
flowchart TD
    A[Disease target identified from research] --> B[Compound library screened against target]
    B --> C[Hits validated in follow-up assays]
    C --> D[Lead compounds selected for optimization]

Preclinical Development

6-step flow

Running toxicology and animal studies before human testing. Establishes a safety baseline required to start clinical trials.

Where it breaksCompiling and reviewing study data across multiple labs/CROs is a manual, document-heavy process.

Open process page
flowchart TD
    A[Lead compound enters preclinical testing] --> B[Toxicology studies conducted in animal models]
    B --> C[Data compiled and reviewed]
    C --> D{Safety profile acceptable?}
    D -->|Yes| E[IND application prepared]
    D -->|No| F[Compound deprioritized]

Clinical Trials (Phase I–IV)

5-step flow

Trial design, patient recruitment, data collection, monitoring.

Where it breaksPatient recruitment is often the single biggest bottleneck, relying on manual outreach by site staff.

Open process page
flowchart TD
    A[Trial protocol designed] --> B[Sites selected, patients recruited]
    B --> C[Data collected during trial visits]
    C --> D[Monitors verify data accuracy on-site]
    D --> E[Data locked and analyzed]

Regulatory Submission

7-step flow

NDA/BLA filing, FDA interactions.

Where it breaksCompiling the massive submission dossier across many contributing teams is a manual coordination effort.

Open process page
flowchart TD
    A[Clinical and manufacturing data compiled] --> B[Regulatory submission drafted]
    B --> C[Submitted to FDA]
    C --> D[FDA reviews, may request more information]
    D --> E{Approved?}
    E -->|Yes| F[Drug approved for market]
    E -->|No| G[Complete Response Letter, resubmission needed]

Manufacturing & Quality

5-step flow

GMP production, quality control/assurance, batch release.

Where it breaksOut-of-specification investigations are manual and can delay batch release significantly.

Open process page
flowchart TD
    A[Production batch manufactured under GMP] --> B[Quality control tests run on batch]
    B --> C{Tests pass specification?}
    C -->|Yes| D[Batch released for distribution]
    C -->|No| E[Batch investigated, possibly rejected]

Commercial Launch

5-step flow

Market access strategy, pricing/reimbursement, HCP engagement.

Where it breaksNegotiating payer coverage one contract at a time is slow and delays patient access after approval.

Open process page
flowchart TD
    A[Drug approved] --> B[Pricing/reimbursement strategy set with payers]
    B --> C[Sales force trained and deployed]
    C --> D[HCP engagement begins]
    D --> E[Launch metrics tracked]
Biotechnology2 processes

Genetic Engineering / Bioprocessing

4-step flow

Cell line development, fermentation.

Where it breaksOptimizing fermentation conditions is an iterative, manual trial-and-error process.

Open process page
flowchart TD
    A[Target protein/gene identified] --> B[Cell line engineered to produce it]
    B --> C[Fermentation process optimized]
    C --> D[Product harvested and purified]

Gene & Cell Therapy Development

5-step flow

Vector design, therapy manufacturing.

Where it breaksPer-patient manufacturing (autologous therapies) is manually coordinated and logistically complex.

Open process page
flowchart TD
    A[Delivery vector designed for target gene] --> B[Vector manufactured under GMP]
    B --> C[Patient cells collected if autologous]
    C --> D[Therapy manufactured per-patient or per-batch]
    D --> E[Therapy shipped to treatment site]
Genomics & Precision Medicine4 processes

Genomic Sequencing

4-step flow

DNA/RNA sequencing and analysis.

Where it breaksInterpreting raw sequencing output into clinically meaningful findings still requires significant manual expert review.

Open process page
flowchart TD
    A[Sample collected from patient] --> B[Sequencing run performed]
    B --> C[Raw data processed through analysis pipeline]
    C --> D[Results interpreted by geneticist]

Bioinformatics

4-step flow

Applying computational methods to interpret large-scale genomic and biological data.

Where it breaksValidating computational findings against biological plausibility still requires expert manual review.

Open process page
flowchart TD
    A[Raw biological data generated] --> B[Data cleaned and processed]
    B --> C[Computational analysis applied]
    C --> D[Results validated by scientist]

Biomarker Discovery

3-step flow

Identifying measurable indicators linked to disease presence or treatment response.

Where it breaksValidating a candidate biomarker across independent patient cohorts takes years of manual study coordination.

Open process page
flowchart TD
    A[Patient samples analyzed for candidate markers] --> B[Statistical association with outcomes tested]
    B --> C[Candidate biomarkers validated in follow-up studies]

Personalized Treatment Design

4-step flow

Matching a specific therapy to a patient's genetic or molecular profile.

Where it breaksMatching a profile to the right treatment relies on physician expertise interpreting complex data.

Open process page
flowchart TD
    A[Patient's genetic profile obtained] --> B[Profile matched against treatment database]
    B --> C[Physician reviews match manually]
    C --> D[Treatment plan finalized]
Medical Devices3 processes

Device Design & Engineering

4-step flow

Prototyping devices and testing usability with real users.

Where it breaksEach design iteration cycle (prototype, test, revise) is manual and time-consuming.

Open process page
flowchart TD
    A[Device concept designed] --> B[Prototype built]
    B --> C[Usability testing with target users]
    C --> D[Design iterated based on feedback]

Regulatory Clearance

6-step flow

510(k) or PMA submissions depending on device risk classification.

Where it breaksCompiling the technical file for submission draws from many engineering and testing teams manually.

Open process page
flowchart TD
    A[Device testing data compiled] --> B[Submission prepared: 510k or PMA]
    B --> C[Submitted to FDA]
    C --> D{Cleared/approved?}
    D -->|Yes| E[Device can be marketed]
    D -->|No| F[Additional data requested]

Post-Market Surveillance

5-step flowAlso Healthcare

Monitoring real-world adverse events and managing recalls if needed.

Where it breaksInvestigating individual adverse event reports is manual, and spotting a pattern across many reports takes time.

Open process page
flowchart TD
    A[Adverse event reported from field] --> B[Manufacturer investigates report]
    B --> C{Safety issue confirmed?}
    C -->|Yes| D[Recall or corrective action initiated]
    C -->|No| E[Report logged, no action]
Diagnostics3 processes

Assay Development

4-step flow

Test design and validation.

Where it breaksValidation studies require manually processing many samples to establish statistical confidence.

Open process page
flowchart TD
    A[Target analyte identified] --> B[Assay chemistry designed]
    B --> C[Validation studies run for accuracy/reliability]
    C --> D[Assay finalized for clinical use]

Lab Operations

4-step flowAlso Healthcare

Sample processing, result reporting.

Where it breaksManual review of flagged or unusual results adds time before providers get answers.

Open process page
flowchart TD
    A[Patient sample received at lab] --> B[Sample processed on analyzer]
    B --> C[Technician reviews result for validity]
    C --> D[Result reported back to provider]

Companion Diagnostics

4-step flowAlso Healthcare

Pairing a specific diagnostic test with a matched therapy.

Where it breaksTurnaround time between testing and result delivery can delay treatment decisions.

Open process page
flowchart TD
    A[Patient tested for biomarker] --> B[Result determines therapy eligibility]
    B --> C[Result sent to prescribing physician]
    C --> D[Treatment decision made]
Clinical Research / CRO Functions3 processes

Site Management

4-step flowAlso Healthcare

Investigator site selection, monitoring visits.

Where it breaksOn-site monitoring visits are manual, expensive, and only sample a portion of site activity.

Open process page
flowchart TD
    A[Candidate sites evaluated for trial fit] --> B[Sites selected and initiated]
    B --> C[Monitor conducts periodic on-site visits]
    C --> D[Site performance and compliance tracked]

Data Management & Biostatistics

4-step flow

Data cleaning, statistical analysis.

Where it breaksData cleaning across many sites and forms is a manual, labor-intensive process before analysis can begin.

Open process page
flowchart TD
    A[Trial data collected from sites] --> B[Data cleaned for errors/inconsistencies]
    B --> C[Statistical analysis plan executed]
    C --> D[Results reviewed by biostatistician]

Trial Supply Management

4-step flow

Investigational product packaging and distribution to sites.

Where it breaksTracking chain of custody and expiry across many sites is a manual, error-prone logistics task.

Open process page
flowchart TD
    A[Investigational product manufactured] --> B[Packaged and labeled per protocol]
    B --> C[Shipped to trial sites]
    C --> D[Site inventory tracked manually against usage]
Regulatory Affairs3 processes

Global Regulatory Strategy

4-step flow

Coordinating approval pathways across multiple countries' regulators.

Where it breaksTracking differing requirements across many countries' regulators is a manual, expertise-dependent process.

Open process page
flowchart TD
    A[Product development plan reviewed] --> B[Regulatory strategy mapped per target market]
    B --> C[Filing sequence and timing planned]
    C --> D[Submissions coordinated across regions]

Labeling & Packaging Compliance

4-step flow

Ensuring product labeling meets each region's specific requirements.

Where it breaksLocalizing and re-reviewing labels for each new region is manual and repetitive.

Open process page
flowchart TD
    A[Master label content drafted] --> B[Localized for each region's requirements]
    B --> C[Regulatory review per region]
    C --> D[Approved labels sent to manufacturing]

Post-Approval Changes

4-step flow

Managing regulatory filings needed when a product or process changes after approval.

Where it breaksAssessing which regions require which type of filing for a given change is manually tracked and complex.

Open process page
flowchart TD
    A[Change proposed - e.g., manufacturing site] --> B[Impact assessment conducted]
    B --> C[Regulatory filing prepared per region]
    C --> D[Approval obtained before change implemented]
Quality Assurance & Quality Control3 processes

Quality Management Systems

4-step flow

SOP governance, deviation and CAPA management.

Where it breaksRoot cause investigation is a manual process that can take weeks per deviation.

Open process page
flowchart TD
    A[Deviation from SOP occurs] --> B[Deviation logged and investigated]
    B --> C[Root cause identified]
    C --> D[CAPA plan created and tracked to closure]

Batch Release Testing

5-step flow

Final product testing before market release.

Where it breaksInvestigation of a failed batch test is manual and can delay release of an otherwise good batch.

Open process page
flowchart TD
    A[Batch completes manufacturing] --> B[Samples tested against specification]
    B --> C{Pass?}
    C -->|Yes| D[Batch released]
    C -->|No| E[Batch quarantined, investigated]

Supplier & Vendor Quality Audits

4-step flow

Qualifying and monitoring third-party manufacturers.

Where it breaksOn-site audits are resource-intensive and only happen periodically, missing issues in between.

Open process page
flowchart TD
    A[Supplier proposed for qualification] --> B[On-site audit conducted]
    B --> C[Findings documented]
    C --> D[Supplier approved or required to remediate]
Pharmacovigilance & Drug Safety3 processes

Adverse Event Reporting

4-step flow

Collecting and reporting safety events tied to a marketed product.

Where it breaksManually coding and assessing causality for each case is labor-intensive at scale.

Open process page
flowchart TD
    A[Adverse event reported by patient/provider] --> B[Case processed and coded manually]
    B --> C[Causality assessed]
    C --> D[Reported to regulators per required timeline]

Safety Signal Detection

5-step flow

Analyzing aggregated safety data to spot emerging risk patterns.

Where it breaksSignal detection often runs on a periodic batch cycle rather than continuously.

Open process page
flowchart TD
    A[Adverse event database analyzed periodically] --> B[Statistical signal detection run]
    B --> C{Signal identified?}
    C -->|Yes| D[Safety team investigates further]
    C -->|No| E[Continue routine monitoring]

Risk Management Plans

4-step flow

Designing programs to mitigate known risks of a product.

Where it breaksMeasuring whether a mitigation plan is actually reducing risk in practice is difficult and manual.

Open process page
flowchart TD
    A[Known risk identified for product] --> B[Mitigation plan designed - e.g., education, restricted use]
    B --> C[Plan implemented and communicated]
    C --> D[Effectiveness monitored periodically]
Commercial (Pharma Sales & Marketing)4 processes

HCP Engagement

4-step flow

Rep detailing, sample management, speaker programs.

Where it breaksRep call planning and prioritization across a territory is often based on stale, periodic data.

Open process page
flowchart TD
    A[Rep schedules visit with prescriber] --> B[Detailing conversation and materials shared]
    B --> C[Samples provided if applicable]
    C --> D[Visit logged in CRM]

Market Access

5-step flow

Payer negotiations, formulary placement, prior authorization support.

Where it breaksPrior authorization is a manual, paperwork-heavy process that delays patient access to approved therapies.

Open process page
flowchart TD
    A[Product priced for market] --> B[Payer negotiations conducted per contract]
    B --> C[Formulary placement decided]
    C --> D[Prior authorization criteria set]
    D --> E[Patients navigate PA process for access]

Commercial Data & Analytics

4-step flow

Sales force effectiveness, territory alignment, HCP targeting.

Where it breaksReports are typically produced on a periodic (monthly/quarterly) cycle, not real time.

Open process page
flowchart TD
    A[Sales and prescribing data collected] --> B[Analyst builds territory/targeting reports]
    B --> C[Reports reviewed with sales leadership]
    C --> D[Territory adjustments made periodically]
Medical Affairs3 processes

Medical Science Liaisons (MSLs)

4-step flow

Scientific engagement with key opinion leaders.

Where it breaksCapturing and synthesizing insights from many individual KOL conversations is manual.

Open process page
flowchart TD
    A[MSL identifies relevant KOL] --> B[Scientific meeting scheduled]
    B --> C[Peer-level discussion conducted]
    C --> D[Insights logged internally]

Publication Planning

4-step flow

Scientific paper/abstract development.

Where it breaksCoordinating input from multiple external authors is a slow, manual back-and-forth.

Open process page
flowchart TD
    A[Study results available] --> B[Manuscript drafted with authors]
    B --> C[Internal review and approval]
    C --> D[Submitted to journal/conference]

Medical Information

4-step flow

Responding to unsolicited HCP inquiries.

Where it breaksResearching and drafting a compliant response for each inquiry individually is manual and repetitive.

Open process page
flowchart TD
    A[HCP submits inquiry] --> B[Medical information specialist researches answer]
    B --> C[Response drafted from approved content]
    C --> D[Response sent to HCP]
Health Economics & Outcomes Research (HEOR)2 processes

Cost-Effectiveness Analysis

4-step flow

Evaluating a treatment's value relative to its cost against alternatives.

Where it breaksBuilding and validating the economic model is a manual, specialized modeling exercise.

Open process page
flowchart TD
    A[Clinical and cost data gathered] --> B[Economic model built]
    B --> C[Cost-effectiveness ratio calculated]
    C --> D[Results submitted to payers/HTA bodies]

Real-World Evidence Generation

4-step flowAlso Healthcare

Studying how a treatment performs in everyday clinical practice, drawing on healthcare delivery data.

Where it breaksSourcing and reconciling data from disparate healthcare delivery systems is manual and slow.

Open process page
flowchart TD
    A[Real-world data sourced from health systems] --> B[Data cleaned and structured]
    B --> C[Outcomes analysis conducted]
    C --> D[Findings published or submitted to payers]
Patient Services2 processes

Patient Support Programs

4-step flowAlso Healthcare

Copay assistance, adherence and education programs for patients.

Where it breaksEligibility verification and enrollment paperwork is a manual process that can delay patient access.

Open process page
flowchart TD
    A[Patient enrolls in support program] --> B[Eligibility verified manually]
    B --> C[Copay assistance or education materials provided]
    C --> D[Adherence check-ins conducted periodically]

Patient Access Support

4-step flowAlso Healthcare

Helping patients navigate insurance coverage and reimbursement.

Where it breaksNavigating each payer's unique appeals process is manual and case-manager-dependent.

Open process page
flowchart TD
    A[Patient's insurance coverage checked] --> B[Case manager identifies coverage gaps]
    B --> C[Manager assists with appeals/paperwork]
    C --> D[Coverage resolved or alternative funding found]
Manufacturing & Supply Chain4 processes

GMP Manufacturing

4-step flow

Production scheduling, batch records.

Where it breaksBatch record review for completeness and accuracy is a manual, time-consuming quality check.

Open process page
flowchart TD
    A[Production schedule created] --> B[Batch manufactured per SOP]
    B --> C[Batch record documented manually/electronically]
    C --> D[Record reviewed before batch release]

Contract Manufacturing (CMO/CDMO)

4-step flow

Outsourcing drug or device production to a specialized third-party manufacturer.

Where it breaksTechnology transfer to a new manufacturing partner is a lengthy, manual knowledge-transfer process.

Open process page
flowchart TD
    A[Sponsor selects CMO/CDMO partner] --> B[Technology transfer conducted]
    B --> C[CMO manufactures per agreed process]
    C --> D[Sponsor's quality team reviews batch records]

Cold Chain Logistics

6-step flow

Temperature-controlled distribution.

Where it breaksTemperature excursions are often only discovered after delivery, when the log is manually reviewed.

Open process page
flowchart TD
    A[Product packed with temperature monitoring] --> B[Shipped through cold chain network]
    B --> C[Temperature logs checked on arrival]
    C --> D{Excursion detected?}
    D -->|Yes| E[Product investigated, possibly discarded]
    D -->|No| F[Product released for use]

Serialization & Track-and-Trace

4-step flow

Anti-counterfeiting compliance.

Where it breaksVerifying serial numbers across many supply chain partners requires manual reconciliation when systems don't integrate cleanly.

Open process page
flowchart TD
    A[Unique serial number applied to product] --> B[Serial number registered in tracking system]
    B --> C[Number verified at each supply chain handoff]
    C --> D[Product dispensed, final scan recorded]
Licensing & Business Development2 processes

In-Licensing / Out-Licensing

4-step flow

Acquiring rights to external drug candidates or licensing out internal ones.

Where it breaksDue diligence on external assets requires manually reviewing extensive scientific and legal documentation.

Open process page
flowchart TD
    A[Candidate asset identified for licensing] --> B[Due diligence conducted]
    B --> C[Deal terms negotiated]
    C --> D[Licensing agreement signed]

Partnership & Alliance Management

4-step flow

Managing co-development and commercialization agreements between companies.

Where it breaksTracking obligations and decisions across a long-running partnership is manually maintained and easy to lose track of.

Open process page
flowchart TD
    A[Partnership agreement established] --> B[Joint governance committee formed]
    B --> C[Progress reviewed at periodic meetings]
    C --> D[Decisions documented and tracked]
Animal Health2 processes

Veterinary Pharmaceuticals

4-step flow

Drug development for livestock and companion animals.

Where it breaksSpecies-specific efficacy and safety testing must be manually repeated for each target animal.

Open process page
flowchart TD
    A[Target condition identified in animal species] --> B[Compound developed and tested]
    B --> C[Regulatory approval sought - typically faster pathway]
    C --> D[Product launched to veterinarians]

Livestock Health Management

4-step flow

Disease prevention and treatment programs for agricultural animals.

Where it breaksEarly disease detection relies on manual observation by farm staff, which can miss subtle signs.

Open process page
flowchart TD
    A[Herd health monitored by farm staff] --> B[Disease symptoms observed]
    B --> C[Veterinarian consulted, treatment prescribed]
    C --> D[Treatment administered and outcome tracked]
Consumer Health / Nutraceuticals2 processes

OTC Product Development

4-step flow

Formulating and launching over-the-counter health products.

Where it breaksFormulation iteration and stability testing cycles are manual and can take many rounds.

Open process page
flowchart TD
    A[Product concept and formulation developed] --> B[Safety and efficacy testing conducted]
    B --> C[Regulatory pathway confirmed - lighter than Rx]
    C --> D[Product launched to retail]

Dietary Supplements

4-step flow

Formulation, claims substantiation, regulatory compliance.

Where it breaksSubstantiating health claims from scientific literature is a manual research and documentation process.

Open process page
flowchart TD
    A[Supplement formulated] --> B[Scientific literature gathered to substantiate claims]
    B --> C[Compliance review of labeling and claims]
    C --> D[Product launched]