Virtual Trials: Making Clinical Research More Accessible
There is a good deal of thought around why clinical research advances slowly. Certainly finding the right volunteers to step up and participate is a key rate-limiting activity. If we think about research as a consumer health service, like getting a physical exam or an x-ray, enrolling trials faster is akin to “selling more services.” And when we do that, the problem of enrollment can be seen through a Marketing 101 lens.
The problem of enrollment can be seen through a Marketing 101 lens
A basic Marketing Mix is framed by several models, but one component is universal: what are the distribution channels in play? In other words, how will customers access your product or service? In applying this concept to clinical research, it’s easy to understand how it fits: the service being offered is the research itself and the distribution channel is the brick and mortar clinic, while the promotion might be a phone call, flyer or internet ad that generates interest.
If we think about distribution in the conventional brick and mortar model of clinical research, it becomes clear that the only volunteers who can access this service are those who live close to a clinic and can take time off for clinic visits. Today, the distribution of research is such that if you don’t live close to a clinic, it’s unlikely you’ll “buy the service.”
And even if you do live close by, the burden of participation may be too high. Trial participation might require someone to take off 2-3 hours off every week or so (or more), for as long as the trial is taking place, which could be months and even years. There are many professions that would not allow for this kind of flexibility. As a former public school teacher, I know that few if any teachers could get this flexibility. Skilled labor is be another category of workers who might not have the kind of flexibility today's model requires. And of course, many other segments of the population would struggle with this burden.
But clinical research is not for the faint of heart. For scientific reasons, it requires a great deal more commitment versus the standard of care. And while the industry can certainly streamline study designs more, it may still require a greater amount of interaction with the medical system than the standard of care. So are we doomed to simply accept these high hurdles of burden and distribution for clinical research volunteers?
Let’s think about the banking industry. I might visit a brick and mortar bank six times a year, yet I am using their services multiple times a week. Banks have fragmented their services into a few key distribution channels: mobile banking, online banking and ATMs. I use mobile banking for depositing checks, performing lightweight bill payment and sending small amounts of money. I use online banking to do deep dives into my expenses and perform more complicated tasks. And thank goodness for the ubiquity of ATMs which allow me to access cash around the world. If I were stuck with only a brick and mortar bank, my life would be much different, and I may use banking services far less than I do now. I like having the options and I use them all and everyone wins.
Now back to research. If, like banking, we break up research into a set of activities that have to be done within a certain time frame, could we not activate a wider variety of touchpoints for a research volunteer? Imagine being able to participate in research by using a combination of retail health, mobile health, telehealth, local care and the investigational clinic. Wouldn’t we be broadening the distribution model for many who can’t afford the time it takes for a traditional brick and mortar experience, making it possible for more potential volunteers to participate? Wouldn’t this also allow us to promote the trial in places where we typically didn’t in the past? Wouldn’t we be able to “sell more services,” as it were?
Imagine being able to participate in research by using a combination of retail health, mobile health, telehealth, local care and the investigational clinic.
So what would success look like if the industry were to truly expand the accessibility of clinical research to beyond just the brick and mortar experience? Have you seen any examples where this approach has worked? Let us know on Twitter: @LillyTrials.