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Patient centricity Do’s & Don’ts

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Join @Darshantalks host, @DarshanKulkarni as he discusses Monitoring Clinical Research with guest, @EuniceAikins-Afful.

Darshan

Hey everyone, welcome to the DarshanTalks live stream. I'm your host Darshan Kulkarni. It's my mission to help you trust the products you depend on. Now, right now, with COVID being what it is everyone's fully aware of how clinical research works. So this hopefully helps explain what that looks like at the clinical research level. As you know, I'm an attorney, I'm a pharmacist, and I advise companies with FDA regulated products. So if you think about drugs, wonder about devices, consider cannabis or obsessive pharmacy is the podcast for you. Me and my guests, they are both lawyers. However, neither one of us is giving clinical advice. We I'm a pharmacist, I'm not giving you clinical advice, either. I know legal advice, like you mentioned. And if my guess also is a bit of a regulatory expert, so she's not giving regulatory advice either. I do do these podcasts because they're a lot of fun. And I find myself learning something new each time. But it would be great to know someone's listening. So if you like what you hear, please like, leave a comment. Please subscribe. If you have questions, please ask us questions, we'd love to take your questions as well. And if you like what you hear, please share. If you want, if you want to find me, you can find me on Twitter darsan talks, or just go to our website at DarshanTalks.com. Our podcast today our live stream today is about clinical research. And ideally, we want to get get a little bit into the topic of diversity. So I've ever seen inclusion To be more specific. So if you are in clinical research, you probably will care about today's discussion because it reflects some of the growing concerns that the FDA has in terms of what is actually being reflected in. In our study populations. What's interesting also is the census I believe, came up with some numbers yesterday or day before. So this is very, very topical, because they came back and said that the the, for the first time in history, the US population is not showing the same same type of growth in white Anglo Saxon individuals as two other other groups. So the number of minorities are growing. I haven't looked at the numbers, but I think it's just it was just an interesting headline. So our guest today is a clinical mock trial manager we aren't going to mention her. Her place of work she works at a sponsor. So that's the that's the perspective she's she's going to bring. However, she is an expert in all things. Clinical Research, an expert in all things law, you know, just everything experts everything. So, ladies and gentlemen, our guest for today, I'm Eunice Akin, Aikens APL. Hey, Miss, how are you? Good to see you.

Eunice

I'm well thank you for having me back. Happy Friday.

Darshan

Happy Friday. It's it's been a busy week already. And I'm already excited to be here. And and let's sort of get into it a little bit. Because, as part, your sponsor, and we're going to keep them nameless, just to keep it that way. We're talking about Friday, we're talking right now about the Delta variant sort of going up and the numbers going up. And that's causing people to say, well, we need to take additional precautions. How is that impacting the type of clinical research you're doing? And is that affecting, for example, monitoring visits or, or anything like that?

Eunice

Yeah, so so I'll adjust those in reverse order. So with monitoring visits, it depends on the facility. And so what we find is that if you're, you know, large hospital x, and you're an academic medical center, in you know, town a, you may choose to restrict your population only to patients, and one caregiver. And so that may be it. And so a monitor may not be able to get into that, that facility to see the data in real time and in person. But what we found is that, you know, again, it's been 18 months now, so many folks have found adaptations to you know, we've got we can have a, the monitor can have access to this data, the market manager can sign in, and, you know, say that they'll confidentiality will not be breached, because they've looked at this or looked at that, and then they might get a temporary access to say, and electronic medical record, so that they can compare what they would have seen if they had been there. And so, again, it absolutely depends on the facility and absolutely depends on the country. So again, some countries will say, no problem monitor can come on site. We are happy to do that. That's what we plan for and that's what is available, but again And in the US thus far, we've seen a lot of places say, No, thank you not yet.

Darshan

I love that. No, thank you. Not yet. But I feel like that is the for many sites were unprepared that scenario, I'm legally prohibited from letting you come on site. Yes. I mean, have you seen an impact? And again, we're not obviously using extra numbers, is more experience an impact from an FDA perspective in terms of audits? Are they decreasing? Are they doing it more remote? So interestingly

Eunice

enough, they are doing them remotely. And so again, you know, I think we talked about this last time, typically, an audit is, you know, it'll be, it's like a spot check. It's not something that happens to a site on a regular basis. But let again, going back to our example of a large Medical Center, if I've been in business since 1845, you know, this academic medical center, some some part of this hospital is getting audited every year, because we have every, you know, specialty. So, again, I may not know about it, because I'm in specialty x. But the folks in specialty a absolutely got audited last year, but that information is gonna be available in our regulatory department. So when a sponsor or CFO comes to us and says, Have you been audited by the FDA? Yes. And these were the findings, this was our resolution x. So it's absolutely still happening, but they're doing it, you know, they're doing it, they're doing it off campus, until making those records available, you know, it's fine. If you're say, you know, May of 2020. But if it's September of 2021, you need to come up with a plan.

Darshan

And that's, I guess that's part of the question, right? So do you do you find that the quality of the audit has been affected? Because you can physically see the records? Or do you see that, you know, what, we were mostly digital anyway, so it doesn't really change that much.

Eunice

So again, it depends on the resources of the of the institution. And again, I want to step away from the word audit and switch to monitoring. Because no worries, because again, that's what we would be looking for, as a sponsor is, you know, we need to see that every patient assigned consent, there's no reason that that can't be electronic, or scanned or made available to us. You know, it might be something as, you know, base level, as you know, we're standing here and I'm showing, and I'm holding up a piece of paper and you the monitor can now see the patient has consented, you know, this is not some fake document. Here we are. And again, when and if you're available to come on site, you'll then see that you wouldn't want to necessarily transfer that record because it has a patient's name on it. But again, if there's a secure system that's available, that might be one way of doing it. But again, it might be as simple as holding an F in front of the camera for the monitors to see, again, at the most basic of levels. But again, if the if the, if the Medical Center has an availability with which they can say, Oh, no, here's our digital record. Here's our, our digital EMR. I know some places they they didn't have they didn't have paper records for years. And so that, you know, they're completely ready for this, you know, and again, I think part of that is as people expand as people become more savvy, it allows you to do more things if all of the information is available. Again, if the doctor needs it, you know, let's say he wants to check on this patient, he can just log in and get it. Well, that makes life significantly easier if there's an emergency or something like this. Well, pivoting that from there so that the information can be monitored is easy.

Darshan

But do you find in those types of scenarios, Google that the site is now investing a lot more time into these audits, as opposed to just a bunch of files, let me know if you need anything more?

Eunice

Well, they shouldn't have been doing that anyway. We'd like to think that per contract, you have set aside a designated amount of time for the coordinator to sit with the monitor. You know, we'd like to think that that happens all the time. But I don't know that it takes more time because again, the person is still going through the record, the person is still, you know, creating and asking questions. But again, if I've been looking at it online, or if I've been watching what has been posted in the electronic data capture, I'm looking for queries already anyway. You know, and I'm looking for things did you resolve this was this, you know, was this visit entered? Does the drug that was dispensed match the date of the of the clinical visit? And so those are things that as the monitor I've been looking for anyway. And so and again, those systems are already electronic and have been for years. So that part's great. It's just when you talk about you know, is there a shadow chart? Is there a second record that's actually being kept that's for God help you paper for some reason. If that's actually happening, then you know, that does make it that much harder. But again, there's ways to make it secure so that the person can log in into it but not extract, and they can log into it and then not download. So that that makes it a little bit easier. But again, it depends on the technology available at the site. It depends on how savvy they are. But if they've been selected for research, they've probably had, you know, many of these opportunities and gadgets for lack of a better word thanks to make it easier for them to be selected.

Darshan

So so that makes sense for like you said, the large academic, academic medical centers who've been around forever. Show it as you know, there's a constant recycling for lack of a better term or actually not think of the right word. But yeah, refreshing. There you go, maybe, maybe that's the word up is coming in nice shapes coming on show. And they're going What can I start with the no faction like this business? I'll invest more over time? Are you finding that those are not typically the ones that start with cancer oncology? And therefore they build up somewhere else? And then eventually come? Or do you find that they have, they come into oncology, and they're like, this, this got real really quick,

Eunice

I think depends on where they start. Okay, so you know, if I'm at a, again, no named large institution, in, you know, in Philadelphia, the likelihood is, the patient's coming to your facility expecting to be in a research trial, they are fully expecting to be part of whatever's going to happen. Again, you always explain this may not benefit you. But you know, we may learn from your results, you know, the benefits are not guaranteed those kinds of things. But if there's a willing to do it, they've chosen your facility. Again, if you're in a, in a city that has multiple cancer centers, the likelihood is, there's no reason that they can't pick someplace else, but they've chosen you because they expect to be in research. And so if you're the new physician, and you're privileged enough to be starting at this place, then the likelihood is you've also been taught and been trained. And again, the larger the facility, you will be specifically trained on this is what the expectation is, this is how you can create a note, this is how you do all of the things that make you a good investigator, you'll get those opportunities early. And if you're lucky, you'll get a mentor who's interested in your success.

Darshan

So that really raises the question, we're talking about how individuals get trained, which is awesome, which is amazing. Yeah, but I feel like in many ways, we're changing the rules around who should be trained, and the way they should be trained for. And what I'm referring to, is this new goal. And this is sort of where we originally started from, which is this new idea that diversity is important that we want to see that reflected in study populations, Shawn, sites are making the effort that's that's required to represent the populations they may be treating, or do you think that cancer happens to all people, and it's, it's hard enough to get people to be part of these studies, and then narrowing down based on diversity will will take away from the efforts of actual recruitment.

Eunice

So luckily, as a sponsor, we leave it to the sites to decide who's in who's involved. But, you know, if your cancer center is in, you know, East Baltimore, for example, there's a strong likelihood that you're going to get a strong population of African American folks, because that's where you are, you know, if you're by that same token, in owings mills, Maryland, maybe not, you know, so it really depends on where you are, and what outreach is available, and how you're trying to gather your patients. I know that, you know, some centers, they take in, you know, true efforts to make this happen. And so they may have to be folks go out to churches, or the YMCA or these kinds of things, and they talk about, did you know that that, you know, this is what clinical research is, did you know that this, you can participate? You know, we're taking your blood, but we're not doing this, we're giving you just going over what the types of things that people can expect, and what it leads to. Because I think the other thing is, we talk about things, we assume people know what we're talking about, and then we never give them results. We never tell them what happened with what they did. And they're so otherwise interest. This is why I participate in what happened, what happened. It's like when you take you know, you get to a jury trial, and then they settle the jury and listen to the entire thing, and they don't know how it comes out. They're like, wait, I'm invested in this. Tell me what happened. It's the same for our trial patients. You know, especially if a patient is not on an oncology trial. They really want to know, what have I contributed to what's happening and where, what's the what's the outcome? And I think that if we can partner with community organizers and leaders and groups that are interested in these types of works, you then get that continuity because they can say, Oh, well, you know, I trust our Shawn, you know, he works in our in our community. We know that he's not going to lead us astray. He's he's going to tell us straight up what's the deal and so If they feel like they have someone that they can ask that's outside of that medical realm, they may feel more comfortable participating in the medical realm. So it's not an easy answer. It's beyond an easy fix. But I think that as we're having more of the conversations, there is an impetus to do that. But I also think it also goes back to, you know, opportunity. And I think of it from way, way back, right. So if you continue to have opportunities where all children are being exposed to education, all children are giving me an opportunity to go to decent schools, and all children are being given the opportunity for STEM and all children are then leading from STEM programs to medical schools, all of a sudden, you have kids that look like all people. And they're not just children. Now, they're people that are encouraging people that look like them to be in the clinical trials, because they are reflecting if at the community,

Darshan

it's interesting, so so we have a comment from Jonathan, saying social determinants of health are absolutely barriers to why people volunteer, I have, I've seen the the use of social determinants of health, mostly being used in the context of health care, there's a whole argument is, you know, in clinical research, where we go, we're not healthcare, because we're not treating you. But do you? Do you find that social determinants of health are having a major impact? And you've sort of highlighted a couple of them. But as a sponsor, when you get get into these conversations, do you talk to people and go, look, we need to adjust for this so that we have a clear representation? That might mean, if you're choosing between 15 sites, we want sites that have access to more to a more diverse population? Is that what happens? Or how does that play out?

Eunice

Yes, and so that that absolutely can happen. And you do want to look at, you know, there's so many factors that will go into a site. So for example, you know, how much experience a physician has, where the site is, and how easy it is for them to have all the tests that you need to have a form, and so forth. But then once you drill down for that, and everything's equal, you it's easier to then say we'd like to work with Dr. Aikens off one side of Dr. McCarney. Because and then you can you can move it from there. But there many times it's you know, it impaired many times you'll find that it revolves around the the investigator. And so I'm seeing John's point about, you know, you know, what would you do, if you say that somebody's time to volunteer, I understand that, and that that is real, that is absolutely real. And it may not even be a level of, you know, from a clinical trial stamp bite when I lived in Memphis, you know, one of the bigger things that we were able to do through one of the organizations locally was we were able to raise money for mammography that, well, if you can imagine the van coming to your place of work, instead of you now needing to drive, you know, two hours. Again, you might have childcare responsibilities you might have, you might be paid by the hour. And instead of having to travel that distance, and then worry about all the other things outside your life, you can walk outside your workplace, get a mammogram and decide and find out if you're okay. That's huge. That's huge. And again, if it's organized and carefully planned, that takes away some of that barrier for somebody even participating again, not in an uptrend or trial in their own care. Because this, again, we find that women are more likely to defer their own care for the needs of their family, when in fact, if they're unhealthy, they can't take care of their families. So it's a it's definitely a double edged sword. But that's just one of the solutions that I've seen in the community.

Darshan

So it's, it's interesting, you made a comment, and I want to explore that a little bit more. What you said was, the decision of choosing the site often also pivots on on the on the pie themselves. If you talk a little bit more about that.

Eunice

Yeah, sure. So if you're trying to do and, again, use the mammography example, again, if you're trying to do a trial in, in, in breast cancer, going to a liver specialist is the wrong way to go. You know, so you want to make sure that you're, you know, you're starting at the baseline, um, you know, do you treat those patients? Is that the best way to do it? And then they'll say, Okay, well, how long have you been treating this patient so we'll look at the CD. As part of the sponsors role of oversight, we have to make sure that you're trained in what it is that we need you to do that so that again, it's not just a funnel for giving you money excessively, you actually know what you're you're working on, you actually are trained, we have a CD to backup the fact that you know what you're doing, and then you'll go from there to say, Alright, you know, okay, so you do treat the disease specialty that we're interested in. You do have research experience in doing it. You do have the facilities and availability to do that. And now all of a sudden, you know, it's like, Okay, what does the pop your population look like? And you We can ask you that, you know, we can say, you know, tell us who you who you treated? Because you didn't know the answer to that, because you had to capture it. So you know, share it, share that data with us, you know, tell us, you know, how many of these studies because you may also say, in again, you did 10 studies last year, how many patients? Did you actually enroll? What did they look like? You know, were they men, were they women, how were they selected? You have the right to ask those questions. And again, if someone's not willing to share that information, you probably don't want to work with them, because that's the most basic thing. You know, that yeah, that opportunity is definitely there to look at, you know, who those folks are, and it's so many things available on the internet, you can kind of even, you know, figure out if it's true, you know, if somebody's telling you something, you obviously you want to give them the benefit of the doubt that the integrity that they're sharing is, is real. But you also want to, you know, you want to do your own due diligence.

Darshan

And we definitely need to talk a little bit about how you do to do the due diligence. But before we get into that I one of the questions that I want to ask about the reason I asked that question, yeah. is there's always this discussion about, are the P eyes being recruited? Because they are the appropriate physicians, which in most cases they are? Or is it because that their key opinion leaders and you want them on the right up on the medical writing that happens in the end? Is that? Again, I don't mean in your specific company, but in general, do you see that being a actual consideration, or has the sunshine accurately handled that for the most part,

Eunice

I have never seen that in any work, any place I've worked. And I'm, I'm proud to say that in no place that I worked at, we said, Oh, we absolutely want Dr. Kulkarni, his name on this paper. So even if he doesn't enroll a patient, you know, he'll forget to be involved in the write up, because we then spent money on you, you know, so starting up at your clinical trial, and all all the pieces that come with that, all of the parts that go through it, and they don't even so much as screen a patient, that's energy and time loss that I had to pay the CFO to work with you to get all the correct, you know, the correct documents, and so forth. So it's just wow, you know, that's, that's, that's a long way to go, you know, for for one guy's name on it, or one gals name on a piece of paper, as opposed to get somebody who's actually going to get a curry, it's actually gonna recruit patients to write the paper. So they may have more experience and have more to contribute, because they actually work on the study. So So

Darshan

it's interesting you say that, though, but we because we've both heard, and we've all heard of what are called seeding trials. And the idea of a seeding trial is, as I know, you know, but for the people who are listening in is that the company is really hoping that they'll, you you that you'll use the product, get used to the product, and then hopefully, be an advocate for the product in the future. So it's not like companies are, aren't cognizant of the fact that they are fighting in a crowded marketplace. And unless your drug is a complete game changer, but you still have to worry about the competition out there. So yes, maybe it costs you a little bit more to get Dr. x to be part of the study. But in the long term, it's worth it because I don't have to do a seating trial, because now he or she is already part of the process. Little bit to me, as I say, even as I say that feels a little bit to me, like, like almost a DOJ perspective. And I again speaking with the DOJ, but I don't work for the DOJ. The DOJ is perspective sort of Monday morning quarterbacking a little bit and going back and going well, is that what you really thought we didn't put it down? But that was the actual intention. Tell me more about reality. How does that how does that actually work in reality?

Eunice

So I want to make sure that I understood the question. So we're saying that I know, you know, so. So again, so for planting, you know, this position of, you know, get position x into the, into the discussion by making them part of it, you know, so that they can so that we can then sell more of those because position x is so popular. That's not the resource side. Right? So that's the, the drugs on the market at that, you know, something So absolutely, you know, it's like we really want Dr. Y to you know, to tout this and use it and love it. But it's also available to be sold. You know, when you're in research, it's a little bit further back in that process. And so I can see that argument for doing so. And definitely, you know, sure you want dr Sorenson to promote your thing, but again, if something's not available, that you know, no matter how much influence that person has you, that doesn't help you. Because physicians won't have access to it.

Darshan

I think that that's absolutely fascinating. Um, I do have one more comment from dinan. Sure, yeah. But I'll leave that for those people who are not yet sure seeing this. Sorry for the long one. I'm currently researching breast cancer patients, many of whom are black women, and new potential oral therapies that are out there for stage four treatment, because these patients are less likely to get screened their ideal candidates. But as a pharmacist, I struggled to recommend these states for options because the CRS study most of these meds in a minority of black patients. So what are her position? And I'm speaking I'm putting into words I'm summarizing, I'm could be inaccurate about the summary. But her position is that as a pharmacist, how do I how do I recommend a product that one has not been adequately studied in the population? And and as a, as a sponsor? This is coming from a practicing pharmacist, how do you address that proactively? The only time you can, which is when you're doing the research? Or do you wait for for phase four? And go? That's what I'm going to Matt try to manage this?

Eunice

If so, unfortunately, you can't pick who gets cancer, you know, you can't say well, we really want all of these folks, you know, to John's on point, we don't always get the representation for people to participate in the study. So maybe these were the only folks that we had available. That said, I would like to think that on some level and again, as pharmacists, you guys would know better than I that on some level, the histology is going to be the same because it's still breast tissue. And so absolutely, you don't necessarily know how this population is going to react. But we're not necessarily talking about something that's, you know, like sickle cell that's specific specifically going to target one population or another. breast tissue is pretty similar. And, again, I'm not suggesting the seat to her own, you know, trial to see how things panned out. But it is, it is a bit concerning to say, you know, Gods how do we how do we affect, effectuate that? I don't know the right answer. I truly don't I can only say that, you know, if she does happen to know that there are only a few patients that look like the patient that she's now seeing. I would ask how they fared

Darshan

things, how do you know how they fare compared to how they could have fared and that's that's?

Eunice

Yeah, absolutely, absolutely. And again, she's she's not wrong. You know, I mean, this is something that that all of us struggle with, you know, I was talking to someone recently who was saying that she works at a COO, and she was a and again, they're trying to make a push towards diversity and inclusion. And so they had brought in a specialist to have the conversation with them about, you know, these are the reasons that you want to make sure that, you know, patients are treated ethically. And here's another way of doing that. And we can try this, we can try that we can do this. And she said she was learning so very much. And it's it's startling to hear about some of the things that have happened to folks in the past that said, you know, how do I sitting here today as person make that better? I don't know that I have the power to know, but we can try?

Darshan

Very, very interesting. We can you just meet me, as you can tell, we can keep going this, this is always conversation. But but we're, as I promised, we're about 15 minutes over time, which is always okay. But that's because there's just a fascinating conversation. The the let's talk a little bit about us, based on what we've discussed, what's something that's the audience?

Eunice

Oh, gosh, I still want to know more about, you know, who is participating in telemedicine, you know, because, again, we talk about the technology, and we talk about the things that are available to folks. But let's say I have, you know, I need to see a dermatologist, I may not want to use the computer at the library to have that conversation. You know, so is there is there a way that I can do that on my device? Is there a way that I can, you know, do that privately? If I don't have access? You know, and what are some of the other ways that are doing it? I found that because of COVID. So many more people have had access to physicians because of the availability and I know that at some point, I want to say maybe June or July, the the transferring between the between the licensing, you know, so if I have a license, the Massachusetts kind of practicing New York, the COVID exception has kind of passed, but maybe I wanted to continue seeing that person. Or maybe there's, you know, because again, the availability, there's only so many physicians, Lord knows we need nurses, we've had a nursing shortage since I was born. So you know, we constantly need people in the fray. And we possibly need physicians, you know, because to your point, as people are aging out and new folks are coming in, how are they being trained? How are they being schooled, what's being offered? Those are things that are there. Again, they're not easy, not easy questions or answers, but you know, but I know that a lot of folks are in it for the right reasons.

Darshan

So I'm going to try to answer the question for you based on my experience then please Iran wants to answer that she's Welcome to as well and anyone else who's listening. But the question you asked was, how, if at all, are people using telemedicine? My ex, my experience with telemedicine? I'm not specifically talking about research a second, but I'm talking about telemedicine in general, is that and I think that I would have the same exact question, if I was doing this research is what is this going to cost me? And it's really unclear. All I hear about is telemedicine is problematic from a payment standpoint. I can never tell whether my insurance is going to cover it or it's coming out of my pocket. I can never tell whether if it's a clinical trial, I'm looking at some of these agreements, and I'm seeing in there, you might be billed for some of this and you may not be billed for this other stuff. And I'm kind of going with the clinical trial. No, you should you as a sponsor are picking up the tab. Sure. But it's in the contract saying no, no, no, we're gonna be splitting this up. Again, there are legitimate reasons absolutely for doing that. But it's it's a it's a harder sell as a patient. Subject going, do I want to go down this path? So to me telemedicine has loads of opportunities. But I think that there is they really need to get the message down is really what I think it is.

Eunice

Yes, that's fair. That's fair. That's fair.

Darshan

So that's one. So my second question to you, what is something you've learned in the last month that people might be interested in?

Eunice

Oh, gosh, that, no, unfortunately, this is not a new thought. So I will caveat there. But that we can do better, we can do better about being patient with each other. As far as you know, what people are comfortable with. There's been a lot, a lot of talk surrounding the NFL, because people are saying, Oh, well, I have one more data regarding, you know, the whether or not I should have the vaccine. And so of course, all the talk shows to pick this up, because you know, this player is doing this, and this player is doing that. And I think that I had no reason to know that the NFL has changed the rules again. So whereas last year, they would reschedule games, if say, for example, your star quarterback has COVID and can't play. And for whatever reason your team is down, you're about to forfeit that game. And because the players did not play, they will not get paid. So that is what I've learned in the next month, in the last month. So that is a big deal. That is a that's a really interesting conversation. It completely changes the conversation on vaccinations. No, no. So again, if I'm Vegas, I just create I just found a big hole in what I'll be, you know what the lines are going to be.

Darshan

I love that one is really good. That's a really, Hey, I'll sort of give you one myself that I yeah, that I heard that I thought was very interesting. I think I may have mentioned on the podcast, but I just read somewhere that people people were not getting vaccinated, especially in the south, as you know. And that seemed to be from different explanations or whatever it is out there. The way what I read was they got 100,000 people to get vaccinated, the moment they created a vaccine lottery. And the idea was that people love to play, they'll play the lottery, and if you get vaccinated, you get to play and that will cause 100,000 more people to get vaccinated. Similarly, apparently Amazon apparently has some kind of vaccination lottery as well as you can win products from Amazon.

Eunice

Holy smokes. So to

Darshan

some really patient centric approaches.

Eunice

Yes. Yeah. It's, it's fascinating. And like I said, you know, no matter what side of the argument you're on, you know, everybody is focused on the NFL, it's the most popular you know, thing in our entire country. And so for this for that to be a thing, you know, so again, it let's imagine your CVS and you're completely expecting to broadcast this game. And now one of the teams can't participate. What did you just pay for? What are you gonna put on instead? So it's, it's a big deal. It's a really big deal. So yeah.

Darshan

Like an upcoming TV show, if you almost hope for the NFL going out, because you're coming on to that slot. It's gonna take a turn. I don't even watch enough enough regular TV to know I'm watching everything on Netflix in the light. But, um, anyway, I by my last question to you, yeah, he's one of something that's made you happy in the last week.

Eunice

Oh, gosh, I'm getting to see friends. Very cool. Getting to see friends, you know, because again, this COVID has made life a little more challenging and, you know, how do you have a barbecue or have a dinner or have people and you know, well, it's still it's still possible and And I was able to do that. So it was great. Thank you for asking,

Darshan

of course. And if people want to reach out to you and as you can just find her on LinkedIn, I think he can he Aikens to LinkedIn. But it's out there, you should be able to access it. I'll also put it into the comments that people can access access as well. But yes, this was wonderful. And thank you so much for coming on. I do hope Thank you for having me back again.

Eunice

Thank you for having me. Appreciate it. Absolutely. Well,

Eunice

this is the DarshanTalks podcast, regulatory guy, irregular podcast with hosts Dr. Shaun Kulkarni. You can find the show on twitter at DarshanTalks or the show's website at DarshanTalks.com

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