Tom Farrand — AI Agents, Patient Recruitment & Building Delfa from a Cockroach Hotel

Adam Walker:I am Adam Walker, a biometrics consultant, and this is the Pharma Prescribed Podcast where leaders, innovators, and hidden voices in healthcare open up, no sound bites, no spin, just raw insight, one prescription at a time in an industry driven by data protocols and pressure. We rarely pause to ask the human questions.

Adam Walker:What drives us, what breaks us, and what truths live behind the titles we wear?

Adam Walker:Today\'s guest is Tom Farrand, CEO of Delfa. Tom has worked throughout his career at the intersection of AI and life sciences. First at IBM, helping university hospitals to use supercomputers to model 3D hot scans. Then joining leading startups.

Adam Walker:And the rollout of AI infrastructure for Janssen, Medtronic, and Exentia. Now as CEO and co-founder of Delfa, he\'s building AI agents which automate clinical operations, starting inpatient recruitment. His mission is clear to accelerate access to lifesaving treatments by re-imagining how patients connect with trials.

Adam Walker:Tom, for those of our audience who don\'t know you, who are you and what do you do?

Tom Farrand:Thanks so much for the kind intro. Adam, it\'s a pleasure to be on Pharma Prescribed. Yeah. I\'m Tom. I\'m CEO co-founder of Delfa.

Tom Farrand:As you mentioned we build AI agents to automate clinical operations tasks end to end, and we started in patient recruitment and so primarily we built conversational AI agents.

Tom Farrand:So these are aI bots that can speak to you like a human would over the phone, text messages or online chat. And we use that to support the prescreening reminding and scheduling of participants into clinical trials. I don\'t need to tell your audience that recruitment\'s challenging.

Tom Farrand:In enrollment\'s. Enrollment\'s tough. I won\'t say the 80% stats which always comes up in recruitment conversations, but. 30% of , more sites are activated , in studies these days. There\'s more data that needs to collect, there\'s more stringency around these protocols, and that is also impacting the enrollment of the patients into these studies.

Tom Farrand:And so that\'s really the initial kind of problem that we are trying to tackle. It\'s less for us about identification of participants. So it\'s less about, okay, can we help sites and research centers comb their medical records to flag up people for rarer disease or cancer studies? Really what we identified is that.

Tom Farrand:There\'s a identification challenge in participant recruitment, but there\'s also a conversion challenge, which is a lot of sites coordinators have 25 things that they need to be doing, and making cold calls is at the bottom of that list. And so actually taking a list of potentially eligible participants who are on paper medically qualified and prescreening them, vetting their interest, scheduling for their first visit.

Tom Farrand:There\'s a huge amount of work that goes into that, and that\'s really the problem that we focus on solving today. Giving sites the tools that they need to manage their recruitment process and funnel far more sufficiently. So we are live on over a hundred research studies already across three continents.

Tom Farrand:So we\'re in the us, the uk, and Europe, as well as Australia and New Zealand. And to date, we\'ve helped our customers randomize over a thousand participants.

Adam Walker:Thank you. That\'s very impressive, Tom. And that\'s a very good elevator pitch, I think, with which to start the conversation. I\'m really fascinated by how you got into patient recruitment in the first place.

Adam Walker:Because having worked extensively in my career around early phase, I know it\'s a huge heavy lift. It\'s always been a heavy lift. We\'ve always had teams of people on the phones. Emailing out to potential recruits for these studies. How on earth did you get into this business in the first place?

Tom Farrand:Yeah, so I think the specific challenge that we found in patient recruitment actually came from an insight from my co-founder.

Tom Farrand:He\'s got a PhD from the ETH Zurich in medical image analysis. And while he was working at Zurich Hospital during that period of time, he was working alongside some of his colleagues in biology. And they were running trials themselves, and he\'d see them come in every day, frustrated, slap their laptop down on the desk, boot up a big old Excel spreadsheet, and then just start hammering the phones, trying to get participants in.

Tom Farrand:That was the story that he told me that kicked off our initial exploration and insight into the space.

Tom Farrand:I think taking a step back out of patient recruitment, more specifically I\'ve always enjoyed the life sciences. I have a master\'s in chemical engineering. Clinical research became the focus when my co-founder and I met, and so I think.

Tom Farrand:The interest for us has always been there. And on the macro side, like with within clinical research, there\'s no other industry like it, right? It\'s, you\'re getting to run the world\'s largest science experiments at the end of the day, thousands of people, hundreds of millions of dollars, all to answer one singular scientific question about, does this medication work or not?

Tom Farrand:I think the scale is incomparable to any other industry. Where you have such a large orchestration of resource to answer a singular question. And then, for me, more personally on, the micro side, the types of studies that we run on today and Delfa really succeeds on are common and chronic conditions.

Tom Farrand:So we run on migraine epilepsy, weight management, vaccine studies, but more serious diseases with higher mortality, my grandparents and my dad\'s side passed away from heart disease. We are running on A-S-C-V-D studies today.

Tom Farrand:My grandma currently suffers from late stage Alzheimer\'s. We have the pleasure of partnering with companies like Recognition Health here in the UK that are dedicated and focused to both private treatment and also trials for those studies. There\'s a huge personal pull that I know many in the industry also feel around why they work in this space as well.

Adam Walker:Yes, and thank you for explaining that. I think it\'s extremely thought provoking and I appreciate your honesty around that. You\'re right. People do come into this industry to make a difference, and usually most people have got a story. We\'ve all got a story. It doesn\'t matter what. Time of our lives. We are in people around us, our families, our friends, our colleagues.

Tom Farrand:yeah, health doesn\'t stop, right? It\'s always on. No matter what happens.

Adam Walker:You\'ve nailed it. I love the fact that you are so principled and your motivation is quite as clear as it is Tom. So beyond your intrinsic motivation. What is it that you are trying to do in a technical sense to change the paradigm?

Adam Walker:Because as I mentioned, I know how these things used to be. I\'m also quite aware, and I think most of our audience are aware of the implementation of AI tools in software development, in, improving the processes in and around clinical research. What is that special source that Delfa are doing that no one else is doing right now?

Tom Farrand:Our view and our observation is that clinical operations for a long time has been viewed as a cost center to be optimized. And so over the past 20 years, I interim\'s law, the cost of clinical getting a drug to mark has exploded exponentially. But this is despite massive seismic shifts in clinical operations taking place like.

Tom Farrand:The outsourcing model. So the CRO model, blowing up across the nineties, it\'s now, 50, \$60 billion industry worldwide offshoring, downsizing with, reducing the size of teams and trying to be cost efficient. And so despite all of this, organizations are seeing a massive balloon in the cost base that they have for clinical research.

Tom Farrand:What we see with. Technology. And the result of that is really organizational knowledge for running these clinical programs in a lot of places has walked out of the door, whether that be a revolving door of CRO CRAs or whether it be, a reduction in that team size and by treating clinical operations as this cost center to be optimized, I think a lot of organizations are now finding themselves in a world where they realize that with the amount of competitive molecules, the amount of regulation, the amount of complexity in getting these drugs to market, there\'s now a competitive advantage within clinical operations.

Tom Farrand:And we see our technology as helping our customers grow their organizational knowledge. Four, running clinical operations succinctly. And so to tie this back to the original question about technology specifically, we effectively help our customers build a knowledge base of how to run successful trials across many different programs.

Tom Farrand:Many different indication areas at the moment. We primarily do that for our site customers and for recruitment. So not only what recruitment outcomes do I get to, but how do I get those recruitment outcomes? And so our technology shows the process. For a given study, why are people dropping out?

Tom Farrand:Why are they disqualifying? Which channels are most effective across that? I think that\'s really where our technology shines. It\'s less around the, building a new frontier, LLM. It\'s really about applying it and collecting the proprietary knowledge that can be applied in a reasonable way to improve future programs.

Adam Walker:So I think I\'ve understood and taking that a step further effectively, you are saying that it\'s not necessarily large language models, but it\'s learning through improving dropout rates and channels that already exist to improve not just retention, but. Bringing new patients, new recruits into clinical trials, is that correct?

Tom Farrand:Exactly. It\'s about giving for the first time the ability for sites and sponsors to have an understanding of their clinical research data and have it structured and searchable such that they can get new insights from it and learn from those over time. We call it compound clinical operations.

Tom Farrand:How can you actually compound your clinical operations effectiveness over time through the use of technology?

Adam Walker:So once again, building on that thought around the structure and the searchability of the data, patient recruitment is complex, but at the same time, you said from the outset that you were starting with patient recruitment. You started with patient recruitment because that\'s the first.

Adam Walker:Key to the door, presumably in unlocking patients that then continue through to a clinical trial. I\'ve had other people on the podcast that have talked about many of the challenges in patient recruitment and is there something different? Is there something new? Around patient recruitment that others aren\'t doing right now, because I\'m wondering if you should all just crunch your heads together because there\'s lots and lots of people peddling very hard around patient recruitment, aren\'t there?

Tom Farrand:Yeah, absolutely. I think that. One of the big challenges with patient recruitment is the diversity of the issue, right? Something that works for one study may not be applicable to another study. And so really the challenge that clinical operations leaders have is what levers do I pull in order to actually make that enrollment work for the studies that I have?

Tom Farrand:I think the view that we\'ve taken is that. As opposed to building specific levers, if we can have these AI agents that are broadly applicable that can engage participants. So we do very lightweight prescreening for things like vaccine studies and just do that over a, text message.

Tom Farrand:But we also can collect a full medical history using a voice agent. And so this makes the technology broadly applicable to a range of therapeutic areas. And that means that it can be a more horizontal technology that others can then plug into. And so we have partnerships with companies like Beck Health who do EMR mining, and they then passes those potentially medically eligible folks that we can contact.

Tom Farrand:Understand their intent to join the study, which of course is just as important as their medical eligibility. In doing so, we are really relieving that burden and that pressure from the site and just delivering much higher quality referrals and ultimately like scheduled visits that touch would turn into screens and randomizations,

Adam Walker:thank you for explaining that.

Adam Walker:Just to take a step back, let\'s imagine I know nothing. I don\'t know what an AI agent is, and I don\'t know what electronic medical records are. Can you just simplify that for a very broad audience, if you wouldn\'t mind?

Tom Farrand:Of

Adam Walker:course.

Tom Farrand:Yeah. So

Adam Walker:I\'d love to understand if I\'m a 60, 70-year-old person, how do I engage with one of your AI agents, and would that feel like I was dealing with a human being?

Tom Farrand:Yeah, so I think the easiest way to conceptualize it is you\'re at home on a Sunday night. You\'re scrolling through Facebook and you see an advert for a given health condition. That resonates with you. You click and you sign up and you express interest in joining that clinical research study.

Tom Farrand:And it may be because your current treatment isn\'t working. Let\'s say it\'s migraine and your current, medication isn\'t working. you are looking to try something new so you express interest. At that point, our solution can then start to engage with you and understand whether you\'d be a good fit for that study.

Tom Farrand:That can come through a number of different forms. But as you say, I think the easiest way to think about it is just a phone call. So the agent would ring you. It would of course disclose that you are speaking to an AI assistant, but it would then walk you through each of the different conditions that are required for you to join the study and also educate you about the study.

Tom Farrand:It would be able to answer questions that you might have. Where\'s the site located? How long does it last for all of these types of things, we can actually have a two-way conversation, a natural conversation with the participant around, and then ultimately, if you\'re qualified and eligible, we offer you some times, schedule your first visit, and then you can come into the clinic. The benefit from a participant\'s point of view is as soon as I express interest in joining that study. I can then be engaged, I can get more information, I can be educated about it. I think one of the big challenges that we see in our inpatient recruitment is that because there are so many other things going on at a site level.

Tom Farrand:People who express interest can sit there for days, if not weeks before they\'re even contacted. And by that point, that Sunday evening where you\'ve been sat on the sofa is long gone. It\'s totally forgotten about. And maybe your symptoms have subsided or maybe you\'re on holiday. And so really the goal is about getting people informed and excited and interested in research at the point that they express their own intent to join.

Adam Walker:Thank you for explaining that, Tom. That makes a lot of sense.

Adam Walker:I do understand also that in patient recruitment, the funnel is the thing, isn\'t it? Yeah. Getting as many of those people into your funnel that you can then determine whether or not they\'re suitable, eligible lifestyle choices. All the initial questions.

Adam Walker:That\'s a heavy lift, isn\'t it? It\'s a really onerous task and I\'m just wondering what the kind of level of engagement you are having at that particular. Point. Of connection, namely the first connection, because if that bit goes wrong, you\'ve lost that patient forever, haven\'t you? Or that potential recruit?

Tom Farrand:Absolutely. I think, as with everything in clinical research there\'s no one size fits all. And we run in a variety of therapeutic areas, we\'re running at the moment on a number of depression studies. And, these are people who don\'t necessarily want to speak on the phone, but actually can chat and text.

Tom Farrand:And so we found that engaging them with a text initially saying, Hey, the agent will call you in 15 minutes unless you prefer to text. That\'s one route that we can start to offer patients choice about how they would like to engage on these studies. I think that. Optionality is really important.

Tom Farrand:That ability to opt in and choose which channel to engage or not engage as it may be, really helps to improve the re rates. We\'re live in a number of countries, but I\'ll pick Poland at the moment. We\'re supporting some studies there and, we see a 90% contact rate from the participants that we engage with.

Tom Farrand:And so I think the reasons for that are the speed. Which we can engage them, but also the consistency right? As a human, I\'ve got say 500 potential participants sat in front of me. I might go through that list once and contact everyone once. But doing that five times consistently over the course of a week, it\'s pretty tricky.

Tom Farrand:And that\'s somewhere where we can actually help to support, not only just by handing all of it to. an ai, but by saying, okay, maybe you let the coordinator or the recruiter make that first point of contact, we\'ll then do 2, 3, 4, and five such that you\'re maximizing the likelihood that they speak to a human, but also you\'re maximizing the likelihood that they speak to anyone at all.

Tom Farrand:But I know, Adam, you\'ve been on the site level and on the recruitment side of things as well. Like in the early phase work that you\'ve done what were the challenges that you\'ve seen on the ground?

Adam Walker:Retention is definitely up there.

Adam Walker:And I\'ve got a couple of very good friends who themselves went into their own freelancing in and around patient recruitment and that continues to be a challenge.

Adam Walker:But they are also using smart technologies to enable and cut down many of those kind of handoff points like you\'ve described. And the reason I challenge you back is because. I think we are so distracted. We know we are so distracted. It\'s the distraction economy that we\'re living through now. Yeah.

Adam Walker:Where people forget from one day to the next, nevermind from one minute to the next, who\'s been pinging them, on their notifications, on their phones on particular websites, whatever. It\'s a very hard. Lift to try and get engagement and retain that engagement, and that\'s before we\'re even talking about whether it\'s a decentralized clinical trial.

Adam Walker:Namely where people are remotely being guided towards a clinical trial or physically having to get themselves to a particular site.

Tom Farrand:Yeah.

Adam Walker:What you\'ve described is the very beginning part. Then there is a chunk in the middle where there is a physical taking of readings, blood pressures, ECGs. Blood draws, all those kind of activities that then translate into can we get them into the unit?

Adam Walker:Can we get them at the bedside and are they gonna be happy to sit there for eight weeks while we take everything and pump them full of everything? Do you see what I mean? Yeah. Yeah.

Tom Farrand:Yeah.

Adam Walker:The feed and bleed studies that I was heavily involved in and bridging studies many years ago. I can\'t imagine how difficult that is to engage with people for more than five seconds anymore.

Adam Walker:Nevermind five days. Five weeks and beyond.

Tom Farrand:No, I think it\'s, as you say, it is definitely the attention economy and I think there is challenges around retention and ensuring that participants, even if they schedule, they show up, like sites see a very high no-show rate. And that is challenging.

Tom Farrand:Something that we do is like automated reminders for these visits and make them personalized so. Hey, Adam, you\'re coming in for your first screening visit. Don\'t, fast for eight hours, make sure you don\'t eat grapefruit whatever it may well be. We can help support on that.

Tom Farrand:But I agree with that. I don\'t think there is a silver bullet.

Tom Farrand:I think that what the brutal reality that recruitment faces at the moment is that you are competing against. E-commerce advertising engines that are far more sophisticated, that have huge amounts of data that are optimized to capture and hold potential participants.

Tom Farrand:I think the positive side of things is that ultimately in a lot of cases, a clinical research study can offer something that\'s very differentiated if you do find that right participant who is suffering from. Epilepsy whose current treatment isn\'t working. You are offering them something that potentially could be far better than, the next TV or laptop deal, whatever it is that they\'re otherwise scrolling through.

Tom Farrand:I think there is a compelling case to be made that clinical research can stand out across that noise. I think our view is that up until now, sites, and yeah,, CROs and sponsors haven\'t had the tools to be able to cut through that noise and actually be able to tell that message. That\'s what we really want to try and help them to be able to achieve.

Adam Walker:So you are working alongside. The sites in order to enable them to access these patients to recruit into their clinical trials essentially.

Tom Farrand:Exactly. Yeah.

Tom Farrand:So we primarily today work with sites and site networks. I think that gives us. A fantastic view of how this is done on the ground. We shadow recruiters and coordinators at these sites to understand the reality of their day and what their life entails.

Tom Farrand:I think that gives us a very clear understanding of the processes we embed very deeply within their systems. And, the tech burden challenge that sites face is a huge one, right? And something that we hear consistently within the industry. We try to reduce that as much as possible by integrating very deeply with their CTMS system and make it so that there\'s no double data entry when you are using the Delfa system.

Tom Farrand:By going above and beyond for the site. You ultimately, in a recruitment world, especially where that is one of their core responsibilities, that is how you drive results and that\'s how you see outcomes.

Adam Walker:Thank you for explaining that. And I really do then appreciate the integration with the clinical trial management system.

Adam Walker:As you said, that is a time saver. It\'s also an effort reduction.

Adam Walker:But also there is buy-in clearly from the sites because they can see a reduction in, in, in all aspects of what they have to do. That repetitive entry of information and overcoming of that.

Adam Walker:So if I can circle back to Delfa now. Yeah, I think we\'ve, you\'ve explained the technology and you\'ve explained the rationale behind that.

Adam Walker:Tell me a little bit more about Delfa, because up until recently I hadn\'t heard anything about Delfa. So are you bootstrapping? Where did it come from? Where\'s the name? I\'d just love to hear a little bit more around Yeah. Around the organization and what it is.

Tom Farrand:Yeah, so we\'re, we are a pretty young company.

Tom Farrand:It\'s actually three days before our first birthday. So we incorporated this time last year we\'ve raised \$4 million of venture cash from some fantastic investors who have backed companies like 11 Labs, prof, fluent and others. Where I first met my co-founder is through a startup accelerator called Entrepreneur First and Entrepreneur First.

Tom Farrand:To those who don\'t know, I would describe it is, like Love Island meets the Apprentice. It\'s a number. It is a bunch of single founders who come together. You then pair up and you work on an idea, and the goal is to really find. Someone you, massively click with, you understand.

Tom Farrand:And that\'s, who I found in Gustav. That\'s been totally transformational. As soon as we met, we both understood that research and life sciences was our passion area. He built foundational models for digital pathology at Roche. I\'ve spoken a bit about my background, or you introduced a bit about my background across, Janssen and.

Tom Farrand:Medtronic, Exentra and those types of places. And so immediately we knew that was where we wanted to work. On a personal note, I think we clicked as people he\'s a South African who at 13, his whole family moved to Switzerland. I\'m a Brit who at the age of 12, my whole family moved to India.

Tom Farrand:And so I think there was like a third culture kid understanding between the two of us. And yeah we really got on and. The name Defra actually comes from both of our surnames, so his surname\'s, brodel. So the DEL comes from there, and then my surname\'s Farrand, and so the fa comes from there that we just then smush together.

Adam Walker:That makes perfect sense.

Adam Walker:as soon as you mentioned about having lived overseas, suddenly I saw you in a completely different light because. I know what kind of adaptability that brings out in people when they are pushed out of their comfort zone. And I\'d love to hear a little bit more about that particular experience and what that did for you in building a level of resilience and capability to communicate across cultures.

Adam Walker:\'cause without even asking you, I\'m sensing you\'ve already got those things in your DNA, but tell me more.

Tom Farrand:Yeah. So as I grew up I was in India from when I was 12 to 15, and then our family moved to Malaysia, and that\'s where my parents still live. I think the biggest thing for me is becoming independent and living away from your parents was never a. Thing for me. As soon as I left home and moved to the UK for university, like I was thousands of miles away. It wasn\'t a you can pop in quickly for Sunday dinner to see your mom and dad. I think that is probably the most direct effect of living abroad is really the independence that was just. I never even thought about it. It was just always on. It was a default setting that I had to just deal with. And I think that definitely shaped my view. And then, as you say going from leafy suburban England to a city of 11 million people in Hyderabad, in India is. A very stark contrast.

Tom Farrand:Obviously I lived in a bubble and I was very privileged while I was there, but you are exposed to a massively different group of people than you otherwise would be, and that shapes how you think about the world and how you see things. And so I think it\'s definitely made me more independent, resilient.

Tom Farrand:I would agree with that.

Adam Walker:I appreciate you sharing those insights and. I\'m just thinking about my own grownup children who are both at university, both in the uk and when I think exactly to your earlier point around, coming home for roast, they would like to do that a little bit more often than they do.

Adam Walker:Invariably my wife and I get in a car and take them out for a roast at their universities. But I think that\'s a wonderful insight you provide there. Having also spent some time in India, myself, I didn\'t find it the easiest place to accept. The fact that I had privilege and I was only visiting for various periods of time.

Adam Walker:I went to Mumbai a number of times and worked with an Indian pharma company there.

Adam Walker:It was very unsettling, and I felt guilty to be quite honest. I felt guilty for what I had when I came home having spent the time there, inated. Hotels in gated areas, certainly gated pharma companies. It was really troubling when I then saw what was outside the front door and the gated establishments where there were people living on the streets.

Adam Walker:There were toddlers in prams and in beds by the sides of the gutters. Effectively, I really did struggle with that, so I would. Identify with your experience, but I was only there for a short period of time I would imagine it would shape you, wouldn\'t it?

Tom Farrand:Yeah, absolutely.

Tom Farrand:I think it shapes you in, I think it helps you to realize what you have in the world. I certainly agree with that, but I also think that. In countries like India where, because there is that very obvious divide between those who have and those who have not. I think there is especially as you compare to, some the like his maybe Europe or the UK over the past 15, 20 years, there\'s definitely a.

Tom Farrand:Strive and a drive to better your own life and level up your own life. And India\'s middle class is obviously huge and swelling and there\'s a huge amount of wealth and innovation that happens. There are a lot of lessons that we could take from. Those cultures about how they are pushing themselves forward and how they are, ultimately pulling themselves out of poverty.

Tom Farrand:It\'s not pretty, it\'s not, it doesn\'t align with our sort of like our own, sensibilities. But I do think it\'s like very impressive and admirable. And that\'s definitely shaped my view on okay. Building, Delfa, and doing it to better the lives of my co-founder our team, myself, all of that sort of stuff.

Adam Walker:Yeah, I think that\'s a rich insight that you provide there and it\'s another angle. I would also build on that point by saying I felt as if I was seeing the human race. In its essence racing to succeed. Every single day I was there, I saw enthusiasm and energy and drive the like of which I never seen anywhere else in any other country I\'ve ever visited.

Adam Walker:I\'ve kept in contact with several key people who I was working with there who were just so remarkable. On another level of brilliant and motivated that I just wanted to try and gain something from their experiences. I wanted it to rub off that, just that motivation and that energy that was just so tangible and so palpable every single day I was there.

Adam Walker:So I really appreciate that insight. As I say I\'m curious with regards to that experience around India and Malaysia and.

Adam Walker:That particular region, is it an area that Delfa are expanding into and are you using that opportunity to expand your capabilities broadly?

Tom Farrand:I think for us at the moment, we are primarily focused on the US market.

Tom Farrand:It\'s the largest market. It\'s the one that\'s the most sophisticated. We have some fantastic customers in that region. As we look to expand, we will look at Asia and Southeast Asia in particular, obviously has a close place in my heart. My parents are still in Malaysia. I think, the closest we\'ve got at the moment is we\'re running with some customers in Australia and New Zealand, but.

Tom Farrand:As things come up, we\'d love to engage and work within that region as well.

Adam Walker:Yeah.

Tom Farrand:TBD

Adam Walker:I\'ll cross my fingers on that one and we\'ll put a pin in that one and come back to that a little bit later. But I think that\'s very helpful. And as I say you\'ve given quite a good insight into you, your why and indeed, the opportunities for Delfa.

Adam Walker:So how do you see that playing out? What are the plans with regards to this investment that you\'ve received? And pushing beyond and into that US market as you so clearly are driven to do.

Tom Farrand:The milestones for us are really scaling the business now. We\'re a team of nine working, out of our lovely old street office.

Tom Farrand:And the goal really is to. Yeah, grow, obtain more customers. I think there are a few proof points that we want to make along the way. So at the moment, our agents are evolving more into A PRM, so a patient relationship management system. We\'re seeing a lot of clinical research sites by software such as HubSpot or Salesforce because they\'ve acknowledged this challenge of maintaining these relationships with their participants.

Tom Farrand:So we\'re developing something that\'s specifically for that for clinical research sites, for clinical research to engage participants in a human driven way or an AI native way. And we have. A lot of optimism about that, and we want to see that flow and work with a number of our customers.

Tom Farrand:That\'s a clear kind of roadmap and milestone for us. And then more tangibly we want to get a US office in the next year and a half, have boots on the ground working with the teams there. My co-founder and I regularly go across to the States. We have customer road shows.

Tom Farrand:We love touring round. In fact, when we first got started, when we had very little money no real product no meaningful connections to the space, we were just hustling to get into these sites. We actually were due to shadow a site in Birmingham in England, but at the last minute they, had to pull out, but a site in Texas, fortunately agreed.

Tom Farrand:To run a pilot with us. So we scraped together, our shrapnel flew over to Houston, as it were, and checked into probably the worst hotel I\'ve ever been to in my life. There\'s a very good sort of canonical Delfa photo now, which is out of the bedroom window of this hotel. On the window sill, there\'s this dead cockroach, and in the background there\'s a dumpster with vultures eating out of it.

Tom Farrand:And that was like the origin picture of where we saw. And so hoping to return to the US with a more permanent footprint in a nicer office is the plan.

Adam Walker:I love that. I\'ve got a visual of that particular point, and that\'s a great point of reference, isn\'t it, to come back to

Adam Walker:i\'m sensing, but I\'ll ask you the question. East Coast or West coast,

Tom Farrand:East Coast we are looking at, we are looking at Boston. We\'re looking at Boston.

Adam Walker:Okay. It\'s a good hub. I\'ve done lots of work in and around North Carolina.

Tom Farrand:Okay.

Adam Walker:New York. I was recently only a couple of weeks ago in PhilaDelfaa, but the reason I ask East Coast or West is because a lot of the software developers at West Coast, Palo Alto and the California side, and then a lot of the farmer and biotechs tend to be East Coast.

Tom Farrand:Yeah.

Adam Walker:Was there is there a thought around that particular point? I\'m just curious.

Tom Farrand:If you\'ve spent any brief moment in startup land, you know that Silicon Valley and San Francisco, particularly in the AI ages, is very touted to be the mecca and the place to be.

Tom Farrand:I think we, took a somewhat contrarian position. We saw that, we could get just as good software engineering talent in the uk, in London, and we could build our engineering team. Very close knit, very strongly within the UK and leverage the talent we have here.

Tom Farrand:I think. As we make the decision to expand into the US and it\'ll be more of a go to market hub, we wanna be as close to customers as possible. And ultimately for us, that means the East Coast, the clinical research site landscape really follows us population. US population is mostly clustered around the East coast.

Tom Farrand:We did. Talk about, rally Durham, the Research Triangle Park, all of those areas love visiting there. Super, super beautiful areas. But I think, for us, Boston made the most sense with the biopharma presence. That\'s there.

Adam Walker:Thank you for elaborating and I think that\'s really helpful for our audience to understand that and the rationale behind it.

Adam Walker:You\'re spot on. But also I think something I\'ve recently come into. Understand is the number of data scientists in the UK at the moment that are coming out of UK universities are very impressive.

Adam Walker:As well as the capabilities that the UK is trying to build and be supported by the government r and d.

Adam Walker:Yeah. And ultimately they earn a fraction of what you can in the States. So I think, as a pure overhead even employing people in London is gonna be cheaper than East Coast. The US, isn\'t it? I know it

Tom Farrand:certainly cheaper than San Francisco. Yeah.

Adam Walker:Yeah.

Tom Farrand:It\'s tough to be SF salaries.

Adam Walker:Yeah, absolutely.

Adam Walker:As I say, I just wanted to dig into that and I really appreciate your transparency, Tom, and I think our audience will really resonate with that particular point.

Adam Walker:At this point in the conversation, I always like to finish with a quick fire round okay. Moving on. What is the one piece of advice you would give to your younger self, Tom?

Tom Farrand:As I\'ve gone on this founding journey, one of the pieces, of feedback that stuck with me that I think is true for my younger self as well, is I was described as two European. By some of the startup folks, and that\'s VC venture capital shorthand for, you\'re less comfortable talking about yourself in, public.

Tom Farrand:You, undersell a bit, you\'re a bit risk averse, you\'re very detail oriented, very product focused. So I think like the one piece of advice for me would probably be back yourself if I could speak to my younger self.

Adam Walker:Very good. What are the top three qualities you value most when building a team?

Tom Farrand:Oh yeah. For us as we hire it\'s curiosity, capability and coachability, you\'ve got to want to dive into these problems. You\'ve got to be capable of solving them, and when things go wrong, you\'ve got to be able to update your beliefs and actually get on and change that.

Adam Walker:You\'ve made me think of another question, but I\'ll move on to the third question, which is your favorite thing outside of work, Tom?

Tom Farrand:I am a big nerd, and I\'ve recently gotten very obsessed with a game called Slay the Spire, which is like a, it\'s a rogue so you like build a deck and you go and fight monsters. The slay the spire is at the moment my, stress relief outside of work much to the chagrin of my fiance.

Adam Walker:I dunno whether that will translate well into married life. Lemme give you a little bit of a hint there, Tom. And finally I\'m working,

Tom Farrand:I\'m working on it.

Adam Walker:And finally, what is your number one golden rule in life and in business?

Tom Farrand:One for after the other. You just gotta keep going. Whatever happens, you just , gotta be persistent.

Adam Walker:Perfect.

Adam Walker:I wanted to thank you so much for being on by my prescribed today. It sounded like you might have a question for me there, Tom.

Tom Farrand:I was gonna ask, what\'s your one golden rule?

Adam Walker:My golden rule. Consistency of behavior show up. Have you read a book called Atomic Habits by James Clear?

Tom Farrand:I have not. I think it\'s on my bookshelf though

Adam Walker:no good on your bookshelf.

Tom Farrand:Yeah,

Adam Walker:no good on your bookshelf, Tom. Listen, my life is demonstrably improved since reading that Birkin.

Adam Walker:Impacts of the small percentages. It\'s not the marginal gains, it\'s just the consistent behaviors day after day, month and year and beyond. It\'s those same small things that compound exactly as you said earlier in patient recruitment. They compound in your life. They\'ve compounded in my life and.

Adam Walker:For some reason we\'ve got all sorts of emojis going all over the screen at the moment, so I\'ve clearly triggered something on the zoom, but there you go.

Tom Farrand:I\'m agreeing with you

Adam Walker:If that makes sense. It\'s about the small things, but compounding time and time again and these same principles, I.

Adam Walker:Share with my kids all the time, and they must absolutely hate listening to my voice. We\'ve had a wonderful conversation today. You have been a delight to get to know, and you\'ve been incredibly generous with your time and your storytelling as much as your personal storytelling and sharing your why.

Adam Walker:I think it\'s very clear to anyone who listens to this that you are entirely motivated. Completely focused on delivering for Delfa, and I have absolutely no doubt that with the VC backing behind you and all the plans that you\'ve described today, that you will absolutely fly over and above and beyond anything that you probably believe is possible today.

Tom Farrand:Thank you. And thank you so much for having me.

Adam Walker:It\'s been an absolute delight and thank you for being on Pharma Prescribed Tom.