Friday, September 30, 2011

You Asked For My Phone Number, You Asked For My Email Address

Why was that, Dr. Clark?

Car salespeople touch base with even their most infrequent customers when there is a rebate that they would like to know about.

Bankers and brokers touch base with even their most impecunious customers when there is a policy change that they need to know about.

Shoot, our local ice cream stand reaches out to its customers via email so that they know when to stock up for the winter with their favorite flavors lest they miss their chance.

Why don't doctors reach out to their patients as soon as a clinical trial is recruiting that may make sense? Why don't doctors actively call or email patients who may qualify for a newly approved device such as the diaphram pacer that was approved for people with yesterday. With ALS speeding through their patients' vitality at an incredible clip, why do patients not hear about things that may help until their next regularly scheduled appointments. Three months can be the better part of a lifetime for a lot of people with ALS.

Those patient phone numbers work for things other than billing departments. Sleepy wishes that docs would take the same initiative to take care of patients as my car dealer or the ice cream stand.

Tuesday, September 27, 2011

Whoa, The Government Is Moving Too Fast?

Or perhaps the government is moving without thinking past its fiefdoms.

"The Committee is particularly supportive of the addition of a biorepository component and the development of strategies that can enhance clinical trials and clinical trial enrollment."

It appears that the CDC's ATSDR, the "owner" of the important ALS Registry project, is ready, able, and willing to take on scope creep that will enhance its budget and footprint, and could ultimately take its eyes off of the core mission of providing complete epidemiological data on ALS cases.

In the past few months we have seen how broken the process of getting good clinical trial information to patients is. Having the ALS Registry do an expensive push of information to potential patients won't fix the root problems. It will only add another problem.

Can someone in our government step back and look at the bigger picture? Can someone in our trusted ALS organizations step back and take on a more difficult problem than appropriations for a Registry project? Can someone in our clinical healthcare delivery system take on some responsibility for getting information to patients in a consistent, timely manner?

It doesn't take a Six Sigma Black Belt to figure out that we have a very broken process and taping expensive band-aids on it won't fix it. Who will take on the problem statement (that may leave a little egg on the faces of some in the current process to get information to patients)? Anyone?

Here are just a few of the process concerns that have jumped out to me as I've watched patients take clinical trial recruitment into their own hands in order to fill the Neuraltus NP-001 clinical trial.

  • Are patients relying on their neurologists for guidance on whether a clinical trial is a good idea and on which clinical trials hold the most "promise?"
  • Are patients getting that information from their neurologists?
  • Are members of our ALS organizations' staffs who deal with patients knowledgeable at least on the phase 2 and 3 clinical trials within 500 miles of their locations?
  • Are patients and families being led down wrong paths by the proliferation of websites that say they have clinical trial information (but carry information that is incomplete or outdated)?
  • Do patients and families know that the most dependable source of clinical trial information is
  • Has anyone talked to HHS about putting a nicer, more friendly gui on so that patients could do things like a zip code search for nearby clinical trials?
  • Would a better gui on eliminate the need for redundant websites that are provided for a number of medical conditions?
  • Do some neurologists discourage patients from clinical trials? Why?
  • Can patients in clinical trials have a formal feedback process that would provide better trial design for the next drug candidates?
  • Can the 24-month-from-onset "rule" be revised based on the results of the recent 36-month-from-onset trial?
  • Does the CDC's Registry even have onset date (which would seem to be required for any kind of matching of candidates to clinical trials)?
  • What are the results of the recently introduced NEALS/ALSA Clinical Trial Expert?

Many of us complain about the length of time that it takes the FDA to evaluate and approve new drugs; however, every day wasted in filling a clinical trial is as critical in the timeline as an FDA day. We definitely have a problem in getting good information to eligible patients in a manner in which they can make informed decisions quickly. To add an expensive feature to a Registry that has its own problems getting people to self-enroll isn't going to solve the problem. We need to step back and look at all of the possible factors and fix some of the problems at the root. Throwing Registry money at this problem will not fix a broken process.

My plumber can offer to fix a structural defect in my home, but that's probably not a good way to really fix the problem.

Friday, September 9, 2011

Obsessive, Multi-Level Fundraising To Defeat ALS - Question 4

Today's question involves using walks as a reason to talk about ALS.

Strategy 1: You can raise ALS awareness with walks, but that does not increase walk revenues; therefore, walk staff time and energy should not be spent on awareness. It is not part of the successful walk formula.

Strategy 2: You can raise ALS awareness with walks, and every opportunity to talk about ALS in the community and in media should be pursued aggressively. The key to raising long-term resources and urgency to deal with ALS is increased awareness.

How do organizational rewards and expectations and priorities affect the awareness strategy selected?

Tuesday, September 6, 2011

Obsessive, Multi-Level Fundraising To Defeat ALS - Question 3

Business 101 classes usually teach that the flaw in many multi-level marketing schemes is that recruiting becomes more important than the quality and value of the underlying product being sold.

True or False: This theory can also apply to multi-level fundraising.

Saturday, September 3, 2011

Obsessive, Multi-Level Fundraising To Defeat ALS - Question 2

Here is today's question. Consider two people --

a. An individual who shows up on walk day and writes a check for $100 and walks
b. A team captain who does online fundraising and encourages $150 from others but makes no personal donation and does not show up on walk day

Who is more valued by the walk cookbook?

Extra credit -- Who is more likely to be a donor and walker next year and the next?