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Going paper-free in early phase trials with Joe Erato
8 Plays5 months ago
Sylvain Berthelot sits down with Joe Erato, Chief Operations Officer at Spaulding Clinical. Together, they explore what it really takes to run early phase studies without paper – and why the transition to fully electronic systems can be both challenging and transformative.
Joe shares how Spaulding Clinical was founded with a vision to “take clinical research into the next generation using technology,” and what it meant to implement paper-free processes from the very beginning. He reflects on the steep learning curve, the risks of being first to adopt, and the operational upheaval required to shift an entire unit away from legacy methods.
Sylvain and Joe discuss the importance of integration to reduce manual entry, how real-time data capture accelerates decision-making and improves quality, and why designing systems around the patient experience is critical to compliance and study success.
Tune in to hear how Spaulding Clinical built its operations from the ground up, the lessons learned along the way, and what going truly paper-free means for the future of clinical trials.
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Transcript
Introduction to Clinical Data Talks
Going Paper-Free in Early Phase Units
00:00:14
Speaker
Welcome to Clinical Data Talks, a podcast brought to you by CRS-Cube.
00:00:19
Speaker
I'm your host, Sylvain Bertolo.
00:00:21
Speaker
Join me and industry experts as we discuss the latest trends impacting the world of clinical data.
00:00:29
Speaker
Today, we're going to talk about the implementation and the capture of clinical data in early phase units, and specifically how to do it paper free.
00:00:44
Speaker
I have a great guest for this discussion as he led the implementation of technology for Spalding Clinical from the ground up.
Why Paper-Free from the Start?
00:00:54
Speaker
He's now Chief Operations Officer at Spalding and also a fellow podcast host in his spare time.
00:01:04
Speaker
It's a great pleasure to welcome Joe Erato to the podcast.
00:01:08
Speaker
Hi, Joe.
00:01:08
Speaker
How are you doing?
00:01:09
Speaker
I'm doing great.
00:01:10
Speaker
Thank you very much for the warm introduction.
00:01:13
Speaker
Oh, my pleasure.
00:01:15
Speaker
I actually really like writing those introductions.
00:01:21
Speaker
It makes me feel warm.
00:01:23
Speaker
Yes.
00:01:24
Speaker
So I'm quite interested in your experience with clinical technology.
00:01:32
Speaker
And especially knowing that you come from the early phase unit side of clinical technology because there's kind of a gap between early phase and the later phases.
00:01:48
Speaker
And when we first discussed this topic, you shared with me that from the start, you had an objective to do it paper free.
00:01:59
Speaker
Could you tell me why you had this objective in mind?
00:02:04
Speaker
Sure.
00:02:04
Speaker
So I'm from Spalding Clinical Research.
00:02:07
Speaker
And when we were founded, the idea of the purpose of our founding was essentially to take clinical research into the next generation using technology.
00:02:17
Speaker
In 2017, when we started the business, or 2007, excuse me, 2007 when we started the business, a lot of the phase one units were still paper-based.
00:02:28
Speaker
Meanwhile, all of our healthcare systems were going to EMR, electronic medical record, and it's a better way of doing things.
00:02:35
Speaker
Using computers reduces human error, increases safety for participants.
Benefits of Electronic Systems Over Paper
00:02:40
Speaker
So we looked at it as an opportunity to break into the space as a brand new phase one unit and really make a difference for the industry.
00:02:46
Speaker
I would say we had the advantage of a lot of our founding members not being in the space originally because it can be very difficult to do something the same way you've done it forever and then try and change to something new.
00:03:00
Speaker
I'd say we have the advantage of not being stuck in the old way of doing things on paper and going into it really fresh and trying to build something new from scratch.
00:03:10
Speaker
Okay, that's interesting.
00:03:11
Speaker
Do you think it's more difficult if someone's already in the industry to change the way of doing things?
00:03:17
Speaker
With what I know now, yes, absolutely.
00:03:20
Speaker
I would say it'd be very difficult if you're an existing phase one unit that's been operating under your SOPs or your SOGs the entire time because the entire unit is based around paper.
00:03:32
Speaker
staff are trained on paper and then when you drop in an entire new system uh even if it's a new paper-based system it's going to take a lot of time to learn but when you bring in an electronic system you're changing almost everything about your operation how you collect the data how you schedule your employees everything you need to do essentially switches and even if your staff is all on board everybody's ready to make the change it's still really hard to do there's still learning curves there's still going to be mistakes and errors
00:03:59
Speaker
And when you're trying to run studies continuously throughout the year, there's not really a lot of time.
00:04:04
Speaker
Um, and there's a lot of risk involved in who's going to be the first study that you've implemented your new process on that you don't want to screw up, uh, in what customer is going to essentially go for that.
00:04:15
Speaker
It's a very, um, slow to change industry because there's a lot of people who are very nervous about making changes and, and screwing up data, uh, data for customers are screwing up the study that they're working on.
00:04:28
Speaker
Yeah, yeah, that makes sense.
00:04:31
Speaker
So thinking about when you first started and you were leading this implementation of technology for Spalding Clinical, did you find it easy or hard to do this implementation, especially to go paper free essentially?
00:04:53
Speaker
It was very difficult, even though we weren't paper to begin with.
00:04:57
Speaker
You really don't know what you don't know until you until you figure it out.
00:05:02
Speaker
And that essentially is when you're operating in a study.
00:05:04
Speaker
Luckily, our plan was to do an initial study that we self-funded.
00:05:10
Speaker
Uh, we did a study where we compared moxie flocks us in, we did basically a mock through a QT, but different doses of moxie flocks in this to show that we could catch a signal and prove to customers, Hey, we're a brand new phase one unit, but we are capable of running a study.
00:05:25
Speaker
And we learned a lot in execution of that first study during the dosing, how we had to coordinate our staff for dosing, how we had to coordinate our staff for blood draws, because instead of just writing things on a piece of paper, you're now.
00:05:38
Speaker
scanning barcodes, verifying, then you're signing off on the electronic record and you're making sure it gets into that database.
00:05:44
Speaker
And unlike on, on paper, it's readily available to our customers live.
00:05:48
Speaker
So we'd have our customers logged into the system, essentially watching dosing, watching blood draws as our team's collecting data on the bedside.
00:05:56
Speaker
So there was obviously a really
00:06:01
Speaker
had a big pension for making sure that we caught anything as it was happening it was very scary to us that maybe there'd be a late draw and our customer or the monitor might even recognize it before our floor staff does if they're watching that event so we put a lot of pressure on ourselves to really ensure we're collecting that data the best we can right at the bedside and if we did see any issues come up because it does happen when you're drawing blood you can blow a vein or
00:06:26
Speaker
If somebody's having nausea and they're not able to swallow a pill, those are real life human reactions that occur during a study.
00:06:33
Speaker
So we wanted to make sure we're in the system commenting on any type of deviation right away to make sure that if our customers are watching that data, they're seeing that we're on top of this and it's not something they're going to discover later.
00:06:45
Speaker
I'd say one of the benefits outside of paper is
00:06:48
Speaker
If there's a deviation or there's things that would fall outside of the protocol window because of something out of our control, you know, someone's sneezing during an ECG or someone's vomiting when they're supposed to be taking the pill.
00:07:01
Speaker
We're dealing with those right away versus on a paper source.
00:07:05
Speaker
You might have to wait for a monitor to be physically on site.
00:07:08
Speaker
Then they're going to be in some closet somewhere looking through all the paper source documents and then they see a deviation.
00:07:13
Speaker
They have questions on it.
00:07:14
Speaker
Well, now it's two weeks later.
00:07:16
Speaker
And we're going to have to go find that employee.
00:07:18
Speaker
Hey, remember two weeks ago when you did this one blood draw, I know you've done about a thousand cents, but this particular one, you were three minutes late.
00:07:26
Speaker
Um, and you wrote, you know, the vein was blown.
00:07:28
Speaker
Can you give me more information on that?
00:07:30
Speaker
How accurate is that data going to be?
00:07:31
Speaker
You know, there's a lot of clinical practitioners that have good memories and might actually remember that specific event.
00:07:37
Speaker
But when you're doing it electronic at the bedside, if you're late and you're clicking the button, and this is just one example.
00:07:45
Speaker
because we're programming in all those deviations and what to do if you deviate per the protocol right in the system, when they miss that time point, they're going to be prompted on the screen with essentially how they need to document it, what they need to do next.
00:07:57
Speaker
Hey, if you miss this blood draw, you're supposed to do X, Y, Z. And the system's allowing them to essentially follow the protocol without having to remember it.
00:08:05
Speaker
You know, we're always trained on the protocol, but there's a lot of information for a clinical technician or a nurse to remember on the studies they're working on.
00:08:14
Speaker
Having an electronic system really is an advantage by allowing you to follow those protocols to a T without having to necessarily remember it just because it's programmed right in the system.
00:08:23
Speaker
Just hearing you talk, what I find extremely interesting is that you're talking about patients.
00:08:33
Speaker
Mm-hmm.
00:08:34
Speaker
You're talking about events that happen on a daily basis, I can imagine, like blood draws, for example, or taking a pill.
00:08:44
Speaker
So you seem a lot closer to patients than maybe, well, I'll talk about myself, like,
00:08:55
Speaker
I'm at a clinical vendor and for me, I don't necessarily see patients.
00:09:04
Speaker
I don't necessarily hear about patients or what happens at the site.
00:09:08
Speaker
So you seem much closer to the operations than others in later phases.
00:09:16
Speaker
Yes.
00:09:18
Speaker
And did that help you actually to decide on what systems to implement?
00:09:26
Speaker
Um, if I'm being honest, it wasn't one of the initial factors, but once you start operating and again, uh, our team, when we started Spalding, a lot of the team hadn't been in early phase.
00:09:37
Speaker
We've been in other technologies.
00:09:39
Speaker
I worked in a hospital.
00:09:41
Speaker
So I came in on a lower level operations to help run the floor because it's very similar to it's a medical environment.
00:09:47
Speaker
Essentially, it's very similar.
00:09:48
Speaker
You're you're making sure blood draws are happening.
00:09:51
Speaker
ECGs are happening.
00:09:52
Speaker
Blood pressures are happening much like you do in a hospital.
00:09:54
Speaker
It's just more time.
00:09:56
Speaker
What I realized was if we don't focus on the individual that's there volunteering their time and their body to help further science and it's just treating them like cattle.
00:10:09
Speaker
it doesn't work well because you need them to be compliant and follow the study.
00:10:16
Speaker
And if they don't feel
Proprietary Integrations & Real-Time Data
00:10:17
Speaker
like they're being cared for or they matter, they're not going to be very compliant with the study.
00:10:22
Speaker
So one of the things we did, and this doesn't necessarily fall into the category of what's different between paper and electronic systems, but with an electronic system, what we noticed was it's a lot less chaotic.
00:10:34
Speaker
And my only comparison is
00:10:38
Speaker
When we started the company, we had the ability to visit a lot of other phase one sites.
00:10:43
Speaker
I had the opportunity to watch dosing days of other phase one sites and in a paper-based system, there's people filling stuff out, throwing stuff at like trying to organize a lot of paper.
00:10:55
Speaker
I said, it almost felt like early New York stock exchange where people are just holding tickets and throwing information around.
00:11:01
Speaker
And it's kind of terrifying, like to understand of how are you keeping this all organized?
00:11:06
Speaker
And what you realize is they have to go kind of in on the back end and clean up all the mess from the chaotic day.
00:11:12
Speaker
When we came to our site, then with the electronic system fully implemented, it was a lot less chaotic.
00:11:19
Speaker
We didn't have centralized dosing areas.
00:11:21
Speaker
We're actually doing it at the bedside in the room.
00:11:23
Speaker
We'd bring computers into, uh, by the person.
00:11:26
Speaker
So they're more.
00:11:28
Speaker
We're not shuffling them in and out of rooms and like kind of yelling at them, like, hurry up and go here for this.
00:11:32
Speaker
Hurry up and go here for this.
00:11:33
Speaker
It's no, we're going to come to you.
00:11:35
Speaker
You're the person.
00:11:36
Speaker
You're the focus.
00:11:37
Speaker
We're we're we're catering essentially to them to make sure they're comfortable.
00:11:42
Speaker
They're in a good state.
00:11:43
Speaker
And then our staff is moving fluidly through the unit bedside to bedside with our system.
00:11:49
Speaker
We're doing our verifications electronically.
00:11:52
Speaker
Again, the electronic system is helping guide our staff through the protocol so it's less
00:11:57
Speaker
relying on humans to remember what needs to be done in the study and more, okay, you're a medical practitioner, you're a blood drawer, what you're good at is drawing blood.
00:12:06
Speaker
That's what we need you to be top tier at.
00:12:08
Speaker
We don't need you to memorize every detail of the protocol.
00:12:11
Speaker
That's what this electronic system is going to do for you.
00:12:14
Speaker
So how did you do the implementation?
00:12:16
Speaker
Did you use external vendors for the systems you use or did you build it yourself?
00:12:23
Speaker
That's a two-part answer because when we originally started, we did use external vendors.
00:12:27
Speaker
So we had obviously external vendors for our telemetry system, which was the Mortara Surveyor system.
00:12:34
Speaker
We used GE blood pressure cuffs.
00:12:37
Speaker
And then what we had to do is find a clinical trial management software that was able to integrate with those systems.
00:12:44
Speaker
A big thing for us was making sure we removed as much of the human data entry as possible.
00:12:51
Speaker
So if a blood pressure is taken by a machine, that machine should put the data right into the system.
00:12:56
Speaker
If we're sending out safety labs, those safety lab results should go right into the system, not send me a fax or an email, then I have to have somebody typing it in.
00:13:04
Speaker
That's where a lot of errors can come into play.
00:13:06
Speaker
The biggest hurdle for us was there was no integration for telemetry.
00:13:10
Speaker
And if you're doing QT studies, that's the main data point that's being collected, which takes the most time to enter into a system.
00:13:18
Speaker
Uh, so
00:13:19
Speaker
We used originally it was called AlphaDOS.
00:13:22
Speaker
It was made by Logos Technologies.
00:13:24
Speaker
And then we had in-house an in-house IT guy, essentially.
00:13:30
Speaker
He would kill me if you heard me say, call him an IT guy.
00:13:32
Speaker
But he developed a proprietary integration between our telemetry system, our lab,
00:13:40
Speaker
and alpha does so we built our own system and validated it for automatically capturing ecgs at the protocol time point and then importing all the those data points directly into the electronic system so we didn't need to print any paper ecgs we didn't have to have anybody physically overread something the mortera surveyor system
00:14:01
Speaker
Uh, had all the components to have cardiologists do the measurements with the calipers, do the over-reading.
00:14:07
Speaker
And then we just built the connection or the bridge between the systems that allowed them to, you know, watch on the telemetry system when time points were coming up so that we knew that they were laying steady during their collection point.
00:14:19
Speaker
And then when it was captured, it would automatically send it to the cardiologists.
00:14:23
Speaker
As soon as they over-read it, it would come right back into the system.
00:14:26
Speaker
So we didn't have any lag or delay.
00:14:28
Speaker
Uh, I think on our first study, just to kind of prove that this worked in real time, we had all of our cardiologists live reading ECGs as they were being collected.
00:14:37
Speaker
So by the end of our first day where we had a dosing day with heavy ECG collection by eight or nine o'clock at night, we had a hundred percent of the ECGs over read in the system already completed.
00:14:51
Speaker
And that was huge, obviously, because as we continue to do that through the study, we're able to get top line results in only a couple of weeks where it used to take months because you're not waiting for all this data collection, the data entry.
00:15:02
Speaker
We're doing the data cleaning, review, edit checks, queries, all real time so that by the time at the end of the study, you have last subject, last visit.
00:15:14
Speaker
95 to 98 percent of the study has been queried checked over read and is ready to go so all of those timelines for database lock top line results and all that stuff that takes months uh after the last subject last visit really only took several weeks for us to complete that's amazing and that's direct impact for for the study team because what they care about at the end of the day is being able to analyze the data
00:15:39
Speaker
to then make the decisions on next phases, submit it, and so on.
00:15:45
Speaker
Absolutely.
00:15:45
Speaker
And if you imagine on a sad, mad study where you're doing safety review to determine your next cohort's dose, when we started this, the typical buffer was you have your cohort check in, and when they were done, you need a week for safety review, and then you'd make your decision on your second cohort.
00:16:03
Speaker
Yeah.
00:16:04
Speaker
our data available real time, many times those decisions were able to be made during the first cohort while they're still in house so that we would actually be able to back up if we ended up doing three cohorts with no delay.
00:16:17
Speaker
So by the time the cohort checked out, there might even be an overlap with the second cohort already checking in.
00:16:23
Speaker
And if you can save somebody a month or two months of time
00:16:27
Speaker
on their decision making for their other clinical projects, that's huge.
00:16:31
Speaker
That saves them a ton of money, puts them ahead of schedule.
00:16:34
Speaker
Smaller companies, their investors really like that because saving time and money.
00:16:40
Speaker
And that's something
Reducing Errors with Automation
00:16:41
Speaker
that, you know, I'm not going to give away any secret sauce, but just by simply automating and bringing
00:16:48
Speaker
current technology into clinical research is what allowed that to happen.
00:16:51
Speaker
And you talked about barcode scanning at the very beginning.
00:16:57
Speaker
Is that something you use a lot throughout the unit?
00:17:00
Speaker
Absolutely.
00:17:02
Speaker
Obviously, the biggest thing that can go wrong in the clinical study is if you dose somebody the wrong dose or you do the wrong procedure on somebody that they're not supposed to get.
00:17:12
Speaker
And outside of, we kind of go over the top at Spalding.
00:17:16
Speaker
So
00:17:16
Speaker
Everything is barcoded.
00:17:18
Speaker
So if, uh, Sylvan, if you're checking into a study, when you come in here, you're going to have your picture taken.
00:17:23
Speaker
It's going to be in the system.
00:17:23
Speaker
You're also going to be given your own barcode on your wrist that will scan.
00:17:27
Speaker
So it pulls you up in our system.
00:17:28
Speaker
We can see your face.
00:17:30
Speaker
And then we actually even audibly say, you know, tell me your, your date of birth and your initials every single time for every time point, just to verify that we have the right person, right.
00:17:39
Speaker
Time point.
00:17:40
Speaker
And then on top of that, if it's say it's a, a plus two hour blood draw for you,
00:17:45
Speaker
all of our blood draw tubes are barcoded with the right time point.
00:17:48
Speaker
So we'll have to scan you and then your next event will pop up and we'll have a little countdown saying, hey, there's two or three minutes until your blood draw.
00:17:55
Speaker
And then I have to then scan the tube and the system will alert me if it's the wrong tube.
00:18:00
Speaker
So if I accidentally picked up the three hour blood draw tube and I scan it, a big display is going to pop up with a thing saying, hey, you have the wrong time point.
00:18:07
Speaker
This isn't that.
00:18:08
Speaker
And I can visually see on the tube, oh my gosh, I grabbed the wrong one, put it back.
00:18:12
Speaker
And then I have to scan the right one before it will allow me to collect the data point.
00:18:16
Speaker
So again, electronic systems are going to help us from making human errors that people make, no matter how good you are at your job, you're going to eventually make an error because that's what happens.
00:18:25
Speaker
So the systems reduce that.
00:18:27
Speaker
Whereas if I'm again, if I'm on paper and I grab that tube and fill it, it might not get caught until we see the PK report.
00:18:34
Speaker
And there's this weird spike where it kind of goes up where it should have gone up earlier.
00:18:39
Speaker
And now
00:18:41
Speaker
But it's word of mouth.
00:18:42
Speaker
I'm going to have to go talk to you like, hey, did you grab the wrong two?
00:18:44
Speaker
Well, no, my job's on the line.
00:18:46
Speaker
I definitely didn't grab the wrong.
00:18:47
Speaker
I never grabbed the wrong two.
00:18:50
Speaker
I've heard stories of people that were paper based and they say, you know, we've never missed a PK time point ever.
00:18:54
Speaker
We're always on time.
00:18:56
Speaker
And as soon as they implement an electronic system, they're at like 70%.
00:18:59
Speaker
It's like, oh, so you were just essentially, I'm not going to accuse anyone of it, but
00:19:05
Speaker
If you're consistently late on your blood draws and you can lose your job and you're writing it on paper, it's really easy to say you didn't miss the time point.
00:19:13
Speaker
You can just write in the correct time.
00:19:15
Speaker
Whereas our system, if you scan it and hit enter and it's not the right time, it's going to alert you and ask for a comment as to why it was late.
00:19:23
Speaker
And you have to put in the narrative as to explain what happened.
00:19:27
Speaker
Yeah.
Challenges in Broader Implementation
00:19:31
Speaker
I can't stop thinking, well, it would be amazing if we could do exactly the same in phase two or three.
00:19:40
Speaker
So have you looked into that?
00:19:43
Speaker
Do you think it's possible to implement this level of automation for phase two, three?
00:19:52
Speaker
Absolutely.
00:19:53
Speaker
I think I don't I don't like using the word easy because none of this is easy.
00:19:57
Speaker
Everyone would be doing it.
00:20:01
Speaker
But there's a lot less rigor in later phase studies as far as timing goes.
00:20:06
Speaker
So there's no reason why you can't implement an electronic system to collect all the data for a late phase study.
00:20:13
Speaker
I would say the hard part would be.
00:20:15
Speaker
you're working with less control.
00:20:18
Speaker
Meaning if you have multiple sites, you're dealing with multiple personalities at these sites, staff with different levels of training.
00:20:25
Speaker
So really the impetus would be on the system being incredibly easy to use and easy to adopt.
00:20:31
Speaker
Yeah.
00:20:31
Speaker
So I, when you look at it that way, there's almost gotta be less rigor in the collection and more rigor in like the CRO that is managing all the sites.
00:20:42
Speaker
And there's a lot of, I think a lot of work there and probably helping doctors offices or sites that are running the study with technology issues.
00:20:51
Speaker
You know, there's gonna be a lot of that, that you see at any workplace, you know, forgetting passwords, not knowing how to click on something.
00:20:58
Speaker
So I think the burden of
00:21:01
Speaker
making it work would be on the CRO to almost be like a customer service organization at that point.
00:21:07
Speaker
And all the technical glitches and issues that would occur at all the different sites.
00:21:12
Speaker
But if you, you know, if you're a good CRO, we have several good partners that know how to work with the systems we use.
00:21:20
Speaker
And if you have good relationships and you have people that are willing to really dive in and use the technology, once you get over that initial hump,
00:21:29
Speaker
I think the benefits are staggering compared to trying to manage it all manually on paper and collect it in a single area and then enter it all in a database.
00:21:40
Speaker
Yeah.
00:21:41
Speaker
Yeah.
00:21:44
Speaker
What I'm wondering now is like, obviously you've done it and it's a well-oiled machine.
00:21:56
Speaker
But now I'm thinking which sponsor is going to take the risk of working with potentially different barcode scanning systems that all need to integrate with an eSource system or an EDC.
00:22:17
Speaker
not knowing if it's actually going to work.
00:22:20
Speaker
So I can imagine that it could be a big headache and instead of making things better, it would make things worse potentially.
00:22:29
Speaker
So you'd have to come with a well oiled machine like you have to make it appealing.
00:22:35
Speaker
Yeah, absolutely.
00:22:36
Speaker
And that's again, I think it's the amount of control you have.
00:22:39
Speaker
And once you get later, you're relinquishing a ton of control to the other sites.
00:22:44
Speaker
So it might be
00:22:46
Speaker
You know, you might not be able to do more of the barcode scanning unless as a CRO, you're willing to ship out, you know, wristband printers, barcode scanners, you're shipping out.
00:22:55
Speaker
I think of it much like how a core lab would work for late phase studies where you have to ship out the equipment and then hold trainings on how to use it.
00:23:02
Speaker
And then they're going to screw it up.
00:23:04
Speaker
They're not going to know how to use it.
00:23:05
Speaker
You're going to have to have a 24 seven call line, especially if it's a global study.
00:23:09
Speaker
help troubleshoot things like, hey, I can't turn this on.
00:23:14
Speaker
Oh, did you plug it in and charge it?
00:23:16
Speaker
Oh, no, I left it on the charger all night.
00:23:17
Speaker
Okay, now you're going to have to charge it for at least an hour.
00:23:20
Speaker
So you kind of turn into more of an IT organization than a CRO.
00:23:25
Speaker
But even with the phase one, it's almost like you're front-loading a lot of the burden and work.
00:23:32
Speaker
So that when you hit play and you execute that study, the study itself runs a lot more smoothly versus in the method, maybe the, the work setting it up is relatively simple because you just got to print all the source documents and get it all ready.
00:23:45
Speaker
And the chaos happens in the study.
00:23:48
Speaker
And then the chaos happens after the study.
00:23:50
Speaker
I would much rather have a lot of the work done up front and then have it
00:23:54
Speaker
I won't say coast through the study, but when you hit play and you execute, it's a lot smoother and you're able to really act on deviations a lot easier because all the chaos is happening during the study.
00:24:08
Speaker
Yeah, makes sense.
Advice on Focus and Minimizing Distractions
00:24:10
Speaker
Well, I have one last question for you, Joe, which I love asking everyone who comes on the podcast.
00:24:18
Speaker
What's the best piece of advice you've received that you consistently apply to your work?
00:24:28
Speaker
I won't say I've consistently applied it because that'd be a lie, but by, by doing it wrong, I've learned that this is probably the best way.
00:24:35
Speaker
It's minimizing distractions from your intended goal, because there's a ton of distractions, especially when you're, when you're building a business and I don't want to make it feel like it was just me.
00:24:44
Speaker
I was, I was younger, but I was on a big team of people that were all heading in the same direction.
00:24:50
Speaker
And the more we minimize distraction, um, and the more focused we were on our intended goal,
00:24:58
Speaker
the better the results were.
00:24:59
Speaker
So it was minimizing distraction and then just keeping passion and consistency through the hard times.
00:25:05
Speaker
Like that's really like you're going to encounter really difficult times where everything seems like it's falling apart, not working.
00:25:12
Speaker
But again, if you cannot get distracted by the shiny objects and just stay on your mission and your purpose,
00:25:19
Speaker
you can get through it.
00:25:20
Speaker
Yeah.
00:25:22
Speaker
Nice.
00:25:24
Speaker
As you were saying that, I couldn't stop looking at your drum kit, which is a nice and shiny distraction right in your room.
00:25:33
Speaker
So I wonder how often that becomes too much of a distraction for you.
00:25:38
Speaker
It's not too bad.
00:25:39
Speaker
It's more of it helps get a lot of the energy out that I might need to get out after a long day.
00:25:45
Speaker
So it helps to be more sane.
00:25:48
Speaker
Yes.
00:25:49
Speaker
Yeah, I get that.
00:25:50
Speaker
I get that.
00:25:51
Speaker
Well, Joe, thanks a lot for your time.
00:25:53
Speaker
I absolutely love what you've been telling us today because it's interesting, like you said, it's how much control you have.
00:26:02
Speaker
And in an early phase unit, you have much more control than
00:26:06
Speaker
in later phases.
00:26:09
Speaker
But still, you have to put all this energy up front to make it a smoother operation as you get studies.
00:26:17
Speaker
So
Episode Conclusion and Future Prospects
00:26:18
Speaker
it's very interesting.
00:26:20
Speaker
Hopefully one day I'll be able to visit it because I'd love to see it, how it works.
00:26:26
Speaker
Most people don't understand it until they physically come to our site and they have kind of that aha moment of like, okay, I get it now.
00:26:32
Speaker
Because we
00:26:34
Speaker
very differently.
00:26:35
Speaker
But no, I appreciate you having me on, Sylvain.
00:26:37
Speaker
And this is a lot of fun.
00:26:38
Speaker
So thank you.
00:26:39
Speaker
No, thank you.
00:26:40
Speaker
And thanks, everyone, for watching us or listening to us today.
00:26:44
Speaker
We've got more episodes of the podcast on our website.