Are we holding AI to a higher standard than the humans it's supposed to help?

Dr. AJ Blood, cardiologist, clinical trialist, and co-founder of AIwithCare, joins Steve to discuss what it takes to turn AI-powered patient identification into actual clinical trial enrollment—and why technical accuracy alone isn't enough.

They explore the importance of preserving patient relationships, how to evaluate AI against real-world human performance, and why evidence matters more than promises when introducing new technology into clinical research. AJ also explains why physicians aren't necessarily good at translating clinical problems into software specifications, why healthcare procurement can be brutal for startups, and how remote, team-based care could change chronic disease management.

Plus: a clinical research haunted house, the perils of AI-generated presentations, and AJ's ongoing battle with the furry inhabitants of his historic New England home.

00:00

Meet Dr. AJ Blood

01:16

Finding Eligible Patients vs. Actually Enrolling Them

04:15

AI Outreach, Patient Trust & Clinical Relationships

06:47

Are We Holding AI to a Higher Standard Than Humans?

12:25

The Self-Driving Car Comparison

14:38

What Evidence Should Clinical AI Produce?

15:19

The Clinical Research Haunted House

16:38

How AJ Uses AI at Work

19:10

What Should Physicians Stop Doing?

21:32

Algorithmic Chronic Disease Management

23:33

The Biggest Barrier to Changing Healthcare

25:00

Why Physicians Struggle to Write Software Requirements

27:18

Technology Buyers vs. Actual Users

29:45

The Last Ticketed Event

30:26

AJ's Personal Animal Feud

31:39

Closing

What if the traditional site initiation visit isn't the best way to prepare a site for a complex clinical trial? Dr. Kate Trigg joins Steve to discuss why she believes realistic dry runs could prevent operational problems that conventional training misses—and why sites often don't have access to the technology they need to practice before enrolling their first patient.

Drawing on her experience in academic medical center research operations, Kate also explains the hidden costs that study budgets don't adequately cover, how specialization creates new handoff risks, and why a principal investigator's enthusiasm doesn't always translate into operational feasibility. Plus: the phrase she'd ban from study meetings, using AI to defuse angry emails, and the unexpectedly colorful world of sourdough bread.

00:00

Meet Dr. Kate Trigg

01:50

The Hidden Costs of Running a Study

04:07

Is That Really Just the Cost of Doing Business?

05:12

Why Sites Struggle to Negotiate Budgets

06:48

The $20 Study-Meeting Swear Jar

07:40

When “We've Always Done It This Way” Is Valid

09:10

Sleepy Hollow & Spooky Season

10:20

What Specialization Has Cost Clinical Research

13:04

More Handoffs, More Failure Points

14:38

Can Cross-Training Restore the Benefits of Generalists?

17:00

Simulated Participants & Study Startup Dry Runs

19:46

Should Dry Runs Replace SIVs?

21:31

AI, Source Documents & Angry Emails

24:35

When PI Enthusiasm Meets Operational Reality

28:13

Should Site Operations Have Veto Power?

29:06

Sourdough & the Optimization Icebreaker

31:17

Closing

What happens when clinical trial technology works exactly as requested—but makes the study worse? Jason Spivey, founder of Unifora, joins Steve to unpack the operational mistakes that can turn promising technology into expensive problems, from overwhelming participants with notifications to testing site workflows without anyone who understands how sites actually work.

They also discuss why sponsors, CROs, sites, and vendors struggle to align their incentives, how technology gets purchased without enough scrutiny, and why some integrations consume months of work without solving a real problem. Plus: carbon-copy paper belongs in a museum, Jason's enthusiasm for haunted attractions, and how much he'd pay to escape a particularly unfortunate chair-related curse.

00:00

Meet Jason Spivey & Unifora

04:48

Do Sponsors, Sites & Vendors Really Share the Same Goals?

08:02

Why Collaboration Breaks Down

10:13

The Clinical Research Museum

11:23

Haunted Houses & Halloween Horror

12:51

The $1 Million Chair-Fart Curse

14:10

When Technology Works but the Experience Fails

16:32

Who Owns a Bad Technology Decision?

18:06

The Problem With User Acceptance Testing

20:38

Are We Getting Better at Choosing Technology?

22:53

The Mistakes Sponsors Keep Repeating

26:11

How Jason Uses AI

29:25

When Technology Was the Wrong Purchase

32:51

When to Cut Your Losses

34:47

Closing & Where to Find Jason