Trial Better host and ERT’s Vice President of Trial Oversight, Otis Johnson, is joined by Dan Brenner, founder and CEO of 1nHealth. They discuss the changing landscape of patient recruitment, and what sponsors should consider as they aim to develop digital recruitment strategies that reflect the patient voice and virtual platform.
Tell us a little bit about yourself and 1nHealth.
I’m kind of a cross between a life science veteran and an e-commerce veteran. I created 1nHealth based on those philosophies to answer the question, “how do you use compelling marketing to incite individuals to take action?” At 1nHealth, we are putting an advertising catalyst in front of individuals in hopes of getting them to enroll in clinical trials.
Early last year, the COVID-19 pandemic was beginning to impact sponsors' ability to run clinical trials. What kinds of choices did you see them making?
For the first stage, sponsors’ and CROs initial decision was to wait. The evening the NBA cancelled the season was kind of the stark flag in the sand that this year was going to be very different. After that, sponsors and CROs had to adapt and create a more robust strategy to recruit participants, thinking beyond the standard playbook of bringing participants into sites.
We saw sponsors choose to go the virtual route. Did we start to see that in the patient recruitment space as well? How are patient recruitment vendors adapting to this shift to more decentralized trials?
You can take the same protocol and apply a digital lense to it to get the same results. Overall, what we have seen is instead of looking at sites as the bread and butter for patient recruitment, we are seeing studies and RFPs come to us with digital as the central point to recruitment with sites as the adjunct for recruitment.
How was 1nHealth able to effectively reach people throughout the pandemic?
What every digital recruitment firm is going to do is put ads in front of people and hope they take some action. Here at 1nHealth, we believe that marketing around clinical trials is about starting a conversation. We are able to reach folks for clinical trials because they are what is outside the “norm” for clinical trial recruitment. Second, we are using creative content that belongs on their newsfeed or search bar.
The clinical research industry has been accused of being slow to adopt AI compared to other industries. For sponsors who have found themselves turning to digital solutions in response to COVID, what advice would you give them? How should they adjust their patient recruitment strategies?
The status quo does need some shaking up. In many cases sponsors are used to sticking to what is required of the participants. We want to get sponsors to think about what is going to get people to read more - it has to be about the patient when we think about what patient centricity online looks like. We want to create content that is native to the environment and gets them to take the next step.
What do you think the state of patient recruitment will be after COVID-19? Do you think it will be predominantly digital or will site-based trials come back?
I think it’s going to be somewhere in the middle. COVID forced us to stay in our houses for a while, and as that lifts we’ll see the requirement for sites to be part of studies still remains. I think there is a seismic shift that is happening in the push for decentralized trials. With all of that in mind, digital will become more central to trials as some trials cannot function without sites.
Are there any final thoughts you would like to share with our audience?
I just want to reinforce how we have an industry that is so sophisticated and technical. We need to remember that these are people who are scrolling through their feed and come across a trial ad. Sponsors need to work to throw out sterile advertising copy because the way we talk to them is what compels them to move forward in the study.
Dan: Marketing around clinical trials is really around starting a conversation. And the two most important parts of the conversation are who are you talking to and what are you saying.
Man: Welcome back to the Trial better podcast. On today's very exciting episode, we’re welcoming our new host Otis Johnson to the Trial Better family. Otis is ERT’s Vice President of Trial Oversight and Chief Diversity Officer. He is joined by Dan Brenner, founder and CEO of 1nHealth. Will changes to sponsor patient recruitment strategies in response to the pandemic stick around? Or will the site-based model reign supreme again in a post covid world? Listen now as Dan and Otis discuss this and more on Trial Better.
Otis: Hi everyone and welcome to the Trial Better podcast. I am your host Otis Johnson, ERT’s Vice President of Trial Oversight. Today we are excited to welcome Dan Brenner to Trial Better. Dan Brenner is CEO and founder of 1nHealth. I am looking forward to a great discussion with Dan about the way the industry has had to evolve its patient recruitment strategies in response to the COVID-19 pandemic. Dan, thanks for joining us and welcome to Trial Better!
Dan: Otis, thanks for having me. It’s certainly a pleasure and indeed very much looking forward to the before and afters of what COVID has done to the industry and also some cool adjustments that we’re seeing as the industry evolves beyond 2020.
Otis: Oh that’s great. Well, to kick things off, why don’t you tell us a little about yourself and 1nHealth.
Dan: Sure! So a bit of my background, I am kind of a cross-breed between a life science veteran and an e-commerce veteran. And so I came and started 1nHealth kind of combining both of those philosophies of how do you incite individuals with compelling marketing to take some action and so leveraging my life science history and background what we’re doing at 1nHealth is basically what marketing does across really any industry which is putting some sort of advertising catalyst in front of someone hoping they take some action. And for us at 1nHealth, what the action we’re hoping folks are driven towards is enrolling in clinical trials. We just happen to think that the catalyst we put in front of them and the way that we target them are class-leading and that’s why we’ve been able to produce such good results since we’ve started.
Otis: It sounds like you’re doing some fantastic work over there at 1nHelath that our industry certainly needs, our industry still struggles to recruit enough patients on time. So early last year as the COVID-19 pandemic was gaining momentum and beginning to impact sponsors' ability to run clinical trials, what kind of choices did you see them making?
Dan: Yeah so for the first stage the choice that every sponsor and CRO made was wait, and that was really just seeing how things played out. I remember the evening that the NBA cancelled the season was kind of the very stark flag in the sand that this year was indeed going to be different. And after that what we really found that sponsors and CROs kind of had to adapt. They had to take projects or studies that were about to launch and adjust the protocols or they were going to take things that had been underway and figure out how to adjust the site-based model that allowed for a more decentralized patient-centric approach. And that ebbed and flowed throughout the year, but I think what ended up happening, sponsors and CROs really found that there were multiple ways to recruit and engage and retain patients that maybe the pandemic kind of forced them to develop a bit more of a robust strategy around thinking beyond the standard playbook of bringing folks into sites and then following them through the protocol.
Otis: Yeah no absolutely! Remote, virtual, decentralized trials suddenly became the de facto option to maintain trial continuity. And obviously, we know that many sponsors chose to go the virtual or hybrid route. Did you see that start to happen in the patient recruitment space as well? How are patient recruitment vendors adapting to this shift to more decentralized trials?
Dan: Great question. I actually have a really interesting apples to apples example where we had a sponsor and the study was live in January and February and ended up closing in March of last year as COVID restrictions basically locked down the site-based model. So what me and my team were doing is we were providing a digital adjunct support for recruitment and funneling patients to all of these sites. So fast forward a year later that same study has kind of a second round to it and now the entire protocol has basically been revamped to allow for a completely decentralized model because a lot of the elements of the protocol that were linchpinned upon certain sites to be operative. They actually realized it wasn’t completely necessary so they are doing things like sending products to the customer at their home and using more tech to make sure that they are doing real-time monitoring and following up with them. And so from an apples to apples comparison we do see that you can take the same protocol and apply a digital lens to it and get ideally the same results or better. But overall, what we have seen is instead of looking at sites as kind of the bread and butter for recruitment, I think what COVID did is it forced sponsors to really evaluate whether that is a true premise. And what we are seeing now are RFPs and studies coming through to us that look more digital as the central point of recruitment and sites as more of the adjunct or built on professional roles.
Otis: Absolutely, I mean we all had to adapt. So with sponsors being forced to turn to digital recruitment how was 1nHealth able to help them effectively reach and recruit patients throughout the pandemic?
Dan: Yeah so it’s a small question with a lot of big answers to it. So, one of the things that really any digital recruitment firm is going to do is to put ads in front of folks and hope that they take some action as I mentioned earlier. What we believe at the core of what 1nHealth is and does is that marketing around clinical trials is really around starting a conversation and the two most important parts of a conversation are who are you talking to and what are you saying. And so the way that we have driven our technology development and our AI that allows us to target individuals in a way that is a bit more patient centric. Plus, creating materials that are really about the patient and not so much about informational about the study. By combining those two factors, what we are able to do is two-fold and they really kind of have an amplification effect. We’re reaching folks who are otherwise not getting ads for clinical trials because they’re outside quote, the norm, or the obvious target a study might go after. Number two, we are using content and creative that belongs on a Facebook newsfeed or belongs in their Google search bar. Because of the way we think about the consumer journey, we don’t think we are producing something that would look good at a doctors office. We’re thinking about something that would look good on their Facebook feed, on their Instagram feed, on Tik-Tok in a way that resonates with them innately.
Otis: Oh that’s great, that’s great Dan. I mean I can’t tell you how refreshing it is to hear you speak about the use of AI techniques to find patients normally missed in the traditional approaches. The clinical research industry has been accused of being slow to adapt AI compared to other industries like banking or insurance. In fact, you can take pictures of a car that has been in an accident and get a check in the mail to repair it, and the whole process is driven by AI and requires very little human input. It’s really refreshing to hear you talk about how you incorporate that. Now, for sponsors who find themselves turning to new digital solutions in their response to COVID: what advice would you give them? How should they adapt and adjust their patient recruitment strategies?
Dan: I think a lot of it is that the status quo does need a bit of shaking up. And so, if you put yourself in the shoes of the sponsors which we often do before we speak with them when we’re about to unveil our creative for a particular study. In many cases, sponsors are very used to sticking to the study particulars, what is going to be required of the participant, and in many cases, they don’t actually get to what is what we call a “thumb-stopper” as someone is scrolling through their feed. What is the thumb-stopper that is actually going to make them read more? And it’s got to be about the patient. And so some of the things that differentiate how we write our copy or the way that we produce our creative is really around what patient centricity online looks like. And so, making the study itself about an opportunity or potential patient is the quintessential difference between how a pamphlet you might see in a doctor's office that is adapted to online. What we’re not trying to do is take a pamphlet and put it into a Facebook newsfeed. We’re trying to create content that is native to the environment and feels normal to the person that is seeing it and is engaging to get them to take the next step. That shift from the look and feel of typical IRB approved materials to understanding that the platform has to denote the type of content that is produced on it, particularly for clinical trials is the widest gulp we see for sponsors and their ability to adapt, is what is this kind of status quo ad look like which is all study centric versus what we propose which is a study ad that is entirely patient centric and compelling that might be different than what they are used to seeing.
Otis: Yeah, patient centricity definitely the way to go Dan, couldn’t agree with you more. What do you think the state of patient recruitment will be after COVID? Will the industry move back to relying on sites for recruitment or start developing digital recruitment strategies from the start? What are your thoughts?
Dan: Yeah another good question. I think it is going to be somewhere in the middle. I mean, COVID basically forced us to stay in our houses and not leave for a while. As that lifts, we will see the interaction and requirements for sites to be part of studies still remain. I do think that there is a seismic shift that’s happening though where as we mentioned already decentralization of trials is going to be more paramount especially after the pressure test that was 2020 to figure out if studies could really be done that way. And I think most sponsors would say they give themselves a B or better on their report card in how they conducted themselves over the course of a very tough year. So with all of that in mind I think what has happened is digital is not going to be looked so much as a nice to have, I think it is going to be a central part of the design of the recruitment strategy. And sites will still find their value because there are simply some studies that aren’t going to be able to operate without some sort of site focus.
Otis: Okay great! Any final thoughts you would like to share with our audience?
Dan: Yeah! The only thing I just want to reinforce is because we come against this a lot. I think that when we have an industry that is highly technical, extremely sophisticated, the standard for validation is so high, and the standard for data fidelity is so high. We often get lost in the fact that there is somebody that has just looked at a Lady Gaga video on their phone and is next going to see a trial ad. And so much of the push back or much of the convincing case that we have to do with sponsors is around convincing them that in order to reach people on a particular digital platform you really have to throw out the old school thought process that the only way to do so is very sterile advertising copy. We believe that the way that we target people is unique to start the conversation with the right people, but the way that we talk to them is what compels them to move forward and enroll in studies. And so that would be the thing that I would ask sponsors to really consider and think about as they start envisioning what 2021 looks like for their particular clinical validation pathways.
Otis: Well there you have it! Dan Brenner, CEO of 1nHealth. Thank you so much for joining us on Trial Better. This has been a really interesting and insightful discussion on one of the many ways the clinical research has been pushed to accelerate change in the last year. This is your host, Otis Johnson, as always, thanks to our audience for tuning in. Please remember to comment, rate, or review Trial Better on Apple Podcast or your favorite podcast channel. You can also reach us at trialbetter@ert.com with any questions or suggestions. We’ll see you next time on the Trial Better Podcast.
Man: That’s all for this episode of Trial Better! We appreciate Dan joining us to talk about the changing landscape of one of the biggest challenges in clinical research: patient recruitment. To stay up to date on all the latest content from this season of the Trial Better podcast, make sure to subscribe to Trial Better on your favorite listening platform. Until next time, you can reach us at trialbetter@ert.com. We would love to hear from you! Thanks for listening.