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Dutch Clinical Tech Startup on how COVID-19 is Changing Clinical Trials

kokou adzo



Raymond van der Waal Triall

We talked to Raymond van der Waal about how Triall is a digital ecosystem for clinical trials, and this is what he had to say.

First of all, how are you and your family doing in these COVID-19 times?

Raymond van der Waal: Fortunately, all safe and healthy. In the Netherlands, we are now in a so-called ‘partial lockdown,’ which means that restaurants and bars are closed, but we can travel domestically or workout individually at the gym, for instance. We have started to get used to this new normal and strongly hope that vaccines’ distribution will help alleviate the healthcare system’s current pressure.

Tell us about you, your career, how you founded Triall?

Raymond van der Waal: I’m co-founder and Head of Marketing at Triall, a Dutch tech startup that develops blockchain-integrated software solutions for clinical trials. I initially started my career as a Ph.D. candidate researching the role of market intelligence and emerging technologies in the development of new medicines. At that time, our research group focused on blockchain out of academic interest. Some of the other co-founders and I worked at a company called CR2O, a full-service clinical contract research organization (CRO) that specialized in managing clinical trials. It’s in those early days that the idea for Triall was born. While studying blockchain, we realized that these technologies’ unique properties could be used to tackle several recurring issues and inefficiencies in clinical trials. We’re currently with a team of 7, and I’m lead responsible for all of our marketing, partnering, and communication activities, which gradually became a full-time commitment and forced me to put my Ph.D. on hold for now. I enjoy making complex technology explainable and understandable to a broader audience. I also co-authored several successful European grant proposals for other Life Sciences ventures in this capacity.

How does Triall innovate?

Raymond van der Waal: Before a new medicine enters the market, it needs to be tested for its safety and efficacy in humans in so-called clinical trials. This process typically takes up to 10 years and has become increasingly complex, data-heavy, and regulated over the past decade. As a result, many pharma companies, service providers, and hospitals currently lack oversight over their clinical trial operations, leading to significant delays, reiterations, and an enormous amount of unnecessary costs. All of these issues delay the patient’s access to new medical solutions and drive up their price.

At Triall, we aim to accelerate society’s access to safe and affordable new medicines by making clinical trials smarter, safer, and more efficient. We develop targeted software solutions that promote data integrity, auditability, and operational efficiency in clinical trials using targeted blockchain integrations. We are the first organization to have implemented blockchain in live clinical trials and are now supported by an international partner network and a global advisory board of industry experts and key opinion leaders. Together with our partners and advisors, we gradually build towards a multi-sided platform for clinical trial stakeholders: the Triall Ecosystem. This platform will comprise a selection of modular and integrated best-in-class software solutions designed for modern-day and future clinical trial requirements. Our first application is a blockchain-integrated document management solution that enables researchers to create verifiable proofs of their clinical trial documents’ existence and integrity. Over time, this generates an immutable audit trail that promises to provide patients, health authorities, and regulators with greater assurance of clinical trial data integrity and authenticity.

Since blockchain and related technologies are new to many, if not most of our target users, successful innovation also requires us to inform them about these innovative tools’ possibilities. Therefore, we regularly publish about the role of blockchain technology in clinical trials on our blog

How the coronavirus pandemic affects your business, and how are you coping?

Raymond van der Waal: The importance of the clinical trial industry is more evident than ever now; we are in the midst of a vaccine race. The pandemic has also further accelerated our industry’s digitalization as many industry professionals are forced to work remotely. Thus, our software solutions may have become even more relevant, and we’re happy to help customers navigate this new digital playing field. 

As a business, we are all working from home nowadays. Being a B2B SaaS company, the lockdowns and restrictions have not hampered our team’s productivity too much, but you miss the social aspects of meeting face-to-face. To illustrate, we have been able to continue our product development as usual, as most of our product and development team’s touchpoints were already digital. Moreover, considering business development, discovery calls, and product demos can easily be done through video communication tools and, essentially, the entire sales cycle can be digitalized. Unfortunately, we see that decision-making on the customer and other stakeholders, such as potential investors, has been slower.

Did you have to make difficult choices, and what are the lessons learned?

Raymond van der Waal: As a startup, you need to be even more creative in navigating through the current climate. We have been fortunate enough to close our pre-seed funding round at the beginning of this year, which provided us with the runway to continue our operations. Nevertheless, we did have to cut our monthly running costs and have been even pickier in prioritizing our development activities. Lucky enough, our team has broad experience with building a business, having managed several Life Sciences companies through different stages of growth. These prior endeavors have also provided us with substantial relational capital, assisting us in building out an international value network of partners and advisors who support us in different business areas, from product design and quality & compliance to strategy and business development.

How do you deal with stress and anxiety?

Raymond van der Waal: The startup environment is inherently stressful. The level of uncertainty is often high, and the road from A to B is always different from what you expect it to be. Nevertheless, thorough planning and preparation do help. As a startup founder, you’re always wearing many different hats, bringing a risk of losing focus and control. Project management is therefore essential, both on the company and individual level. In some ways, even more on the individual level, its organizational structure can still be relatively fluent in its early days. Next to planning, being passionate and excited about the vision of your business truly is a gamechanger. It helps you cope with whatever is thrown at you, and it’s also contagious. For instance, being extremely well-prepared and showing confidence and excitement in an investor pitch meeting can make a difference. Lastly, for me, it’s essential to work on something with real impact. Meaning we’re not just here to make money; we want to contribute to society and those patients in need.

Who are your competitors? And how do you plan to stay in the game?

Raymond van der Waal: The market for clinical trial software (‘eClinical solutions’) is vastly growing due to the digitalization and globalization of clinical research. We see that many stakeholders are currently making the switch from general-purpose solutions (e.g., SharePoint) to advanced, purpose-built applications. The eClinical solutions market is currently highly fragmented. At the bottom, many small vendors offer function-specific and often isolated software solutions. A handful of huge vendors at the top offer all-encompassing platforms at a significantly high price only accessible to ‘Big Pharma.’ At Triall, we aim to fill the vacuum in the middle of the market by serving small-to-medium-sized companies in two customer groups. On one end, we offer SaaS solutions to pharma/biotech companies, CROs, and hospitals. On the other end, we offer APIs to eClinical solutions providers that want to synergize with our infrastructure. By connecting rather than competing, we ultimately aim to turn competitors into collaborators, as our blockchain-integrated back-end infrastructure opens up the possibility of connecting previously isolated eClinical solutions in a multi-sided platform. Using our APIs, existing clinical providers get an easy entry to the blockchain functionalities within Triall’s infrastructure while also having the possibility to connect with Triall solutions and other third-party connected solutions.

Your final thoughts?

Raymond van der Waal: The COVID-19 pandemic teaches us that it doesn’t always have to take 8-10 years of clinical trials to bring new medicine on the market. These long development pathways are not always necessary and can, to an extent, be explained by ‘regulatory hurdles.’ There are clear opportunities for increasing efficiency, even outside epidemic emergencies, as long as these do not compromise patient safety and scientific integrity. Data and documentation will have to be recorded and timestamped with a high level of precision and tamper-resistance to achieve this. With Triall, we respond directly to this need by making clinical trial activities more verifiable and auditable using targeted integrations with blockchain.

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Kokou Adzo is the editor and author of He is passionate about business and tech, and brings you the latest Startup news and information. He graduated from university of Siena (Italy) and Rennes (France) in Communications and Political Science with a Master's Degree. He manages the editorial operations at

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