The final choice of a business

During the course of writing this trilogy, many possibilities and tempting opportunities for creating an e-business emerged. All, except one, they had to be eliminated because they broke one or more of the above rules. To be more accurate, I did not start with those rules: they evolved out of the reasons I had for aborting so many of the opportunities that came along.

The exception, that seemed to comply with all the rules, was a business based upon helping cancer patients locate treatment trials. This particularly appealed to me because it was a business that was based upon providing help to people with needs rather than being concerned solely with the amoral pursuit of making profits.

As you will have gathered from previous chapters, this was not an idea I came up with myself. It emerged out of a problem posed by the oncologist Tillman Pearce. At the time, it did not occur to me to be a suitable subject for business, but, I was intrigued by the problem.

When the subject was first broached, my thoughts went to the famous physicist, the late Professor Richard Feynman, who died from a rare form of cancer in 1988. It has been argued that his affliction could be traced directly to his work on the atomic bomb during World War 2. Many of his colleagues at Los Alamos also suffered a similar fate.

Freeman Dyson, of the institute for Advanced Study in Princeton, New Jersey, called Richard Feynman 'the most original mind of his generation', while the New York Times in its obituary described him as "arguably the most brilliant, iconoclastic and influential of the post war generation of theoretical physicists".

Feynman was one of the world's top authorities in particle physics, winning a Nobel Prize in 1865 with Tomanaga and Julian Schwinger, for his work in quantum electrodynamics. His principle interest was in trying to understand the composition of matter by analysing the collision of heavy particles at extreme high energies, but, his biographies showed him to have been a compulsive problem solver with an insatiable curiosity.

There are many anecdotes of Feynman spending many evenings in cafes with his associates and students, covering the tablecloths with diagrams and figures as they amused themselves with all kinds of problem solving, both serious and non serious. Such was his reputation for problem solving that when on January 28, 1986, the Challenger space shuttle accident happened, NASA asked Feynman, to help with their investigations. Feynman figured out what was wrong: it turned out to have been a gasket material that had lost its resiliency in freezing temperatures.

Feynman suffered from his cancer for the last decade of his life. It always struck me that with his brilliant mind he must have had many thoughts as to the explanation of cancer and the possibilities of a cure. Yet, there is no record of him taking any special interest in the causes and cures for cancer. These thoughts prompted me to think more deeply about Tillman Pearce's revelation that there were no really authoritative sites that covered all the possibilities of treating the various kinds of cancer. Surely, this must be frustrating and agonising to all cancer patients and their families and friends.

As this interest prompted me to look further into the problem, I discovered that all the most recent advances in the treatment of cancer weren't available through prescribed treatment. Treatments have to be exhaustively tested and approved before they can be prescribed by physicians, a process that can take typically eight to ten years.

In effect, this disbars cancer sufferers from all recent medical advances. The only way a patient can receive up-to-date treatment is to take part in a treatment trial. This presents several problems. Firstly, the field is so vast that cancer patients wouldn't know where to start looking. Secondly, there are so many trials taking place that nobody has a complete record of them. Web sites that try to provide information to cancer sufferers are overwhelmed by the scale and volatility of the information that needs to be processed.

In discussing this problem with patients, I found that besides the frustration of being confronted with vast amounts of confusing information, their problems were compounded by the fear of being used as guinea pigs, in trials that would be of little real benefit to them. This forced them to place implicit trust in their physicians.

The problem with this, as I discovered, was that most physicians are fallible. Like their patients, they are not able to have anywhere near the full knowledge that covers all the current research – even when limiting themselves to specialist areas. This has been why knowledge of cancer treatments has been used so often in this book: to illustrate the problems of information overload and data volatility.

Using a people space, where patients can meet other patients with a similar condition to discuss trials and treatments seemed an obvious solution to this problem. From my own experience in researching for this book, I'd discovered that the best way to know what was going on in a particular area of technical complexity was to communicate with others who were trying to do the same thing. This shares the work load and brings up areas of investigation that a solitary searcher might not even have found to exist.

As I made further inquiries and met more specialists in the field of cancer, I discovered another problem area: an area where the same people space that could help cancer patients meet each other to exchange information could also help the physicians and researchers who were working on the cures.

The drug companies developing treatments needed to run many different kinds of trials. They start off a promising treatment with a small trial. If this shows positive results they will conduct a further larger trial. If this also shows benefits they will run an even larger trial. This series of trials can continue for several years, with each new trial getting progressively larger and closer to the stage where it can be safely authorised for general treatment.

This trial activity by the various drug companies involves finding hundreds of thousands of trial patients. Every trial requires the careful selection of people with exactly the right profiles. They have to have a specific type of cancer. The cancer has to be at a particular stage of progression or remission. The patients have to be in a particular age group. They can be selected only if they have, or have not, received particular types of previous treatment. Every profile drawn up for each trial contains a large number of specific requirements that describe a patient suitable for the trial.

This presents a huge problem for drug companies because to get patients for a particular trial they have to source a large geographic area. This necessitates using numerous clinics in all parts of the world who can each identify suitable candidates within their local areas. A typical drug trial might involve a hundred such intermediary clinics, who assist in carrying out these trials.

With many drug companies running hundreds of trials, needing thousands of clinics who would need to search for hundreds of thousands of specific patients – a formatted people space would be an ideal structure to reduce their costs. This saving could be used to finance the setting up and running of a people space for the patients, who would need to be part of it for the benefit of the researchers and physicians.

It was the perfect situation. The profits made by the drug companies could be used to finance a free and valuable service for the patients because it was in their interests to do so. This then constituted the basis for a valid business opportunity. A business where everyone could benefit and everyone would have an incentive to take part.

Discussing the idea with various doctors, oncologists, clinicians and patients, there was overwhelming enthusiasm. But would it form a basis for a viable and stable business?

What happened next? Did the business succeed?

We now have to move forward three years to find out, when in October 2004 I begin another book that details the progress from the end of writing this book.

It is a journey that takes an unpredictable twist, as technological advances in brain imaging techniques reveal a more enlightened view of the way in which the human brain works. This is not just of academic interest: it opens up a completely different approach to Web based businesses and Internet communication.

If you would like to take part in the virtual cafe, to read and discuss the chapters of this new book as it is written: apply here: