Ideas·Trials & Triumphs

The thinking behind the build.

Field notes on the work that actually happens between RFI and First Patient In, from the team building the infrastructure for it.

Presentation · October 2026

106 days from Brussels

The impact of the EU-CTR on the European clinical trial market: what the public register shows about authorisation timelines, Europe’s share of trials and the value at stake.

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Latest essay

Selling Uncertainty: The Business of Clinical Trials

How the absence of agreed-upon execution standards breeds the price war and erodes CRO margins.

Pre-AwardAugust 21, 2026

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Pre-AwardJune 26, 2026

Why CROs Lose Bids They Should Win

You and your five competitors ran the same race, on the same clock. The sponsor picked the cheapest and moved on. Completeness is not persuasion.

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Product StoryJune 23, 2026

Site Engagement Without Site-Facing Tech: How We Got Here

We scaled a site-facing marketplace to 1,400 sites in three months, then killed it. The story of why portals are the wrong model, and what we built instead.

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Pre-AwardJune 5, 2026

Why Pharma and Biotech Struggle to Choose the Right CRO

Capability is a corporate fact. Delivery is what these specific people do for this specific protocol when the plan breaks.

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StrategyOctober 24, 2025

Why We Decided To Build For CROs First

We bet on the infrastructure that runs clinical trials today and will still run them tomorrow.

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First PrinciplesOctober 8, 2025

Is Single Sign-On Really What Sites Need?

We let the complaint dictate what we build. But SSO is a falsche Fährte, a false trail. The real problem is somewhere else.

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Trial DesignAugust 29, 2025

Platform Trials as a Service: A CRO Model for Rare Diseases?

Clinical trials today are still prototypes. Ford’s revolution wasn’t the car. It was the assembly line.

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OperationsAugust 14, 2025

The Whitespace Tax: Why Biotechs Lose Time, Money, and Patients Before First-Patient-In

The silence between “site selected” and “site activated” costs about $80,000 a day, and sometimes a patient’s last good option.

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History · Part 1May 16, 2025

Why Drug Development Slowed Down (And What Can Be Done)

Drugs once reached patients in months. A journey back to the era before regulation tightened its grip.

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Category DesignApril 18, 2025

A Theory of Site Engagement

Sites are the atomic unit of clinical development. Yet no company has a structured view of the quality of its relationships with them.

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InfrastructureApril 11, 2025

Why Commercial Teams Obsess Over HCP Data, and What ClinOps Must Learn

The most valuable data isn’t in your lab notebooks. It’s in how you select, engage, and contract with your sites.

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