Effective Communication – The Overlooked CRO Advantage

Earlier this week, my 8 year old daughter Sara suffered an unfortunate accident. Sara was playing with a neighbor when she fell while holding a glass bottle. Sara suffered a complex laceration on her right hand – a more sophisticated way of saying she had a severe gash with glass and debris embedded in her hand. Over 48 hours she was rushed to two emergency rooms and had two surgeries. Fortunately, a full recovery is expected without any long term damage. Sara is now home recovering (asleep in our family room as I write this).

While my wife (Danielle) and I navigated Sara through this process – two thoughts often came to mind. The benefits of drug development on display – the numbing agent used while they cleaned Sara’s wound, the antibiotics to ward off infection and medicines used to ward off pain. Quite often the discussion around healthcare is about cost, and that is a true challenge. However, watching the full process play out is truly remarkable. So how does Sara’s story tie in with effective communication for CROs?

During our first emergency room visit at Chester County Hospital (Sara was later transported to the emergency room at Children’s Hospital of Philadelphia), she had a fantastic nurse (let’s call him Nurse B). Nurse B took a challenging situation and handled it perfectly using his excellent communication skills. Picture the scene, an eight year old girl, in pain with a bloody hand filled with glass shards. Mom and Dad are frantic, distressed and want nothing more than to help their child – but are powerless and have to put their trust in complete strangers. Nurse B did the following:

  1. Kept a calm demeanor during a stressful situation

  2. Set clear expectations for us so we knew what to expect

  3. Had the tough conversation when conveying our options (do surgery now or wait hours for a hand specialist which would prolong Sara's discomfort)

  4. Most importantly, he focused on Sara and kept her at ease throughout the whole process

Danielle and I were discussing Nurse B’s efforts while we were in the emergency room and have been discussing him ever since. His communication skills did not go unnoticed and he helped simplify a complex challenging situation. We are eternally grateful for his efforts – I’m sure Sara will never forget him (even after taking the drugs that made her loopy).

Clinical Research Communication

Last month, Outsourcing-pharma.com released their State of the global pharmaceutical contract services industry 2018. The report contains survey results from 376 readers of Outsourcing-Pharma. I've shared the report with all Clinipace employees as I found it to be a timely review of our industry. Several of the data points I expected (like patient recruitment being listed 76% of the time as the main challenge of clinical trials). What was astounding to me was the following:

And...

I find it remarkable that Sponsor/CRO communication is list 5th biggest challenge facing clinical trials at 42% (study start-up was 3rd at 44% - I would have guessed a much wider gap between the two). The bigger surprise may be that Sponsor/CRO relationship management and communication registered slightly higher than inclusion/exclusion criteria in relation to driving study complexity. I was initially stunned but then realized we talk about communication a lot at Clinipace (and then we talk some more about it).

Effective communication is more than a text, an email or a data set. Effective communication:

  • Is timely - communicate good news quickly, bad news even faster. Nothing will irritate a client more than "hiding" bad news because you are afraid communicate it.

  • Is clear and concise - provide the information needed to inform or make a decision. Providing too much information and making a complex situation more confusing doesn't help.

  • Is done professionally - becoming biased or emotional can throw gas on an already intense situation. A calming presence can help resolve conflicts.

  • Utilizes non-verbal cues - body language, facial expressions and tone can help convey a message just as effectively as the words spoken.

I wish I could say that I had enough foresight to see the enormity of our industry's communication challenge. Fortunately, Clinipace's COO Susan Acker-Walsh saw this coming. Susan started a book club with her team, which is Clinipace's operational leadership. The first book on the docket was Crucial Conversations: Tools for Talking When Stakes Are High. Here is a brief description of the book: "Crucial Conversations gives you the tools you need to step up to life's most difficult and important conversations, say what's on your mind, and achieve the positive resolutions you want." Brilliant selection and idea by Susan as her team has numerous communication touch points:

  • Investigator to patient

  • CRA to investigator

  • Project Manager to Sponsor

  • Internally within functions

The number of potential critical and important conversations is really endless on one study. Multiply that across a hundred studies and multiple geographies and one would have an extremely large matrix of key conversations. I think I'm going to add "Have the Best Communication Processes in the CRO Industry" to Clinipace's long-term objectives. I'm glad Susan's team has already made great progress.

Wrapping Up

When I think about CRO marketing, we all (mega, large, mid-size and small CROs) talk a lot about our therapeutic expertise, geographic footprint and technology/data streams. Maybe we should spend more time demonstrating how we are going to improve our communication processes. Clearly sponsors are seeing a breakdown that is adding complexity to an already complex process. Improving communication is a great opportunity as size, scale and expertise doesn't matter. Any sized CRO can make effective communication a difference maker.

Technology has and will continue to improve drug development (check Medidata's market cap for further proof), however there will always be a valuable "people" component. There were numerous medical technologies in the emergency room this week - we don't remember any of them (I know there were valuable and each played a vital role). We do remember that Nurse B's communication skills gave us confidence and clarity during a complex situation. Sounds a lot like of what's expected out of a quality CRO. I know one patient who would agree.